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Background This study aimed to retrospectively examine the morbidity and mortality rates after discharge of patients who applied to the emergency department with high D-dimer values but had no pathology upon evaluation. Material and Methods Patients over the age of 18 who applied to Bursa Uludağ University Faculty of Medicine Emergency Department with preliminary diagnosis of pulmonary embolism in a two-year period between January 2018 and December 2019 were included in the study. The patient group consisted of cases with high D-dimer levels while the control group inluded patients with negative D-dimer and no pathology on discharge. Results A total of 594 cases; 297 D-dimer positive (+) and 297 D-dimer negative (-), were included in the study. A significant difference existed between the percentage of patients developing illness post-discharge in the D-dimer (+) 18.86% (n=56) and D-dimer (-) 1.68% (n=5) groups, respectively. The most common illness identified in the dimer (+) group after discharge up was pneumonia (n=11), followed by Coronary Artery Disease (n=5). Death rate was 1.68% (n=5) in the D-dimer (-) group and 11.78% (n=35) in the D-dimer (+) group; a statistically significant difference (p=0.001). Conclusions In conclusion, both morbidity and mortality rates were found to be significantly higher in the D-dimer positive group.

Transradyal yaklaşım, koroner anjiyografi (CAG) ve perkütan koroner girişim (PCI) için yeni bir yöntemdir. İlk uygulamasından bu yana popülaritesi arttı ve şimdi birçok tesiste yaygın kullanılmaktadır. Bunun nedeni, transradyal yaklaşımın, koroner arterlere kateter yerleştirilmesini gerektiren geleneksel yaklaşımdan daha az invaziv olmasıdır. Transradial erişim, girişim bölgesinde daha az komplikasyona neden olması, daha kısa hastanede kalış süresi gerektirmesi, hastanın daha erken mobilize olmasını sağlaması, daha yüksek derecede hasta konforu sağlaması ve daha düşük risk taşıması nedeniyle trans-femoral erişimden daha güvenlidir. Bu makale, koroner arterlere radyal arter yoluyla erişmenin faydalarını, kılavuzların önerilerini ve tekniğin gündeme getirdiği sorunları incelemektedir. Tüm bu konular araştırmalar ışığında tartışılmaktadır., The transradial approach is a novel method for coronary angiography and percutaneous coronary intervention. Its popularity has grown since its initial application and is now a common technique in many facilities. This is because the transradial approach is less invasive than the conventional approach, which requires catheter placement into the coronary arteries. Transradial access is safer than trans-femoral access because it results in fewer complications at the interventional site, requires a shorter hospital stay, enables the patient to be mobilized sooner, provides a higher degree of patient comfort, and carries a lower risk of significant bleeding events. This research examines the advantages of accessing coronary arteries through the radial artery, as well as the suggestions made by the guidelines and the challenges generated by the technique. All these issues were discussed in light of existing studies.

Objective: In this study, we aimed to compare blood pressure variability among irritable bowel syndrome subtypes.Methods: Patients with newly diagnosed irritable bowel syndrome and existing hypertension were included in the study. Average real variability (ARV) was calculated by consecutive one week home blood pressure measurements. Groups were compared for blood pressure variability.Results: While diastolic ARV was found to be similar among subtypes (p=0.919), a significant difference was found between them in terms of systolic ARV (p, Amaç: Bu çalışmada, irritabl bağırsak sendromu alt tipleri arasında kan basıncı değişkenliğini karşılaştırmayı amaçladık.Yöntem: Yeni tanı almış irritabl bağırsak sendromu ve mevcut hipertansiyonu olan hastalar çalışmaya dahil edildi. Ortalama gerçek değişkenlik (ARV), ardışık 1 haftalık ev kan basıncı ölçümleri ile hesaplandı. Gruplar kan basıncı değişkenliği açısından karşılaştırıldı.Bulgular: Alt tipler arasında diyastolik ARV benzer bulunurken (p=0,919), sistolik ARV açısından aralarında anlamlı fark bulundu (p

Background Interferon and ribavirin treatments previously used in treating chronic hepatitis C virus (HCV) infection cannot be used effectively in hemodialysis patients due to dose adjustment and drug-related side effects. Direct-acting antivirals (DAAs) therapies have been reported to be effective in hemodialysis patients. This study aimed to evaluate the effectiveness of DAAs in hemodialysis patients with chronic hepatitis C. Material and Methods Twenty hemodialysis patients with chronic hepatitis C followed in the gastroenterology outpatient clinic between 2016 and 2018 were evaluated retrospectively. Results Twelve of the 20 patients were male, and eight were female. The mean age of the patients was 50.7±8.6 years. Six patients had no treatment experience. Fourteen patients had been previously treated with interferon and/or ribavirin but did not achieve sustained virological response (SVR). Genotype 1b was detected in 14 patients, genotype 1a in 4 patients, and genotype 1 in 2 patients. Patients were treated with ombitasvir/paritaprevir/ritonavir (OBV/PTV/r) and dasabuvir (DSV) or ribavirin (RBV) for 12 or 24 weeks. Two patients were cirrhotic and had a Child-Pugh score of A. Treatment was discontinued in 2 patients due to thrombus formation in the arteriovenous fistula in the first month of DAAs treatment. SVR12 was evaluated in 14 of 18 patients and found to be 100%. One of the ten patients accepted as SVR24 had a relapse. This rate of SVR24 was similar to that in the general population. Conclusions Our results supported that the OBV/PTV/r and DSV or RBV regimen was a safe and effective therapy for hemodialysis patients with chronic hepatitis C virus genotype 1.

Squamous cell carcinoma (SCC) is the second most common skin cancer and it often occurs in sun-exposed areas such as head and neck skin. Invasive SCC located on breast skin is a rare entity and may clinically mimic breast cancer. We report a case of a 39 years old female with a non-eroded, vegetative, growing lesion on the right breast skin, initially mimicking breast cancer both clinically and histopathologically. After surgery with clear margins, adjuvant radiotherapy was administered, by considering the pathological risk factors for recurrence. At 14 months, the patient is disease-free and under regular follow-up. Invasive SCC of the breast skin is a rare entity and may have different etiology/behavior or directly develop de novo when compared to SCCs located on sun-exposed skin. Medical history and physical examination in conjunction with histopathological examination of the biopsy specimen are critical for the accuracy of the diagnosis and the correct treatment decision in patients presenting with a mass invading breast skin., Skuamöz hücreli karsinomu (SHK), 2. en sık cilt kanseridir ve sıklıkla baş- boyun gibi güneş gören bölgelerde ortaya çıkar. Meme cildinden kaynaklanan invazif SHK nadir bir tablodur ve klinik olarak meme kanserini taklit edebilir. 39 yaşındaki hastada; sağ memede non-erode, vejetatif, büyüyen lezyondan biyopsi alınmıştır ve klinik ve histopatolojik olarak meme kanserini taklit eden bu vaka sunulmuştur. Cerrahi sınırları temiz bir şekilde opere edilen hasta, rekürrens için risk faktörleri değerlendirilerek, adjuvant radyoterapi ile tedavi edilmiştir. 14 ay sonrasında, hastada halen nüks saptanmamış ve düzenli takiplerdedir. İnvazif meme cilt SHK’u nadir bir tablodur ve güneşe maruz kalan bölgede gelişen SHK’a göre farklı etiyoloji/ davranışa sahip olabilir. Meme cildinde kitle ile başvuran hastanın doğru tanı ve tedavisi için tıbbi hikaye ve fizik muayene ile birlikte histopatolojik değerlendirme kritiktir.

Bu çalışmada preeklamptik gebelerin normal gebelerden farklı olabilecek hemogram parametrelerini tespit etmek ve yine gebelik seyrinde preeklamptik gebelerde görülebilecek diğer sistemik hastalıkları saptamak, preeklamptik gebelerin gebelik seyir ve sonuçlarını incelemek amaçlanmıştır. Araştırma 2017/2020 yılları arasında bir eğitim ve araştırma hastanesinin kadın doğum kliniğine başvuran ve 80 preeklampsi tanısı almış ve 100 normal gebelik süreci geçiren hastalara ait dataların retrospektif olarak taranmasıyla gerçekleştirilmiştir. Her iki grupta da bulunan gebelerin hemogram parametreleri karşılıklı olarak incelenmiştir. Ayrıca gebelik seyirlerinde preeklampsiye eşlik eden başka bir hastalık gelişip gelişmediği, hastaların kaçıncı gebelik haftasında doğum yaptıkları, doğum şekilleri, bebeklerin doğum ağırlıkları ve cinsiyetleri de karşılaştırılmıştır. Araştırmada preaklamptik gebelerin, normal gebelere göre Hemoglobin (Hb), Kırmızı kan hücresi (Rbc), Hematokrit (Hct), Ortalama eritrosit hemoglobin konsantrasyonu (Mchc), Lokosit (Wbc), Trombosit (Plt), Nötrofil (Neu), Monosit (Mo), Lenfosit (Ly) ve Trombosit dağılım genişliği (Pdw) değerlerinde istatistiksel olarak anlamlı farklılıkların olduğu belirlenmiştir (p 0.05). Ayrıca preeklamptik gebelerin %10’unda gestasyonel diabet de eşlik ettiği %1’inde diabet bulunduğu, %1’inde gebelik kolestazı geliştiği belirlenmiştir. Hastaların %3’ünde ise tansiyon yüksekliğine bağlı dekolman geliştiği saptanmıştır., In this study, it was aimed to determine the hemogram parameters of preeclamptic pregnant women that may be different from normal pregnant women and to determine other systemic diseases that may be observed in preeclamptic pregnant women during pregnancy, to examine the course and results of pregnancy of preeclamptic pregnant women. The research was carried out by retrospective screening of data from 80 preeclampsia diagnosed and 100 normal pregnancy patients who were admitted to an Education and Research Hospital's obstetrics clinic between 2017/2020. Hemogram parameters of pregnant women in both groups were mutually examine. In addition, whether another disease that accompanies preeclampsia develops during pregnancy, how many weeks of pregnancy patients give birth, birth patterns, birth weights and sex of babies were also compared. Research preaklamptik pregnant women compared to normal pregnant women Haemogram (Hmg), Red blood Cell (Rbc), Hematocrit (Hct), Mean Corpuscular Hemoglobin Concentration (Mchc), White Blood Cell (Wbc), Platelet (Plt), Neutrophil (Neu), Monocyct (Mo), lymphocytes, and Platelet distribution Width (Pdw) values were statistically significant (p< 0.05). Mean corpuscular hemoglobin (Mch), Red Cell Distribution Width (Rdw), Mean Corpuscular Volume (Mcv), Mean Platelet Volume (Mpv), In eosinophic and Basophil values, there were no statistically significant differences between preaklamptic pregnant women and normal pregnant women (p> 0.05). In addition, 10% of preeclamptic pregnant women had diabetes in 1%, accompanied by gestational diabetes, and 1% developed gestational cholestasis. 3% of patients developed detachment due to high blood pressure.

Aim Anemia is a major public health problem, affecting about one-third of the world's population, and is most commonly caused by iron deficiency. Iron deficiency anemia requires oral or intravenous iron replacement therapy. The purpose of this study was to assess the change in several hematological parameters, vitamin B12, and folic acid from baseline to the first month of follow-up following therapy with oral ferrous glycine sulfate or intravenous ferric carboxymaltose.Methods: All patients who received oral ferrous glycine sulfate or intravenous ferric carboxymaltose for the treatment of iron deficiency anemia between January 1, 2016, and December 31, 2018, were included in the trial. Along with age and gender information, values of hemoglobin, ferritin, transferrin saturation, mean corpuscular volume, vitamin B12, and folic acid were derived from patients’ records at the beginning of treatment and first month follow-up.Results: Laboratory values obtained after treatment showed statistically significant improvement in both groups (intra group, p, Amaç: Dünya nüfusunun yaklaşık üçte birini etkilemesiyle önemli bir halk sağlığı sorunu olan anemi, en sık demir eksikliğinden kaynaklanır. Demir eksikliği anemisi, oral veya intravenöz demir replasman tedavisi gerektirir. Bu çalışmanın amacı, oral demir glisin sülfat veya intravenöz ferrik karboksimaltoz tedavileri altında başlangıçtan birinci ay takibine kadar çeşitli hematolojik parametrelerin, vitamin B12 ve folik asidin değişimini incelemektir.Yöntemler: Çalışma, 1 Ocak 2016 ve 31 Aralık 2018 tarihleri arasında oral ferröz glisin sülfat veya iv ferrik karboksimaltoz ile demir eksikliği anemisi nedeniyle tedavi edilen tüm hastaları içermiştir. Hastaların dosyalarından elde edilen yaş ve cinsiyet verilerinin yanısıra, tedavi başlangıcında ve tedaviden sonraki birinci ay kontrollerinde alınan hemoglobin, transferrin satürasyonu, ferritin, ortalama korpüsküler hacim, vitamin B12 ve folik asit değerleri kayıt edildi.Bulgular: Tedavi sonrasında elde edilen laboratuvar değerleri her iki grupta da istatistiksel olarak anlamlı iyileşme göstermiştir (grup içi, p

Amaç: Çapı, Objective: The treatment of colorectal polyps

Introduction: Medical students are among the frontline health care providers most likely to be exposed to COVID-19 patients. Achieving high COVID-19 vaccination rates in this group is necessary and important. The aim of this study is to evaluate medical students' COVID-19 vaccine hesitancy and related factors in Turkey. The information will help identify potential concerns. Methods: Our study was designed in cross-sectional type. 225 students studying at Bolu Abant Izzet Baysal University Faculty of Medicine were included in the study. As a data collection tool, an evaluation form was created by scanning the relevant literature. Results: 53.3% (n=120) of the participants had no COVID-19 vaccine hesitancy, while 46.7% (n=105) had hesitations about COVID-19 vaccination for various reasons. It was stated that 'they have hesitations about long-term effects of COVID-19 vaccination' with 22.7% (n=51). Participants with COVID-19 infection did not trust information about the vaccine they received from public health professionals and family physicians (p=0.237). Conclusion: In our study, medical students in Turkey seem to have hesitations about the long-term effects of COVID-19 vaccines. These hesitations of physicians and physician candidates should be eliminated. In addition, in our study, it is seen that the rate of those who think about getting the fluvaccine in the next year has increased approximately 10 times. The pandemic has increased students' desire to be vaccinated., Giriş: Tıp öğrencileri, COVID-19 hastaları ile temas eden ön saflardaki sağlık hizmeti sağlayıcıları arasındadır. Bu grupta yüksek COVID-19 aşılama oranlarına ulaşmak gerekli ve önemlidir. Bu çalışmanın amacı, Türkiye’de tıp fakültesi öğrencilerinin COVID-19 aşısına karşı aşı tereddütlerini ve ilişkili faktörleri değerlendirmektir. Elde edilen bilgiler potansiyel endişelerin belirlenmesine yardımcı olacaktır. Yöntem: Çalışmamız kesitsel tipte dizayn edilmiştir. Bolu Abant İzzet Baysal Üniversitesi Tıp Fakültesinde eğitim gören 225 öğrenci çalışmaya dahil edilmiştir. Veri toplama aracı olarak ilgili literatür taranarak değerlendirme formu oluşturulmuştur. Bulgular: Katılımcıların %53,3’ünün (n=120) COVID-19 aşısı ile ilgili tereddütü yoktu, % 46,7’si (n=105) ise çeşitli nedenlerle aşı tereddütü yaşıyordu. %22,7 (n=51) ile en yüksek oranda 'uzun dönem etkileri konusunda tereddütleri olduğu' belirtildi. COVID-19 enfeksiyonu geçiren katılımcılar halk sağlığı uzmanları ve aile hekimlerinden aldıkları aşı hakkındaki bilgilere güvenmiyordu (p=0,237). Sonuç: Türkiye’deki tıp fakültesi öğrencilerinin COVID-19 aşılarının uzun dönem etkileri konusunda tereddütleri olduğu görülmektedir. Hekim ve hekim adaylarının bu tereddütleri giderilmelidir. Çalışmamız sonucunda bir sonraki yıl grip aşısı yaptırmayı düşünenlerin oranının yaklaşık 10 kat arttığı görülmektedir. Pandemi öğrencilerin aşı olma isteğini artırmış gibi görünmektedir.

Objectives: To investigate the effects of vaccination on age, mortality, and healthcare workers among patients followed in the COVID-19 Intensive Care Unit. Methods: We examined age, gender, occupation, demographic characteristics, comorbid diseases, hemogram, biochemistry parameters, coagulation tests, morbidity–mortality characteristics of 548 patients in Bozyaka Training and Research Hospital COVID-19 intensive care unit admitted between March and October 2021. In addition, the vaccination status of the patients and the type of vaccination were recorded via the Ministry of Health Vaccine Tracking System (VTS). Within the vaccine follow-up system, patients who received at least 2 doses of vaccine 4 weeks prior to study were considered vaccinated. Results: The data of 548 patients in the COVID-19 intensive care unit between March 2021 and October 2021 were analyzed. The mortality rate was 50.7% (n = 278). It was determined that 428 (78.1%) of the patients followed in the COVID-19 intensive care unit were not vaccinated. In terms of age distribution, the number of patients under the age of 65 was 357 (65.1%), while the number of patients aged 65 and over was 191 (34.9%). When mortality rates were compared based on vaccination status, the mortality rate in the unvaccinated group was found to be statistically significantly higher than in the vaccinated group (p < 0.05). Mortality rate in the vaccinated group was 12.5% whereas it was 61.4% in the unvaccinated group. Conclusions: Vaccination to protect against SARS-CoV-2 infection reduces intensive care unit admission and reduces mortality rates. Being unvaccinated increases hospitalization and mortality in intensive care units in addition to carrying risks for all age groups.

Objective: Hereditary angioedema (HAE) is an autosomal dominant disorder characterized by recurrent episodes of angioedema without urticaria or pruritus. In this study, we compared the levels of anabolic hormones, such as insulin, insulin-like growth factor, growth hormone, and thyroid hormones (thyroid-stimulating hormone [TSH], triiodothyronine [T3], and thyroxine [T4]), and the levels of hormones that are considered catabolic, such as adrenocorticotrophic hormone (ACTH) and cortisol, between HAE patients and controls. We also discuss the contribution of these hormones to the pathophysiology of HAE. Methods: The study included 18 patients (9 diagnosed with HAE type 1 and 9 with HAE type 2) who were followed in the immunology and allergy clinic between January 2013 and January 2020. The control group comprised 28 age- and gender-matched subjects. Results: The HAE type 1, HAE type 2, and control groups showed no significant differences in insulin, insulin-like growth factor, ACTH, cortisol, TSH, or T4 levels. The C-peptide and T3 levels were significantly different between the groups (p = 0.011 and p = 0.027, respectively) (Table 3). Post-hoc pairwise comparison revealed no significant difference in C-peptide level among the groups, but a significant difference in the T3 level was detected between HAE type 1 patients and controls (p = 0.029) Conclusions: Although no significant differences were observed in other anabolic hormone levels between the controls and HAE patients, T3 levels were significantly lower in type 1 HAE patients. Close monitoring of low T3 levels is required, particularly in patients with type 1 HAE.

Amaç: Bronkopulmoner displazi erken doğumun sık görülen uzun vadeli bir komplikasyonudur. Hastaların erken dönemde en yeni radyolojik teknikler kullanılarak değerlendirilmesi, hastalığın şiddetinin değerlendirilmesi ve takip planının yapılması açısından çok önemlidir. İyonize olmayan bir modalite olan manyetik rezonans görüntüleme, bronkopulmoner displazi ile ilgili akciğer patolojilerin radyolojik değerlendirmesi ve izleminde yol gösterici olabilir.Gereç ve Yöntemler: Ağustos 2017-Ağustos 2019 tarihleri arasında bronkopulmoner displazi tanısı ile takip edilen ve akciğer manyetik rezonans görüntülemesi yapılan hastalar retrospektif olarak değerlendirildi. Koronal ve aksiyel T2 ağırlıklı magnetik rezonans görüntüleri incelendi (TR/TE: 4500-5300/90-106 msn). Manyetik rezonans görüntüleme bulguları bir pediatrik radyolog tarafından değerlendirildi. Akciğerlerin yapısal durumu ve patolojik bulguları değerlendirildi (fibrotik bantlar, distrosiyon). Bulgular, BPD hastalarının şiddeti, klinik ve demografik özellikleri ile karşılaştırıldı. Görüntüleme sedasyon yapılmadan veya kloralhidrat verilmeksizin hastanın uyku süresinde yapıldı.Bulgular: Toplamda yedi hasta araştırmaya dahil edildi. Hastaların dördü erkek, üçü kızdı. Bonkopulmoner displazi sınıflamasına göre 1 hastanın hafif, 3 hastanın orta düzeyde ve 4 hastanın şiddetli bronkopulmoner displazisi vardı. Ortalama gebelik haftası 26.2 haftaydı. Hafif bronkopulmoner displazi hastalarında, Objective: Bronchopulmonary dysplasia is a common long-term complication of preterm birth. The evaluation of patients with advanced radiologic methods at early ages is essential in terms of determining the severity of the disease and follow-up. As a non-ionizing modality, magnetic resonance imaging is particularly appropriate for the repeated radiological assessment of pulmonary pathologies associated with bronchopulmonary dysplasia.Material and Methods: Patients who were followed up with the diagnosis of bronchopulmonary dysplasia and underwent lung magnetic resonance imaging between August 2017 and August 2019 were evaluated retrospectively. Coronal and axial T2-weighted magnetic resonance imaging was performed (TR/TE: 4500-5300/90-106 msec). A pediatric radiologist evaluated magnetic resonance imaging findings. Pulmonary structural findings and their distribution were determined (fibrotic bands, distortion). The findings were compared with bronchopulmonary dysplasia patients’ severity, clinical and demographic characteristics. The imaging was performed during the patient’s sleep time without sedation or by giving chlorhydrate.Results: A total of 7 patients were included in the study. Three patients were female, and 4 were male. According to bronchopulmonary dysplasia classification, 1 patient was mild, 3 patients were moderate, and 3 were severe bronchopulmonary dysplasia. The median gestational week was 26.2. In mild bronchopulmonary dysplasia patients, fibrotic bands were seen in

Giriş: Bu çalışma, ilaç alerjisi olan hastalarda otoantikor sıklığını incelemeyi amaçlamaktadır. İlaç alerjisi üzerine gözlemsel araştırmalar, otoimmünite patofizyolojisi hakkında yeni hipotezlerin oluşturulmasına katkıda bulunabilir.Yöntem: Eğitim ve Araştırma Hastanesi veri tabanına 31 Aralık 2018 sonuna kadar kayıt olan ve ilaç alerjisi tanısı konan hastaların verileri geriye dönük olarak değerlendirildi. Genel olarak, ICD 10'a göre “ilaçlara alerji durumu” tanısı konan ve en az bir otoantikor sonucu olan 617 adet yetişkin hasta çalışmaya dahil edildi.Bulgular: Araştırmada en az bir otoantikora sahip olma sıklığı % 0 ile % 92,1 arasında değişti. En sık saptanan otoantikor romatoid faktör (RF) idi (n = 241; % 92,1). İkinci en sık rastlanan oto antikorun anti-doku transglütaminaz IgA (Anti-tTG-IgA) (n = 22; % 68,2) olduğu görüldü. Anti-tiroglobulin (Anti-TG), anti-tiroid peroksidaz (anti-TPO) ve anti-çift sarmallı DNA (Anti-dsDNA) sıklıkları sırasıyla % 65,2 (n = 155), % 59,7 (n = 159) ve % 43,6 (n = 55) olarak saptandı.Sonuç: Birçok ilaç, otoimmün hastalıkları için ilerleme olmaksızın otoantikor gelişimini tetikleyebilir. İlaçlara alerjisi olan hastalarda otoantikorlardan şüphelenilmesi gereklidir. İlaç alerjisi üzerine yapılan gözlemsel araştırmalar, otoimmünitenin patofizyolojisi hakkında yeni hipotezlerin oluşturulmasına katkı sağlayacaktır. Bu alanda yapılacak çok sayıda çalışma, riskli ilaçların yaygın kullanımını daha objektif bir şekilde tartışmamızı sağlayabilir. Çalışmamızın ilaç reaksiyonu ile otoimmün hastalıklar arasındaki ilişkiye ışık tutacağını düşünüyoruz.Anahtar kelimeler: Otoantikorlar, otoimmünite, ilaç alerjisi, ilaç aşırı duyarlılığı, Introduction: This study is aimed to analyze the autoantibody frequency in patients with drug allergy. Descriptive, observational research on drug allergy will contribute to the creation of new hypotheses about the pathophysiology of autoimmunity.Methods: The data of patients who were registered in the Training and Research Hospital database until the end of December 31, 2018 and diagnosed with drug allergy were retrospectively evaluated. Overall, 617 adult patients who had been diagnosed as “allergy status to drugs,” according to ICD 10, and had had at least one autoantibody result were included in the study.Results: The frequency of having at least one autoantibody varied between 0% and 92.1%. The most commonly detected autoantibody was rheumatoid factor (RF) (n = 241; 92.1%). The second most common one was anti-tissue transglutaminase IgA antibody (Anti-tTG-IgA) (n=22; 68.2%). The frequencies of anti-thyroglobulin (Anti-TG), anti-thyroid peroxidase (anti-TPO), and anti-double stranded DNA (Anti-dsDNA) were 65.2% (n = 155), 59.7% (n = 159), and 43.6% (n= 55), respectively.Conclusions: Many drugs can trigger the development of autoantibodies with no progression to autoimmune disease. Autoantibodies should be suspected in patients with allergies to medications. Observational research on drug allergy will contribute to the creation of new hypotheses about the pathophysiology of autoimmunity. Numerous studies in this area can enable us to discuss the widespread use of risky drugs in a more objective way. We think that our study will shed light on the relationship between drug reaction and autoimmune diseases.Keywords: Autoantibodies, autoimmunity, drug allergy, drug hypersensitivity

Pulmonary embolism is one of the reversible causes of death. Simultaneous diagnostic procedures are beneficial for successfully resuscitating patients brought to the emergency department as an arrest after pulmonary embolism. Ultrasonography is one of the few diagnostic procedures to be performed on an unstable patient during resuscitation and is a direct guide for treatment. We followed the passage of the thrombus from the inferior vena cava to the right atrium in the ultrasonography performed simultaneously with the resuscitation of the 76-year-old male patient who was brought to the hospital with arrest, and we started thrombolytic therapy simultaneously with resuscitation. Thrombus enlargement was observed in the right atrium. The patient who did not respond to resuscitation died. Although the causes of reversible arrest are known, there may be uncertainties in diagnostic procedures and treatment during resuscitation. Classical resuscitation practice may be insufficient to solve reversible problems such as pulmonary embolism. Although there are reservations about the inclusion of point-of-care ultrasound in resuscitation, it can play a life-saving role.

‘Drug Induced Hypersensitivity Syndrome’ (DiHS) or ‘Drug Rash with Eosinophilia and Systemic Symptoms’ (DRESS) syndrome is a life threatening, delayed type drug hypersensitivity reaction. This syndrome is characterized by fever, skin rash, lymphadenopathy, hematological abnormalities and visceral involvement and liver is the most frequently involved visceral organ. Liver involvement is mostly presented as acute anicteric hepatitis with elevated liver enzymes. Rarely, it can be presented as cholestasis which indicates a worse prognosis. In this article, a case of valproic acid induced-DRESS syndrome who presented with acute hepatic failure is presented. Diagnosis of DRESS syndrome may delay due to the long interval between drug intake and the onset of symptoms. The variety of symptoms can also be challenging. Early diagnosis is important in terms of reducing morbidity and mortality., “Drug Induced Hypersensitivity Syndrome” (DiHS) ya da diğer adı ile “Drug Rash with Eoshinophilia and Systemic Symptoms” (DRESS) sendromu, yaşamı tehdit edebilen gecikmiş tip ilaç hipersensitivite reaksiyonudur. Ateş, deri döküntüsü, lenfadenopati, hematolojik anormallikler ve çoklu organ tutulumu ile karakterizedir. Karaciğer en sık tutulan organ olup, çoğunlukla karaciğer enzim yüksekliği ve akut anikterik hepatit şeklinde karşımıza çıkmaktadır. Çok daha nadir olarak kolestaz eşlik edebilir ve bu durum kötü prognoza işaret etmektedir. Bu yazıda valproik asit ilişkili hepatik yetmezlik ve ağır kolestazın görüldüğü DRESS sendromlu bir olgu sunulmuştur. İlaç kullanımı ile semptomların başlangıcı arasındaki sürenin uzun olması ve semptomların çeşitliliği nedeniyle DRESS sendromunun tanısında gecikmeler olabilmektedir. Hastalığın erken tanınması, morbidite ve mortaliteyi azaltmak açısından oldukça önem taşımaktadır.

Amaç: İnhaler ilaçların tedavi başarısı ancak doğru bir teknikle uygulanırsa mümkün olmaktadır. Hatalı inhaler teknik; terapötik etkinliği azaltır, tedavi uyumunu bozar ve hastalığın yetersiz kontrolüne yol açar. Çalışmamızda; üçüncü basamak çocuk hastanesinde hem yataklı servis hem de poliklinik hizmetlerinde astımlı çocuk hasta takibinde önemli rol üstlenen pediatri asistan hekimlerinin uygun inhaler teknik konusundaki bilgi düzeylerini değerlendirmek ve kısa süreli bir eğitimin bilgi düzeyine katkısını belirlemek amaçlanmıştır.Gereç ve Yöntemler: Tüm katılımcılardan demo cihazlar ve manken kullanarak, inhaler cihaz kullanımını göstermeleri istendi. Bu değerlendirme ‘Ön-Test’ olarak adlandırıldı. Daha sonra katılımcılara maksimum 15 kişiden oluşan gruplar halinde, tüm uygulama basamaklarını içeren yüz yüze inhaler cihaz kullanım eğitimi verildi. Eğitim sonunda inhaler cihaz kullanımına ait basamaklar tekrar değerlendirildi.Bulgular: Ölçülü Doz İnhaler ve Kuru Toz İnhaler cihazlara ait inhaler teknik ile ilgili eğitim öncesi değerlendirme sonucunda 148 katılımcıdan hiçbirinin önceden belirlenmiş zorunlu basamakları eksiksiz tamamlayamadığı görüldü. Eğitim sonrasında tüm katılımcıların önceden belirlenen kontrol listesinin adımlarını tam olarak uygulayabildikleri gözlemlendi.Sonuç: Tıp fakültesi müfredatı ve uzmanlık eğitim sürecine astım tedavisi için son derece önemli olan inhaler cihazların uygulama eğitiminin dahil edilmesi gerektiğine dikkat çekmek istiyoruz. Sağlık profesyonelleri arasında, inhaler teknik uygulamalarını içeren hizmet içi eğitimlerin düzenli aralıklarla tekrarlanması uygulamadaki hataları gidermekle birlikte astım tedavisinde doğru inhaler tekniğin önemi konusundaki farkındalığı da arttıracaktır., Objective: The use of inhaler drugs results in clinical success only when they are applied using the right technique. Faulty inhaler application techniques reduce therapeutic efficacy, impair treatment compliance, and lead to inadequate control of the disease. This study aimed to evaluate the knowledge levels of pediatric residents who play an important role in the follow-up of patients with pediatric asthma in both inpatient and outpatient services in a tertiary children’s hospital and to determine the effect of short-term training on the level of knowledge.Material and Methods: All participants were asked to demonstrate the use of inhaler devices using demo devices. This assessment was designated as the “Pre-test.” The participants were then given face-to-face inhaler device training in groups of up to 15 people, which included all application steps. At the end of the training, the steps of inhaler device use were reassessed. Results: Pre-training evaluation of inhaler technique on Metered Dose Inhaler and Dry Powder Inhaler devices showed that none of the 148 participants successfully completed the predetermined mandatory steps of the inhaler technique. After the training, it was observed that all participants were able to fully apply the steps of the previously determined checklist.Conclusion: Medical school curricula and specialty education should include the application training of inhaler devices, which are extremely important for asthma treatment. Regular repetition of in-service training involving inhaler technique and application among health professionals can correct application errors and increase awareness regarding the importance of the right inhaler technique in the treatment of asthma.Key Words: Asthma, Children, Inhaler, Treatment tech

Introduction: this study aimed to evaluate the prognosis of patients with low rates of oocyte maturity and compare those who are aforethought poor responders with respect to the Bologna criteria. Methods: all assisted reproductive technology (ART) cycles conducted from 2004 to 2018 in a tertiary center in Istanbul were analyzed retrospectively. Patients were grouped into three accordingly the count of total retrieved oocytes and metaphase-II [(M-II) -mature] oocytes after denudation (group 1: 3 oocytes and 3 oocytes and >3 M-II oocytes). A Low oocyte maturity rate was diagnosed when s50% of all harvested oocytes were in the M-II stage before the fertilization procedure. Results: during the study period 14,899 intracytoplasmic sperm injection cycles were evaluated. The study group's mean age was 32.6 +/- 5.3. The mean counts of total and mature oocytes were 9.8 +/- 5.9 and 7.3=4.5, respectively. A mean count of 2.38 embryos was transferred in 10118 cycles. The group 3 patients had a considerably higher live birth ratio compared to the group 1 and 2. Conclusion: we propose oocyte maturity rate and the count of M-I1 oocytes as two diagnostic criteria for the case definition of asynchronous follicle growth. Based on our findings, stimulation cycles ending with low oocyte maturity rate (, NA

Background: Tuberculosis (TB) is still a severe problem in underdeveloped and developing countries. Diagnostic tests are unavailable in every health institution, and TB culture can take up to 45 days. Therefore, there is a need for cheaper, faster, and easily accessible diagnostic methods that can guide the diagnosis. This study aimed to determine whether red blood cell distribution width (RDW), C-reactive protein (CRP)-lymphocyte ratio (CLR), platelet-lymphocyte ratio (PLR), and lymphocyte-monocyte ratio (LMR) can be used as biomarkers in the diagnosis of pulmonary TB in patients with no comorbidities. Material and Methods: Files of microbiologically confirmed 122 patients with pulmonary TB and 153 patients in whom pulmonary TB was excluded were retrospectively reviewed. Out of them, patients with comorbidities were excluded from the study. Eighty-one patients with TB and 100 controls were included in the study. Results: The lymphocyte, eosinophil, and LMR levels remained significantly lower in the TB group, while neutrophil, monocyte, RDW, platelet, and PLR levels were higher in the same group. Conclusion: In those patients suspicious of pulmonary TB, higher levels of RDW, PLR, and CLR, whereas lower levels of eosinophil, PDW, and LMR may predict the diagnosis of pulmonary TB in previously healthy individuals.

Cytomegalovirus (CMV) pneumonia is a rare opportunistic infection in the progression of human immunodeficiency virus (HIV) infection. Also, COVID-19 has been named a pandemic since the beginning of 2020. During this period, physicians were exposed to many COVID-19 cases, and it was challenged to consider different diagnoses in patients who applied to the emergency room with lung complaints and bilateral pneumonia. Here we reported a 30-year-old man diagnosed with HIV- associated opportunistic CMV pneumonia mimicking COVID-19. The diagnosis of CMV pneumonia was obtained through consistent clinical, radiological, microbiological and cytologic examinations. The patient made a complete clinical recovery after being initialized on anti-CMV treatment.

Background To examine the relationship between an institutionally prepared standardized patient evaluation form and the Edmonton Frail Scale (EFS) in patients receiving home health care. Material and Methods Our prospective, observational study included 200 patients over the age of 18 who requested home health care, regardless of gender. The EFS and institutional data collection forms were applied consecutively on the same day to all patients included in the study. Results Among the 200 individuals recruited for the study, 59% were female and 41% were male; the overall average age was 80 years. According to the EFS results, 4.5% of the patients were classified as non-frail, 6% were vulnerable, and 89.5% had varying degrees of frailty (mild, moderate and severe). There was a significant positive correlation between EFS score and age (p

Amaç: Çalışmamızda prenatal ve postnatal dönemde tanı alan konjenital akciğer malformasyonu olan hastaların klinik özelliklerinikarşılaştırmayı amaçladık.Gereç ve Yöntemler: 2007-2021 yılları arasında Çocuk Göğüs Hastalıkları Bölümü’nde izlenen konjenital akciğer malformasyonu olanhastalar cinsiyetleri, yaşları, başvuru yakınmaları, ilk semptom zamanı, tanı yaşları, tanı yöntemleri, doğum haftaları, doğum ağırlıkları,ebeveyn akrabalığı, operasyon varlığı, operasyon yaşı ve endikasyonları, uzun dönem komplikasyonları açısından değerlendirildi. Prenataldönemde tanı alan hastalar ile postnatal dönemde tanı alanlar klinik özellikleri açısından karşılaştırıldı.Bulgular: Konjenital akciğer malformasyonu nedeniyle izlenen 37 hastanın ortalama yaşları 6.7±5.8 yıldı ve 17’si (%45.9) kızdı. Prenataldönemde tanı alan hastalar (n:18) yakınması olmadan başvururken diğer hastaların en sık başvuru nedenleri öksürük ve tekrarlayan akciğerenfeksiyonuydu. Postnatal dönemde tanı alan hastaların (n:19) ortanca tanı yaşları 30 (en küçük:10; en büyük:1080) gündü. Hastaların18’i (%48.6) prenatal ultrasonografi, 14’ü (%37.8) bilgisayarlı tomografi, beşi (%13.6) akciğer grafisi ile tanı aldı. İzlemde iki hastanınmalformasyonu kendiliğinden geriledi. Oniki hasta opere olurken diğer hastalar mevcut anomalileri ile takip edilmektedir. Prenatal dönemdetanı alan hastaların asemptomatik izlem süresi, postnatal tanı alan hastalardan istatistiksel olarak anlamlı farklıydı (36.5±4.7 ve 24.0±12.7ay) (p:0.004).Sonuç: Çalışmamızda prenatal dönemde tanı alan konjenital akciğer malformasyonu olan hastaların daha uzun süre, Objective: We aimed to compare clinical features of children with congenital lung malformations (CLM) who werediagnosed in prenatal and postnatal period.Material and Methods: Children with CLM followed in our pediatric pulmonology department between 2007-2021were evaluated in terms of sex, age, complaints at presentation, time of onset of symptoms, age at diagnosis, diagnosticmethods, gestational ages, birth weights, parental consanguinity, presence of any operations, age and indications ofoperations and long-term complications. Children who were diagnosed in prenatal period and those in postnatal periodwere compared in terms of their clinical features.Results: The mean age of 37 children with CLM was 6.7±5.8 years, and seventeen (45.9%) of the children were girls.Children who were diagnosed during the prenatal period (n:18) had no complaints, whereas cough and recurrentpneumonia were the most common reasons at admission in others. Median age at diagnosis of children whowere postnatally diagnosed (n:19) was 30 days (10-1080). Eighteen (48.6%) children were diagnosed by prenatalultrasonography, 14 (37.8%) by computed tomography, and five (13.6%) by chest X-ray. During follow-up, malformationsof two children regressed spontaneously. Twelve children were operated while others were followed up with theiranomalies. Asymptomatic follow-up duration of children who were prenatally diagnosed was significantly different thanthe children who were diagnosed in the postnatal period (36.5±4.7 vs 24.0±12.7 months) (p:0.004).Conclusion: Children with CLM who were diagnosed in the prenatal period were found to remain asymptomatic forlonger. Prenatal diagnosis enables them to live longer without symptoms with appropriate surgical timing.

Eritema multiforme (EM) tipik hedef lezyonlarıyla simetrik eritematöz döküntü ile karakterize, immün aracılı bir durumdur. İlaçlar, enfeksiyonlar, immünolojik durumlar ve gıda katkı maddeleri etiyolojik nedenler arasındadır, ancak Herpes simplex virus enfeksiyonu en yaygın olanıdır.Herpes labialis enfeksiyonu ilişkili üç rekürren EM olgusu sunuyoruz. Hepsi herpes labialis döküntüsünden yaklaşık bir hafta sonra ortaya çıkan tipik hedef lezyonlarla başvurdu. Her hastanın farklı sıklıkta tekrarlayan benzer atakları vardı. Her üç hastaya da önce oral valasiklovir tedavisi, ardından günlük 500 mg dozda 6 ay profilaktik valasiklovir tedavisi uygulandı.Herpes virüs enfeksiyonu ile tetiklenen otoreaktif T hücrelerinin, Herpes ilişkili EM (HAEM) patogenezinde önemli bir rol oynadığı ileri sürülmüştür. Tekrarlayan HAEM’in birinci basamak tedavisinde, antiviral tedaviler genellikle güvenlidir ve pediyatrik ve genel popülasyonlarda iyi tolere edilir. EM döküntüsünün şiddetini ve süresini azaltmak için oral asiklovir ya da valasiklovir tedavisinin erken uygulanması önerilir. Altı ay süreyle verilen profilaktik oral asiklovir veya valasiklovir, tekrarlayan HAEM ataklarını kontrol etmede etkili olabilir. HSV enfeksiyonu ve HAEM tekrarlayabilir ancak profilaktik tedavi bu epizotların sıklığını ve şiddetini azaltabilir., Erythema multiforme (EM) is an immune-mediated condition characterized by symmetric erythematous rash with typical target lesions. Drugs, infections, immunologic conditions and food additives are among etiologic causes; but Herpes simplex virus infection is the most commonly seen reason.We report three cases of recurrent EM associated with herpes labialis infection. They all presented with typical target lesions appearing nearly one week after the herpes labialis lesion had begun. Each patient had similar EM episodes with different frequencies. All three patients were initially treated orally with valacyclovir, then prophylactic valacyclovir with a daily dose of 500 mg for six month period.Autoreactive T cells triggered by Herpes virus infection, are suggested to play an important role in Herpes-associated EM (HAEM) pathogenesis. The first line management of recurrent HAEM is antiviral treatments and they are generally safe and well tolerated in pediatric and general populations. Early administration of oral acyclovir or valacyclovir are recommended to reduce the severity and duration of the EM rash. Prophylactic antiviral treatment using for 6 months may be effective in controlling recurrent epizodes of HAEM. HSV infection and HAEM may recur; but prophylactic treatment may reduce the frequency and severity of epizodes.

Purpose: we aimed to evaluate the radiological and functional results of humeral shaft fractures treated with minimally invasive percutaneous plate osteosynthesis (MIPPO) in our clinic. Material and Methods: data of 21 humeral shaft fractures of 20 patients treated with MIPPO were evaluated retrospectively. Demographic data, type of injury, fracture classification according to AO classification and fracture location, smoking, radial nerve injury were recorded. Radiographically, the union at 6th month and alignment were evaluated. Objective results were evaluated in terms of shoulder and elbow range of motion. Subjective results were assessed by the American Shoulder and Elbow Society Score (ASES), University of California, Los Angles (UCLA) score, Mayo Elbow Performance Index (MEPI), the Disability of The Arm, Shoulder and Hand (DASH) Score and Constant Shoulder Score. Results: the average elbow motion was 131.4 degrees +/- 19.8 degrees. The mean ASES and UCLA scores were 88.5 +/- 16.4 and 32.1 +/- 5.2, respectively. The mean MEPI and DASH scores were 93.1 +/- 11.3 and 11.8 +/- 20.0, respectively, and the Constant score was mean 9.1 +/- 15.3. Nonunion was observed in two patient at 6th month. Conclusion: we believe that MIPPO is a successful technique for the treatment of humeral shaft fractures with minimal soft tissue damage, intact shoulder and elbow motion function. / Amaç: lliniğimizde minimal invaziv perkütan plak osteosentezi (MIPPO) ile tedavi edilen humerus cisim kırıklarının radyolojik ve fonksiyonel sonuçlarının değerlendirilmesi amaçlanmıştır. Gereç ve yöntem: MIPPO ile tedavi edilen 20 hastanın 21 humerus cisim kırığına ait verileri retrospektif olarak değerlendirildi. Hastaların demografik verileri, yaralanma şekilleri, AO sınıflaması ve bölgesine göre kırık sınıflaması, sigara kullanımı, radial sinir yaralanması kaydedildi. Radyografik olarak 6. ayda kaynama durumu ve dizilim değerlendirildi. Hastaların son kontrollerinde omuz ve dirsek hareket açıklığı ile objektif, Amerikan Omuz ve Dirsek Derneği (ASES) skoru, California Üniversitesi Los Angeles (UCLA) skoru, Mayo dirsek performans indeksi (MEPI), Kol Omuz El Engellilik (DASH) skoru ve Constant omuz skoru ile subjektif değerlendirme yapıldı. Bulgular: hastaların ortalama omuz fleksiyonu 169,5°±26,4°, abdüksiyonu 169,5°±26,4° idi. Ortalama dirsek hareket arkı 131,4°±19,8° bulundu. Ortalama ASES ve UCLA skorları sırasıyla 88,5±16,4 ve 32,1±5,2, MEPI ve DASH skoru sırasıyla 93,1±11,3 ve 11,8±20,0, ortalama Constant skoru 9,1±15,3 bulundu. İki hastada 6. ayda kaynamama gözlendi. Sonuç: MIPPO yöntemi humerus cisim kırıklarının tedavisinde; minimal yumuşak doku hasarı, korunmuş omuz ve dirsek fonksiyonları ile başarılı bir tekniktir., NA

Amaç: Bu çalışmada çocuk acil servis başvurularında sodyum ve potasyum bozuklukları spektrumunun incelenmesi amaçlanmıştır.Gereç ve Yöntemler: Araştırmamız kesitsel ve tek merkezlidir. 2017-2020 yılları arasında çocuk acil kliniğine herhangi bir nedenle başvurup tetkiklerinde sodyum ve/veya potasyum bozukluğu tespit edilen, 18 yaşından küçük hastalar çalışmaya dahil edildi. Hastaların başvuru tanıları ve elektrolit düzeyleri kaydedildi. Elektrolit bozuklukları hafif, orta ve şiddetli olarak gruplandırıldı.Bulgular: Çalışmaya toplam 757 hasta dahil edildi. Bunların 358 (%47.3)’i kız ve 399 (%52.7)’u erkekti. Katılımcıların 649 (85.8%)’nda tekli elektrolit bozukluğu saptanırken 108 (%14.2)’nde mikst tipte elektrolit bozukluğu saptandı. Hastalarda en sık rastlanan elektrolit bozukluğu hiponatremiydi (%56). Bunu sırasıyla hiperkalemi (%27.5), hipokalemi (%19.9) ve hipernatremi (%10.8) izledi. Akut gastroenterit, hem tek hem de mikst elektrolit bozukluğu gruplarında en sık altta yatan hastalıktı.Sonuç: Çalışmamız, çocuk acil servislerinde en sık elektrolit bozukluklarının gastroenteritli hastalarda meydana geldiğini saptamıştır. Bu bozukluklar genellikle hafif şiddetteydi. Hafif elektrolit bozuklukları subklinik olabilir, bu nedenle pediatrik acil serviste rutin elektrolit ölçümü erken tanı için önemlidir., Objective: In this study, it was aimed to examine the spectrum of sodium and potassium disorders in a pediatric emergency department.Material and Methods: Our study was cross-sectional and single-center. Patients under the age of 18, who were admitted to the pediatric emergency clinic for any reason except trauma, between 2017 and 2020 and were found to have sodium and/or potassium disorders in their examinations were included in the study. The admission diagnoses and electrolyte levels of the patients were recorded. Electrolyte disturbances were grouped as mild, moderate, and severe. Results: A total of 757 patients were included in the study. Of these, 358 (47.3%) were female and 399 (52.7%) were male. Single electrolyte disturbance was detected in 649 (85.8%) of the participants, while mixed type electrolyte disturbance was detected in 108 (14.2%). The most common electrolyte disturbance in the patients was hyponatremia (56%). This was followed by hyperkalemia (27.5%), hypokalemia (19.9%) and hypernatremia (10.8%). Acute gastroenteritis was the most common underlying disease in both the single and mixed electrolyte disorder groups.Conclusion: Our study detects that the most common electrolyte disturbances in pediatric emergency services occur in patients with gastroenteritis. These disorders were often of mild severity. Mild electrolyte disturbances may be subclinical, so routine electrolyte measurement in the pediatric emergency room is important for early diagnosis.

Giriş: Önceki çalışmalar, COVID-19 pandemisi sırasında sağlık çalışanlarında stres, kaygı düzeyleri ve depresif semptomların normal popülasyona göre daha yaygın olduğunu göstermiştir. Çalışmamızın amacı, hastalığı sevdiklerine ve başkalarına bulaştırma konusunda belirgin kaygı yaşayan sağlık çalışanlarının depresyon, kaygı ve stres düzeylerini, baş etme stratejilerini ve öz-anlayış düzeylerini karşılaştırmaktır. Yöntem: Çalışmamız Mayıs 2020'de yapılmıştır. Örneklemi COVID-19 pandemisi sırasında aktif olarak çalışan 113 sağlık profesyoneli oluşturmuştur. Araştırma ölçekleri Google Forms programı aracılığıyla elektronik ortama aktarılmış ve katılımcılara ulaştırılmıştır. Bulgular: Çalışmamızda sağlık çalışanlarının kaygılarının en önemli nedeninin hastalığı sevdiklerine bulaştırmak olduğu saptanmıştır. Hastalığı sevdiklerine bulaştırma kaygısı olan kişilerin, hastalığı sevdiklerine bulaştırma kaygısı olmayanlara göre daha işlevsel başa çıkma stratejileri kullandıkları, depresyon, kaygı ve stres düzeylerinin daha düşük olduğu ve öz-şefkat düzeylerinin daha yüksek olduğu bulundu. Sonuç: Hastalığı sevdiklerine bulaştırma kaygısı taşıyan sağlık çalışanlarında bu kaygının işlev kaybından çok işlevsel bir etkisi olabileceği gözlemlendi. Sağlık profesyonellerini depresyon, kaygı ve stresten korumak için bireylerin öz-anlayış becerilerini ve işlevsel başa çıkma stratejilerini kazanmalarına yönelik çalışmalar yapılmalıdır., Background and objectives: Previous studies have shown that stress, anxiety levels, and depressive symptoms were more common in healthcare workers than in the normal population during the COVID-19 pandemic. The aim of our study was to compare the depression, anxiety and stress levels, coping strategies and self-compassion levels of healthcare workers who had significant anxiety of transmitting the disease to their loved ones and others. Method: Our study was conducted in May 2020. The sample was consisted of 113 healthcare professionals actively working during the COVID-19 pandemic. The research scales were transferred to the electronic environment via the Google Forms program and delivered to the participants. Result: In our study, it was found that the most important reason for the anxiety of healthcare workers was to infect their loved ones. People who had significant anxiety about infecting loved ones used more functional coping strategies, had lower levels of depression, anxiety, and stress, and higher levels of self-compassion than those who did not have significant anxiety about infecting loved ones. Conclusion: It has been observed that this anxiety may have a functional effect rather than a loss of function in healthcare workers who are concerned about transmitting the disease to their loved ones. In order to protect health professionals from depression, anxiety and stress, studies should be carried out for individuals to gain self-compassion skills and functional coping strategies.

Objective: We aimed to evaluate the frequency of diabetic retinopathy (DRP), related factors and DRP awareness of diabetic patients. Materials and Methods: The study was conducted between February 2019andApril 2020. Three hundred and fifty diabetic patients were contacted by phone and invited to the study. A total of 200 patients with DM over 18 years were included. Sociodemographic and clinical characteristics of the patients were recorded and DRP awareness questionnaire was applied. The patients were referred to a secondary healthcare center and an ophthalmologist performed detailed ophthalmic examinations. Data were analyzed with SPSS 20. Significance level was set at p, Amaç: Çalışmamızda Tip 2 diyabet hastalarımızda diyabetik retinopati (DRP) sıklığını, ilişkili faktörleri ve DRP farkındalık düzeyini değerlendirmeyi amaçladık. Gereç ve Yöntem: Çalışma Şubat 2019-Nisan 2020 tarihleri arasında Atatürk Üniversitesi Tıp Fakültesine bağlı Eğitim Aile Sağlığı merkezlerinde (EASM) yürütülmüştür. Kayıtlı 350 diyabet hastasına telefonla ulaşılıp çalışma hakkında bilgi verilerek çalışmaya davet edildi. Yapılan örneklem hesabına göre 18 yaş üstü Tip 2 diyabet tanısı almış 200 hasta çalışmaya dahil edildi. Tip 1 DM olanlar, oftalmolojik cerrahi geçirenler çalışmaya dahil edilmedi. Yüz yüze görüşme ile hastaların sosyodemografik ve klinik özellikleri kaydedilip; DRP farkındalık anketi uygulandı. Hastalar ikinci basamak sağlık kuruluşuna yönlendirildi ve bir göz hekimi tarafından detaylı oftalmalojik muayeneleri yapıldı. Veriler SPSS 20.0.0 ile analiz edildi. Anlamlılık düzeyi p

Amaç: Amacımız, çocuk yoğun bakım ünitesinde diyabetik ketoasidoz (DKA) ile takip edilen daha önce tanı almış ve yeni tanı almış Tip 1Diabetes Mellitus (T1DM) hastalarının şiddeti, klinik özellikleri, komplikasyon varlığı ve sonuç farklılıklarını belirlemektir.Gereç ve Yöntemler: Bu çalışma, 32 yataklı üçüncü basamak çocuk yoğun bakım ünitesinde geriye dönük olarak yapıldı. Hastalar yenitanı almış ve önceden tanı almış T1DM olarak ayrıldı. Toplanan tüm veriler gruplar arasında karşılaştırıldı.Bulgular: 107 hasta çalışmaya dahil edildi. Hastaların çoğu erkekti (%51.4). Yeni tanı alan hastaların çoğu 6-10 yaş grubundaydı (%49.2).Başvuru öncesi hasta şikâyetleri değerlendirildiğinde kusma şikayeti, daha önce tanı almış DM hastalarında istatistiksel olarak anlamlıderecede yüksekti (p=0.041). Yeni tanı alan Tip-1 DM’de halsizlik, poliüri, polidipsi, kilo kaybı şikâyetleri istatistiksel olarak anlamlı derecedeyüksekti (p değeri sırasıyla 0.001, 0.001, 0.001, 0.001). Diyabetik ketoasidoz tedavisi sırasında yeni tanı almış DM grubunda hipokalemiistatistiksel olarak daha yüksekti (p=0.015). Yoğun bakım süreleri arasında fark olmamasına rağmen yeni tanı konmuş DM hastalarındatoplam yatış günleri istatistiksel olarak daha uzundu (p değerleri sırasıyla 0.145, 0.007). Hastalarda mortalite görülmedi.Sonuç: Okul yaş grubu, yeni tanı konan T1DM’de en sık görülen yaş grubuydu. Yeni tanı Diyabetik Ketoasidoz hastalarında poliüri,polidipsi, kilo kaybı sık iken; eski tanılı diyabetik ketoasidoz hastalarında kusma yaygın olarak saptandı. Hastalar ve ailelerin bu semptomlarve hastalık hakkında bilgi düzeyini artırıcı eğitimler, ulusal reklamlar vb uygulamalar yapılmalıdır., Objective: Our aim is to determine the severity, clinical features, presence of complications and outcome differencesin previously diagnosed and newly diagnosed Type 1 Diabetes Mellitus (T1DM) patients followed up with diabeticketoacidosis (DKA) in the pediatric intensive care unit.Material and Methods: This study was conducted retrospectively in a 32-bed tertiary pediatric intensive care unit.The patients were divided into newly diagnosed and previously diagnosed T1DM. All collected data were comparedbetween groups.Results: 107 patients were included into the study. Most of the patients were male (51.4%). Most of the newly diagnosedpatients were in the 6-10 age group (49.2%). When patient complaints were evaluated before admission, the complaintof nausea was statistically higher in previously diagnosed DM patients (p=0.041). The complaints of fatigue, polyuria,polydipsia, and weight loss were statistically higher in newly diagnosed Type-1 DM (p value 0.001, 0.001, 0.001,0.001, respectively). Hypokalemia was statistically higher in the newly diagnosed DM group during diabetic ketoacidosistreatment (p=0.015). Although there was no difference between intensive care durations, total hospitalization days werestatistically longer in newly diagnosed DM patients (p values 0.145, 0.007, respectively). All patients survived.Conclusion: The school age group was the most common age group in newly diagnosed T1DM. While polyuria,polydipsia and weight loss are common in newly diagnosed Diabetic Ketoacidosis patients; Vomiting was common indiabetic ketoacidosis patients with previous diagnosis. Trainings, national advertisements, etc. should be done to increasethe knowledge level of patients and families about these symptoms and the disease.

Objective: Left ventricular hypertrophy is the most commonly studied index for hypertension related target organ damage due to the wide usage of echocardiography. Renalase is a monoamine oxidase, mainly produced by the kidneys, regulating blood pressure by reducing catecholamines and acting on cardiovascular functions. In this study, the relationship between serum renalase level and hypertensive cardiac changes in children with essential hypertension was compared with the healthy control group.Materials and Methods: A total of 60 hypertensive children (female/male 20/40) aged between 4-18 years (mean 15.1 ± 1.9 years) were included in the study. Twenty healthy children with normal body mass index (4-18, mean14.2 ± 1.3 years) and similar gender (female/male 10/10) formed the control group. In 30 of hypertensive children (female/male: 9/21), echocardiography showed left ventricular hypertrophy. Echocardiographic findings of 30 remaining hypertensive patients (female/male: 11/19) were normal. A venous blood sample was collected from the hypertensive groups for biochemical examinations and renalase level. Urine samples and 24-hour urine samples were collected. 24-hour ambulatory blood pressure monitoring (ABPM) was used to measure blood pressure of hypertensive groups. The cardiac evaluation of hypertensive groups was performed using M-mode echocardiography.Results: The body mass index was significantly higher in hypertensive groups than the group with normal blood pressure (p, Amaç: Sol ventrikül hipertrofisi, ekokardiyografinin yaygın kullanımı nedeniyle hipertansiyona bağlı hedef organ hasarı için en sık çalışılan indekstir. Renalaz, esas olarak böbrekler tarafından üretilen, katekolaminleri azaltarak kan basıncını düzenleyen ve kardiyovasküler fonksiyonlara etki eden bir monoamin oksidazdır. Bu çalışmada esansiyel hipertansiyonlu çocuklarda serum renalaz düzeyi ile hipertansif kardiyak değişiklikler arasındaki ilişki sağlıklı kontrol grubu ile karşılaştırıldı.Gereç ve Yöntemler: Çalışmaya 4-18 yaş (ortalama 15.1 ± 1.9 yıl) arasında 60 hipertansif çocuk (kız/erkek 20/40) dahil edildi. Vücut kitle indeksi normal (4-18, ortalama 14,2 ± 1,3 yıl) ve benzer cinsiyete sahip (kadın/erkek 10/10) 20 sağlıklı çocuk kontrol grubunu oluşturdu. Hipertansif çocukların 30'unda (kadın/erkek: 9/21) ekokardiyografide sol ventrikül hipertrofisi görüldü. Geriye kalan 30 hipertansif hastanın (kadın/erkek: 11/19) ekokardiyografik bulguları normaldi. Hipertansif gruplardan biyokimyasal incelemeler ve renalaz düzeyi için venöz kan örneği alındı. İdrar örnekleri ve 24 saatlik idrar örnekleri toplandı. Hipertansif grupların kan basıncını ölçmek için 24 saatlik ambulatuar kan basıncı izleme (ABPM) kullanıldı. Hipertansif grupların kardiyak değerlendirmesi M-mod ekokardiyografi kullanılarak yapıldı.Bulgular: Hipertansif gruplarda vücut kitle indeksi normal kan basıncı olan gruba göre anlamlı olarak daha yüksekti (p

Amaç: Yasadışı uyuşturucu maddeler, özellikle de metamfetamin, dünyada olduğu gibi Türkiye'de de ergenler arasında giderek daha popüler hale gelmektedir. Türkiye'de bu amaçla yapılan çalışmaların çoğu anket çalışmalarıdır. Çalışmamız ise hastanemize başvuran ve metamfetamin intoksikasyonu saptanan hastaların klinik özelliklerini ve laboratuvar parametrelerini değerlendirmeyi amaçlamıştır.Gereç ve Yöntemler: Ağustos 2019-Aralık 2021 tarihleri arasında Ankara Şehir Hastanesi Çocuk Acil Servisi'ne başvuran ve idrar toksik madde taramasında metamfetamin pozitif saptanan 18 yaş altı hastalar çalışmaya dahil edildi ve verileri retrospektif olarak değerlendirildi.Bulgular: Çalışmamızda metamfetamin intoksikasyonu saptanan 10 hastayı inceledik. Ortalama yaş 16.3 ± 0.94 (14-17) idi ve hastaların %80'i erkekti. Sekiz hasta başvuru sırasında madde kullanımını gizledi. Başvuru anında en sık kardiyovasküler, nörolojik ve gastrointestinal sistem semptomları görüldü. Dört hastada eşzamanlı alkol kullanımı, bir hastada çoklu uyuşturucu kullanımı saptandı. Laboratuar testlerinde önemli bir patoloji gözlenmedi. Karın ağrısı olan bir hastada mide perforasyonu, göğüs ağrısı olan bir hastada pnömomediastinum tespit edildi.Sonuç: Metamfetamin intoksikasyonunun spesifik klinik ve laboratuvar göstergeleri yoktur ve olası bir nedenin hastanın klinik bulgularını açıklayamadığı tüm durumlarda madde kötüye kullanımı düşünülmelidir. Alkol kullanan çocuklarda madde kullanımı sorgulanmalı, çoklu madde kullanımı açısından dikkatli olunmalı, buna göre hasta takip ve rehabilitasyon planları yapılmalıdır., Objective: Illicit substances, especially methamphetamine, are becoming increasingly popular with adolescents in Turkey as well as around the world. Most of the studies conducted for this purpose in Turkey are survey studies. Our study therefore aimed to evaluate the clinical features and laboratory parameters of patients who applied to our hospital and were found to have methamphetamine intoxication.Materials and Methods: Patients under 18 who applied to the Ankara City Hospital Pediatric Emergency Department (PED) between August 2019 and December 2021 and were found to be positive for methamphetamine in the urine drug screening were included in the study,and their data were evaluated retrospectively.Results: We reviewed 10 cases presenting to our PED with methamphetamine intoxication. The mean age was 16.3 ± 0.94 (14-17) and 80% of patients were male. Eight patients concealed substance use at admission. The most frequent complaints upon presentation were cardiovascular, neurological, and gastrointestinal system symptoms. Concomitant alcohol use was detected in four patients, multidrug use in one patient. No significant pathology was observed in the laboratory tests. Gastric perforation was detected in one patient with abdominal pain, and pneumomediastinum was detected in one patient with chest pain.Conclusion: There are no specific clinical and laboratory indicators of methamphetamine intoxication, and substance abuse should be considered in all cases where a possible reason cannot explain the patient’s clinical findings. Children who use alcohol should be questioned about substance abuse, care should be taken in terms of multiple substance use, and follow-up and rehabilitation plans for patients should be made accordingly.

Introduction: The aim of the study was to examine the 30-day total SARS-CoV-2 antibody positivity in patients across a clinical spectrum ranging from asymptomatic to pneumonia.Methods: This prospective cohort study consisted of 51 consecutive patients who were RT-PCR positive and diagnosed COVID-19 pneumonia (Group 1) and 58 consecutive patients who were also RT-PCR positive but were asymptomatic or had mild symptoms (Group 2). On the 30th day from the date of symptom onset, the patients were called for examination and blood samples were taken for the detection of SARS-CoV-2 antibodies.Results: Patients with pneumonia, fever, muscle pain, and loss of taste and smell had significantly higher rates of antibody positivity (p= 0.001, 0.003, 0.030, and 0.018, respectively). Antibody positivity was found to be significantly higher in patients with at least one symptom on admission compared to asymptomatic patients (p = 0.001). While the antibody positivity rate was 96.1% in Group 1 (patients with pneumonia), it was 50% in Group 2 (patients without pneumonia), and 77.7% in patients with at least one symptom on admission compared to 33.3% in asymptomatic patients (p=0.001).Conclusions: Patients with COVID-19 pneumonia have significantly higher disease-specific total antibody positivity rates than patients without pneumonia. Considering the 50% antibody positivity in patients who had COVID-19 infection who were asymptomatic or had symptoms other than pneumonia, the issue of COVID-19 re-infection and immunity is much more important than it appears., Giriş: Klinik spektrumu asemptomatik hastalardan pnömonili hastalara kadar değişen hastalarda 30. gün total SARS-CoV-2 antikor pozitifliğini incelemeyi amaçladık.Yöntem: Bu prospektif kohort çalışması, RT-PCR pozitif olan ve COVID-19 pnömonisi teşhisi konan 51 hastadan(Grup 1) ve aynı zamanda RT-PCR pozitif olan ancak asemptomatik veya hafif semptomları olan 58 hastadan (Grup 2) oluşmaktadır. Semptomların başladığı tarihten itibaren 30. günde hastalar kontrole çağrılarak SARS-CoV-2 antikorlarının tespiti için kan örnekleri alındı.Bulgular: Pnömoni, ateş, kas ağrısı, tat ve koku kaybı olan hastalarda antikor pozitiflik oranları anlamlı olarak daha yüksekti (sırasıyla p= 0.001, 0.003, 0.030 ve 0.018). Başvuru anında en az bir semptomu olan hastalarda antikor pozitifliği asemptomatik hastalara göre anlamlı derecede yüksek bulundu (p=0.001). Antikor pozitiflik oranı Grup 1'de (pnömonili hastalar) %96.1, Grup 2'de (pnömonisi olmayan hastalar) %50 ve başvuru anında en az bir semptomu olan hastalarda %77.7 iken asemptomatik hastalarda %33.3 idi(p=0.001).Sonuç: COVID-19 pnömonisi olan hastalar pnömonisi olmayan hastalardan önemli ölçüde daha yüksek total antikor pozitiflik oranlarına sahiptir. Asemptomatik veya pnömoni dışında semptomları olan COVID-19 enfeksiyonu olan hastalarda %50 antikor pozitifliği göz önüne alındığında, COVID-19'un re-enfeksiyonu ve immunitesi göründüğünden çok daha önemlidir.

Giriş: B12 vitamin eksikliğinin; kan tetkiklerine, ortalama trombosit hacmine (MPV) ve inflamasyon markerlarından nötrofil-lenfosit oranına (NLR) etkilerinin araştırılması amaçlanmıştır.Yöntem: Çalışmamız 375 hasta üzerinde yapılmıştır. B12’si düşük (0,05). B12 eksikliğinin, düzeyi ve süresi uzadıkça nasıl değişiklikler gözlenebileceği ve özellikle de bu vitamin eksikliğinin aterojenik olaylara olan etkileri hakkında yapılacak yeni çalışmalara ihtiyaç vardır., Introduction: It was aimed to investigate the effects of vitamin B12 deficiency on blood tests, mean platelet volume (MPV), and neutrophil-lymphocyte ratio (NLR), which is one of the inflammation markers.Methods: Our study is a case-control study of 375 patients. 170 patients with low B12 ( 0.05). There is a need for new studies on how B12 deficiency will change as the degree and duration of B12 deficiency increases, especially its effect on atherogenic events.

Amaç: Dünya genelinde sahte ilaçlar insan sağlığını tehdit etmektedir. Yapılan çalışmalar göz önüne alındığında; sahte ilaç konusunda adli olarak ele geçirilmiş, bağımlılık potansiyeli bulunan ilaçlar ile ilgili çalışmalar yapıldığı ancak diğer ilaç grupları ile ilişkili yeterli çalışma yapılmadığı görülmektedir. Biz bu çalışmamızda Türkiye piyasasında; belirli miktarlarda alındıklarında sağlığı olumlu yönde etkileyen mikroorganizmalar şeklinde tanımlanan; probiyotikler başlığı adı altında satılan ilaçların sahte olup olmadıklarını araştırmayı amaçladık. Materyal ve Metot: Malatya ilinde randominize bir eczaneden kapsül, damla ve şase formu bulunan ve satışı için izinleri bulunan 17 adet farklı marka probiyotik ürün alındı. Bulgular: İncelenen 17 ürüne ait kutular ve kutu üzerinde olması gereken bilgiler açısından herhangi bir eksiklik ve sahtecilik göze çarpmadı. İçerikleri açısından yapılan araştırmada ilk 12 üründe herhangi bir eksik ya da fazla organizma üremesine rastlanmadı. On üç numaralı üründe içerikte bahsedilen mikroorganizmalardan 1 tanesi üremedi. On dört on beş, on altı ile on yedi numaralı ürünlerde prospektüste belirtilen birden fazla mikroorganizma ise elde edilemedi. Sonuç: Eczanelerde satılan ancak Gıda Tarım ve Hayvancılık Bakanlığı tarafından kontrolü yapılan ürünlerin kontrolleri kolay olmayıp sıkı denetimlerin yapılması gereklidir. Bu ürünlerin denetimleri esnasında alınan numunelerin doğru laboratuvarlara gönderilerek detaylı incelemeleri yapılmalı aynı zamanda ilaç etken maddelerinin de miktar yönünden değerlendirilmesi sağlanmalıdır., Aim: Counterfeit drugs are a threat to human health worldwide. It can be seen that insufficient research has been conducted on the subject of counterfeit drugs related to potentially addictive drugs seized by the authorities. The aim of this study was to investigate whether or not there are drugs for sale in the Turkish market, which are counterfeit drugs under the heading of probiotics which are defined as micro-organisms with a positive effect on health when taken in certain quantities. Material and Method: A total of 17 different probiotic products in capsule, drops or sachet form, which were permitted for sale, were obtained from randomly selected chemist’s shops in the province of Malatya. Results: There was nothing missing or counterfeit on the packaging of the 17 products examined. When the contents were investigated, no deficiencies or excess micro-organism production was determined in the first 12 products. In product #13, there was no production of one of the mentioned micro-organisms. In products # 14,15, 16, and 17, more than one micro-organism stated in the prospectus could not be obtained. Conclusion: As the checking of products sold in chemist’s but controlled by the Ministry of Food, Agriculture and Livestock is not easy, there is a need for tighter supervision. This can be provided by sending the samples taken during audits to the correct laboratories, making detailed examinations, and evaluation the amount of active substance.

Amaç: Bu çalışmada gebelerin Beden Kitle İndeksi (BKİ) ile yeni doğan bebeklerinin antropometrik ölçümleri arasındaki ilişkinin değerlendirilmesi amaçlanmıştır.Materyal ve Metot: Araştırmamızda Ocak 2011 ve Haziran 2020 tarihleri arasında Beykoz İlçesinde takip edilmiş ve doğum yapmış gebelerin, Beden Kitle İndeksleri (BKI) ile bebeklerinin boy, kilo ve baş çevresi ölçümlerine ait kayıtlar retrospektif olarak incelendi. İzlemler sırasında Beden Kitle İndeksi (BKİ) 30 ve üzerinde olan gebelerden (Obez) çalışma grubu, aynı tarih aralığında izlem yapılmış BKİ, Aim: In the present study it was aimed to evaluate the correlation between Body Mass Index (BMI) of pregnant women and the anthropometric measures of their newborn babies. Materials and Methods: BMI of four hundred pregnant women who were followed up in Beykoz district between January 2011 and June 2020 and the records of the height, weight and head circumference measurements of their babies were retrospectively analyzed. During the follow-up, the study group consisted from pregnant women with a Body Mass Index (BMI) of 30 and above, and the control group among the pregnant women with a Body Mass Index (BMI) of

Background: In recent years, it has been seen that the concept of health literacy has an increasing interest in academic studies and theses published in Turkey. Within the scope of the study, the theses written on health literacy in the field of family medicine were evaluated. It was aimed to reveal the thematic development and knowledge structure of the theses published in this field. Material and Methods: Within the scope of this study, social network analysis was carried out based on the keywords obtained from the theses prepared with the target of health literacy. Theses included in the study were accessed via https://tez.yok.gov.tr/UlusalTezMerkezi/. The studies that include the phrase “health literacy” in the title were selected in the examination scope, and the keywords obtained from these theses were listed. Results: It is observed that the concept with the highest degree of centrality and betweenness centrality is “health literacy,” as expected. Following the keyword “health literacy,” the keywords “life quality,” “mortality,” “family medicine,” “vaccine,” and “diabetes mellitus” have the highest degree of centrality, respectively. It is observed that the betweenness centrality values of the “newest vital sign” and “life quality” keywords are quite high compared to the degree centrality values. Conclusions: Through this study, researchers can focus on issues that are not emphasized much, create original research questions and contribute to the literature. In addition, it may be important to reveal which concepts are associated with the concept of health literacy through this study.

Background: Noninvasive Follicular Thyroid Neoplasm (NIFTP), Well differantiated thyroid tumor with uncertain malignity potential (WDT-UMP), follicular thyroid tumor with uncertain malignity potential (FT-UMP), and Hurtle cell neoplasia with uncertain malignity potential (HCN-UMP) have been included in the classification of thyroid tumors by WHO, with the incidence of thyroid cancer increasing every passing year. There is no consensus regarding the follow-up and treatment processes of these tumors. Our study aims to shed light on our clinical practice by evaluating the follow-up processes of the groups with and without radioactive iodine ablation in patients followed up with these diagnoses. Material and Methods: The 49 patients older than 18 years of age and followed for at least 12 months, who were performed subtotal and total thyroidectomy between 2015 and 2020 and were diagnosed with WDT- UMP, FT-UMP, HCN-UMP, and NIFTP according to histopathological examination were included to the study. Results: Tumor type rates did not differ between the groups that received and did not receive RAI treatment (p=0.361). The mean follow-up period did not differ between the groups that received and did not receive RAI treatment. Also the rates of RAI treatment according to tumor size did not differ (p=0.413). Tumor size was larger than 4 cm in 13 patients, and 1 patient from this group had received RAI treatment. Recurrence was not detected in the 49 patients included in our study who received or not receive RAI treatment. Conclusions: Some studies recommend giving RAI to these borderline thyroid tumors larger than 4 cm. But in our study no recurrence was detected in patients who did not receive RAI. That supports the view that patients could be followed without RAI treatment even if they are large tumors.

Background: Radiofrequency ablation (RFA) is used in selected patients with recurrent or metastatic thyroid cancer who have high surgical risk or do not accept surgical treatment. However, long-term follow-up data are limited. Here, we present our single-center experience with the use of RFA in the treatment of recurrent or metastatic papillary thyroid carcinoma (PTC). Material and Methods: Patients who underwent RFA for recurrent or metastatic PTC at Bursa Uludag University Faculty of Medicine between September 2014 and January 2021 were included. The data in the endocrinology outpatient clinic follow-ups of the patients were analyzed retrospectively. Results: A total of 10 patients, 11 RFA procedures, and 13 residual or metastatic sites were evaluated. The mean age was 44.50±14.04 years. The mean largest diameter of the tumor in which RFA was applied was 11.85±5.95 mm. Patients developed no major complications. Two patients experienced minor complications. The mean follow-up duration was of 51.20±19.86 months. During the follow-up period, 12 (92.30%) of 13 RFA sites completely disappeared. In one patient (7.69%) residual tumor tissue was detected after RFA. There was no recurrence at the procedure site. A significant decrease was found in the largest diameter of the treated regions after RFA (p=0.002). Thyroglobulin and anti-thyroglobulin levels were not significantly different before and after RFA (p=0.44 and p=1.00, respectively). Conclusions: RFA is highly effective and safe for locally recurrent PTC. It shows promise as an alternative to surgery to control locoregional recurrence of PTC.

Introduction: The specific association between sitagliptin and Fibroblast Growth Factor-19 (FGF19) is yet to be clarified. In this study, we aimed to investigate the effect of sitagliptin therapy on the levels of FDF19 in patients with type 2 diabetes mellitus (T2DM). Methods: A total of 35 patients newly diagnosed type 2 diabetes, and who had not received antidiabetic treatment before were included in this study. Sitagliptin therapy was administered as 100 mg/day. Patients’ demographic, anthropometric features, glycaemic variables, lipid profiles and FGF19 values were evaluated at the baseline and at the 3rd month of the treatment and the obtained data were compared. Results: The mean age of the patients was 53.34 ± 8.09 years. The mean weight, body mass index (BMI), hip circumference, postprandial blood glucose and glycosylated haemoglobin A1c (HbA1c) values were statistically significantly lower at the 3rd month of the treatment compared to the baseline values (for all, p

Background: Therapeutic plasma exchange (TPE) is a treatment method that can be used to provide euthyroidism before permanent treatment in patients with severe thyrotoxicosis, in cases of thyroid storm and in cases where antithyroid drug (ATD) cannot be used due to side effects or ineffectiveness. This study presented our results and experience on TPE in thyrotoxic patients. Material and Methods: The data of 10 patients who underwent plasmapheresis for thyrotoxicosis in Bursa Uludag University Faculty of Medicine Endocrinology Clinic were retrospectively analyzed and compared with the literature. Results: Ten patients, 6 female and 4 male, were included. The cause of hyperthyroidism was Graves’ disease in 8 patients and toxic multinodular goiter (TMNG) in 2 patients. It was observed that the reason for applying plasmapheresis in the patients was primarily due to toxic hepatitis. The mean number of plasmapheresis required to maintain euthyroidism was 4 (1-8). While no difference was found between the thyroid-stimulating hormone (TSH) results before and after TPE, free T4 (fT4) and free T3 (fT3) values were statistically significantly lower after TPE. It was observed that the leukocytes were considerably higher after TPE and the sodium and calcium values were markedly lower after TPE in the patients. After TPE, 7 patients underwent total thyroidectomy, 1 patient received radioactive iodine (RAI) treatment, and 2 were discharged with ATD treatment. Conclusions: TPE is an effective and safe treatment option that can be applied in cases where it is necessary to provide rapid euthyroidism before permanent treatments or non-thyroid surgical procedures or to treat life-threatening thyrotoxicosis. It requires experience in application and follow-up and provides rapid euthyroidism when performed in experienced centres.

Background: In our study, we determined the changes in microalbuminuria and gfr (glomerular filtration rate) values, which are important for diabetic nephropathy, within 1 year after starting treatment in our patients taking DPP-4 inhibitor (linagliptin), GLP-1 analog (exenatide) and SGLT-2 inhibitor (empagliflozin). Material and Methods: We evaluated the urea, creatinine, gfr and microalbuminuria levels of our patients who were treated with linagliptin, exenatide and empagliflozin on their 0th, 6th and 12th month visits. We included patients who were followed up for nephropathy for at least 1 year after starting treatment in each drug group. Results: When the 0th and 12th month GFR values of our 98 patients who were prescribed linagliptin were compared, an increase of 4.57% was detected (p0.05). While no statistically significant difference was found in the 0th and 12th month GFR follow-ups of our 97 patients using exenatide (p>0.05); in this group, it was determined that the microalbuminuria decreased significantly in 12 months in 33 of our patients who could be followed up in terms of microalbuminuria (p0.05); however, it was determined that microalbuminuria decreased significantly at the end of 1 year in our 79 patients who could be followed up for microalbuminuria in this group (p

Objective: Data on whether there is a histopathological difference in cellular features as determined with Ki-67 between giant prolactinomas and smaller macroprolactinomas are not fully clear. In this study, we aimed to compare Ki-67 value between patients followed-up with diagnosis of macroprolactinoma and giant prolactinoma and operated for different reasons. Methods: Files of 15 patients with giant prolactinomas and 16 patients with macroprolactinomas who had been operated with various indications were retrospectively evaluated. Similar number of patients were included to carry out a reasonable analysis. Patients’ demographics (age and gender), age at the time of diagnosis, tumor diameter during the diagnosis and at the last follow-up visit, initial and last PRL and Ki-67 values were compared between the groups. Ki-67 value was studied with MIB-1 monoclonal antibody method. Results: The mean age and gender were similar between the patients with macroprolactinomas and giant prolactinomas. The mean longest tumor diameter at diagnosis was measured as 18.13±9.42 mm in the macroprolactinoma and 47.07±9.70 mm in the giant prolactinoma group (p

Background: The COVID-19 pandemic caused by SARS-CoV-2 has had adverse effects in every field. One of the affected areas is organ supply and transplantation. This study aimed to evaluate the impact of the pandemic period on the number of kidney transplants in 2019 and 2020 in countries with a population of 40 million and above. Material and Methods: We evaluated kidney transplants from living and deceased donors reported between 2019 and 2020 from the Global Observatory on Donation and Transplantation (GODT). We obtained the number of kidney transplants in countries with a population of 40 million and over before and after the COVID-19 pandemic. Results: The total number of kidney transplants performed in 2019 and 2020 of countries with a population of 40 million or more, which sent data to the GODT database, were respectively: Sudan 313 and 139, Algeria 270 and 91, Argentina 1,675 and 854, Spain 3,423 and 2,702, Colombia 947 and 526, Republic of Korea 2,293 and 2,280, Italy 2,139 and 1,907, France 3,643 and 2,595, UK 3,649 and 2,567, Thailand 679 and 712, Germany 2,132 and 1,909, Iran 2,101 and 1,240, Turkey 3,863 and 2,498, Philippines 300 and 132, Ethiopia 35 and 8, Japan 1,913 and 1,697, Mexico 2,976 and 913, Russian Federation 1,473 and 1,124, Bangladesh 205 and 155, Nigeria 164 and 165, Pakistan 1,306 and 129, Brazil 6,298 and 4,830, United States 24,273 and 23,644, India 9,751 and 5,486, China 12,124 and 11,037. Conclusions: Compared to 2019, deceased and living kidney transplants increased only in Thailand in 2020, while kidney transplants in other countries have decreased. Countries where deceased kidney transplants increased in 2020, were Thailand, Korea, and the United States. Total kidney transplants in Turkey decreased by 35.4% in 2020 compared to 2019.

Introduction Insulinomas constituting the most common cause of endogenous hyperinsulinism-related hypoglycemia are neuroendocrine tumors originating from pancreatic beta cells. They are generally benign and solitary lesions. Although most cases are sporadic, multiple endocrine neoplasia (MEN) 1-related patients are also present. Material and Method Thirteen patients followed up in Bursa Uludağ University Medical Faculty Endocrinology and Metabolic diseases clinic between the years 2012 and 2021 were retrospectively evaluated. Demographical, clinical, biochemical, radiological and histopathological data of the patients were assessed. Results Eight of the patients were females, and five were males with an average age of 43±14.9 years. Ten of the patients had sporadic, and three had MEN1 syndrome-related insulinoma. During the prolonged fasting test, the patients had a mean lowest plasma glucose level of 36.4 ± 6.2 mg/dl with a simultaneous mean insulin level of 11.3 (4.4 - 214.1) mIU/L and c-peptide level of 2.8 (0.46-12.8) mcg/L. In preoperative localization studies, a lesion was detected in 11 out of 13 (84.6%) patients with upper abdominal computed tomography (CT) and 6 out of 10 patients (60%) with magnetic resonance imaging (MRI). Six patients had grade 1, and 7 patients had grade 2 neuroendocrine tumor. The whole group's mean lesion diameter was 15 (11-48) mm. The mean patient follow-up duration was 30.5 ± 23 months. Hypoglycemia recurred in none of the patients in the postoperative period, and only two patients (15.4%) developed postoperative diabetes mellitus (DM). Conclusion Preoperative localization rates in insulinomas increased due to non-invasive imaging methods and technological developments in recent years. This will probably cause earlier diagnosis and treatment, and pancreas preserving surgery option will be more available in most insulinoma cases.

Cutaneous drug reactions usually occur with mild and self-limiting lesions, but severe forms can be life-threatening. Non-steroidal anti-inflammatory drugs, antibiotics, and anticonvulsants often cause drug reactions. Herein, we presented two cases of immunological drug reaction, one with mild and localized fixed drug eruption and the other with more severe and diffuse DRESS syndrome.

The World Health Organization has produced a series of publications to create the general framework of mental health services. One of the main data sources is the WHO guide on community mental health services and the document promoting person-centered and human rights-based approaches. It includes the regulation of service providers' relations with the housing, education and employment sectors at the point of implementation of regional and national policies and the promotion of actions that are respectful of human rights and focused on recovery. It is a guide that offers various technical packages for the establishment and successful implementation of community-oriented mental health services. Various international framework agreements, including the United Nations Convention on the Rights of Persons with Disabilities, also suggest the establishment of community-oriented mental health services. The common goal of up-to-date medical evidence-based information and international policymakers is to make the community-based mental health service model permanent on a global scale, especially in low-income and developing countries.

Objectives: Chronic kidney disease (CKD) is an increasing public health problem. It is very important to know the definition of CKD, its risk factors and to predict the progression of its stages. Recently, the monocyte/HDL ratio (MHR) has been thought to be a new marker of inflammation and oxidative stress. In this study, it was aimed to investigate the relationship between stages and MHR in patients with stage 3A, stage 3B and stage 4 CKD. Methods: A total of 632 patients with CKD, aged 18 years and older, with stage 3A, stage 3B and stage 4 (eGFR) according to CKD stage were included in our study. Our study is retrospective and the data of the patients were obtained from the hospital system. Kruskal-Wallis and post hoc Tukey HSD tests were used for statistics. p < 0.05 was considered statistically significant. Results: The mean age of the patients included in the study was 63.4 ± 14.91(min:18max:98), and 305 (48.25%) of these patients were male and 327 (51.75%) were female. According to eGFR, 155 (24.5%) of the patients were stage 3A, 150 (23.8%) were stage 3B, and 327 (51.7%) were stage 4. In the statistical study of the groups divided into CKD stages with MHR, there was no significant difference between the groups (p: 0.245), while there was statistical significance for gender and hypertension (p: 0.004 and p: 0.044, respectively). Conclusion: As a result of this study, we concluded that MHR is not affected by CKD stages.

Giriş ve Amaç: Akut inmeye bağlı mortalite ve morbidite oranları yüksek olduğundan bu hastaların erken prognoz öngörüsünü yapmak önemlidir. Acil serviste iskemik ya da hemorajik inme tanısı alan hastaların Ortalama trombosit hacmi (MPV), Platelet (PLT) ve MPV/PLT değerleri ile hastaların demografik özellikleri, triaj kodu, sonlanımı, hastaların vital parametreleri ve Glaskow Koma Skalası (GKS) arasındaki ilişki değerlendirilmeye çalışılmıştır.Gereç ve Yöntemler: Bu çalışma 3. Basamak Üniversite Hastanesi Acil servisine başvuran 18 yaş üstü, yapılan tetkikler neticesinde iskemik veya hemorajik inme tanısı alan 200 hasta üzerinde retrospektif olarak yapılmıştır.Bulgular: Çalışmamıza 116 (%58)’sı erkek olmak üzere toplam 200 hasta dahil edilmiştir. Hastaların yaş ortalaması 68 yıl olarak tespit edilmiştir. Hastaların 178 (%89)’inin iskemik, 22 (%11)’sinin hemorajik inme tanısı aldığı görüldü. Hastaların yaşı ve MPV/PLT oranları arasında korelasyon bulunmuştur (p, Objective: Since mortality and morbidity rates due to acute stroke are high, it is important to predict early prognosis in these patients. The relationship between mean platelet volume (MPV), Platelet (PLT) and MPV/PLT values of patients diagnosed with ischemic or hemorrhagic stroke in the emergency department, and demographic characteristics, triage code, outcome, vital parameters of patients, and Glasgow Coma Scale (GCS) were tried to be evaluated.Materials and Methods: This study was carried out retrospectively on 200 patients over the age of 18 who applied to the 3rd Stage University Hospital Emergency Department and were diagnosed with ischemic or hemorrhagic stroke as a result of the examinations.Results: A total of 200 patients, 116 (58%) of whom were men, were included in our study. The mean age of the patients was 68 years. It was seen that 178 (89%) of the patients were diagnosed with ischemic stroke and 22 (11%) with hemorrhagic stroke. A correlation was found between the patients'age and MPV / PLT ratios (p

Giriş ve Amaç: Helikobakter pilori (Hp) enfeksiyonu tanısında invaziv ve non-invaziv testler mevcuttur. Bu testler içerisinde endoskopik biopsi altın standarttır. Bu çalışmada; Hp tanısında kullanılan gaitada antijen testinin özgüllük ve duyarlılığını mide endoskopik biopsisi ile karşılaştırmayı amaçladık. Gereç ve Yöntemler: Sağlık Bilimleri Üniversitesi Tepecik Eğitim ve Araştırma hastanesi iç hastalıkları polikliniğine Ocak 2016-Nisan 2018 tarihleri arasında dispeptik şikayetler ile başvuran toplam 220 hasta geriye dönük taranmıştır. Bu hastalardan; eşzamanlı Hp tanısı için gaitada antijen ve endoskopik biopsi yapılan, her iki tanı testi arasında antibiyotik ve proton pompa inhibitörü almamış olan 74 hasta çalışmaya dahil edilmiştir. Bulgular: Gaitada Hp antijeni pozitif saptanan 45 hastanın 42 (%93,3)’sinde endoskopik biopsi pozitif iken; gaitada Hp antijeni negatif saptanan 29 hastanın 3 (%10,3)’ünde endoskopik biopside Hp pozitif saptandı. Endoskopik biopsi ile karşılaştırıldığında gaitada Hp antijeninin duyarlılığı %93.3, özgüllüğü %89,6, pozitif prediktif değeri %93,3, negatif prediktif değeri %89,6 olarak bulunmuştur. Hp tespitinde kitin duyarlılığı %94’ün üzerinde kabul edilmektedir. Bu çalışmada da sonuçlar benzerdir (%93,3). Sonuç: Dispeptik şikayetleri olan ve maligniteden şüphelenilmeyen durumlarda Hp tanısı için endoskopi yerine gaitada antijen testi güvenle bakılabilir., Objective: Invasive and non-invasive tests are available for the diagnosis of Helicobacter pylori (Hp) infection. Among these tests, endoscopic biopsy is the gold standard. In this study; We aimed to compare the specificity and sensitivity of stool antigen test used in the diagnosis of Hp with gastric endoscopic biopsy. Materials and Methods: A total of 220 patients who applied to the Internal Medicine outpatient clinic of Health Sciences University Tepecik Training and Research Hospital with dyspeptic complaints between January 2016 and April 2018 were retrospectively screened. Of these; 74 patients who underwent stool antigen and endoscopic biopsy for the diagnosis of simultaneous Hp, and who did not receive antibiotics and proton pump inhibitors between diagnostic tests were included in the study.Results: While endoscopic biopsy was positive in 42 (93.3%) of 45 patients with positive stool Hp antigen; In 3 (10.3%) of 29 patients who were found to be negative for Hp antigen in the stool, Hp was positive in endoscopic biopsy. When compared with endoscopic biopsy, the sensitivity of Hp antigen in stool was 93.3%, specificity 89.6%, positive predictive value 93.3% and negative predictive value 89.6%. The sensitivity of the kit in the detection of Hp is considered to be over 94%. In this study, the results were similar (93.3%). Conclusion: In cases with dyspeptic complaints and no suspected malignancy, stool antigen test can be safely performed instead of endoscopy for the diagnosis of Hp.

Aim: The natural course of sarcoidosis is heterogeneous. There is no clear marker that can predict the course of this disease and its characteristics over months/years. We aimed to analyze our patients' data to identify a prediction parameter at admission.Methods: The patients with sarcoidosis and followed-up between 01/01/2015 and 31/12/2020 comprised the study group. The patients were staged by a Scadding staging system. Improvement or deterioration in at least two of the clinical-laboratory-radiological parameters indicates regression, stable disease, progression, or relapse of sarcoidosis.Results: The study group comprised 4 cases (6.9%) defined as stage 0; 15 cases (25.86%) as stage 1; 39 cases (67.24%) were defined as stage 2. The mean age at diagnosis was 40.84±13.56 in stage 0 + stage 1 group, while it was 48.05±13.36 in the stage 2 group (p=0.06). 74.1% of the cases were women. The female/male ratio was found at 2.86. 57 out of 58 cases had a pathological diagnosis (EBUS TBNA). While PFTs values and DLCO were significantly lower at advanced stages but the same statistical significance was not identified between these values and the clinical course of the disease. As a result of the multivariate analysis, it was observed that only the presence of chest pain at admission affected the progression of the disease in the follow-up period.Conclusion: Sarcoidosis is a multi-systemic disease and there is no clear finding for predicting the poor prognosis of the disease. We conclude that chest pain symptom at admission is valuable predictive finding and can be used as a clue for the progression at follow-up., Amaç: Sarkoidozun doğal seyri heterojendir. Bu hastalığın seyrini ve özelliklerini aylar/yıllar içinde öngörebilecek net bir belirteç yoktur. Başvuru sırasında bir tahmin parametresi belirlemek için hastalarımızın verilerini analiz etmeyi amaçladık.Yöntem: 01/01/2015-31/12/2020 tarihleri arasında sarkoidoz tanısıyla takipte olan hastalar çalışma grubumuzu oluşturdu. Hastaların başvuru grafileri dahil Scadding evreleme sistemi ile evrelendi. Klinik-laboratuvar-radyolojik parametrelerin en az ikisinde düzelme veya bozulma sarkoidozda gerileme, stabil hastalık, progresyon veya relaps olduğunu gösterir.Bulgular: Çalışmaya dahil ettiğimiz 4 vaka (%6,9) evre 0, 15 olgu (%25,86) evre 1, 39 olgu (%67,24) evre 2 olarak tanımlandı. Tanı yaşı ortalaması evre 0 + evre 1 grubunda 40,84±13,56, evre 2 grubunda 48,05±13,36 idi (p=0,06). Vakaların %74,1'i kadındı. Kadın/erkek oranı 2,86 olarak bulundu. 58 olgunun 57'sinde patolojik tanı vardı. Kullanılan yöntem Endobronşial ultrasonografi eşliğinde transbronşial iğne aspirasyonu idi (EBUS TBNA). Solunum fonksiyon testleri (SFT) ve karbonmonoksit difüzyon testi (DLCO) ileri evrelerdeki hastalarda anlamlı olarak daha düşük iken, bu testlerin sonuçları ile hastalığın klinik seyri arasında aynı istatistiksel anlamlılık saptanmadı. Çok değişkenli analiz sonucunda takip döneminde sadece başvuru anında göğüs ağrısının varlığının hastalığın progresyonunu etkilediği görüldü.Sonuç: Sarkoidoz multisistemik bir hastalıktır ve hastalığın kötü prognozunu öngörmek için net bir bulgu yoktur. Başvurudaki göğüs ağrısı semptomunun değerli bir prediktif bulgu olduğunu ve takipteki progresyon için bir ipucu olarak kullanılabileceğini düşünüyoruz.

Amaç: Pulmoner emboli, acil servislerde sıklıkla karşılaşılan, potansiyel olarak yaşamı tehdit eden bir kardiyovasküler hastalıktır. Bilgisayarlı tomografi pulmoner anjiyografi, pulmoner emboli tanısında tercih edilen görüntüleme yöntemidir. Bu çalışmada, acil serviste akut pulmoner emboli tanısı konulan hastaları inceleyerek klinik bulguların ve tedavi yöntemlerinin prognoz ve mortalite üzerine etkilerini incelemeyi amaçladık.Yöntem: Bu retrospektif kohort çalışmada akut pulmoner emboli hastalarının kayıtlarına arşivden ulaşıldı. Hastaların yaşı, cinsiyeti, tıbbi şikayetleri, ek hastalıkları, hastalara uygulanan tedavi yöntemi ve hastaların klinik sonuçları analiz edildi. Hastaların demografik ve klinik bilgilerinin istatistiksel dağılımı hesaplandı.Bulgular: Akut pulmoner embolili 206 hastanın en sık şikayeti nefes darlığıydı. Hastaların %25.7'sinde masif pulmoner emboli vardı. Masif pulmoner emboli hastalarında kan d-dimer, laktat ve troponin T düzeyleri submasif pulmoner emboli hastalarına göre daha yüksek bulundu. Akut pulmoner emboli hastalarının %6.8'ine trombolitik tedavi uygulanmış ve sağ kalımı istatistiksel olarak olumlu etkileyen bir yöntem olduğu saptanmıştır. Mortal hastalarda d-dimer, beyaz küre, nötrofil, kan üre nitrojen, laktat ve troponin T değerleri daha yüksek bulundu. Hastaların %13.1'inin hayatını kaybettiği belirlendi.Sonuç: Acil serviste ölümcül olabilen akut pulmoner emboli ne kadar erken teşhis edilir ve tedavisine başlanırsa mortalite oranı önemli ölçüde azalacaktır., Aim: Pulmonary embolism is a potentially life-threatening cardiovascular disease frequently encountered in emergency departments. The computed tomography pulmonary angiography is the imaging modality of choice in the diagnosis of pulmonary embolism. This study aimed to examine the effects of clinical findings and treatment methods on prognosis and mortality by examining patients diagnosed with acute pulmonary embolism in the emergency department.Methods: In this retrospective cohort study, records of patients with acute pulmonary embolism were accessed from the archive. Patients' age, gender, medical complaints, co-morbidities, the treatment method applied to the patients, and the clinical outcomes of the patients were analyzed. The statistical distribution of the patients' demographic and clinical information was calculated.Results: The most common complaint of 206 patients with acute pulmonary embolism was dyspnea. 25.7% patients had massive pulmonary embolism. The blood d-dimer, lactate and troponin T levels of patients with massive pulmonary embolism were found to be higher than patients with sub-massive pulmonary embolism. Thrombolytic therapy was administered to 6.8% of acute pulmonary embolism patients and it was found to be a method that had a statistically positive effect on survival. D-dimer, white blood cell, neutrophil, blood urea nitrogen, lactate and troponin T values were found to be higher in mortal patients. It was determined that 13.1% of the patients died.Conclusion: The sooner the early diagnosis of acute pulmonary embolism, which can be mortal in the emergency department, is made and the treatment is started, the mortality rate will decrease significantly.