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The aim of this study was to assess vitamin D serum levels in autoimmune thyroid disease, Hashimato thyroiditis in the Turkish population. the subjects with Hashimato thyroiditis (HT, n=67, mean age 45.1±10.9,F/M-61/6), control subjects (mean age 42.1±15.7, n=29, F/M-26/3) were recruited for the study. Thyroid function tests, thyroid antibodies (AntiTg, AntiTPO, TSHRAb), ultrasound features, demographic and antropometric variables were recorded. Vitamin D level was not different between the HT and the control groups (53.1±24.7 nmol/L and 54.1±19.8 nmol/L, as mean, respectively, p = 0.482) in the HT group, 35.8% of subjects had vitamin D insufficiency, only 16.4% of subjects with HT were vitamin D sufficient. There was no significant difference between the HT and the control groups according to the vitamin D classification status (p = 0.666). Vitamin D levels were significantly higher in the subjects who were taking replacement compared to subjects who were not (58.7 ± 26.0 vs. 46.0 ± 23.3, as mean, respectively, p = 0.033). There was no significant correlation between vitamin D levels and TgAb and TPOAb levels in HT group (p = 0.754 r = -0.039, p = 0.134 r = -0.290, respectively). in both HT and control groups, vitamin D levels were significantly correlated only with the fT4 levels (p

Gastric cancer comprises 10% of all cancers in the world and is rarely seen before the age of 30. Different genetic interactions or molecular changes like e-cadherin, P16, APC, c-erb B2, c-met, ras, or c-myc have been described in the pathogenesis of the disease. MiRNAs play critical roles in various biological processes such as cell proliferation, cell differentiation, apoptosis, repairing of DNA damage, angiogenesis, stress response, and stem cell division. The aim of this study is to investigate the relationship between miRNA gene expressions and gastric cancer. Method: Sixty-four patients with gastric cancer diagnosed consecutively in our pathology laboratory and 30 consecutive participants with normal gastric tissue, as a control group, were included in our study between 2011 and 2013. Total miRNAs were obtained by using genomic miRNA extraction kit (QIAGEN Sample & Assay Technologies, Hilden, Germany) after the samples had been deparaffinized. MiR-21, 107, 141, 150, 192, 202, 218, 331 gene expressions were evaluated by using real time-PCR (RT-PCR) from the whole miRNA. Results: MiR-331 was downregulated in the stage 2 patients and the rest of the miRNAs were significantly upregulated (p < 0.001). All miRNAs were significantly upregulated in the stage 3a patients (p < 0.001). In the antrum localized tumors, miR-107, -150, -202, -218, and -331 were significantly upregulated, whereas miR-21, -192 were statistically downregulated (p < 0.05). In the cardia localized tumors, miR-21 (p > 0.05) was downregulated and miR-107, -150, -202, -218, and -331 were upregulated (p < 0.05) Different gene expressions of miRNAs according to the different localizations of gastric cancer and different stages suggest that it can be tumor marker to predict the stage and localization of gastric cancer. [Med-Science 2019; 8(1.000): 255-9]

HHV-8 is associated with Kaposi sarcoma, multicentric Castleman disease and primary effusion lymphoma mostly in immunocompromised patients. in this report, we describe a female patient without any immunosuppressive state, encountering those three malignancies throughout her lifetime. A-69-year-old female patient was diagnosed with Kaposi sarcoma in 2009 and multicentric Castleman disease in 2011. She received several chemotherapy regimens during 4 years and stayed in remission during following 5 years. Then, she was diagnosed with primary effusion lymphoma, extracavitary/solitary variant on excisional biopsy of her cervical lymphadenopathy. Despite having 5 different lines of chemotherapy protocols, including autologous stem cell transplantation, and systemic cidofovir treatment, she died because of progressive disease. HHV-8 associated malignancies are not prevalent in immunocompetent patients. Our patient, who has suffered from all three malignancies related to HHV-8, is the only HIV negative patient in the literature with primary effusion lymphoma, extracavitary/solitary variant.

Amaç: Bu çalışmada acil serviste çalışan sağlık personelinin uğradığı şiddet türleri ve şiddetin nedenleri ele alınmıştır. Temel amaç, şiddetin nedenleri ve türlerini ortaya koymak ve bu konuda alınması gereken koruyucu ve önleyici tedbirler konusunda farkındalığı arttırmaktır. Gereç ve Yöntem: Bu araştırma betimsel tarama modelini esas alan bir çalışmadır. Bu araştırmanın çalışma grubu, İstanbul Üniversitesi Cerrahpaşa, Cerrahpaşa Tıp Fakültesi Dekanlığına bağlı hastanenin acil servisinde çalışan tüm sağlık personeli (Doktor, hemşire, acil tıp teknisyenleri, gibi sağlık hizmetleri sınıfı, idari hizmetler olan güvenlik, bilgi işlem gibi)’nden oluşmaktadır. Acil serviste çalışan 121 sağlık personeli çalışmaya katılmayı kabul etmiştir. Bulgular: Araştırmada elde edilen sonuçlara göre, sağlık personeline şiddet uygulayanlar sıralamasında %64 oran ile hasta yakınları ilk sırada, %33,3 oran ile hastalar ikinci sırada yer almıştır. Acil serviste şiddet en fazla 24:00–08:00 saatleri arasındaki vardiyada (%40) uygulanmakta, personelin %52,1 daha önce şiddete maruz kalmış, kaldıkları şiddet türü sıralamasında %52 ile sözel şiddet ilk sırada, fiziksel şiddet ikinci sırada, duygusal şiddet üçüncü sırada ve son sırada ise cinsel taciz yer almaktadır. Sonuç: Acil servis personeline göre, acil servislerde şiddetin ortaya çıkmasında en etkili nedenler; hastaların sabırsız olması, hasta ve sağlık çalışanları arasında etkili iletişim kurulamaması, bekleme sürelerinin uzun olması ve personel sayısının eksiliği en önemli faktörler olarak karşımıza çıkmaktadır. Objective: the main purpose of this study is to show the reasons for violence and the types of violence against health staff who work in emergency rooms and to raise awareness of protective and preventive precaution to be taken in this regard. Material and Method: This research is based on a descriptive survey model. the study group for this study consists of all health personnel working in the emergency room department of the hospital of Istanbul University Cerrahpaşa Medical Faculty (doctors, nurses, emergency medicine technicians, security services, administrative services etc.). 121 medical staff working in the emergency department consented to participate in the study. Results: According to the results obtained in the study, 64% of the patients’ relatives in the first place who commit violence towards health personnel, the rate of 33.3% with patients took the second place. Violence in the emergency department is mostly commited in shifts between 00:00–08:00 am. (40%), 52.1% of staff have been subjected to violence in the past, verbal violence is the most common with a rate of 52%, the second place was by physical violence and emotional violence took third place and sexual harassment was the fourth most common form of violence reported. Conclusion: the most common reasons for the emergence of violence in emergency rooms, according to emergency room personnel; impatient patients, communication problem between patients and health workers, long waiting times and lack of workers are the most important factors.

Objective: To evaluate the outcomes of pregnancies with maternal heart disease. Material and Method: the results of 115 patients in our clinic between 2013 and 2018 were retrospectively analyzed. the type of heart disease and functional classification of the New York Heart Association were taken into consideration when evaluating the cases. Results: According to the New York Heart Association classification, the distribution of patients was 67.1% for stage I, 18.2% for stage II, and 14.7% for stage III–IV. There was no maternal or perinatal mortality. the incidence of rheumatic and congenital heart diseases was 51.3% and 27.8%, respectively. Maternal morbidity was observed in 18 cases (15.6%). Mean gestational age and birth weight were significantly higher in the stage I–II functional capacity group (p0.05). Conclusion: It is possible to obtain satisfactory results for both mother and fetus in the majority of pregnant women with heart disease when managed with a multidisciplinary approach. Amaç: Maternal kalp hastalığı bulunan gebeliklerin sonuçlarını değerlendirmek. Gereç ve Yöntem: 2013-2018 yılları arasında bir kliniğimizdeki 115 maternal kalp hastalığı olan olgunun sonuçları retrospektif olarak incelenmiştir. Olgular değerlendirilirken kalp hastalıklarının türü ve New York Kalp Derneği’nin fonksiyonel sınıflaması göz önünde bulundurulmuştur. Bulgular: New York Kalp Derneği sınıflamasına göre hastaların dağılımı evre I için %67,1, evre II için %18,2, evre III–IV için ise %14,7 idi. Maternal ya da perinatal mortalite saptanmadı. Romatizmal ve konjenital kalp hastalıklarının görülme oranı sırasıyla %51,3 ve %27,8 olarak bulundu. Maternal morbidite 18 olguda (%15,6) gözlendi. Ortalama doğum haftası ve doğum kilosu evre I–II fonksiyonel kapasiteli grupta belirgin yüksekti (p0,05). Sonuç: Multidisipliner bir yaklaşımla yönetildiğinde kalp hastalığı bulunan gebelerin çoğunluğunda hem anne hem fetüs için memnun edici sonuçların alınması mümkündür.

Aim: In this study, we aimed to investigate the potential role of lung mast cells in migraine by using a nitroglycerin-induced migraine model in rats. Materials and Methods: Thirty-five adult male Wistar rats were divided into five groups. Each treatment being performed intraperitoneally, the NS group received 0.2 ml normal saline, the NTG group 10 mg/kg nitroglycerin, the NTG vehicle group 0.2 ml 0.1% ethanol in normal saline, the L-NAME+NTG group 50 mg/kg L-NAME + nitroglycerin, and the NS+NTG group normal saline + nitroglycerin. Two hours after the nitroglycerin and other treatments, the rats under anesthesia were intracardially perfused with a solution of 150 ml 4% paraformaldehyde. The lungs were harvested and stained with toluidine blue to observe mast cells. The data were analyzed by using one-way ANOVA. Results: Nitroglycerin increased significantly both number (from 94±3.8 to 131±6.7, p=0.0035) and percent of degranulation (from 11.8±1.3% to 35.5±5.7%, p=0.003) of lung mast cells. However, L-NAME prevented the effects of nitroglycerin on the number and degranulation of lung mast cells, attenuating the increase in both number (from 136±5.1 to 93±2.5, p=0.0011) and degranulation percentage of lung mast cells (from 37.3±1.0% to 13.6±3.1%, p=0.001) induced by nitroglycerin. Discussion and Conclusion: Our findings demonstrate that nitroglycerin treatment leads to an increase in the number and degranulation of lung mast cells in a rat model of migraine induced by nitroglycerin. Moreover, L-NAME prevented these effects, suggesting that nitric oxide released from nitroglycerin directly or indirectly leads to the activation of lung mast cells. The results obtained in the current study can pioneer new research on the role of lung mast cells in migraine. Amaç: Bu çalışmada sıçanlarda nitrogliserin ile oluşturulan migren modeli kullanılarak akciğer mast hücrelerinin migrendeki muhtemel rolünü araştırmak amaçlanmıştır. Gereç ve Yöntemler: Otuz beş yetişkin erkek Wistar sıçan beş gruba bölündü. Tüm uygulamalar intraperitoneal yoldan olmak üzere; NS grubuna 0,2 ml normal salin (serum fizyolojik), NTG grubuna 10 mg/kg nitrogliserin, vehikül NTG grubuna 0,2 ml normal salin içinde %0,1’lik etanol, L-NAME+NTG grubuna 50 mg/kg L-NAME + nitrogliserin, NS+NTG grubuna ise 0,2 ml normal salin + nitrogliserin uygulandı. Nitrogliserin ve diğer uygulamalardan iki saat sonra sıçanlar anestezi altında 150 ml %4’lük paraformaldehit ile intrakardiyak olarak perfüze edildi. Akciğerler alındı ve mast hücrelerini gözlemlemek için toluidin mavisi ile boyandı. Veriler tek yönlü varyans analizi ile incelendi. Bulgular: Nitrogliserin akciğer mast hücrelerinin hem sayısında (94±3,8’den 131±6,7’ye; p=0,0035) hem de degranülasyon yüzdesinde (%11,8±1,3’ten %35,5±5,7’ye; p=0,003) anlamlı bir artış sağladı. L-NAME ise akciğer mast hücrelerinin sayı ve degranülasyonu üzerinde nitrogliserinin yol açtığı bu etkileri önledi, böylece akciğer mast hücrelerinin nitrogliserin ile tetiklenerek artan sayısını ve degranülasyon yüzdesini ayrı ayrı azalttı. Tartışma ve Sonuç: Bulgularımız nitrogliserin ile oluşturulan migren sıçan modelinde nitrogliserin uygulamasının akciğer mast hücrelerinin sayısında ve degranülasyonunda bir artışa yol açtığını göstermiştir. Ayrıca L-NAME’nin bu etkileri önlemiş olması, nitrogliserin kaynaklı nitrik oksidin direkt veya indirekt olarak akciğer mast hücrelerinin aktivasyonuna yol açtığını düşündürmektedir. Bu çalışmada elde edilen sonuçlar akciğer mast hücrelerinin migrendeki rolü üzerine yapılacak yeni araştırmalara öncülük edebilir.

Objective. The aim of this study was to determine the clinical presentation of tuberculosis cases from our center for the last nine years. Methods. This study was set as descriptive and retrospective. The data was obtained from the hospital records. Subjects who had been diagnosed as tuberculosis and received treatment in our center between the years 2007 and 2015 were included. The cases were classified as newly diagnosed, relapse, transferred, and returning after default. Results. There were 276 (171 males and 105 females) patients with a mean age of 41.5 ± 19.2 years. Pulmonary involvement is the most common presentation and seen in 155 (56.2%) patients. Lymph node and pleura are the most common extrapulmonary involvements those are seen in 53 (19.2%) and 23 (8.3%) patients, respectively. Number of the cases seems to decreased after 2012. Most (85.1%) of the patients were newly diagnosed. Among the subjects, 55.2% of them had bacteriologic diagnosis, 35.1% had histopathologic diagnosis. Two subjects died during the treatment period whereas 274 of them completed the treatment program. Conclusions. Our results show that tuberculosis is seen mainly in the adult age group. While pulmonary involvement is the most common presentation, lymph node and pleura involvements are the most common extrapulmonary presentations. Number of the tuberculosis seems to decrease for the recent years. Strict preventive measures and treatment strategies should be administered.

We sought to investigate the prevalence of skin tumors in Muğla, which has a Mediterranean climate and a high population of elderly people. This was a cross-sectional study conducted on patients, 65 years old and older, who consulted at our dermatology outpatient clinics between January 2014 and January 2015. Diagnoses of the patients were obtained and retrospectively evaluated from the electronic medical records of the hospital. Of 2297 geriatric patients, 50.8% were females and 49.2% were males. Of these patients, 12% had actinic keratosis, 5.4% had seborrheic keratosis, 2.1% had basal cell carcinoma, 0.8% had squamous cell carcinoma, and 0.1% had malignant melanoma. In patients

Diabetic retinopathy (DR) is a complication of diabetes mellitus (DM) that may causes blindness. The vitreous is an extracellular matrix and it may have changes through liquefaction and syneresis in patients with DM, even in those without apparent DR. Diffusion-weighted imaging (DWI) is a new technique provide tissue contrast relying on difference with the diffusion of water molecules among tissues, which can be measured by the apparent diffusion coefficient (ADC) value. We aimed to investigate the vitreous of patients in different stages of DR using diffusion-weighted imaging technique. This prospective study included a group of 100 patients with DR and 100 members of an age- and gender-matched control group. All groups were tested using a head coil in conduction with a Achieva 1.5T magnetic resonans imaging (MRI) system (Philips Medical Systems, Best, The Netherlands). The mean ADC values were calculated and used for statistical comparisons. Mean duration of diabetes was 12.22±10.13 years in patients. Compared to controls, both eyes of the DR group had statistically and significantly lower values of ADC (p=0.025 and p=0.002, respectively). No significant correlations were found among the ADC values and central macular thickness, disease duration and stage of DR (all p>0.05) in patients. Mean ADC values revealed no significant differences among the subgroups of patients at different stages of DR (all p>0.05). Decreased ADCs in the vitreous of diabetes patients seem to be associated with the presence of diabetic retinopathy. [Med-Science 2018; 7(1.000): 106-109]

Celiac disease is an autoimmune disease of the small intestine, resulted from villusdamage and malabsorbtion due to ingestion of gluten; and production of antibodies to gliadin. Thedisease can manifest with various presentations. Celiac crisis was described as an acute, serious,life-threatening form of celiac disease about sixty years ago with a higher incidence among pediatric patients than adults. It is characterized by gastrointestinal symptoms like profuse diarrhea andsevere metabolic distubances like hyponatremia and hypoproteinemia. Early suspicion and detection is important. This case report presents a 54-year-old female patient who died from celiac crisis and sepsis.

Harlequin ichthyosis (HI) is a rare and severe form of congenital ichthyosis caused by truncating mutations in the ABCA12 gene. Although it has many distinctive signs on perinatal sonography such as short limbs, wide gaping mouth, joint contractures, edema of the hands and feet and cloudy amniotic fluids, it usually can not be diagnosed until birth. Herein, we report a case of recurrent HI, which remained undiagnosed until labor at 38 weeks of gestational age. A multiparous woman presented to hospital at 38th weeks of gestation. There were no personal or family history. Vaginal delivery was performed and a 3300 gram baby was delivered. The body of the neonate was covered with thick, armor like skin, have generalized edema and erythematous fissures, scanty hair, everted eyelids with exposed swollen conjunctiva, open mouth were noted at the first examination. Newborn was diagnosed to be having Harlequin ichthyosis and was given to neonatal intensive care unit (NICU) for supportive care and additional examination. Genetic counseling is important and should be recommended to affected families. With the growing technology electron microscopes, invasive prenatal diagnostic tools and 3D sonography may reveal suggestive features of the disease. In addition, new treatment regimens, experienced and competent NICU facilities may increase survival rates.

Dieulafoy lesion (DL) is an important cause of acute gastrointestinal hemorrhage (GIH) because endoscopic diagnosis is very difficult. We report an ileal DL in a patient with Glanzmann Thrombasthenia (GT). A forty-year old female presented with bloody stool. Records showed that she was diagnosed with GT at 3 years of age. Physical examination on admission, she was clinically stable, except for tachycardia (110 bpm). Rectal examination revealed bright red blood. Her haemoglobin level was 8.7 g/dl. Colonoscopy revealed a DL at the terminal ileum. It was treated with combined endoscopic therapy of epinephrine injection followed by two clips application. Haemoglobin values were stable in the post-procedural period. DL in the terminal ileum is very rare. There have been fewer than 20 cases reported in the literature to date. Also GT is a rare congenital bleeding disorder. This case report revealed the coincidence of two rare disorders.

To test the null hypothesis that bony pelvis dimensions are different in women with and without polycystic ovarian syndrome (PCOS). In this case-control study all subjects underwent hysterosalphingography examination. The interspinous, intertuberous diameters and subpubic angle were measured from the images independently by author blinded to the clinical and laboratory data of the patients. Women with PCOS had shorter interspinous diameter. There was no significant differences in the length of intertuberous diameters and subpubic angles between the two groups. Significant difference in interspinous diameter was identified when comparing reproductive-aged women with PCO and their similar aged controls. [Med-Science 2018; 7(3.000): 681-3]

Amaç: Sferoid kültürleri, hücrelerin kendi iç dinamikleri ve diğer hücrelerle olan etkileşimleri açısından tek tabakalı kültürlere kıyasla tümör dokusunun özelliklerini daha iyi yansıtmaktadır. Bu çalışmanın amacı, üç boyutlu (3D) ve iki boyutlu (2D) kültür ortamlarında üretilen CD133+/CD44+ prostat kanser kök hücrelerinin (KKH) makromoleküllerindeki benzerlik ve farklılıklarının araştırılmasıdır. Gereç ve Yöntem: DU-145 prostat kanser hücre hattı içerisindeki CD133+/CD44+ yüzey belirteç özelliklerine sahip KKH’leri akış sitometrisi (FACS) kullanılarak izole edilmiştir. Agarla kaplı kültür kapları ile sferoid yapıları oluşturulmuştur. 2D ve 3D kültür ortamlarındaki KHK hücreleri Fourier dönüşümü kızılötesi (FTIR) spektroskopisi ile karşılaştırılmıştır. Bulgular: CD133+/CD44+ hücrelerin birinci haftada agarlı kültür ortamlarında mikro-agregatlar oluşturduğu gözlenmiştir. İkinci haftada ise, olgun sferoid yapıların oluştuğu saptanmıştır. 2D ve 3D (multisellüler tümör sferoidleri) kültür ortamlarında üretilen hücreler ile yapılan FTIR analizleri KHK hücre yapısındaki proteinler, lipitler, karbonhidratlar ve nükleik asitlerde (DNA, RNA) önemli derecede farklanmalar olduğunu göstermiştir. Membran lipit açil zincir uzunluğu ve hücre zarı kalınlığı, proteinlerin sekonder yapıları ve DNA oligonükleotitlerin baz sekanslarında veya fonksiyonel gruplarında önemli farklanmaların olduğu tespit edilmiştir. Elde edilen sonuçlar, 3D kültür ortamında üretilen sfreoid yapılarının in vivo tümör dokusu ile benzer özellikler sergilediğini göstermiştir. Sonuç: Hücre ortam koşulları ile yaratılmış olan fiziksel, kimyasal ve biyolojik özellikler hücrelerin kendi iç dinamiğini ve mikroçevresi içerisindeki etkileşimlerini önemli derecede etkilemektedir. 2D kültür ortamları ile hücreleri tek boyutta indirgemek hücrelerin gerçek özelliklerini yansıtmamaktadır. Bu nedenle, 3D kültür ortamları ile hücre dinamiklerinin incelenmesi gerekmektedir. Bu çalışmadan elde edilen sonuçlar, kanserde önemli bir hücre popülasyonunu oluşturan KKH’lerin membran yapısı, lipitler, proteinlerin sekonder yapıları ve DNA oligonükleotit yapılarının terapötik hedef olabileceğini göstermektedir., Objective: Spheroid cultures reflect properties of tumor tissue better than monolayer cultures in terms of internal dynamics and interaction with other cells. the aim of this study is to investigate the similarities and differences in CD133+/CD44+ prostate cancer stem cells (CSCs) produced in threedimensional (3D) and two-dimensional (2D) culture media. Material and Method: CSCs with CD133+/CD44+ surface marker properties in the DU-145 prostate cancer cell lines were isolated using flow cytometry (FACS). Spheroid structures were formed with agar-coated culture vessels. CSCs in 2D and 3D cultures were compared with Fourier transform infrared (FTIR) spectroscopy. Results: CD133+/CD44+ cells were observed to form micro-aggregates in cultured media in the first week. in the second week, mature spheroid structures were formed. FTIR analysis revealed that the 2D and 3D (multicellular tumor spheroids) models of CSCs exhibit significant differences in proteins, lipids and nucleic acids. Significant differences were detected in membrane lipid acyl chain length, membrane thickness, protein secondary structures and DNA oligonucleotides. the results showed that spheroids in 3D culture medium exhibit similar properties to in vivo tumor tissue. Conclusion: Physical, chemical and biological properties generated by environmental conditions significantly affect internal dynamics of cells and their interactions within the microenvironment. Reducing the cells in one dimension through the 2D culture medium does not reflect actual properties of cells. Therefore, cell dynamics in 3D culture media should be investigated. This study demonstrates that cellular lipids, membrane structure, protein secondary structures and nucleic acids of CSCs constituting an important cell population in cancer may be therapeutic targets.

Objective: Ankylosing spondylitis (AS) is a chronic inflammatory disorder. Micro RNAs (miRNAs) can function as either oncogenes or tumor suppressor genes. Altered miRNA expression has been implicated in the pathogenesis of several diseases. Therefore, we aimed to explore the effects of miR-196a2T/C (rs11614913) variant profile on susceptibility to AS in a Turkish population. Materials and Methods: Blood samples were collected from 78 AS patients and 79 healthy controls. miR-196a2T/C variant was genotyped by PCR-RFLP. Odds ratio (OR) with 95% confidence interval (95%CI) were calculated using the χ2 test. Results: The frequency of T/C and T/T genotypes of the miR196a2T/C were higher in AS patients compared to healthy controls (p=0.034 and p=0.028, respectively). The subjects carrying the miR-196a2T/C variant T/T genotype showed a 2.542-fold increased AS risk than the control group. However, no difference was observed in the allele frequencies of miR-196a2T/C between AS patients and the controls. It was found that C/C genotype of miR-196a2T/C variant was more frequent in AS patients with enthesitis than AS patients without enthesitis (p=0.042). Conclusion: The miR-196a2T/C variant represents a genetic risk factor for increased susceptibility to AS and is associated with enthesitis in the Turkish population., Amaç: Ankilozan spondilit (AS) kronik, enflamatuar bir hastalıktır. MikroRNA’lar (miRNAlar) onkogen veya tümör baskılayıcı genler olarak fonksiyon yapabilirler. Çeşitli hastalıkların patogenezinde miRNA ekspresyonunun değişmesi bulunmaktadır. Bu nedenle, Türk toplumunda AS yatkınlığında miR-196a2T/C (rs11614913) varyant profilinin etkilerini araştırmayı amaçladık. Gereç ve Yöntem: 78 AS hastası ve 79 kontrolden kan örnekleri toplandı. miR-196a2T/C varyantı PCR-RFLP ile genotiplendi. χ2 testi kullanılarak %95 güven aralığı ile Odds oranı (OR) hesaplandı. Bulgular: miR-196a2T/C T/C ve T/T genotipleri AS hastalarında sağlıklı kontrollere kıyasla daha yüksekti (sırasıyla, p=0.034 and p=0.028). miR-196a2T/C varyant T/T genotipini taşıyan kişiler kontrol grubundan 2,542 kat artmış AS riski gösterdiler. Ancak, miR-196a2T/C allele frekansları açısından AS hastaları ve kontroller arasında fark saptanmadı. miR-196a2T/C varyant C/C genotipinin entezitli AS hastalarında entezit bulunmayan AS hastalarından daha çok olduğu bulundu (p=0.042). Sonuç: miR-196a2T/C varyantı Türk toplumunda AS ve hastalığın entezit ile ilişkisine yatkınlık sağlayan genetik risk faktörü rolü göstermektedir.

Background: The first decision rule developed to identify clinically significant injuries in blunt cervicaltrauma patients is National Emergency X-Radiography Utilisation Study (NEXUS). In the NEXUS study, thenegative predictive value (NPV) has been determined as 99.8%. Sensitivity of Canadian Cervical Spine Rules(CCR) was reported as 99.4%, specificity as 45.1% and NPV was reported as 100%. The objective of this studyis to determine the reliability and utility of NEXUS and CCR for Turkish patient population that has a risk ofcervical injury.Methods: This prospective observational study included 225 patients, all stable, conscious patients over 16years of age who had acute trauma and were brought to the hospital with ambulances or using their ownmeans and who had been injured by a mechanism that may cause cervical trauma, and without exclusioncriteria. The patients included in the study were then evaluated for NEXUS and CCR validity.Results: When CCR was evaluated as a whole, it was determined that all pathological cases were identifiedusing these rules. In terms of identifying the presence of pathological imaging finding the sensitivity of CCRwas 100% (95% CI % 56-100) and specificity was 3.2% (95% CI 1.4-6.7%). NEXUS's sensitivity was calculatedas 93% (95% CI 83-97) and specificity as 1.3%(95% CI 0.2-5.1).Conclusion: CCR and the NEXUS were determined to be useful in the emergency department for theexclusion of cervical pathologies. CCR were more reliable and useful when compared with the NEXUS. Giriş ve amaç: Künt servikal travma hastalarında klinik olarak anlamlı yaralanmaları tanımlamak için geliştirilen ilk karar kuralı National Emergency X-Radiography (NEXUS). NEXUS çalışmasında, negatif prediktif değer(NPV)% 99,8 olarak belirlenmiştir. Kanada Servikal Omurga Kurallarının (KSOK) duyarlılığı % 99.4, özgüllük % 45.1 ve NPV % 100 olarak bildirilmiştir. Bu çalışmanın amacı, servikal yaralanma riski olan Türk hasta popülasyonu için NEXUS ve KSOK’'nın güvenilirliğini ve yararlılığını belirlemektir. Gereç ve yöntem: Bu prospektif gözlemsel çalışmaya, 1 Ocak 2012 - 1 Nisan 2012 tarihleri arasında, akut travma geçiren ve ambulansla ya da kendi imkanlarıyla hastaneye başvuran, servikal travmaya yol açabilecek bir mekanizma ile yaralanan 16 yaşın üzerindeki, gebe olmayan, stabil, bilinçli hastaları kapsayan 225 hasta dahil edilmiştir. Bu hastalar daha sonra NEXUS ve CCR geçerliliği için değerlendirildi. Veriler güncel istatistik programında analiz edildi. Bulgular: 225 hastanın 7’sinde servikal patoloji tespit edilmiştir. Patolojik görüntüleme bulgusu varlığını belirleme açısından NEXUS’un duyarlılığı %93(%95 GA 83-97) ve özgüllüğü %1,3(%95 GA 0,2-5,1) olarak bulunurken, KSOK’nin duyarlılığı %100 (%95 GA %56-100) ve özgüllüğü %3,2 (%95 GA %1,4-6,7) olarak tespit edildi. Sonuç: KSOK ve NEXUS düşük risk kriterlerinin acil serviste servikal patolojilerin dışlanmasında faydalı olduğu, KSOK’nın, NEXUS düşük risk kriterleri ile karşılaştırıldığında daha güvenilir ve yararlı olduğu tespit edilmiştir.

Amaç: Antitrombotik ilaçlar birçok farklı hastalığın tedavisinde kullanılan yüksek riskli ilaçlardır. Bu çalışmanın amacı, Türkiye’deki serbest eczacıların antitrombotik tedavi ile ilişkili faaliyetlerinin nitelik ve içeriğinin belirlenmesi ve serbest eczacıların antitrombotik tedavi yönetimine katkıda bulunabilecek farmasötik bakım aktivitelerine yaklaşımlarının belirlenmesidir. Gereç ve Yöntem: Web ortamında hazırlanan kesitsel anket çalışmasına Türkiye’de 53 ilden 321 eczacı kendi kendine uygulama yöntemiyle katılmıştır. Ankette evet/hayır soruları, kapalı uçlu çoktan seçmeli sorular, yarı kapalı uçlu çoktan seçmeli sorular, 0-100 arası derecelendirme ve 5 noktalı Likert ölçeği kullanılmıştır. Bulgular: Eczacılar verdikleri farmasötik bakım hizmetlerinin %21,84 ± 1,05’inin antitrombotik tedavi görmekte olan hastalara yönelik olduğunu bildirmiştir. Eczacıların %99,1’inin birden fazla antitrombotik ilaç hakkında bilgi verdiği belirlenmiştir. Eczacıların sadece %33,0’ü antitrombotik ilaçların kullanıldıkları tıbbi durumlar ve ilgili tedavi protokolleri ile ilgili bilgi düzeylerinin yeterli olduğunu düşündüğünü bildirmiştir. Verilen çeşitli farmasötik bakım hizmetleri ile eczacıların bilgi düzeyi arasında zayıf pozitif korelasyon bulunmaktadır. Eczacılar hastaların %82,2’sinin ilaçları/tedavileri konusunda bilgisinin yeterli olmadığını düşünmesine rağmen %85,7’si hastalara yazılı bilgilendirme materyali vermemektedir. Eczacıların farmasötik bakım hizmeti sağlarken hastalar ile ilgili faktörlerden en çok kullandığı diğer ilaçlar (%88,8), yaş (%78,8), sağlık okuryazarlığı (%72,9) ve eğitim durumunu (%71,7) dikkate aldığı belirlenmiştir. Eczacıların diğer sağlık profesyonellerinin eczacı hizmetlerine verdikleri öneme ilişkin öz değerlendirme sonucu ile olası tedavi sorunları için hekimle iletişime geçme sıklığı arasında istatistiksel olarak anlamlı zayıf pozitif korelasyon bulunmuştur. Sonuç: Bu çalışmanın sonuçları Türkiye’de antitrombotik tedavi yönetiminde serbest eczacıların sundukları farmasötik bakım hizmetleri ile ilgili bir çerçeve sunmaktadır. Sonuçlar doğrultusunda serbest eczacılık hizmetlerin geliştirilmesi ülkemizde güvenli ve etkin antitrombotik ilaç kullanımının artışına katkı sağlayabilir., Objective: Antithrombotic drugs are high risk drugs used in treatment of various conditions. the purpose of this study was to determine the nature of pharmaceutical care activities related to antithrombotic therapy management and the attitudes of community pharmacists in this area. Material and Method: 321 pharmacists from 53 provinces of Turkey completed this cross-sectional self-administered web-based survey. the questionnaire consisted of yes/no, closed-ended multiple choice, semi-closed multiple choice, 0-100 rating and 5-point Likert scale questions. Results: 21.84 ± 1.05% of the pharmaceutical care services provided by pharmacists were directed toward patients using antithrombotic drugs. 99.1% of pharmacists provided information on more than one antithrombotic drug. Only 33.0% of the pharmacists reported that their knowledge on antithrombotic drugs was adequate. There was a weak positive correlation between the pharmacists’ level of knowledge and various pharmaceutical care services provided. Although pharmacists don’t think that 82.2% of patients have enough knowledge about treatments, 85.7% don’t hand out written information to patients. Other drugs (88.8%), age (78.8%), health literacy (72.9%) and education status (71.7%) were the most frequently considered factors while providing pharmaceutical care services. There was a weak positive correlation between pharmacist's perceived value for pharmacy services by other healthcare professionals and frequency of communication with physicians for possible treatment problems. Conclusion: the results of this study provide a framework for pharmaceutical care services provided by community pharmacists in the management of antithrombotic therapy in Turkey. the improvement of community pharmacy services may contribute to the increase of safe and effective antithrombotic drug use in our country.

Aim: Thyroidal incidentalomas (Tis) detected by F-18 fluorodeoxyglucose positron emission tomography/computed tomography (F-18FDG PET/CT) may be associated with three different causes that include metastasis of another malignancy, primary thyroid gland malignancies and lastly benign thyroidal nodules, all require different clinical approaches. For appropriate treatment, quick characterization of the Ti is important, preferably with a lesser invasive method. Our aim was to determine whether the characterization of TIs can be performed with FDG-PET/CT, due to contribute faster diagnosis, and initiation of the therapy.Material and Methods: Forty-four patients with detected TIs in FDG-PET/CT were included in the study. The relationship between metabolically/morphological parameters and pathology results were evaluated statistically. If two subsequent cytology were negative, nodule accepted as benign. If cytology result was suspected or malignant, histopathological confirmation was made. For these patients, histopathological results were accepted as definite diagnosis. Results: Malignant thyroidal pathologies were detected in 29.5% of patients. We could not find any significant relationship between age, nodule size and SUVmax value and pathology results. According to ROC analysis, there were not any cut-off value for nodule size and SUVmax. Similar results were also obtained for papillary carcinoma as a special subgroup.Conclusion: Characterisation of TIs could not be performed by using age, nodule size and SUVmax. Therefore, TIs which detected by FDG-PET/CT should be examined pathologically due to high risk of malignancy.Keywords: Thyroidal incidentalomas; FDG-PET/CT; malignant; characterization.

Aim: Cutaneous lupus erythematosus (CLE) has a multifactorial pathogenesis involving genetic and environmental triggers and congenital and acquired immune response. The aim of this study was to investigate the effects of Glutathione S-Transferases (GST) isoenzymes including GSTT1, GSTM1, and GSTP1 in the CLE patients with an etiology of solar radiation exposure. Material and Methods: Paraffin-embedded skin biopsy sections from the patients were stained by immunohistochemical methods. The results were evaluated under a light microscope by a pathologist. The pattern, localization, and distribution of the immunohistochemical staining were recorded for each patient. Staining of the nucleus or cytoplasm was considered as positive staining. The accuracy of staining was determined based on the intensity and percentage of staining. Results: No significant difference was found between the patient and control groups regarding staining intensity. In terms of staining percentage, the prevalence of GSTP1-3 genotype was significantly lower in the patient group compared to the control group (25% vs. 63.33%) (p=0.002). Conclusion: No significant difference was observed in the staining intensity of GSTP1, GSTT1, and GSTM1 between the patient and control groups and the staining percentage in some genotypes was even higher in the control group compared to the patient group.

Aim: Endometrial polyps are frequently associated with abnormal uterine bleeding. The kispeptin family is one of the peptides that play a role in reproductive functions and whose expression varies in various uterine pathologies. The aim of the study was to determine the relationship between serum Kisspeptin levels and endometrial polyps in women with premenopausal status.Material and Methods: The blood was collected prior to endometrial sampling from women admitted to the hospital due to abnormal uterine bleeding. According to the pathology results, patients were identified as polyp group (n=38) (endometrial polyps) and control group (n=50) (normal endometrial findings). Kisspeptin-54 levels were determined by ELISA method from serum obtained from venous blood. Results: There were no difference was found between the patients’ age, body mass index, gravida, para, abortus and the number of living children were compared (p>0.05). There was no statistically significant difference between the groups in terms of follicle stimulating hormone, luteinizing hormone and thyroid stimulating hormone values (p>0.05). Plasma kisspeptin (1.84±0.93 ng/dL and 1.32±0.47 ng/dL, p= 0.008) and estradiol (90.34±13.02 pg/mL and 81.75±12.36 pg/mL, p=0.002) levels were significantly higher in the polyp group than in the control group. After the Receiver Operating Characteristic (ROC) analysis the area under the curve (AUC) was 1.26 (p= 0.08), (95% CI, 0.550-0.782). The sensitivity value was 0.684 (0.512-0.819), the specificity was 0.620 (0.471-0.750).Conclusion: The serum Kisspeptin-54 and estradiol levels were found higher in patients with endometrial polyps.Keywords: Abnormal uterine bleeding; endometrial polyps; kisspeptin.

Günümüzde genel anestezinin santral sinir sistemine etkisi sağlıklı genç yetişkinlerde önemli bir sorun olarak karşımıza çıkmazken, yapılan bir çok hayvan deneyi yanında az ama önemli klinik çalışmalar, yaşamın erken veya geç dönemlerinde santral sinir sistemi üzerine anestezik toksisite kuşkusunu güçlendirmektedir., Nowadays, while the effects of general anesthesia on central nervous system is not considered to be an important problem on healthy young adults, alongside many experiments on animals, few but significant clinical studies strengthenthe suspicion of anesthetic toxicity on the central nervous system in early or late ages

Objectives: Lung cancer is the most common cause of cancer-related deaths worldwide. The use of tobacco and tobacco products is among the leading risk factors with proven association with lung cancer, although various environmental and dietary factors have been also implicated. Vitamin D deficiency has been identified as a poor prognostic factor in advanced stage colon cancer and breast cancer. The aim of the present study was to compare 25-hydroxyvitamin D [25(OH)D] levels between patients with non-small cell lung cancer (NSCLC) at the time of diagnosis and healthy controls and to evaluate the differences in serum 25(OH)D levels across the subgroups and stages of NSCLC., Methods: A total of 462 patients with NSCLC who were followed and treated in three participating centers were compared retrospectively with and age- and sex-matched 462 healthy controls who underwent testing for serum calcium, lactate dehydrogenase (LDH), magnesium, phosphorus, creatinine, and vitamin D levels in the between January 2016 and June 2018. The patients with NSCLC were further classified according to the histological subtype., Results: The mean age was 63.46 +/- 8.86 years. The patient group was composed of 58 females (12.6%) and 404 males (87.4%). Serum 25(OH)D, calcium, LDH, and magnesium levels were significantly different between the patient and the control group (p=0.0001, p=0.0001, p=0.0001, p=0.0001, respectively). Among patients with NSCLC, serum 25(OH) D was significantly lower in patients with adenocarcinoma subtype than in patients with squamous-cell carcinoma subtype (p=0.001). There was a significant correlation between advanced stage with decreased serum 25(OH)D and increased LDH levels (p=0.0001, p=0.0001, respectively)., Conclusion: The study is the most extensive study in our region in terms of the number of participating patients. Demonstration of a difference in serum 25(OH)D levels between histological subtypes also contributes to the literature.

As in all living cells, cancer cells are evaluating is very important in the frames of tumor development and treatment. As in all evolutionary process, the environment of living cells has an important role. Tumor cells have an environment is called tumor microenvironment, affects the therapeutic response and clinical results. Tumor microenvironments involve various cell types, extracellular matrix substances that are in the niche of cancer cells. The microenvironment is not only important in tumorigenesis but it is effective on therapeutic efficacy. In this review, we carried out the interaction between non-small cell lung cancer and its microenvironment to point out the significance of the tumor environment.

Objectives: Megestrol acetate (MA) can induce significant secondary adrenal suppression. We designed this study todetermine the extent of adrenal insufficiency in cancer patients receiving MA and whether ther was any predictivefactor for this.Methods: Thirty-one patients (aged 48–83 years) who were receiving MA took part in this study. Serum concentrationsof TSH, ACTH, free T4, cortisol were measuresd in samples obtained at 7 AM, at baseline and 1st month. Standart ACTH(250 mg) stimulation test was performed if cortisol levels were below 18 µg/dl at any time.Results: 1 month after drug initiation, 32% of patients were accepted as adrenal insufficient. There wasn’t any correlation between the basal cortisol, ACTH levels, any biochemical parameter and overall survival. There was negativecorrelation between 1 month cortisol levels and survival time (p=0.04) If cortisol levels were lower at month of theraphysurvival time was longer. Cox regression analysis showed that patients having lower cortisol levels at first month had98% lower risk of death compared to patients having higher cortisol levels (p=0.02: OR 0.12 (0.02-0.75)).Conclusion: It is important to evaluate adrenal functions especially during episodes of infection or after withdrawalof MA therapy since this may require prompt corticosteroid treatment.

Aim: This study was planned to determine cut-off values of the Tinetti Performance Oriented Mobility Assessment (POMA) and the Self-Assessment Fall Risk Questionnaire (FRQ) in older adults with mild cognitive impairment.Material and Methods: This study included a total of 213 individuals aged 65 years and over in the study. These individuals were divided into two groups according to Mini Mental Test (MMT) scores: 116 individuals with an MMT score of 18-23 (mild cognitive impairment) and 97 individuals with an MMT score of 24 or more (normal cognitive function). Balance and gait performance was assessed by the POMA, the fall risk self-assessment by older adult susing a FRQ.Results: In Older Adults with mild cognitive function, the clinical cut-off points for the POMA and FRQ were determined according to ROC curve analysis. The clinical cut-off point for the POMA was determined as 15.5 points; and 15.5 points or more in the POMA were considered normal with a 95% confidence level. The clinical cut-off point for the FRQ was determined as 4.5 points; and 4.5 points or less in the FRQ were considered normal with a 95% confidence level.Conclusions: We think that it is important to take the values obtained in the present study into account in interpreting the above-mentioned commonly used tests when cognitive status is considered related to falling. Therefore, it is suggested that these tests used in the clinic should be examined considering the risk of falling in older adults with mild cognitive function.

Aim: The aim of this study was to investigate the relationship and difference between balance, physical fitness and the quality of lifein retired people living in different geographical regions of Turkey.Material and Methods: For balance evaluation Berg Balance Scale, for physical fitness evaluation Senior Fitness Test (Chair StandTest, Arm Curl Test, 2-Minute Step Test, Chair Sit-and-Reach Test, Back Scratch Test and 8-foot Up-and-Go Test) for quality of lifeevaluation Short Form (36) Health Survey were administered to 155 retired individuals from seven geographical regions of Turkey(Antalya, Gaziantep, Elazığ, Eskişehir, İstanbul, İzmir, Samsun) For statistical analysis, one-way analysis of variance and Spearman’scorrelation analysis were used.Results: A total of 155 individuals aged between 55 and over were included in the study. The mean age of the individuals was64.235.86 years. The results of Berg Balance Scale showed statistically significant differences (p0.05) both between balancescore and 8-foot Up-and-Go Test scores in Eskişehir and between the balance score and the results of the Arm Curl Test in Antalya(p0.05). There were no significant differences between regions in the results of the SF-36 assessment of quality of life. A significantpositive correlation between Berg Balance Scale score and the scores of Chair Stand, Arm Curl and 2-Minute Step Tests was recorded.Furthermore, Berg Balance Score and 8-foot Up-and-Go score were found to present a negative correlation.Conclusion: Aging and differences between geographic regions in which individuals live cause deterioration in balance and thissituation effects physical fitness. Although participants had different lifestyles, the fact that our evaluation indicated a lack ofdifference in the quality of life assessment results was pleasing.

Introduction: Paranasal sinuses are one of the most common anatomical variations in humans. Computed tomography (CT)is an imaging modality used as the gold standard in the evaluation of patients before endoscopic sinus surgery (ESS). Thisstudy aims to evaluate the anatomic variations that should be considered before and during the surgical procedure by CTexamination and to determine their frequency.Methods: In this study, the images of patients who were referred to the otorhinolaryngology (ENT) outpatient clinic, consideringthat they had had sinus pathology and underwent paranasal sinus CT imaging were retrospectively analyzed. A total of320 patients aged between 15-90 years were evaluated. Non-contrast images obtained by multislice CT were examined. Thebreakdown of anatomic variations evaluated in CT sections obtained according to these protocols is presented in Table 1.Results: Of the 300 patients, 151 were male (47.2%) and 169 were female (52.8%). The mean age was 39.8±15.8 years. Themost common anatomic variation was agger nasi cell with 86.3% (n=276). The least detected anatomical variations werepneumatized inferior turbinate and bifid inferior turbinate as 0% (n=0), inferior turbinate hypoplasia as 0.3% (n=1), and bifiduncinate process variations as 0.6% (n=2).Discussion and Conclusion: Considering that a significant portion of the variations identified in this study (such as ICA protrusionand dehiscence, ethmoid roof asymmetry, Onodi cell, atelectatic UP) may lead to significant complications duringsurgery, it is important to know and describe the appearance of these variations on CT. In our study, significant variation wasobserved in the sinonasal region, and it was once again emphasized that paranasal sinus CT was very valuable in determiningthese variations.

Meckel's diverticulum is remnant of omphalomesenteric ductus and it is the most frequent congenital malformation of the gastrointestinal tract. Rarely, any hernia sac contains it and named as a Littre hernia. A 59-year-old male patient with Meckel's diverticulum perforation due to strangulated inguinal hernia, was successfully treated with diverticullectomy using linear GIA stapler and performing graft-free hernia repair. Littre’s hernia may also be present in abdominal wall hernias requiring urgent surgical intervention due to incarceration. For this reason, it is important to have information about treatment management of this clinical entity.

Objectives:Microfluidic technology is a fast-growing area and provide high-efficient MEMS (Micro-Electro-Mechanical-Systems) sensor integration platform that helps to advance healthcare systems. Due to proper the chemical and mechanical properties of polymers, PDMS (Polydimethylsiloxane) (6) and PMMA (Poly-methyl-methacrylate), they became on the best candidate for health care studies in microfluidic studies (7). Besides, they perform great optical properties for observation of living cell experiments. To increase their performance, surface interactions works with cells, modification techniques are widely used in microfluidic chips. In this paper, our primary purpose is to modify such polymers and glass with matrigel, PDA and APTES so as to increase cell-surface interaction. Patients and Methods:Cells were seeded into the micro-channels that is modified with 1%, 3% and 5% matrigel. The cell culture were observed 48-hours and images were taken. In the next stage, static culture experiments were performed on glass surfaces modified with PDA (polydopamine) and APTES (3-Aminopropyl triethoxysilane). 3-hour images were received. Results:The area filled by the cells was calculated using the ImageJ software ver.1.149. In the Matrigel modified chips, at the end of the 48th hour, the surface area of the cells reached to 22.58%-29.14- 26.97% for the matrigel sample rates 1%, 3% and 5%, respectively. In PDA, APTES modified surfaces (dissolved in ethanol) and APTES modified surface (dissolved in water), the cells overlaid on surface after 3rd hour 5,32% 8,08%; and 3,33%, respectively. Conclusion:The tendency of the cells to attach and colonize on increasing matrigel concentrations and on PDA, APTES modified surfaces was higher than the unmodified surface.

Introduction: Ventricular septal defect (VSD) is the most common congenital heart anomaly. in surgical treatment, the transatrial approach is frequently utilized because of causing less right bundle block and ventricular scarring. However, some VSDs are obscured by the chordae tendineae or a pouch formation of the septal leaflet; therefore, alternative techniques are required. in such cases, tricuspid valve detachment (TVD) provides a complete visualization and ease to access to ventricular septal defects. in this study, we evaluated the results of the patients of whom we performed TVD. Patient and Method: Our study includes 50 patients who underwent TVD during the procedure with the diagnosis of perimembranous VSD. Patients were examined by transthoracic echocardiography (TTE) before and after operation and the valvular functions are evaluated. All patients were kept in follow up for 3 months after discharge. Results: the mean age of the patients was 27.56±34.81 months. At the end of the study, all patients were in New York Heart Association class I. There was no residual shunt through VSD. Except 4 patients with mild tricuspid regurgation (TR), the TTE has not revealed any TR in majority of patients. Conclusion: We suggest that, in appropriate patients, VSD closure can be performed safely with a TVD application thru an incision of the septal leaflet of the tricuspid valve without any adverse effect on function or growth at of the valve at midterm follow-up.

Objectives: The aim of this study was to investigate the temporomandibular joint mobility, cervical mobility, head position, and kinesiophobia in individuals who were seperated into different groups according to the Research DiagnosticCriteria for Temporomandibular Disorders, and were diagnosed with only one.Methods: Individuals with temporomandibular disorders were divided into 3 groups according to the Research Diagnostic Criteria for Temporomandibular Disorders. After obtaining sociodemographic information of individuals, cervical mobility and head position with a goniometer, temporomandibular joint mobility with a ruler, and kinesiophobiawith a Tampa Scale for Kinesiophobia were assessed.Results: In the statistical analysis among the groups; values for the Tampa Scale for Kinesiophobia of individuals ingroup 3 were higher than the others with temporomandibular disorders (p0.002); while head position, temporomandibular joint mobility and cervical mobility values did not differ (p0.05).Conclusion: It is considered that craniocervical symptoms can different in subgroups of temporomandibular disordersat the beginning. However, these symptoms were same in all groups, except kinesiophobia. On this basis, it is need forfurther study with high level of evidence.

Aim: Preoperative biliary drainage is suggested for patients with jaundice, considering that surgical operations may increase postoperative complications in the presence of jaundice. The aim of this study was to test the effect of biliary drainage on possible serious complications, deaths, or period of hospital stay.Material and Methods: Between January 2012 and June 2016, 160 patients with operable and resectable periampullary tumors who were diagnosed with periampullary tumors underwent pancreaticoduodenectomy (Whipple’s procedure) in Marmara University Pendik Training and Research Hospital, Department of General Surgery. The patients’ demographics, accompanying comorbid diseases, type of biliary drainage, drainage duration, pre- and post-drainage laboratory data, emerging complications and need for re-hospitalization were recorded retrospectively from the accessible files and records.Results: It was observed that out of 158 patients with periampullary tumors, 116 that were operated with drainage had a higher occurrence of surgical site infections and anastomotic leaks, compared to the 42 patients that were operated without drainage. Similarly, when patient results were classified according to the Clavien-Dindo complication classification, the ratio was again against the patients that were operated with drainage. Drainage patients stayed in the hospital for a longer period; however, in terms of pancreatic fistula, re-hospitalization, need for intensive care and relaparotomy ratios, and especially in terms of mortality ratios, a difference between two patient groups was not observed. Conclusion: Investigating the data collected from patients that were operated without drainage, and specifically considering the bilirubin values of the patients who had complications, there was no threshold identified that contributed to a higher likeliness of complications. Consequently, even though there were no results to motivate recommending drainage, it was concluded that applying drainage does not create any difference in short-term prognosis, but drainage increases infectious complications.Keywords: Periampullary cancer; obstructive jaundice; preoperative biliary drainage; postoperative complication; hyperbilirubinemia.

Objectives: The aim of our study is reducing the healthcare workers’ duration of exposure to the cytotoxic agentswithout increasing the unused dose wasting during preparation by making changes in vial sizes of cytotoxic drugs.Methods: Wasted doses and preparation time (potential exposure time) of the selected antineoplastic drugs weremeasured for six months. The usage of small dose vials which causes prolongation in preparation time has been avoided and larger dosage forms were preferred in last trimester. Wasted drug dose amounts and preparation periods wererecorded. Subsequently, the data compared between the trimesters.Results: The total preparation period in the first trimester was 1407 minutes while it was 1058 minutes in the secondtrimester. There was no significant changes between the first and the last trimester of the study in terms of patientsnumbers that receiving chemotherapy and the rate of unused drug doses extermination (p>0.05). On the other hand,drug preparation time, in other words the health employee's exposure period to cytotoxic drugs was reduced 24.81%.Conclusion: In the study, it has been shown that by making rational choices about drug usage can reduce thehealthcare workers duration of exposure to the cytotoxic agents.

GİRİŞ ve AMAÇ: Türkiye’de sıklığı %3.7 olarak tanımlanan tiroid kanserleri en sık görülen endokrin neoplazilerdir. Mitojen aktive protein kinaz (MAPK) yolağındaki proteinleri kodlayan genlerdeki mutasyon ve yeniden düzenlemeler, diferansiye tiroid kanseri gelişimi ve ilerlemesi için giderek daha fazla önem kazanmaktadırlar. Bifosfonatlar invitro olarak; tümör hücre proliferasyonunu azaltır, hücre viabilitesini azaltır, tümör hücre apopitosisini uyarır, hücre adezyonu inhibisyonu yapar, anjiyogenezde inhibisyon ve metastatik potansiyelde azalma yaparlar. Çalışmamızda zoledronik asit monohidratın tiroid papiller karsinomu hücre hattında sitotoksisite ve apoptozis üzerine etkileri araştırılmıştır. YÖNTEM ve GEREÇLER: İnsan kökenli bir papiller tiroid karsinomu hücre hattında (BCPAP) bifosfonat olarak zoledronik asid monohidratın 10-100 µM şeklinde artan dozları kullanıldı. BULGULAR: BCPAP hücre hattında zoledronik asid monohidratın IC50 değeri 1. deneyde 48. saatte 55 µM olarak saptandı. Ancak 2, 3 ve 4. deneylerde sonuç alınamadı. Bu nedenle apopitozis deneyleri kurulmadı. TARTIŞMA ve SONUÇ: Zoledronik asit, çalıştığımız doz aralığında tiroid papiller karsinomu hücre hattında etkisiz bulunmuştur.., INTRODUCTION: Thyroid cancer is the most common endocrine neoplasm with an incidence of 3.7% in Turkey. Mutations and re-arrangements in genes encoding proteins of the the mitogen-activated protein kinase (MAPK) pathway for the development and progression of differentiated thyroid cancer, gain more and more importance. Bisphosphonates decrease tumor cell proliferation, reduce cell viability, stimulate apopitosis in tumor cell, inhibit cell adhesion and angiogenesis, and decrease metastatic potential in vitro. in our study, the effects of zoledronic acid monohydrate on cytotoxicity and apoptosis in thyroid papillary carcinoma cell line were investigated. METHODS: Zoledronic acid monohydrate with increasing doses of 10 to 100 ?M was used on a papillary thyroid carcinoma cell line of human origin named BCPAP. RESULTS: IC50 value with zoledronic acid monohydrate was found in first experiment at 48th hour to be 55 ?M, but 2nd, 3rd and 4th experiments were failed. Therefore, apoptosis assays were not to be established. DISCUSSION and CONCLUSION: Zoledronic acid was found to be ineffective in the thyroid papillary carcinoma cell line at the dose range we were working with

Phthiriasis Palpebrarum is an infrequent and uncommon eyelid infestation caused by phthirus pubis. In this study, we report a case of phthiriasis palpebrarum imitating allergic blepharoconjonctivitis. A 58-year-old female patient had itching, stinging and watering together with temperate crust around her right eyelid Initially the diagnosis of allergic conjunctivitis was made because of symptoms of hyperemia, mucoid secretions and itching on the lashes and anti-allergic eye drop was prescribed. On the attentive biomicroscopic examination, it was revealed many buried live lice attached to the lashes, hyperemia on the lid margin and translucent nits in right eyelid. Microscopic examinations of samples taken from the lashes infestated with live lice and translucent nits were consultated to microbiology department for certain diagnose and to dermatology department for scanning phthiriasis and other veneral diseases. Administitation of pure vaseline, topical antibiotic drops and topical steroid drops were used for the treatment. At the end of the third week, no louse or nit was present. In spite of it was known that Phthiriasis palpebrarum is an exceptional and infrequent reason of blepharoconjunctivitis; it might observe as an isolated infestation of eyelids and this condition can easily be misdiagnosed as an allergic conjunctivitis or blepharitis. Pitriyasis Palpebrarum, phthirus pubis'in neden olduğu ender görülen bir göz kapağı enfestasyonudur. Bu ça- lışmada, alerjik blefarokonjonktiviti taklit eden bir pitriyasis palpebrarum olgusu sunuyoruz. 58 yaşında ka- dın hastanın sağ göz kapağı çevresinde hafif kabuklanma ile beraber kaşıntı, batma ve sulanma yakınmaları mevcuttu. Hiperemi, kirpikler üzerindeki mukoid sekresyonlar ve kaşıntı gibi semptomlar nedeniyle, ilk olarak alerjik konjonktivit tanısı koyuldu ve anti-alerjik göz damlası reçete edildi. Dikkatli biyomikroskobik inceleme sonrasında, kapak kenarında hiperemi ile birlikte, kirpiklere gömülü birçok canlı bit ve yarı saydam bit yavru- su gözlemlendi. Canlı bitler ve yarı saydam sirke ile enfekte olmuş kirpiklerden alınan mikroskobik inceleme örnekleri, kesin tanı için mikrobiyoloji bölümüne; phthiriasis ve diğer veneral hastalıkların taranması için de dermatoloji bölümüne danışıldı. Tedavide saf vazelin, topikal antibiyotik damlaları ve topikal steroid damlaları kullanıldı. Üçüncü haftanın sonunda, hiçbir bit veya bit yavrusu gözlemlenmedi. Her ne kadar Pitriyasis Palpeb- rarum blefarokonjonktivitin istisnai ve nadir görülen bir sebebi olsa da; izole bir göz kapağı enfeksiyonu olarak gözlenebilir ve bu durum alerjik konjonktivit veya blefarit olarak kolaylıkla yanlış teşhis edilebilir.

Amaç: Bu çalışmada ibandronik asit ve kalsiyum- D vitamini kompleksinin osteointegrasyon üzerine olan etkilerini histomorfometrik ve mekanik olarak değerlendirmeyi amaçlamaktadır. Gereç ve Yöntem: Çalışma 45 adet dişi Sprague-Dawley cinsi ratın sol femurları üzerinde yapılmıştır. Cerrahi olarak ratların sol femurlarına intramedüller K teli yerleştirilmiştir. Ratlar rasgele eşit sayıda olacak şekilde kontrol grubu, ibandronat alan grup ve Ca+D vitamini alan grup olacak şekilde gruplandırılmıştır. Altı hafta sonra sakrifiye edilen ratların femurları mekanik teste ve histomorfometrik inceleme tabi tutulmuştur. Elde edilen veriler istatistiksel olarak kıyaslanmıştır. Bulgular: Grup A (kontrol) ve Grup B (Ca+D vitamini) arasında ortalama maksimum çekme gücü ve osteo- integrasyon endeksi açısından istatistiksel olarak anlamlı bir farklılık yoktu (maksimum çekme için p=0,828, OintE için p=0,172). İbandronik asit verilen Grup C için ortalama maksimum çekme gücü ve osteointegras- yon endeksi Grup A ve Grup B ile kıyaslandığında elde edilen değerin istatistiksel olarak anlamlı derecede yüksek olduğu saptandı (Maksimum çekme gücü için grup A’da p=0,001, grup B’de p=0,001, OintE için grup A’ da p=0,009, grup B’de p=0,016) Sonuç: Bu çalışma ibandronatın metal implant-kemik tutunumu üzerinde belirgin bir olumlu etkiye sahip olduğunu göstermektedir. Ancak, bu deneysel çalışmanın sonuçlarını destekleyecek ileri klinik çalışmalara ihtiyaç vardır. Objective: The aim of this study is to evaluate the effects of ibandronate and calcium-vitamin D complex on osteointegration of metal implants histomorphometrically and mechanically. Material and Method: The study was performed on 45 female Sprague-Dawley rats. Rats were divided into three groups. Intramedullary nailing was performed in all rat’s left femurs with a stainless steel K-wire in 1 mm diameter. The rats in Group A, the control group, didn’t receive any medication after the intramedullary nailing of left femur. The rats in Group B received calcium and 25IU vitamin D daily; in Group C received single dosage ibandronate subcutaneously after intramedullary nailing of left femurs. At the end of six weeks all the rats were sacrificed. Maximum pull out strenghts were measured for all K wires and the mean maximum pull out strenghts were calculated for each group. Hystomorphometrically the thickness of the new bone around the K wire was measured and proportioned to the thickness of the K wire to get the novel osteointegration index(Oint-E) for each group. Results: There were no statistically significantly difference between Group A and Group B with regard to Oint-E (p=0,172) and mean pull out strength(p=0,828). The mean pull out strength and Oint-E for Group C, ibandronate medication group, were higher when compared with Group A and B with a statistically significant difference (for mean pull out strengths p=0,001 for Group A, p=0,001 for Group B; for Oint-E p=0,009 for Group A, p=0,016 for Group B). Conclusion: The results of this study demonstrated that ibandronate has a significant positive effect on bone metal implant integration. We believe that ibandronate can be used postoperatively to augment osteointegration of metal implants. However further clinical studies are needed to support results of this experimental study.

Objectives: Bleeding control is crucial in preventing negative consequences by reducing blood loss in surgical operations. The aim of this study is to evaluate the hemostatic effect of a new herbal hemostatic agent called Algan Hemostatic Agent (AHA) in an uncontrolled bleeding model made by liver laceration.Methods: In these study 5–7 weeks-old 64 rats were used. Rats were randomly divided into 8 groups each consistingof eight rats (4 groups heparinize and 4 groups non-heparinize). The experimental liver laceration was performed, andphysiological serum impregnated gauze was applied to the control group for hemorrhage control, AHA liquid formimpregnated gauze, AHA gel, and AHA powder form were applied to experimental groups, respectively.Results: The shortest bleeding time was found in the AHA powder group. The AHA powder form stopped the bleedingin the heparinize group for a mean of 4 s, the non-heparinized group for 2 s. This was followed by the gel group and theliquid group. The bleeding time was significantly shorter in the all AHA group compared to the control group.Conclusion: This study showed that AHA is a highly effective hemostatic agent in controlling bleeding compared tothe control group.

Objectives:psychometric properties of the Turkish version of the Functional Assessment of Cancer Therapy-Lung (FACT-L) scale and the sensitivity tochanges in clinical indicators.Patients and Methods:This study was conducted within the framework of a national multicentre project. Patients with either stage IIIB or IV primary lungcancer diagnosed after April 2010were included in thisstudy. A classical confirmatory approach was used for both the reliability and validity analyses.Internal consistency was tested using Cronbach’s α value, and the validity analysis was performed using construct validity and clinical validity.Results:276 (92.3%) patients were male and the average age was 60.8 ± 9.4 years. The most frequently observed histological type was squamous cellcarcinoma (36.8%), and 61.5% of these stage IV tumours. Cronbachs α values for the subscales ranged from 0.60 to 0.84. The majority of the FACT-Lsubscales revealed inter-scale correlation coefficients greater than 0.35. All sub-dimensions, except that of the social/family well-being scale, are ableto significantly discriminate between stages IIIB and IV. Significantly lower scale scores were detected in patients with stage IV than stage IIIB. Thecomparative fit index was 0.917, and the root mean square error of approximation was 0.091. Dyspnoea, haemoptysis, chest pain, weight loss, anorexia,localised pain, and fever symptoms had a significant correlation with the FACT-L, trial outcome index, and lung cancer subscale.Conclusion:Turkish version of the psychometric properties of the original FACT-L scale is regarded as a valid and reliable tool and can be used safely ina clinical context when managing patients with lung cancer in Turkey.

Objectives: Lung cancer is the most common cause of cancer-related deaths worldwide. The use of tobacco and tobacco products is among the leading risk factors with proven association with lung cancer, although various environmental and dietary factors have been also implicated. Vitamin D deficiency has been identified as a poor prognosticfactor in advanced stage colon cancer and breast cancer. The aim of the present study was to compare 25-hydroxyvitamin D [25(OH)D] levels between patients with non-small cell lung cancer (NSCLC) at the time of diagnosis and healthycontrols and to evaluate the differences in serum 25(OH)D levels across the subgroups and stages of NSCLC.Methods: A total of 462 patients with NSCLC who were followed and treated in three participating centers were compared retrospectively with and age- and sex-matched 462 healthy controls who underwent testing for serum calcium,lactate dehydrogenase (LDH), magnesium, phosphorus, creatinine, and vitamin D levels in the between January 2016and June 2018. The patients with NSCLC were further classified according to the histological subtype.Results: The mean age was 63.46±8.86 years. The patient group was composed of 58 females (12.6%) and 404 males(87.4%). Serum 25(OH)D, calcium, LDH, and magnesium levels were significantly different between the patient andthe control group (p=0.0001, p=0.0001, p=0.0001, p=0.0001, respectively). Among patients with NSCLC, serum 25(OH)D was significantly lower in patients with adenocarcinoma subtype than in patients with squamous-cell carcinomasubtype (p=0.001). There was a significant correlation between advanced stage with decreased serum 25(OH)D andincreased LDH levels (p=0.0001, p=0.0001, respectively).Conclusion: The study is the most extensive study in our region in terms of the number of participating patients.Demonstration of a difference in serum 25(OH)D levels between histological subtypes also contributes to the literature.

Aim: To screen the symptoms of attention deficit and hyperactivity disorder in adult migraine patients. Material and Methods: Our study included 102 migraine patients and 93 sex- and age-matched healthy volunteers. Gender, age, level of education and duration of disease were recorded. We used the adult attention deficit/hyperactivity disorder self-report scale to evaluate the symptoms of adult attention deficit / hyperactivity disorder. In addition, the short form-36 and the hospital anxiety and depression scale were applied to the patients and the healthy controls. Results: The mean scores of attention deficit hyperactivity disorder were significantly higher in migraine patients compared to the control group. There was no significant relationship between the Adult Attention Deficit and Hyperactivity Disorder Self-Report Scale scores and the duration of the disease. There was a negative correlation between the SF-36 health questionnaire scores and the Adult Attention Deficit and Hyperactivity Disorder Self-Report Scale scores. There was a positive correlation between the Migraine Disability Assessment scores, the number of migraine attacks and the Adult Attention Deficit and Hyperactivity Disorder Self-Report Scale scores. Conclusion: Attention-deficit and hyperactivity symptoms can develop in adult migraine patients and cause psychosocial morbidity and poor quality of life.

Amaç: Bu çalışma, sağlık hizmetleri meslek yüksekokulu öğrencilerinin genital hijyen davranışlarının ince- lenmesi amacıyla planlanmıştır. Gereç ve Yöntem: Araştırmanın evrenini, Gümüşhane Üniversitesi Kelkit Sağlık Hizmetleri Meslek Yükse- kokulu paramedik kız öğrencileri (n=100) oluşturdu. Çalışma anketini doldurmayı kabul eden öğrencilere (n=97) “katılımcıların sosyo-demografik özellikler” ve “genital hijyen davranışları ölçeği”nin bulunduğu anket formu (Mayıs-Haziran 2018) dolduruldu. Verilerin değerlendirilmesinde (SPSS 18.00 paket programında) sa- yı-yüzdelik dağılımı, ortalama ve bağımsız t-testi kullanıldı. Bulgular: Katılımcıların yaş ortalamasının 20,01±1,12 (min:18, max:23) olduğu, %55,7’sinin birinci sınıf ol- duğu, %27’sinin Akdeniz bölgesinden geldiği tespit edilmiştir. Genital hijyen davranışları ölçeği puan orta- lamasının 86,89±7,124 (min:68, max:108) bulundu. Katılımcıların %70,1’inin haftada en az bir kez banyo yaptığı, %90,7’sinin iç çamaşırlarını sadece kendinin kullandığını fakat %2,1’inin başkalarıyla ortak kullandığı, %20,6’sının iç çamaşırlarını 3-4 günde bir değiştirdiği, %41,2’sinin tuvalete girmeden önce ellerini yıkadığı- nı, %2,1’inin tuvalleten sonra ellerinin yıkayıp yıkamadığı konusunda karasız olduğu, 63,9’unun tuvaletten sonra temizliğini her zaman önden arkaya doğru yaptığı, %92,8’inin adet dönemlerimde sadece hazır ped kullandığı fakat %2,1’inin adet dönemlerinde bez kullandığı, %3,1’inin ped değiştirmeden önce ellerimi yıka- madığı fakat %92,8’inin ped değiştirdikten sonra ellerimi yıkadığı, %3,1’inin adetli iken pedini yalnızca iyice dolduğu zaman değiştirdiği belirlenmiştir. Sonuç: Sonuç olarak; kız öğrencilerin genital hijyen alışkanlıkları ve adet hijyeni alışkanlıklarında yetersiz oldukları saptanmıştır. Öğrencilerin ped değişimi sırasında, tuvalete öncesi ve sonrasında el hijyenin önemi, genital enfeksiyonlar ve üreme sağlığı konusunda eğitim verilmesi gerektiği tespit edilmiştir. Objective: This study was planned to examine the genital hygiene behavior of vocational high school students in health services. Materials and Methods: The study population consisted of paramedic female students (n=100) from Gümüşhane University Kelkit Health Services Vocational School. The questionnaire (May-June 2018) was filled out by the participants who agreed to fill the study questionnaire (n=97) with "socio-demographic characteristics of participants" and "scale of genital hygiene behavior". Number-percentage distribution, mean and independent t-test were used in the evaluation of the data (in the SPSS 18.00 package program). Findings: It was determined that the mean age of participants was 20,01±1,12 (min:18, max:23), 55,7% was first class and 27,0% was from Mediterranean region. The mean score of genital hygiene behaviors was 86,89±7,124 (min:68, max:108). 70,1% of the participants had at least once a week bathing, 90,7% of them used their underwear only, 2,1% used common with others, 20,6% had their underwear in 3-4 days 41,2% of them had washed their hands before entering the toilet, 2,1% were unfriendly about washing their hands after quilting, 63,9 had always cleaned from the front to the back, 92,8% used only ready-to-use pads, 2,1% used cloths during menstruation, 3,1% did not wash their fingers before replacing the pads, but 92,8% had washed their hands after changing the pads, 3,1% it only changes the pad when it is fully loaded. Conclusion: As a result; it was found that girls were inadequate in genital hygiene habits and menstrual hygiene habits. It has been determined that students should be educated about hand hygiene prevention, genital infections and reproductive health before and after the toilet.

Amaç: Vezikoüreteral reflü (VUR) genelde tekrarlayan üriner enfeksiyonlarla birlikte olan ve böbrek parankiminde hasara yol açabilen, çocukluk çağında sık görülen bir sorundur. Tüm çocuk nüfusunun %0,5-1,5’inde görülür. Tedavi edilerek kontrol edilmezse, kronik böbrek yetmezliğine neden olabilir. Vezikoüreteral reflüde prognozun kötüleşmesi; reflü nefropatisi, skar gelişmesi ve kronik böbrek yetersizliği tablosunun gelişmesi ile anlaşılmaktadır. Bu çalışmada, VUR’lü olguların özelliklerini tanımlamak ve kötü prognoza neden olan riskleri saptamak amaçlanmıştır, Gereç ve Yöntem: 1990-2014 yılları başvurularını kapsayan kesitsel bir çalışma gerçekleştirildi. Retrospektif olarak veriler kayıtlardan toplandı. Sonuç değişkeni VUR kötü prognozudur ve skar varlığı, reflü nefropatisi, kronik böbrek hastalığı gelişmesi ile belirlenmiştir. Kayıtlardan alınan demografik, öz-soygeçmiş, klinik özellikler nedenler olarak incelenmiştir. Veri analizinde sayı ve yüzdelerle tanımlayıcı sunulan veriler ki-kare ve çok değişkenli lojistik regresyon analizi ile SPSS 24.0 programı ile çözümlenmiştir, p, Objective: Vesicoureteral reflux (VUR) is a common problem in childhood, often associated with recurrent urinary infections, which can cause damage to the renal parenchyma. It occurs in 0.5-1.5% of the whole children population. If not treated and controlled, it may cause chronic renal failure. Worsening prognosis of VUR becomes evident as reflux nephropathy, scarring and chronic renal failure. in this study, we aimed to define the characteristics of VUR patients and to determine the risks that cause a poor prognosis. Material and Method: A cross-sectional study of 1990-2014 was performed. Data were collected retrospectively. the outcome variable was poor prognosis of VUR and was determined by the presence of scarring, reflux nephropathy, and the development of chronic kidney disease. the demographic, self-family history and clinical characteristics of the children were examined as causes. in the data analysis, descriptive data with numbers and percentages were analyzed by chisquare and multivariate logistic regression analysis with SPSS 24.0 program. Results: the fact that the child with VUR was 2 years or younger and the presence of urinary infection reported in the history was found to be the cause of worsening of the prognosis. the number of urinary infections after follow-up did not affect the prognosis. Conclusion: According to the results obtained as an indirect finding in this study, good management of the child with VUR has a positive contribution to prognosis.

Giriş: Vasküler ring terimi embriyolojik hayatta, aortik ark ve dallarında gelişen anomalileri içeren geniş bir spektruma sahiptir. Hastalar tanı aldıktan sonra yapılan dekompresyon amaçlı cerrahi girişim, vasküler ring tedavisinde altın standart yöntemidir. Gereç ve Yöntem: Çalışmaya 2005-2017 yılları arasında kliniğimizde vasküler ring nedeni ile opere edilen hastalar dahil edildi. Hastaların hastane kayıtları retrospektif olarak tarandı. Hastaların tanısınının doğrulanması için kullanılan yöntemler çalışmada sunuldu. Operasyon sırasında kullanılan teknik, yoğun bakım takip süresi, entübasyon süresi, hastane kalış süresi ve operasyon sonrası oluşan komplikasyonlar kayıt altına alındı. Bulgular: Vasküler ring anomalisi nedeni ile toplam 16 hasta opere edildi. Hastaların yaş ortalaması 43,50±38,61 ay olarak saptandı. Hastaların altısında çift arkus aorta, yedisinde sol arkus aorta ve sağ aberran subklavian arter, üç hastada sağ arkus aorta ve sol ligamentum arteriozus saptandı. En sık görülen klinik yakınma öksürüktü. Ortalama entübasyon ve yoğun bakım kalış süreleri 9,31±16,79, 32,62±26,33 saat, hastane yatış süreleri, 6,31±2,62 gün olarak saptandı. Sonuç: Erken çocukluk çağında sık tekrarlayan solunumsal ve özefageal semptomlar varlığında vasküler ring tanısı akılda tutulmalıdır. Geri dönüşümsüz hasar oluşmadan konulacak erken tanı ve yapılacak cerrahi tedavi ile hastalarda uzun dönem semptomsuz sağ kalım sağlanabilmektedir., Introduction: The vascular ring has a broad spectrum of anomalies in the aortic arch and its branches in embryological life. Surgical intervention with decompression purpose after the diagnosis of the patients is the gold standard method in vascular ring treatment. Material and Method: Patients who were operated in our clinic on with vascular ring reasoning were included in our clinic between 2005 and 2017. The methods used to confirm the diagnosis of the patients were presented in the study. The technique used during the operation, the intensive care follow-up period, the duration of intubation, the duration of the hospital stay and the complications that occurred after the operation were recorded. Result: A total of 16 patients were operated with the cause of vascular ring anomaly. The mean age of the patients was 43.50 ± 38.61 months. In six of the patients were double aortic arch anomaly, in seven of the patients were left arcus aorta and right aberran subclavian artery anomaly and in three of the patients were right arcus aorta and left ligamentum arteriosus anomaly revealed. The most common clinical complaint is cough. Mean intubation andintensive care unit stay were 9.31 ± 16.79, 32.62 ± 26.33 hours, hospitalization time, 6.31 ± 2.62 days was founded. Conclusion: In the presence of frequent repetitive respiratory and esophageal symptoms in early childhood, the diagnosis of vascular ring should be kept in mind. Late-term asymptomatic survival can be achieved with early diagnosis and surgical treatment before the occurrence of irreversible damage.

Aim: The aim of this study was to compare the important parameters for life, such as sleep, fatigue and quality of life, between the asymptomatic and schizophrenic individuals.Material and Methods: The study included 38 individuals diagnosed with schizophrenia by the psychiatrist and 39 asymptomatic individuals.All participants of our study applied to the outpatient clinic of Kirikkale High Specialization Hospital, Community Mental Health Center. Sociodemographic information of the individuals was questioned by the evaluation form. Sleep qualities of the individuals were evaluated with Pittsburgh Sleep Quality Index (PSQI), fatigue scores were evaluated with Fatigue Severity Scale (FSS), and quality of life scores were evaluated with World Health Organization Quality of Life Scale Brief Turkish Version (WHOQOL-BREF-TR).Results: A total of 77 individuals aged between 20 and 71 were included in the study. The mean age of the individuals with schizophrenia was 40.07 12.14 years, whereas the mean age of the asymptomatic individuals was 43.61 12.19 years.When the quality of sleep and the sleeping medication use were examined between the two groups, it was found that there was a statistically significant difference (p0.05). When the total scores of the sleep quality questionnaires were evaluated between the two groups, it was detected that there was no statistical difference (p0.05).When the quality of life was evaluated between the two groups, it was seen that the physical and social sub-parameters of the patients with schizophrenia were worse (p0.05).It was detected that there was no statistically significant difference in evaluations of fatigue severity between the two groups (p0.05).Conclusion: It was found that individuals with schizophrenia had a lower quality of life than asymptomatic individuals.We think that the physiotherapy and rehabilitation approaches in addition to medical and psychotherapy should be applied to improve sleep quality and quality of life in individuals with schizophrenia.

Objective: We are currently training a generation of students who cannot remember the days before Internet, are learning in digital environment, will practice in a predominantly e-health world. We think they are ready to learn online, but are they? The aim of this study was to determine the students’ readiness for e-learning in terms of the technologies they have with the skills for online learning. Methods: This is a descriptive study with survey method by using a scale of university students’ readiness for e-learning. The research was done with volunteer 4 th -year medical students. Results: The results show that e-learning readiness for medical students is enough for five sub-scales, and almost enough for one sub-scale. The medical undergraduates have smartphones(92.3%), laptops(81.6%) and tablets(26.7%) only 0.9% of the undergraduates have no hardware. The participants have regular internet connection(92.1%) and mobile internet connection(80.89%). Male undergraduates’ readiness is significantly higher than females. The undergraduates who use internet for studying and learning during the day or several times in a day have statistically higher readiness levels than others. Conclusion: Medical students’ e-learning readiness level is moderately high. They use Internet daily with own hardware. The organizational readiness is well in terms of resources, learning management systems. Amaç: Günümüzde, internetten önceki günleri hatırlayamayan, dijital ortamda öğrenen, ağırlıklı olarak e-sağlık dünyasında çalışacak bir kuşağı yetiştiriyoruz. Bu bireylerin çevrimiçi öğrenmeye hazır olduklarını düşünüyoruz, acaba gerçekten hazırlar mı? Bu çalışmanın amacı, öğrencilerin çevrimiçi öğrenme becerileri ile sahip oldukları teknolojiler açısından e-öğrenmeye hazırbulunuşluklarını belirlemektir. Yöntem: Öğrencilerin e-öğrenme hazırbulunuşluklarının “E-Öğrenme için Hazırbulunuşluk Öz Değerlendirme Ölçeği” kullanılarak yürütülen tanımlayıcı (betimsel) bir çalışmadır. Çalışmaya gönüllü 4. Sınıf öğrencileri ile yürütülmüştür. Bulgular: Sonuçlara göre, tıp öğrencilerinin e-öğrenmeye hazırbulunuşlukları beş alt ölçek için de yeterli düzeyde ve bir alt ölçek için de kısmen yeterli düzeyinde tespit edilmiştir. Tıp fakültesi öğrencilerinin sahip oldukları teknolojiler; akıllı telefon (% 92,3), dizüstü bilgisayar (% 81,6) ve tablet (% 26,7) olup, % 0.9'u bu teknolojilerden hiçbirine sahip değildir. Öğrenciler yerel internet erişimine (% 92,1) ve mobil internet erişimine (% 80,89) sahiptir. Erkek öğrencilerinin hazırbulunuşluğu kız öğrencilerden anlamlı derecede yüksektir. Gün içinde veya günde birkaç kez eğitim ve öğrenim amaçlı interneti kullanan öğrencilerin hazırbulunuşluk düzeyleri, diğerlerine göre daha yüksektir. Sonuç: Tıp öğrencilerinin e-öğrenme hazırlıkbulunuşluk düzeyleri kısmen yüksektir. İnterneti günlük olarak ve kendi donanımlarıyla kullandıkları görülmüştür. Gazi üniversitesi bağlamında örgütsel hazırbulunuşluk açısından (öğrenme yönetim sistemleri ve e-kaynaklar) iyi düzeydedir.

Objective: Natural products with antimicrobial effect are currently investigated in order to eliminate the use of synthetic antibiotics that cause the resistance of microorganisms. This study determines the antibacterial, antioxidant activity, and also the cytotoxic and apoptotic effect of Satureja khuzestanica on various cancer cell lines. Materials and methods: The individual constituents were identified by their identical retention indices referring to known compounds from the literature. Methanol and ethanol extracts of S. khuzestanica (25 and 50 mg/mL) were screened against four Gram-positive and four Gram-negative bacteria. The plant extracts were tested for their antioxidant activity against 2,2-diphenyl1-picrylhydrazyl (DPPH) radical. The interaction between the extracts and plasmid DNA were analyzed by agarose gel electrophoresis. In addition, the cytotoxic activity of the extracts was evaluated on MCF-7, DLD-1, osteosarcoma, and fibroblast cell line. Finally, gene expression of caspase-3, Bax and Bcl-2 were investigated by real-time PCR. Results: Our result indicated that both extracts showed good inhibitory activity against both Gram-negative (Escherichia coli ATCC 35218) and positive (Bacillus subtilis ATCC 6633) bacteria. In addition, the methanol extract of S. khuzestanica had strong antioxidant activity (IC50=37.0±0.3 ?g/mL). The extracts showed a strong effect on plasmid DNA. The methanol extract of S. khuzestanica showed a good concentration-dependent cytotoxicity. Finally, IC50=47.00a±1.21?g/mL, ethanol, and water extract had apoptotic effect in MCF-7 cell line. Discussion: MCF-7 was detected as the most sensitive cell line therefore further studies should be done on this plant extract as a potential anticancer agent against breast cancer. Amaç: Antimikrobiyal etki gösteren doğal ürünler, mikroorganizmaların direncine neden olan sentetik antibiyotiklerin kullanımını ortadan kaldırmak için araştırılmaktadır. Bu çalışmada, Satureja khuzestanica bitkisinin antibakteriyel, antioksidan aktivitesi ve çeşitli kanser hücre hatlarında sitotoksik ve apoptotik etkisi araştırılmıştır. Yöntem: Tek tek bileşenler, literatürden bilinen bileşiklere atıfta bulundukları özdeş alıkonma endeksleri ile tanımlanmıştır. S. khuzestanica'nın (25 ve 50 mg / mL) metanol ve etanol özütünün dört Gram-pozitif ve dört Gram-negatif bakteri üzerindeki etkisi belirlendi. Bitki özütlerinin 2,2-difenil-l-pikrilhidrazil (DPPH) radikaline karşı antioksidan aktiviteleri hesaplandı. Özütlerin plazmid DNA üzerine etkisi agaroz jel elektroforezi ile analiz edildi. Ayrıca, özütlerin MCF-7, DLD-1, osteosarkom ve fibroblast hücre hatları üzerinde üzerinde sitotoksik aktiviteleri araştırıldı. Son olarak, gerçek zamanlı PZR ile özütlerin kaspaz-3, Bax ve Bcl-2'nin gen ifadesi üzerine etkisi araştırıldı. Bulgular: Bizim sonuçlarımız, her iki özütünün de hem Gram-negatif (Escherichia coli ATCC 35218) hem de pozitif (Bacillus subtilis ATCC 6633) bakterilere karşı iyi bir inhibitör aktivite gösterdiğini ortaya çıkarmıştır. Ayrıca, S. khuzestanica'nın metanol özütünü kuvvetli bir antioksidan aktivitesine sahip olduğu bulunmuştur (IC50 = 37.0 ± 0.3 ?g / mL). Özütler plazmid DNA üzerinde güçlü bir etki göstermiştir. S. khuzestanica'nın metanol özütü konsantrasyon bağımlı güçlü sitotoksik aktivite göstermiştir. Son olarak, IC50, 47.00a ± 1.21?g / mL olarak hesaplanmış, etanol ve su özütü MCF-7 hücre hattında apoptotik etki göstermiştir. Sonuç: MCF-7 en hassas hücre hattı olarak tespit edilmiştir. Meme kanserine karşı potansiyel antikanser ajan olarak ileri çalışmalar yapılması önerilmektedir.

Psoriasis is a common and serious systemic inflammatory disease. The purpose of this study is to research the relationship between bisphenol A, betatrophin, urocortin 3 and vitamin D levels in patients with psoriasis. Sixty patients with psoriasis (mean age, 34.1±9.6 years) and twenty six age and gender-matched healthy individuals (mean age, 35.5 ±10.5 years) were included in this study. Bisphenol A, betatrophin, urocortin 3 and vitamin D levels were assessed by using enzyme-linked immunosorbent assay in all participants. Serum levels of bisphenol A were detected using UPLC-ESI-MS/MS. In psoriasis patients, the median bisphenol A serum level was 0.537 ng/mL (range 1.1), and significantly higher compared to controls (median 0.2 range 0.9 ng/mL) (p

Amaç: Çalışmamızda çocuklarda soldan sağa şantlı doğumsal kalp hastalıklarında serum kardiyotrofin-1 (CT-1) düzeyleri ile şant miktarının karşılıklı etkileşimlerini araştırmak, bu belirtecin intrakardiyak defekt tipine göre değişimlerini incelemek amaçlanmıştır. Gereç ve Yöntem: Çalışmamızda, 1 ay–13 yaşları arasında, 45 hasta ve 23 sağlıklı çocuk incelendi. Hasta grubu içinde 19 olguda atriyal septal defekt (ASD), 17 olguda ventriküler septal defekt (VSD), 6 olguda ASD ve VSD (ASD+VSD) ve 3 olguda patent duktus arteriyozus (PDA) mevcuttu. Tüm çocuklara konvansiyonel ekokardiyografi incelemesi (iki boyutlu, M-Mode, iki boyutlu Doppler ve renkli Doppler ekokardiyografileri) yapıldı. Tüm olgulardan ekokardiyografi çalışmaları ile eş zamanlı olarak plazma BNP düzeyleri kemilüminisans ve CT-1 düzeyleri de “enzyme-linked immunosorbent assay” (ELISA) yöntemleriyle ölçüldü. Bulgular: Hasta grubunda CT-1 ile şant miktarı arasında (p2) CT-1 ile EF ve FS arasında negatif korelasyon bulundu (p 2) (p

Amaç: Yağlanma oranı, steatohepatit tanısında ve transplantasyon öncesiverici adayı karaciğer biyopsilerinde değerlendirilmesi gerekenparametrelerdendir. Kantitatif/semikantitatif olarak değerlendirilen yağlanmayüzdeleri, gözlemci-içi ve gözlemciler arası farklılık göstermektedir. Bu farklılığıen aza indirgemek amaçlı, görüntü analizi yöntemleri geliştirilmektedir.Çalışmamızda, karaciğer yağlanmasını taklit eden sanal olarak oluşturulmuşdijitalize resimler, patologlar tarafından incelenmiştir. Sonuçların bilgisayarcahesaplanan değerler ile uyum oranları ve klinik yönetimi etkileyecekdeğerlendirme farklılıklarına neden olup olmadığı araştırılmıştır.Yöntem: ’Kameram’ programı ile hazırlanmış, pembe zeminde, yağlanmayıtemsil eden, alan ölçüleri bilinen beyaz dairesel boşluklar içeren 9 resim,İstanbul Hepatopankreatobiliyer patoloji çalışma grubu ile paylaşıldı.Katılımcılardan her resim için yağlanma yüzdesi belirtmeleri istendi. Sonuçlar,bilgisayar tarafından hesaplanan değerler ile kıyaslandı.Bulgular: Çalışmaya 19 patolog katıldı. Onbeşi resimlerin tamamında ya daçoğunda bilgisayarın hesapladığı değerlere göre yüksek yağlanma yüzdesibelirtti. Sadece 1 katılımcı, bilgisayar ile aynı değerleri bildirdi. Bilgisayardeğerleri ile patologların değerleri arasında %40’a kadar yüksek, %20’ye kadardüşük değişkenlik mevcuttu. Resimlerin verici adayı karaciğerini temsil ettiğidüşünüldüğünde, 11 patolog 1 olguda, 4 patolog 2 olguda, 1 patolog 3 olgudaklinik yönetimi etkileyebilecek değerlendirme yaparken, 3 patolog tümolgularda klinik yönetimi etkilemeyecek değerlendirme yaptı. Resimlerinsteatohepatit değerlendirmesini temsil ettiği düşünüldüğünde, sadece 2 resimtüm patologlar tarafından bilgisayar ile aynı şekilde skorlandı ve resimlerin5’inde en az 2 patologun bilgisayar değerlerine göre yüksek skor verdiğigörüldü. Patologlar arası uyum steatohepatit ve verici karaciğerinideğerlendirmede orta-iyi düzeydeydi (sırasıyla kappa değerleri: 0.51 ve 0.63)Sonuç: Çalışmamızda, karaciğer yağlanma oranlarının patologlar tarafındangenel olarak yüksek değerlendirildiği gözlenmektedir. Steatohepatitsınıflamasında ve greft yönetimi açısından kliniği farklı etkileyen kararlarverilebileceği düşünülmüştür. Patoloji rutinine her geçen gün daha fazla dahilolan bilgisayar destekli otomatize programların, patologlar arasıdeğerlendirme farklılıkları ve klinik yansımaları nedeniyle, karaciğer yağlanmaoranlarının doğru tespitinde de yeri olabileceği görülmektedir.

Amaç: İnfektif endokardit ölümcül bir hastalıktır. Tedavisindeki ilerlemelere rağmen yüksek mortalite ve ciddi komplikasyonlarla ilişkili-dir. Bu çalışmadaki amacımız, infektif endokardit ile başvuran hastalarda hastane içi mortalite ile ilişkili klinik ve laboratuvar faktörleribelirlemektir.Gereç ve Yöntem: Bu çalışmaya Nisan 2014 - Ağustos 2018 tarihleri arasında IE tanısıyla Pamukkale Üniversitesi Tıp Fakültesi HastanesiKardiyoloji Bölümünde takip edilen 37 hasta dahil edildi. Hastaların demografik, klinik ve laboratuvar özellikleri retrospektif olarak in-celenmiştir.Bulgular: Çalışmaya dahil edilen hastaların yaş ortalaması 50 ± 28 yıldı ve 22 hasta (%60) erkekti. 21 (%56,7) hastanın kan kültüründeüreme mevcuttu ve en sık sorumlu olan mikroorganizma gram pozitif kok idi (%52,3). Hastanedeki izlemde 12 hasta ölmüş olup hasta-ne-içi mortalite oranı %32,4 olarak saptandı. Ölüm grubundaki hastaların kreatinin değerleri [1,74 (0,68-4,69) mg/dL vs. 0,91 (0,54-1,91)mg/dL, p