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Objectives To evaluate the central sensitization (CS) and the related parameters in patients with axial spondyloarthritis (axSpA). Methods Quantitative sensory testing (QST) which consists of pressure pain threshold (PPT), temporal summation (TS), and conditioned pain modulation (CPM) were applied to the participants. Disease activity, functional status, sleep quality, pain, depression, and fatigue were assessed. Patients were divided as the ones with and without CS according to the central sensitization inventory (CSI) and the results were compared. Results One hundred patients and 50 controls were recruited. Sixty axSpA patients had CS. When QST results were compared between the patient and control groups, all PPT scores were found lower (p 0.05). All investigated comorbidities were found to be significantly more frequent (p Conclusions CS and related comorbidities were found to be increased in axSpA patients. This increase should be taken into consideration in the management of these patients.

This study aimed to investigate the frequency of CS and its clinical and functional effects on familial Mediterranean fever (FMF). A hundred FMF patients were included in this study. The presence of CS was investigated by the central sensitization inventory (CSI). In addition to the detailed clinical features of patients and genetic mutations, quality of life, disability, sleep disorders, depression, anxiety, and fibromyalgia frequency were examined to evaluate the negative effects of CS on the individual. Patients were divided into groups according to the presence and severity of CS, and their results were compared. Correlation and multivariate regression analysis were performed to investigate the association of CS with selected demographic and clinical parameters. The mean CSI was 37.72 (SD: 19.35), and thirty-eight (38%) patients had CS. Sacroiliitis occurred in 11 patients (11%), amyloidosis in 3 (3%), and erysipelas-like erythema in 11 (11%). The most prevalent genetic mutation was M694/any compound heterogeneous (35.7%), followed by M69V homogeneous (30%). Regarding comparing the patients with and without CS, the number of attacks, disease activity, daily colchicine dose, and all investigated comorbidities were significantly higher in the patients with CS (p < 0.05). In regression analysis, gender, colchicine dose and sleep disturbance were detected as related parameters with CS (OR (95% CI): 6.05 (1.39; 26.32), p: 0.017, OR (95% CI): 6.69 (1.65; 27.18), p: 0.008, OR (95% CI): 1.35 (1.35; 1.59), p: 0.001, respectively). Concomitant pain sensitization appears to be related to FMF patients\" clinical and functional characteristics. These results suggest taking into consideration CS in the management of FMF patients.

Objective:The aim of this study is to investigate the frequency of fractures and related factors in children with spina bifida who were followed up in our hospital.Materials and Methods:By retrospectively examination of the medical records of 450 patients with spina bifida, who were followed up by our clinic between 2000 and 2018, the patients were evaluated in terms of factors such as frequency of fracture, age of the first fracture, lesion level, ambulation capacity, physical therapy initiation age, fracture site and mechanism.Results:In the 450 patients examined, the fracture rate was 5.7%. While there was a relationship between low ambulatory capacity and high-level lesions and fracture risk, the early initiation of physical therapy did not protect against fracture.Conclusion:According to these data, fractures are more common in patients with spina bifida. It was concluded that the quality of mobilisation, not the duration, was the more important risk factor for fracture.

This study aimed to synthesize zinc nanoparticles with antimicrobial and antioxidant activities using alternan (ZnNPs-Alt) produced by Lactobacillus reuteri E81 as the stabilizing agent. For the ch...

Bu araştırmanın amacı alkol bağımlılarında benlik saygısı, algılanan sosyal destek, başetme stratejileri ve bunlar arasındaki ilişkiyi ortaya koymaktır. Bu çalışma, İstanbul, Ankara, İzmir, Konya ve Bursa’da Adsız Alkolikler toplantılarına katılan 100 alkol bağımlısı ve alkolü bırakan bireyle gerçekleştirilmiştir. Veri toplama aracı olarak araştırmacılar tarafından geliştirilen sosyodemografik bilgi formu, Çok Boyutlu Algılanan Sosyal Destek Ölçeği, Coopersmith Benlik Saygısı Ölçeği ve Kısa Form Başetme Ölçeği kullanılmıştır. Verilerin analizinde Mann Whitney U, Kruskal Wallis ve Spearman Brown test teknikleri kullanılmıştır. Algılanan sosyal destek düzeyi yüksek katılımcıların benlik düzeyi yüksek bulunmuş ve daha çok sorun odaklı başetme stratejilerini kullandıkları bulunmuştur. Bu bulgudan hareketle sosyal destek sistemlerinden yeterince yararlanamayan alkol bağımlılarının ruh sağlığı profesyonelleri tarafından psikososyal açıdan daha çok desteklenmeleri tavsiye edilmektedir.

BACKGROUND This study evaluated the effect of bilateral endoscopic sphenopalatine ganglion block (SPGB) for management of postoperative pain in patients undergoing septoplasty. METHODS Sixty septoplasty patients (51.7% male, 48.3% female, aged 18 to 45 years) were randomly assigned to general anesthesia (GA) alone (control) (n = 30) or GA plus endoscopic SPGB (n = 30). Demographic data, duration of surgery, blood loss, postoperative visual analogue scale (VAS) pain scores (upon arrival at the postanesthesia care unit [PACU] and 2, 6, 12, and 24 hours after surgery), overall analgesic usage (end of 24 and 168 hours after surgery), overall satisfaction with the pain control (end of 24 and 168 hours after surgery), and complications (bleeding, nausea and vomiting, and visual disturbance) were recorded. RESULTS Pain scores upon arrival to the PACU and 2, 6, 12, and 24 hours after surgery were significantly lower in the SPGB group compared to the control group (p < 0.001). Moreover, the SPGB group had significantly lower analgesic requirements and higher satisfaction scores with their pain control at the end of 24 and 168 hours after surgery compared to the control group (p < 0.001). The 2 groups significantly differed in terms of intraoperative blood loss (p = 0.024), and surgery time was longer in the SPGB group compared to the control group (p < 0.001). CONCLUSION SPGB with bupivacaine is a safe and effective method to reduce pain after septoplasty, and it is a cost-effective alternative to high doses of analgesics.

Background: to retrospectively assess the impact of prognostic nutritional index (PNI) on survival outcomes of patients with locoregionally advanced nasopharyngeal carcinoma (LA-NPC) treated with concurrent chemoradiotherapy (CCRT). Methods: this study incorporated 154 patients with LA-NPC who received exclusive cisplatinum-based CCRT. Receiver operating characteristic (ROC) curve analysis was utilized for accessibility of pretreatment PNI cutoffs influencing survival results. The primary end point was the interaction between the overall survival (OS) and PNI values, while cancer-specific survival (CSS) locoregional progression-free survival (LR-PFS), distant metastasis–free survival (DMFS), and PFS were the secondary end points. Results: a rounded PNI cutoff value of 51 was identified in ROC curve analyses to exhibit significant link with CSS, OS, DMFS, and PFS outcomes, but not LR-PFS. Patients grouping per PNI value (≥51 [N = 95] vs 5% over past 6 months (49.2% versus 11.6%; P =.002) compared to PNI < 51 group. Conclusion: low pre-CCRT PNI levels were independently associated with significantly reduced CSS, OS, DMFS, and PFS outcomes in patients with LA-NPC treated with definitive CCRT., NA

Although meningioma is mainly a central nervous system tumor, primary pulmonary meningioma is a rare lung neoplasm located outside the central nervous system. There is no clear consensus on its origin. A 42-year-old female patient, without any pre-diagnosis or symptom, was admitted to our clinic due to an incidentally detected lesion on chest X-ray during routine controls. The lesion in the lower lobe of the left lung was successfully resected by surgical intervention. In this study; primary pulmonary meningioma was examined because of its rarity and presented with the literature data.

INTRODUCTION Brain metastasis prevalence is higher in patients with positive epidermal growth factor receptor (EGFR) mutation, anaplastic lymphoma kinase (ALK) and C-ROS oncogene 1 (ROS-1) fusion change in lung adenocarcinoma. OBJECTIVES The purpose of our study is to investigate the relation between the genetic change type and the initial distant metastasis in stage IV lung adenocarcinoma patients with genetic changes. METHODS The study was conducted between January 2007 and December 2018 in a retrospective fashion with patients who had lung cancer diagnosed as stage IV adenocarcinoma. The relation between genetic mutation change (EGFR, ALK or ROS-1) and distant metastasis was analysed. RESULTS A total of 845 patients were included in the study. The median age was 62 (28-88). It was determined that lung and pleura metastases were more frequent at a significant level in patients with positive EGFR mutation (P = 0.032, P = 0.004, respectively). In patients with positive ALK fusion change, pleura metastasis was determined to be more frequent (P = 0.001). Multiple metastases were determined to be significantly more in patients with positive ALK fusion change than single metastasis (P = 0.02). CONCLUSION In patients with EGFR mutant lung adenocarcinoma, lung and pleura metastasis is more frequent and pleura metastasis is more frequent in ALK positive adenocarcinoma. Additionally, multiple organ metastases are higher in ALK positive lung adenocarcinoma.

Previous reports have indicated the association of allergy with Waldeyer's ring. The aim of this prospective study was to evaluate the correlation between the allergy and the number of eosinophils in the adenoid and tonsil tissue.101 children who were underwent adenoidectomy and/or tonsillectomy were prospectively enrolled in this study. 46 children who had positive skin-prick test for at least one of the allergen panel were sensitized and 55 children were nonsensitized as a result of skin-prick test. Hematoxylin-eosin stained sections were examined under 400× magnification in a blinded fashion in 10 random sections for all samples and compared the groups.The number of eosinophils in adenoid and tonsil tissue was significantly higher in sensitized patients. The number of eosinophils in the adenoid and tonsil samples also were interrelated too (p 0.001, kappa coefficient: 0.617). As a result of ROC analysis, patients with a cut-off of ≥5 eosinophils was in the sensitized group for adenoid samples [Sensitivity value: 72.09 and specifity value: 91.84]. Patients with a cut-off of ≥3 eosinophils are in the sensitized group for tonsil samples [Sensitivity value: 52.94 and specifity value: 92.11].Presence of sensitization can be distinguished by looking at the number of eosinophils in the adenoid and tonsil tissue. It can be used to determine whether the patient is allergic or not. Examination of the routine hematoxylin-eosin stained adenotonsillary specimen for eosinophilia will guide us the diagnosis and treatment of allergic rhinitis and also reduce the cost considerably.

Başarılı bir üreme döngüsü sağlıklı aydınlık/karanlık döngüye sahip fizyolojik koşullarla doğrudan ilişkilidir. Sirkadyan ritim olarak da ifade edilen, bu aydınlık karanlık döngü memeli üreme sistemleri için önemlidir. Özellikle dişi üreme döngüsü ovulasyon ve sirkadyan ritmi içeren kompleks bir süreçtir. Bu kompleks süreçte antioksidan aktivitesiyle melatonin çok önemli bir yere sahip olmakla birlikte, melatonin sentezleyen organ listesi yapılan çalışmalar ışığında gün geçtikçe artmakta ve bu organların arasında ovaryum da yer almaktadır Dolayısı ile pineal bezin yanısıraovaryumda da melatonin sentezlendiği ve sentezlenen melatoninin foliküler sıvıya salındığı ileri sürülmektedir. Benzer şekilde in vitrofertilizasyon (IVF) çalışmalarında medyuma melatoninin eklenmesi ile tedavide pozitif sonuçlar elde edilmiştir. Bu derlemede, karanlığın mucizesi olan melatoninin genel özelliklerini ve özellikle son yıllarda yapılan çalışmalar ile ortaya konulan ovulasyon-melatonin ilişkisini farklı yönleri ile ele almayı amaçladık.

Background: to retrospectively investigate the influence of pretreatment anemia and hemoglobin levels on the survival of nasopharyngeal carcinoma patients treated with concurrent chemoradiotherapy (C-CRT). Methods: a total of 149 nasopharyngeal carcinoma patients who received C-CRT were included. All patients had received 70 Gy to the primary tumor plus the involved lymph nodes, and 59.4 Gy and 54 Gy to the intermediate- and low-risk neck regions concurrent with 1-3 cycles of cisplatin. Patients were dichotomized into non-anemic and anemic (hemoglobin, NA

OBJECTIVES The effect of non-steroidal anti-inflammatory drugs (NSAID), mostly used for postoperative analgesic purposes for wound healing, is still a matter of debate. Our goal was to evaluate the effects of the most widely used NSAID and corticosteroids after surgical operations on tracheal wound healing in an experimental rat model. METHODS Thirty-nine male Wistar albino rats were included in this study. Tracheotomy was performed in 32 rats; then they were divided into 3 groups. After the first day, the animals in group 1 were treated with an NSAID (diclofenac 10 mg/kg/day) (NSAID, n = 12) for 7 days; the animals in group 2 were treated with a corticosteroid (dexamethasone, 2 × 0.1 mg/kg/day) (steroid, n = 10) for 7 days; the animals in group 3 (control, n = 10) were not given any medications. For a fourth group (histological control, n = 7), in order to evaluate normal morphological and histological characteristics, neither surgery nor medication was used. Five rats were eliminated from the study (2 rats in the NSAID group died and 3 rats in the steroid group developed local wound infections). The drop-out rate was 12.8%. Histological characteristics, inflammation, fibrosis, necrosis, neochondrogenesis, neovascularization and epithelization were evaluated in 34 rats. Non-parametric tests were used for statistical analysis. RESULTS Inflammation, vascularization and number of fibroblasts and chondrocytes were significantly higher in the control group than in the histological control group. There was some reduction in all parameters except vascularization in the NSAID group (P > 0.05). When the steroid group was compared to the NSAID group, inflammation (P 0.05) were more suppressed in the steroid group. The number of fibroblasts increased in the steroid group (P > 0.05). CONCLUSIONS Steroids and NSAID may have negative effects on tracheal wound healing, probably by suppressing inflammation and fibroblast proliferation. NSAID was mostly used postoperatively for analgesic purposes and should be avoided.

OBJECTIVES Among the nodule types, the most controversial group are indeterminate solid nodules from 1 to 2 cm in size with the first choice being transthoracic needle biopsy (TTNB) or positron emission tomography (PET-CT) or both methods together. However, no single diagnostic algorithm could be applied to all cases. This research discusses the diagnostic success of PET-CT and TTNB. MATERIALS AND METHODS 407 Patients who referred to our hospital for any reason, with solid nodules with the size from 1 to 2 cmincidentally identified on the thoracic CT tests were investigated. Among the patients who underwent biopsy, 312 cases had PET-CT, and maximum SUV (SUVmax) values of the nodules were examined. Values of ≥2.5 were accepted as hypermetabolic. RESULTS The mean age of the patients was 61 ± 10.8 years. 84 patients were female (20.6%) and 323 were male (79.4%). For TTNB; sensitivity, specificity and accuracy rates of all cases, who were correctly diagnosed, were 76.9%, 83.3% and 78.9%, respectively (P

Background and Aims: Pulmonary hamartomas appear as parenchymal or endobronchial lesions, the latter representing ‘1.4 to 11%’ of the total number of pulmonary hamartomas. Endobronchial hamartomas usually emerge as a single mass. As they are accepted as benign tumors, endobronchial treatments are recommended today. 45 year-old male patient admitted with cough, phlegm and fever. A lesion totally obstructing the right main bronchus was found in CT. Methods: In his brochoscopy, a mobile, smooth-surfaced lesion obstructing right main bronchus was seen. Its histopathology was reported as ‘hamartoma.’ Results: The lesion was removed by using argon plasma coagulation and electrocotery. After the removal of the lesion in right main bronchus, another lesion with similar characteristics was seen in the intermedius bronchus and this lesion which histopathology was reported as ‘hamartoma’ was excised by using electrocauter snare. There was no recurrence in the 24 month follow-up. Conclusion: Reports of multiple endobronchial hamartomas are rare in the literature, and the awareness of this form of benign disease is important in the differential diagnosis of pulmonary diseases.

Purpose: The aim of this study is to evaluate the psychological profile and personality traits of patients with vestibular dysfunction (VD).Materials and Methods: A total of 452 participants, 225 patients with VD and 227 control subjects who had no complaints of VD, were included in the study. Otorhinolaryngologic examination and vestibular assessment were performed. The Dizziness Handicap Inventory (DHI) was completed by the patients to determine the handicap and the severity caused by dizziness. The psychological aspects of the patients were assessed using the Eysenck Personality Questionnaire-Revised Abbreviated form (EPQR-A), Type D personality scale (DS-14), and the Hospital Anxiety and Depression Scale (HADS).Results: Of the 452 participants, 157 (69.8%) were female and 68 (30.2%) were male, while, of the control subjects, 133 (58.6%) were female and 94 (41.4%) were male. It was found that 81 (36%) patients and 42 (18.2%) control subjects had received psychiatric treatment. The EPQR-A neuroticism subscale and the anxiety and depression subscale of the HADS were statistically significantly higher in the patients. The negative emotions and social suppression subscales of the DS-14 were statistically significantly higher in the patients.Conclusion: This study revealed that neurotic personality traits and type D personality were higher in patients with VD. Thus, we believe that the psychological profile and personality traits of patients complaining of vestibular diseases are important in diagnosis and treatment., Amaç: Bu çalışmada, vestibüler disfonksiyonlu hastaların, psikolojik profil ve kişilik özelliklerini değerlendirmeyi amaçlanmıştır.Gereç ve Yöntem: Vestibüler disfonksiyon şikayeti olan 225 hasta ve vestibüler disfonksiyon şikayeti olmayan 227 kontrol olmak üzere toplam 452 kişi çalışmaya alındı. Otorinolaringolojik muayene ve vestibüler değerlendirme yapıldı. Baş dönmesinin yol açtığı özür ve şiddeti belirlemek için Dizziness Handicap İndeksi (DHI) formu hastalar tarafından dolduruldu. Hasta ve kontrol grubuna, Eysenck Personality Questionnaire-Revised Abbreviated (EPQR-A), Type D personality scale (DS-14) ve Hospital Anxiety Depression Scale (HADS) formları dolduruldu.Bulgular: Hastaların 157’si (%69.8) kadın, 68’i (%30.2) erkek, kontrollerin 133’ü (%58.6) kadın, 94’ü (%41.4) erkek idi. Hasta ve kontrol grubunda ortalama yaş 39.72±14.08 ve 35.02±11.80 idi. Hastaların 81’inin (%36), kontrollerin 42’sinin (%18.4) psikiyatrik tedavi aldığı saptandı. EPQR-A, nevrotizm alt ölçeği, vertigolu hastalarda kontrol grubuna göre istatistiksel olarak anlamlı düzeyde daha yüksek bulundu. HADS’ın anksiyete ve depression alt ölçeği, vertigolu hastalarda kontrol grubuna göre daha yüksek ve istatistiksel olarak anlamlı bulundu. DS 14’ün, negative emotions and social suppression alt ölçekleri, vertigolu hastalarda kontrol grubuna göre daha yüksek ve istatistiksel olarak anlamlı olarak bulundu.Sonuç: Bu çalışma, vestibüler disfonksiyonlu hastalarda "nevrotik" kişilik özelliklerinin ve Tip D kişiliğin daha yüksek oranda olduğunu gösterdi. Sonuç olarak, vestibüler hastalıklardan şikayet eden hastaların psikolojik profil ve kişilik özelliklerinin, tanı ve tedavide önemli olduğunu düşünmekteyiz.

Myxomas of the nose are very rare benign neoplasms. They grow slowly, infiltrate the surrounding bone cortex, and develop multiple local recurrences with no distant metastasis. Almost, even knowing seen at any age, it is very rare in newborn. The authors present a patient with sinonasal soft tissue fibromyxoma in a newborn baby nose followed by the literature.

Objective: To report a case of Churg-Strauss syndrome who had asthma and allergic rhinitis treated with montelukast. Clinical Presentation and Intervention: A nonsmoking 59-year-old woman presented with fever, hemoptysis and dyspnea. Past medical history included allergic rhinitis and asthma which were diagnosed 18 years ago. The asthma was treated successfully with inhaled salmeterol and beclamethasone. She also received montelukast (10 mg/day) for 3 years. Although her chest X-ray was normal a week earlier, she had widespread bilateral pulmonary infiltrates on admission. She had leukocytosis (12.5 × 109/l) with eosinophilia (15.6%). Her total IgE count was 550 U/ml. Testing for protoplasmic-staining antineutrophil cytoplasmic antibodies was positive. Bronchoalveolar lavage could not be performed due to bronchospasm and severe hypoxemia; however, mucosal biopsies were obtained, which revealed eosinophil leukocytes in the lumen and walls of small vessels. She was diagnosed to have Churg-Strauss syndrome and had remarkable clinical improvement on day 5 with high-dose of oral prednisolone (50 mg/day). Radiological improvement was detected at the end of the second week. Conclusion: This case shows the importance of being aware that leukotriene receptor antagonists could cause Churg-Strauss syndrome, in spite of the uncertainty about its mechanism.

Introduction: Several markers have been investigated to predict the prognosis of lung cancer. In the present study, the prognostic values of epithelial growth factor receptor (EGFR), vascular endothelial growth factor (VEGF), E-cadherin, and p120 catenin expression were investigated by immunohistochemistry in patients with a surgically resected non-small cell lung carcinoma (NSCLC). Patients and method: EGFR, VEGF, E-cadherin, and p120 catenin expression were prospectively determined in resected specimens from patients with NSCLC who had undergone surgery between 2003 and 2007. Patients’ and disease-related general characteristics and survival rate were recorded.