GÝRÝÞ ve AMAÇ: Bu çalýþmanýn amacý, pelvik organ prolapsusu cerrahi onarýmýnýn nüks oranlarýný deðerlendirmektir.
YÖNTEM ve GEREÇLER: Haziran 2012 ile Mayýs 2017 tarihleri arasýnda rastgele seçilen 126 kadýna pelvik organ prolapsusu cerrahi onarýmý yapýldý. Evreleme için POP-Q Sistemini kullandýk. Hastalar dört gruba ayrýldý; ön onarým grubu (n = 64), arka onarým grubu (n = 29), ön-arka onarým grubu (n = 13) ve vajen kubbe prolapsusu grubu (n = 20).
BULGULAR: 126 hastanýn yaþ ortalamasý 58.5 ± 10.8 yýl (en az 42, en fazla 75), ortalama aðýrlýk 70 ± 12.7 kg (en az 48 kg, en fazla 92 kg) ve ortalama parite 3 (en az 0, en fazla 6) idi. Nüks oranlarýmýz ön onarým grubunda 8 (%12.5), arka onarým grubunda 7 (%24.1), ön-arka onarým grubunda 1 (%7.6), vajen kubbe prolapsusu grubunda hiçbir hasta yok þeklinde idi. Tüm durumlarda, genel nüks oraný %12.69 idi.
TARTIÞMA ve SONUÇ: Menopoz ile POP nüksü arasýnda anlamlý iliþki tespit edilmiþtir. Ayrýca cerrahi teknik ile nükssüz olgular arasýnda da anlamlý bir iliþki bulunmuþtur.

INTRODUCTION: The objective of this study was to assess the recurrence ratios of pelvic organ prolapse surgical repair.
METHODS: BBetween June 2012 and May 2017, 126 non-randomly selected women underwent pelvic organ prolapse surgical repair. We used POP-Q System for staging. The patients were divided into four groups as follows; anterior repair group (n=64), posterior repair group (n=29), anterior-posterior repair group (n=13), and vaginal cuff prolapse group (n=20).
RESULTS: Mean age of the 126 patients was 58.5 ± 10.8 years (min. 42, max. 75), while mean weight was 70 ±12.7 kg (min. 48 kg, max. 92 kg) and mean parity was 3 (min. 0, max. 6). Our recurrence ratios were 8 patients (12.5%) in anterior repair group, 7 patients (24.1%) in posterior repair group, 1 patient (7.6%) in anterior-posterior repair group, and no patients in vaginal cuff prolapse group. In all cases, the overall recurrence ratio was 12.69%.
DISCUSSION AND CONCLUSION: A significant relationship between menopause and POP recurrence was determined. A significant relationship between surgical technique and recurrence free cases was also detected.

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GÝRÝÞ ve AMAÇ: Koroner arter hastalýðý (KAH) önemli bir halk saðlýðý sorunudur. Gensini skorlama sistemi (GS) klinik pratikte ateroskleroz yükü, KAH yaygýnlýðý ve ciddiyetini belirlemede kullanýlan en popüler skorlama yöntemlerinden birisidir. Daha önce yapýlmýþ çalýþmalarda geniþ açýlanma ile ciddi koroner arter darlýðý arasýnda korelasyon olduðu gösterilmiþtir. Bu çalýþmada, koroner arter bifurkasyon açýsý ve LMCA uzunluðunun koroner aterosklerotik yük ile iliþkini incelemeyi amaçladýk.
YÖNTEM ve GEREÇLER: Koroner anjiografi yapýlan hastalar incelendi. Akut koroner sendromu, normal koroner arterleri, LMCA osteal lezyonu, LAD osteal lezyonu, CX osteal lezyonu, bifurkasyon açýsýnýn ölçümü için yeterli görüntüleme yapýlamamýþ olan hastalar dýþlandý. 2 deneyimli kardiyolog tarafýndan "extreme pacs" yazýlým sistemi kullanýlarak çalýþmaya dahil edilen hastalarýn LAD-CX bifurkasyon açýsý ve LMCA uzunluðu ölçüldü. Dahil edilen hastalarýn aterosklerotik plak yükü GS kullanýlarak hesaplandý.
BULGULAR: 63 hasta (36 erkek, 27 kadýn) çalýþmaya dahil edildi. LAD-Cx bifurkasyon açýsý ile gensini skoru arasýnda kuvvetli pozitif korelasyon mevcuttu (r= 0,854; p<0,001). LAD-CX bifurkasyon açýsý ile LMCA uzunluðu arasýnda ise istatistiksel olarak anlamlý olmayan pozitif korelasyon mevcuttu (r= 0,228; p=0,11). Regresyon analizi ile LAD-CX bifurkasyon açýsýnýn aterosklerotik plak yükü için baðýmsýz bir risk faktörü olduðu gösterildi
TARTIÞMA ve SONUÇ: Bu çalýþma ile LAD-CX bifurkasyon açýsý arttýkça aterosklerotik plak yükünün de arttýðý gösterilmiþtir. Bunun yanýnda bifurkasyon açýsýnýn aterosklerotik plak yükü için baðýmsýz bir risk faktörü olduðu söylenebilir

INTRODUCTION: Coronary artery disease (CAD) is an important public health problem. The Gensini score system (GS) is one of the most popular coronary scoring systems used in clinical practice to determine the atherosclerotic burden, extent and severity of CAD. Previous studies have showed the direct correlation between wide angulation and significant coronary stenosis. In this study we analysed the effect of coronary bifurcation angle and left main coronary artery (LMCA) length on the coronary atherosclerotic burden.
METHODS: Patients, who underwent coronary angiography were scanned. Patients having; acute coronary syndrome, normal coronary arteries, LMCA lesion, osteal left anterior descending (LAD) coronary artery lesion, osteal circumflex (CX) coronary artery lesion, inadequate visualisation for bifurcation angle measurement were excluded. LAD-CX coronary artery bifurcation angle and LMCA length of included patients were analysed by 2 experienced cardiologists by using "extreme pacs" software system. Atherosclerotic burden of included patients were determined by GS.
RESULTS: 63 patients (36 male, 27 female) were included. There was a strong positive correlation between LAD-CX bifurcation angle and gensini score (r= 0,854; p<0,001). There was a statistically nonsignificant positive correlation between LAD-CX bifurcation angle and LMCA length (r= 0,228; p=0,11). Regression analysis showed that LAD-CX bifurcation angle is an independent risk factor for atherosclerotic burden
DISCUSSION AND CONCLUSION: In this study, we concluded that as the LAD-CX bifurcation angle increases atherosclerotic burden significantly increases. It might also be said that LAD-CX bifurcation angle is an independent risk factor for atherosclerotic burden

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GÝRÝÞ ve AMAÇ: Babalýk rolü gebeliðin teþhis edilmesiyle baþlar ve doðumu takip eden aylarda geliþir. Týpký anne gibi baba da gebelik süresince, baðlanma davranýþlarýný geliþtirir. Baba, eþinin karnýnda bebeðin hareketlerini hissettiðinde, çocuk ile doðrudan iliþkisi baþlar. Bu araþtýrma, Rahim Ýçi Baba Baðlanma Ölçeði'nin (RÝBBÖ) geliþtirilmesi, ölçeðin geçerlilik ve güvenilirlik çalýþmasýnýn yapýlmasý amacýyla planlanmýþtýr.
YÖNTEM ve GEREÇLER: Araþtýrma, Kasým 2017-Nisan 2018 tarihleri arasýndaki rutin gebelik kontrolü için baþvuran 24-38 haftalýk gebelerin eþleri ile metodolojik olarak yapýlmýþtýr. 23 maddeden oluþan RÝBBÖ’nün uygulamasýnda 158 babaya ulaþýlmýþtýr. Ölçeðin geçerlik ve güvenirlik analizleri korelasyon analizi, Cronbach alpha güvenirlik katsayýsý, Kendall W testi, Kaiser Meyer Olkin ve Barlett’s Test yöntemleri kullanýlmýþtýr.
BULGULAR: Ölçeðin kapsam geçerliliði analizine göre uzmanlarýn tarafýndan ölçek maddelerine verilen puanlar arasýnda istatistiksel olarak anlamlý bir fark bulunmamýþtýr (Kendall’s W=0.256; p=0.705). RÝBBÖ'nün tüm maddeleri için Cronbach alfa deðeri 0.73’dür. Ölçekten bir madde çýkarýldýðýnda yeniden hesaplanan Cronbach Alpha katsayýlarýnýn tamamý, tüm sorularýn yer aldýðý ölçeðin Cronbach Alpha katsayýsýndan daha düþük bulunmuþtur. RÝBBÖ’nün yapý geçerliliði analizi için Kaiser Meyer Olkin (KMO) Testi ve Barlett’s Testi kullanýlmýþ ve ölçekten elde edilen verilerin faktör analizi için uyumlu olduðu sonucuna varýlmýþtýr (KMO=0.861; p<0.05).
TARTIÞMA ve SONUÇ: Çalýþmanýn sonucunda RÝBBÖ’nün eþleri 24-38 haftalýk gebelik döneminde olan babalarýn, bebeklerine baðlanma durumlarýnýn belirlenmesinde geçerli-güvenilir bir ölçek olarak kullanýlabileceði sonucuna varýlmýþtýr.

INTRODUCTION: The paternity role begins with the diagnosis of pregnancy and develops in the months following birth. Like mother, father also develops attachment behaviors during pregnancy. When the father feels the baby's movements in the womb, a direct relationship with the child begins. The aim of this study was to develop the Intrauterine Father Attachment Scale and to perform the validity and reliability of the scale.
METHODS: The study was performed methodologically with the spouses of the pregnant women between 24-38 weeks of age who applied for routine pregnancy control between November 2017 and April 2018. In the implementation of the scale, consisting of 23 items, 158 fathers were reached. Correlation analysis, Cronbach's alpha reliability coefficient, Kendall W test, Kaiser Meyer Olkin and Barlett's Test methods were used.
RESULTS: According to the scale's validity analysis, there was no statistically significant difference between the scores given by the experts to the scale items (Kendall göres W=0.256; p=0.705). The Cronbach's alpha value for all items of the scale is 0.73. The Cronbach Alpha coefficients were lower than the Cronbach Alpha coefficient of the scale. Kaiser Meyer Olkin (KMO) Test and Barlett's Test were used for the structure validity analysis of the scale and it was concluded that the data obtained from the scale were compatible for factor analysis (KMO = 0.861; p <0.05).
DISCUSSION AND CONCLUSION: It was concluded that the fathers who were at 24-38 weeks gestational age of the scale could be used as a valid-reliable scale in determining the attachment status of their babies

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GÝRÝÞ ve AMAÇ: Bu çalýþmanýn amacý; Dicle Üniversitesi Týp Fakültesi KBB kliniðinde boyun kitlesi nedeniyle takip edilmiþ ve cerrahi uygulanmýþ olan hastalarýn tanýsal daðýlýmýný saptamaktýr.


YÖNTEM ve GEREÇLER: Dicle Üniversitesi Týp Fakültesi Kulak Burun Boðaz anabilim dalýnda, 2006-2011 yýllarý arasýnda boyun kitlesi nedeniyle takip edilmiþ olan ve taný/tedavi amacýyla cerrahi uygulanmýþ 1002 olgunun (406 kadýn/596 erkek)patolojik raporlarý yaþ, cinsiyet ve histopatolojik taný bulgularý not edilerek retrospektif olarak incelendi.
BULGULAR: Boyun kitlelerinin 425’i (%42) enflamatuar, 242’si ( %24) malign neoplastik, 229’u (%23) benign neoplastik, 106’sý (%11) konjenital orjinli idi. Yaþ ortalamasý enflamatuar kitlelerde 37.6 ± 14.1, konjenital kitlelerde ise 14.7 ± 6.8 idi. Benign kitleli hastalarda yaþ ortalamsý 41.8 ± 10.3 iken malign kitleli hastalarda yaþ ortalamasý 54.5 ± 15.9 idi.
TARTIÞMA ve SONUÇ: Yurdumuzda boyun kitleli hastalarda enflamatuar nedenler en sýk sebep olarak karþýmýza çýkmaktadýr. Çalýþmamýzdaki sonuçlarda bu bilgiyi desteklemektedir. Fakat bu gruptaki bazý hastalýklarýn insidansýnda farklýlýklar gözlenmiþtir.

INTRODUCTION: The aim of this study is to investigate the diagnostic distribution of the neck masses which were surgically treated in Dicle University School of Medicine ENT clinic.

METHODS: Between 2006-2011, 1002 patients (406 females,596 males) with neck masses who were diagnosed and treated at the Dicle University Hospital, Diyarbakýr, were reviewed noting their age, sex and histologic finding.
RESULTS: 425 (42%) of 1002 patients that has been examined, classified as inflammatory masses, 242 (24%) as malign neoplastic masses, 229 (23%) as benign neoplastic masses and 106 (11%) as congenital masses. The mean age was 37.6 ± 14.1 for patients with inflammatory neck masses, 14.7 ± 6.8 for patients with congenital neck masses. In the neoplastic neck masses group the mean age was 41.8 ± 10.3 in benign lesions, however, it was 54.5 ± 15.9 in malignant lesions
DISCUSSION AND CONCLUSION: In our study, inflammatory lesions were the most common pathologies in the etiology of the neck masses. This result is consistent with some studies in our country previously reported; however in this group the incidence of some diseases seems to be different.

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GÝRÝÞ ve AMAÇ: Amacýmýz, sistemik lupus eritematozuslu (SLE) hastalarda ortalama trombosit hacmi (MPV) ile renal tutulum arasýndaki iliþkiyi belirlemektir. Ayrýca renal tutulumlu SLE hastalarýnda eritrosit sedimantasyon hýzý (ESH), C-reaktif protein (CRP), kompleman bileþen 3 (C3), C4 ve hastalýk aktivitesini baþlangýçta ve tedavinin 6. ayýnda deðerlendirmeyi amaçladýk.
YÖNTEM ve GEREÇLER: Çalýþmaya SLE tanýsý almýþ 85 hasta (4 erkek, 81 kadýn, ortalama yaþ 39,5±10,5 yýl) alýndý. Yaþ, cinsiyet, MPV, CRP, ESH, C3, C4 ve SLE hastalýk aktivite indeksi (SLEDAI) deðerlendirildi. Veriler Kolmogorov-Smirnov, Mann-Whitney, Wilcoxon testi ve Spearman korelasyonu ile deðerlendirildi.
BULGULAR: MPV düzeyi, nefriti olmayan hastalarda nefriti olan hastalara göre daha yüksekti. Her iki grup arasýnda MPV açýsýndan anlamlý farklýlýk yoktu. Böbrek tutulumu olan ve böbrek tutulumu olmayan SLE hastalarýnda MPV ile hastalýk aktivitesi arasýnda korelasyon saptandý (sýrasýyla, r=-0,396, p=0,04, r=-0,262, p=0,03).
TARTIÞMA ve SONUÇ: Böbrek tutulum olan ve olmayan lupus hastalarýnda hastalýk aktivitesi ile MPV negatif korelasyon göstermektedir. MPV, SLE'li hastalarda hastalýk aktivitesini ve organ tutulumunu deðerlendirmede yardýmcý olabilir. Yinede, bu konuyla ilgili uzun dönem sonuçlarý hakkýnda bilgiler sýnýrlýdýr.

INTRODUCTION: Our aim is to determine the relationship between mean platelet volume (MPV) and renal involvement in patients with systemic lupus erythematosus (SLE). We also aimed to evaluate erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), complement component 3 (C3), C4, and disease activity at the baseline and 6th months of treatment in SLE patients with renal involvement.
METHODS: A total of 85 SLE patients (4 male, 81 female, with the mean age of 39,5±10,5 years) who had been diagnosed with SLE were enrolled in the study. Age, gender, MPV, CRP, ESR, C3, C4, and SLE Disease Activity Index (SLEDAI) were evaluated. The data were assessed with Kolmogorov-Smirnov, Mann-Whitney, Wilcoxon test, and Spearman correlation.
RESULTS: The levels of MPV were higher in patients without nephritis compared to patients with nephritis. There was no significant difference in MPV between both groups. We found a correlation between MPV and disease activity for SLE patients with renal involvement and without renal involvement (r=-0,396, p=0.04, r=-0.278, p=0.03, respectively).
DISCUSSION AND CONCLUSION: MPV is negatively correlated with disease activity in lupus patients with renal involvement and without renal involvement. MPV may be helpful to assess disease activity and organ-involvement in patients with SLE. the knowledge about long-term results about this topic is limited.

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GÝRÝÞ ve AMAÇ: Brankial yarýk anomalileri embriyolojik geliþimin nadir anomalilerindendir. Fetal geliþim sýrasýnda brankial aparatýn geliþiminin tamamlanmamasýna baðlý olarak geliþir ve kist, sinüs traktý, fistül veya kýkýrdak kalýntýsý olarak gözlenebilir. Bu çalýþmanýn amacý, kliniðimizde opere edilen brankial yarýk anomalilerin klinik özelliklerini ve cerrahi tedavi sonuçlarýný gözden geçirmektir.
YÖNTEM ve GEREÇLER: Brankial yarýk anomalisi tanýsý alan ve 2007-2017 tarihleri arasýnda opere olan 62 hasta retrospektif olarak incelendi. Tüm hastalarýn dosya kayýtlarý yaþ, cinsiyet, klinik prezentasyon, semptomlarýn süresi, tetkikleri, patolojik sonuçlarý ve takibi açýsýndan incelendi.
BULGULAR: Çalýþma süresi boyunca kliniðimizde brankial yarýk anomalisi tanýsý ile tedavi edilen 62 hastanýn 40’ý (%64.5) kadýn, 22’si(%35.5) erkekti. Ortalama yaþ 26.5±12.9 iken en genç hasta 7 en yaþlý hasta 71 yaþýndaydý. Hastalarda en sýk izlenen baþvuru þikayeti 53(%85.5) hastada izlenen boyunda þiþlikti. 62 hastadan 20'i (%32.3) birinci, 42’i (%67.7) ikinci brankial yarýk anomalisiydi. Üçüncü ve dördüncü brankial yarýk anomalisi izlenmedi.
TARTIÞMA ve SONUÇ: Baþ boyun yapýlarýnýn geliþiminde brankial aklar önemli rol oynar. Bu yapýlarýn anormal geliþimi, boyunda kist, sinüs veya fistül gibi ileriki dönemde ortaya çýkan farklý anomalilerin oluþumuna yol açar.Brankial yarýk anomalilerinin tedavisi cerrahi eksizyondur.

INTRODUCTION: Branchial cleft anomalies are rare anomalies of embryological development. It develops due to incomplete development of branchial apparatus during fetal development and can be observed as a cyst, sinus tract, fistula or cartilage residue. The aim of this study is to evaluate the clinical features and surgical treatment results of branchial cleft anomalies operated in our clinic.
METHODS: A total of 62 patients diagnosed as the branchial cleft anomaly in our clinic and operated between 2007-2017 were evaluated retrospectively. The records of all patients were examined in terms of age, gender, clinical presentation, duration of symptoms, examinations, pathological results, and follow-up.
RESULTS: 40 (64.5%) of the 62 patients who were treated with the diagnosis of branchial cleft anomalies were female and 22 (35.5%) were male. The mean age was 26.5 ± 12.9 and the youngest patient was 7 and the oldest patient was 71 years old. The most common complaint in the patients was neck swelling in 53 (85.5%) patients. 20 (32.3%) of 62 patients have first and 42 (67.7%) second branchial cleft anomaly. The third and fourth branchial cleft anomalies were not observed.
DISCUSSION AND CONCLUSION: Branchial arches play an important role in the development of head and neck structures. Abnormal development of these structures leads to the formation of different anomalies such as cysts in the neck, sinus or fistula in the future. The treatment of branchial cleft anomalies is surgical excision.

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GÝRÝÞ ve AMAÇ: Menstruasyon, kadýn hayatýnýn yaklaþýk 30-35 yýlýný kapsayan fizyolojik bir durum olmakla birlikte menstruel dönemde üreme çaðýndaki pek çok kadýný olumsuz etkileyen problemler de görülebilmektedir. Menstrual döneme iliþkin en çok görülen problemler arasýnda amenore, dismenore, disfonksiyonel uterus kanamalarý ve premenstruel sendrom yer almaktadýr. Bu araþtýrma, hemþirelik öðrencilerinde premenstrual sendrom (PMS) görülme sýklýðý ve etkileyen faktörlerin belirlenmesi amacýyla planlanmýþtýr.
YÖNTEM ve GEREÇLER: Araþtýrma, Gaziantep ilinde bulunan bir üniversitede okuyan 319 hemþirelik kýz öðrencisi ile tanýmlayýcý olarak yapýlmýþtýr. Veri toplama aracý olarak; Tanýlama Formu ve Premenstüel Sendrom Ölçeði (PMSÖ) kullanýlmýþtýr.
BULGULAR: Katýlýmcýlarýn yaþ ortalamasý 20.16±1.50 olup %75.5'inin gelir durumunun orta seviyede olduðu saptanmýþtýr. Çalýþmada PMSÖ toplam puan ortalamasýnýn 122.20±39.54 (min=44, max=220) olup, PMS prevalansýnýn %63.0 olduðu bulunmuþtur. Premenstruel dönemde öðrencilerin %63.3’ünde depresif duygulaným, %39.8’inde anksiyete, %73.0’ünde yorgunluk, %67.1’inde sinirlilik, %48.9’unda depresif düþünceler, %67.7’sinde aðrý, %64.9’unda iþtah deðiþimleri, %56.1’inde uyku deðiþimleri ve %60.2'sinde þiþkinlik yakýnmalarýnýn görüldüðü belirlenmiþtir. Ayrýca menarþ olduklarýnda öðrencilerin %33.5'inin korktuðu ve %74.0'ünün ise bu durumu ilk olarak annesiyle paylaþtýklarý belirlenmiþtir.
TARTIÞMA ve SONUÇ: Çalýþmanýn sonucunda öðrencilerin yarýsýndan fazlasýnýn PMS yaþadýðý ve yaklaþýk dörtte üçünün PMS'den kaynaklý yaþam aktivitelerinin olumsuz etkilendiði saptanmýþtýr. PMS'nin olumsuz etkilerini azaltmak için öðrencilerin PMS'ye yönelik farkýndalýklarýnýn artýrýlmasý ve saðlýk çalýþanlarý bu durumla baþ etmede kullanýlabilecek yöntemler konusunda öðrencilere eðitim ve danýþmanlýk hizmeti vermelidir.

INTRODUCTION: Menstruation is a physiological event involving 30-35 years of female life, and problems related to the menstrual cycle negatively affect many women in reproductive age. The most common menstrual problems are amenorrhea, dysmenorrhoea, dysfunctional uterine bleeding, and premenstrual syndrome. This study was designed to determine the prevalence of premenstrual syndrome in female nursing students and the affecting factors.
METHODS: This descriptive study was conducted with 319 female nursing students studying at a university in Gaziantep between October 2017 and November 2017. Students were surveyed by using the personal information form and Premenstrual Syndrome Scale.
RESULTS: The mean score for the overall scale was 122.20±39.54 and the prevalence of PMS was 63.0%. The analysis of the mean subscale scores in terms of the cutoff point revealed that in the premenstrual period, of the participants 63.3% experienced depressive mood, 39.8% had anxiety, 73.0% had fatigue, 67.1% had irritability, 48.9% had depressive thoughts, 67.7% had pain, 64.9% experienced a change of appetite, 56.1% experienced changes in sleep patterns, and 60.2% had bloating complaints.
DISCUSSION AND CONCLUSION: It was determined that more than half of the students experienced PMS and approximately one-third of them were affected by PMS–related life activities negatively.

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GÝRÝÞ ve AMAÇ: Etanol analizinde iþleme yöntemleri ve depolama sürelerinin standardizasyonu adli ve toksikolojik disiplin için önemlidir. Bu geriye dönük çalýþma, farklý depolama süreleri için +40C'de saklandýktan sonra serum örneklerinde etanol davranýþýný araþtýrmak için yürütülmüþtür.
YÖNTEM ve GEREÇLER: Travma ve adli nedenlerle etanolün ölçülmesi gereken 183 olgudaki kan örnekleri kullanýldý. Yedi çalýþma grubu oluþturuldu (1 ile 36 ay arasýnda deðiþen). Ayný tüpler yeniden analiz edildi ve sonuçlar ilk ölçümlerle karþýlaþtýrýldý.
BULGULAR: Koruyucu kullanýlmayan kan etanol numuneleri +40C 'de saklandýðýnda 3 yýl civarýnda stabilolarak kalabildiði kaydedilmiþtir. Ýlk ayda% 4.1 oranýnda düþüþ olmuþtur. Ardýndan, etanol konsantrasyonlarý için 5 aylýk dönemden itibaren 26 aya yükseliþ eðilimi baþlamýþ ve daha sonra duraðan sürece girilmiþtir (26 ve 36 ay, %7.4 ve % 7.4). Negatif numuneler için orta ve uzun vadeli süreli gruplarda etanol üretimi gözlenmemiþtir. Düþük konsantrasyonlu etanol numuneleri nispeten daha fazla azalma göstermiþtir. Kan etanol konsantrasyonlarý yaralanma ciddiyet puanlamasý (YCP) ve Glasgow Koma Ölçeði Puanlarý (GKÖP) ile anlamlý bir þekilde iliþkili deðildi (P <0.862, P <0.675).
TARTIÞMA ve SONUÇ: Çalýþmanýn yapýldýðý laboratuvarda, katkýsýz numuneler için saklama süresinin 3 yýla kadar olabileceði önerildi. Ek olarak, þahit örnek olarak ideal bir örnek türü olmasa da, zorunlu durumlarda orta ve uzun süreli depolama için serum örnekleri kullanýlabilir.

INTRODUCTION: The standardization of processing methods and storage duration for ethanol analysis is important for the forensic sciences and toxicology. This retrospective study was conducted to investigate ethanol stability in serum specimens stored at 4°C for distinct periods
METHODS: The study was carried out by using blood specimens from 183 patients in whom ethanol measurement was ordered due to trauma and forensic causes. Seven study groups were created (ranging from 1 to 36 months). The same tubes were re-analyzed for blood ethanol concentration and the results were compared to the first measurements.
RESULTS: It was recorded that the stability was 3 years around for non-preservative blood ethanol specimens at +4oC. There was a 4.1% decrease in the first month. Then, an elevation trend for ethanol concentration was observed from month 5 to 26 and ethanol concentration was stabilized thereafter for month 26 and 36: 7.4% and 7.4% respectively. No ethanol increase was observed for negative specimens in medium-and long-term storage groups. Ethanol specimens with lower concentration exhibited relatively lower reduction. No significant association was shown between blood ethanol concentration and Glasgow Coma Scale Scores (GCSS) and/or Injury Severity Score (ISS) (P<0.862 and P<0.675).
DISCUSSION AND CONCLUSION: In the laboratory where the study was carried out, it was proposed that thestorage period could be up to 3 years for samples without additives. Additionally, although it is not an ideal sample type as a split sample, serum samples are usable for medium and long-term storage in obligatory situations.

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GÝRÝÞ ve AMAÇ: Atriyal fibrilasyon (AF), farklý klinik durumlarda ortaya çýkabilir ve çeþitli tedavi seçeneklerine sahiptir. Bu nedenle, gerçek yaþam koþullarýnda klinik uygulama da heterojen olabilir. Bu araþtýrmanýn temel amacý, invazif kardiyologlarýn AF’ ye yaklaþýmýný ve bu konudaki tedavi yaklaþýmlarýný deðerlendirmektir.

YÖNTEM ve GEREÇLER: 2017 Giriþimsel kardiyoloji kongresinde, katýlýmcýlarýn rastgele seçildiði ancak katýlýmýn gönüllük esasýna dayandýðý bir anket çalýþmasý yapýlmýþ ve 134 anket sonucu deðerlendirilmiþtir. Anket formu, i) AF’yi tanýma ve belirli durumlarda medikal tedavi yaklaþýmlarý, ii) AF ablasyonu yaklaþýmlarý ve iii) stent takýlan hastalarda antikoagülasyon ve antiplatelet tedavinin yönetimi konularýný içermiþtir.

BULGULAR: AF ve hafif mitral darlýðý olan hastada, katýlýmcýlarýn çoðu yeni oral antikoagülan kullanýmýný tercih ederken, katýlýmcýlarýn dörtte biri vitamin K antagonisti kullanmayý tercih etmiþtir. CHA2DS2-VASc skoru 0, hipertrofik kardiyomiyopatisi olan AF hastasýnda katýlýmcýlarýn çoðu asetilsalisilik asit kullanmayý tercih etmiþ, oral antikoagülan tercih oraný ise %33.58 olmuþtur. Semptomatik AF hastalarýnda hekimlerin %73,88' i üçüncü ataktan sonra ablasyonu tercih etmiþ. Akut miyokard enfarktüsü nedeniyle ilaç kaplý stent takýlan hastalarda ikili antiplatelet tedavi ile beraber oral antikoagülasyon süresine bakýldýðýnda, çoðunlukla 3 ay üçlü tedavi, 12 aya kadar ikili tedavi seçeneði tercih edilmiþtir (%64.18).

TARTIÞMA ve SONUÇ: Mevcut araþtýrma, giriþimsel kardiyologlar arasýnda atriyal fibrilasyona yaklaþým konusunda farklýlýklar ve bazý durumlarda kýlavuzlarla uyumsuz yaklaþýmlar olduðunu göstermiþtir. Bu sonuç, kýlavuzlarýn yetersiz takibinden veya bazý konularda yeterli veri ile desteklenen net bir tavsiyenin bulunmayýþýndan kaynaklý olabilir.

INTRODUCTION: Atrial fibrillation (AF) may occur in different clinical situations and has various treatment options. Therefore, clinical practice in real-life conditions may also be heterogeneous. The main aim of this survey was to evaluate the treatment approaches taken by invasive cardiologists in response to AF.

METHODS: At the 2017 interventional cardiology congress, a survey was conducted in which voluntary participants were randomly assigned, and 134 survey results were evaluated. The survey questionnaire covered topics of i) AF recognition and medical treatment approaches in certain situations, ii) approaches to AF ablation, and iii) the management of anticoagulation and antiplatelet therapy in patients with recent stent implantations.

RESULTS: Most participants preferred novel oral anticoagulation in patients with AF and mild mitral stenosis, but one-quarter of the participants preferred using VKA. For AF patients with hypertrophic cardiomyopathy whose CHA2DS2-VASc score was zero, 58.96% of participants preferred acetylsalicylic acid. Regarding their approach to ablation, 73.88% of physicians preferred ablation after third attack in symptomatic AF patients. When it came to the duration of prescribing oral anticoagulants in combination with dual antiplatelet therapy for patients with implanted drug-eluting stents due to acute myocardial infarctions, 64.18% of physicians preferred to prescribe triple therapy for three months, followed by 12 months of dual therapy.

DISCUSSION AND CONCLUSION: The present survey showed differences in the approach to AF and, in some cases, incompatibility with the guidelines. This may be due to insufficient follow-up of the guidelines, or it may be due to a lack of clear recommendations supported by sufficient data on some subjects.

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GÝRÝÞ ve AMAÇ: Ýzole pulmoner kapak yetersizliði (IPKY) nadir görülen bir klinik durumdur ve genellikle yýllarca iyi tolere edilir. IPKY'de sað ventrikül diyastolik fonksiyonlarýný deðerlendirmek istedik.
YÖNTEM ve GEREÇLER: Çalýþma grubu, kurumumuza yönlendirilen 3 kýz ve 10 erkek çocuk hastadan oluþuyordu. Hastalar 5-16 yaþ arasýndaydý. Bu hastalar yaþ ve cinsiyete göre benzer bir grup olan 27 saðlýklý çocukla karþýlaþtýrýldý. Tüm hastalar için ayrýntýlý fizik muayene, elektrokardiyogram, ekokardiyografi ve akciðer grafisi çekildi.
BULGULAR: Çalýþmamýzda grup (grup I) 13 IPKY hastasýndan oluþuyordu. Kontrol grubunda (grup II) 6-19 yaþlarý arasýnda 27 çocuk (15 kýz, 12 erkek) vardý. Grup I ve II arasýnda pik erken diyastolik akým hýzlarýnda (E) istatistiksel olarak anlamlý fark vardý. Gruplar arasýnda pik geç diyastolik akým hýzý (A) ile istatistiksel olarak anlamlý fark yoktu. Grup I'de Grup II ile karþýlaþtýrýldýðýnda E: A oraný anlamlý olarak azdý. Grup II ile karþýlaþtýrýldýðýnda grup I'de izovolemik gevþeme süresi (IVRT) uzundu, ancak gruplar arasýnda istatistiksel olarak anlamlý fark yoktu. Gruplar arasýnda karþýlaþtýrýldýðýnda; grup I'de E hýz zaman integrali (VTI E) az, A hýz zaman integrali (VTI A) ayný ve VTI E / A azalmýþtý.
TARTIÞMA ve SONUÇ: Her ne kadar IPVR'nin iyi huylu bir lezyon olduðu kabul edilmese de bu hastalarda sað ventrikül diyastolik disfonksiyonunun olduðunu gördük. Bu arada, klinik semptomlar ortaya çýkmadan önce aritmi ve sað taraflý yetmezliðin belirlenmesi önemlidir.

INTRODUCTION: Isolated pulmonary valve regurgitation (IPVR) is a rare clinical entity is usually well tolerated for many years. We wanted to evaluate right ventricular diastolic functions in IPVR.
METHODS: The study group was consisted of 3 girls and 10 boys who were referred to our instution. Patients were aged between 5-16 years. These patients compared with 27 age and sex matched healthy children. All patients detailed physical examination, electrocardiogram, echocardiography and chest X-ray were recorded.
RESULTS: In our study the group (group I) was consisted of 13 IPVR patients. In the control group ( group II ) there were 27 children (15 girls, 12 boys) aged between 6-19 years There was statistically significant difference in peak early diastolic flow velocity (E) between group I and II. There was no statistically significant difference in peak late diastolic flow velocity (A) between groups. The E: A ratio was significantly decreased in group I when compared with group II.Isovolemic relaxation time (IVRT) was prolonged in group I when compared with group II but it was not statistically significant different between groups. When compared between groups; in group I the E velocity time integral (VTI E) was decreased, A velocity time integral was (VTI A) was unchanged and VTI E/A was decreased.
DISCUSSION AND CONCLUSION: Although it is consent that IPVR is a benign lesion we found that right ventricular diastolic dysfunction in this patients. Worthwhile it is important to determine the arrythmias and right sided failure before the clinical symptoms appear.

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GÝRÝÞ ve AMAÇ: Q ateþi, Coxiella burnetii’nin neden olduðu bir zoonozdur. Baþlýca klinik prezentasyonlarý pnömoni ve hepatit’tir. Bununla birlikte, birçok farklý klinik prezentasyonlar nedeniyle Q ateþini tanýmak güç olabilir. Bu çalýþmada, kurumumuzdaki Q ateþi olgularýnýn klinik ve laboratuvar özelliklerini sunarak Q ateþi farkýndalýðýný artýrmayý amaçladýk.
YÖNTEM ve GEREÇLER: Hastanemiz veri tabanýndaki Q ateþi tanýlý hastalar retrospektif olarak deðerlendirilmiþtir. Hastalarýn karakteristikleri, baþvurudaki klinik ve laboratuvar deðerleri kaydedilmiþtir.
BULGULAR: Bu çalýþmaya toplam altý hasta dahil edilmiþtir. En sýk ateþ, iþtahsýzlýk ve bitkinlik gibi semptomlar olmak üzere çeþitli klinik prezentasyonlar gözlenmiþtir. En sýk laboratuvar anormalliði tüm hastalarda saptanan CRP yüksekliðiydi, LDH ve transaminaz yüksekliði bunu takip etmekteydi. Gerek LDH yüksekliði gerekse transaminaz yüksekliði dört hastada mevcuttu.
TARTIÞMA ve SONUÇ: Q ateþini teþhis etmek için kullanýlan serolojik yöntemler rutin olarak uygulanmamaktadýr, bu yüzden Q ateþi olgularý kolayca gözden kaçabilir. Biz inanýyoruz ki, endemik bölgelerde nonspesifik antibiyotik tedavisine yeterli yanýt vermeyen hastalarda Q ateþi daha çok araþtýrýlmalýdýr.

INTRODUCTION: Q fever is a zoonosis caused by Coxiella burnetii. The main clinical presentations are pneumonia and hepatitis. However, it can be difficult to recognise Q fever due to many different clinical presentations. In this study, we aimed to increase the awareness of Q fever by presenting clinical and laboratory features of Q fever cases from our institution.
METHODS: Patients with a diagnosis of Q fever in our hospital database were evaluated retrospectively. Patient characteristics as well as clinical and laboratory values at presentation were recorded.
RESULTS: A total of six patients were included in this study. Various clinical presentation was observed such as fever, anorexia and malaise as the most common symptoms. The most common laboratory abnormality was CRP elevation as being detected in all patients followed by LDH and transaminase elevations, both were found in four patients.
DISCUSSION AND CONCLUSION: Serological methods used to diagnose Q fever are not routinely performed, so Q fever cases can be missed easily. We believe that Q fever should be investigated further in patients from endemic regions who did not give adequate response to nonspesific antibiotic treatment.

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GÝRÝÞ ve AMAÇ: Bu çalýþma ile gebelikte nadir görülen bir durum olan persiste adneksiyal kitlelerin malignite potansiyellerini deðerlendirmek ve bu kitlelerin yönetimini incelemek amaçlanmýþtýr.
YÖNTEM ve GEREÇLER: Ege Üniversitesi Týp Fakültesi Kadýn Hastalýklarý ve Doðum Anabilim Dalý’nda 2006-2018 yýllarý arasýnda tanýsý konulan ve tedavi edilen gebelik ile birlikte persiste adneksiyal kitlesi olan olgular çalýþmaya dahil edilmiþtir.

BULGULAR: Çalýþmaya 13 hasta dahil edilmiþtir. Bu olgulardan beþ tanesinde malign/premalign bir lezyon saptanýrken, sekiz olgunun histopatolojik sonucu benign gelmiþtir. Bu iki grup arasýnda yapýlan karþýlaþtýrmada olgularýn yaþý, kist boyutu, preoperatif CA125 düzeyi, operasyon zamaný ve doðum haftasý açýsýndan istatistiksel fark saptanmaz iken (p>0.05), ultrason bulgularý açýsýndan malign/premalign grubunda daha fazla malignite þüphesi uyandýracak görüntüler saptanmýþtýr (p=0.031).

TARTIÞMA ve SONUÇ: Adneksiyal kitleler, gebelikte nadir görülen bir durumdur. Acil olgular dýþýnda, operasyon kararý malignite kuþkusuna göre deðerlendirilerek verilmelidir. Bu deðerlenmede ön plana çýkan yöntem ise kitlenin preoperatif ultrasonografik olarak deðerlendirilmesidir. Opere edilen þüpheli kitlelerin intraoperatif frozen section (donuk kesit inceleme) ile de deðerlendirilmesi tam cerrahinin yapýlabilmesi için önemlidir.

INTRODUCTION: Aim of this study is evaluating of malignancy potential of persistent adnexal masses which is rare situation in pregnancy and scrutinizing of management of these masses.
METHODS: Cases who were diagnosed and treated in terms of pregnancy and concomitant adnexal mass between 2006-2018 in Ege University, School of Medicine, Department of Obstetrics and Gynecology were recruited for study.

RESULTS: Thirteen eligible cases were recruited for study. While, malign/premalign pathology was diagnosed in five of these cases, histopathologic results of eight cases were determined as benign. Comparing of two group, while no statistical significance was determined between two groups in terms of age of cases, cysts size, preoperative level of CA125, operation time and time of delivery (p>0.05), increased more suspicious malignant pathologic view was diagnosed in malign/premalign group in terms of ultrasonography findings (p=0.031).

DISCUSSION AND CONCLUSION: Adnexal masses is a rare situation in pregnancy. Except of urgent cases, operation decision should be given according to suspicious of malignancy. Ultrasonographic evaluation of mass come into prominence in this evaluation. Evaluating of operated suspicious adnexal masses with frozen section in intraoperatively is crucial for performing complete surgery.

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GÝRÝÞ ve AMAÇ: Posterior perikardiyal pencere tekniðinin, koroner arter bypass greftleme (CABG) ameliyatý sonrasý perikardiyal efüzyon geliþimini önlemedeki etkinliðini belirlemekti.
YÖNTEM ve GEREÇLER: Koroner cerrahi geçirecek hastalar rastgele bir kontrole veya perikardiyal pencere tekniði grubuna ayrýldý. Toplamda 210 hastayý 2 gruba ayýrdýk, posterior perikardiyal pencere grubu (n = 110) ve kontrol grubu (n = 110). Preoperatif, intraoperatif ve postoperatif klinik veriler retrospektif olarak toplandý. Preoperatif, taburcu olmadan önce ve postoperatif 7. ve 30. günlerde yapýlan deðerlendirmelere elektrokardiyografi, göðüs radyografisi, ekokardiyografik incelemeler yapýldý. Postoperatif morbidite nedenleri ve yoðun bakým ünitesinde ve hastanede kalýþ süreleri kaydedildi.
BULGULAR: Ýki grup arasýnda demografik veriler açýsýndan anlamlý fark yoktu (P >.05). Ekokardiyografi incelemeleri ameliyat öncesi gruplar arasýnda anlamlý bir farklýlýk yoktu; bununla birlikte, taburcu edilmeden önce, kontrol grubunda, perikardiyal pencere grubuna kýyasla, erken ve geç kardiyak tamponad anlamlý olarak yüksek bulundu (P <.05). Perikardiyal pencere grubunda postoperatif plevral efüzyon insidansý kontrol grubundan anlamlý olarak yüksek olarak tespit edildi. Yeni baþlangýçlý atriyal fibrilasyon, kontrollerde perikardiyal pencere grubundan anlamlý olarak daha yaygýndý (P <.05).
TARTIÞMA ve SONUÇ: Posterior perikardiyal pencere tekniði, ciddi komplikasyonlar olmadan kolay uygulanabilir ve güvenli bir yöntemdir. Bu prosedür, geç kardiyak tamponadý ve CABG hastalarýnda ölümcül bir komplikasyon olabilen efüzyonla iliþkili atriyal fibrilasyonu azaltabilir.

INTRODUCTION: The aim was to determine the effectiveness of the posterior pericardial window (PW) technique in preventing the development of pericardial effusion (PE) following coronary artery bypass grafting surgery (CABG).
METHODS: Patients undergoing coronary surgery were randomly divided into a control or a PW group. We divided 220 patients randomly into 2 groups, the posterior pericardial window group (n=110) and the control group (n=110). Preoperative, intraoperative and postoperative clinical data were collected retrospectively, including incidence of pericardial tamponade, drainage volume, ventilation time and moderate to large pericardial effusion. Evaluations were completed preoperatively, before discharge, and on postoperative 7 and 30 days including electrocardiography, chest radiography, echocardiography. Postoperative causes of morbidity, the duration of intensive care unit and hospital stay were recorded.
RESULTS: There was no significant difference in demographic data between two groups (P>.05). Echocardiography evaluations revealed no significant difference between groups preoperatively; however, before discharge the control group had a significantly higher number of patients with early and late cardiac tamponade compared with the PW group (P<.05). The incidence of postoperative pleural effusion in the PW group was significantly higher than control group. New onset atrial fibrillation was significantly more common in control subjects than in the PW group (P <.05).
DISCUSSION AND CONCLUSION: Posterior pericardial window technique is a safe and effective method which is easy to perform without any serious complication. This procedure may reduce late cardiac tamponade events and effusion-related atrial fibrillation which may be a fatal complication in CABG patients.

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GÝRÝÞ ve AMAÇ: 45 yaþ üstü postmenopozal kadýn hastalarda visseral adipozite indeksi (VAI) ile aþýrý aktif mesane semptomlarý arasýndaki iliþkiyi araþtýrmak
YÖNTEM ve GEREÇLER: Mart 2017- Aralýk 2017 tarihleri arasýnda aþýrý aktif mesane semptomlarý olan 76 postmenopozal kadýn hasta deðerlendirildi. Antropometrik veriler, serum kolesterol düzeyleri, açlýk glukoz seviyeleri, ürodinamik bulgular ve OAB-8 formu kayýt edildi. VAI cinsiyete özgü formüle göre hesaplandý. Hastalar VAI seviyelerine göre üç gruba ayrýldý. VAI ile aþýrý aktif mesane semptomlarý arasýndaki iliþki ürodinamik sonuçlar ve OAB-8 skoru açýsýndan istatiksel olarak karþýlaþtýrýldý.
BULGULAR: Hastalarýn yaþ ortalamasý 57.2+/-8.3 yýl, ortalama vücut kitle indeksi (VKÝ) 32.3+/-2.8 kg/ m2 idi. Gruplar arasýnda Pabd, post miksiyonel rezidü idrar miktarý (PMRÝ), maksimum mesane kapasitesi (MMK) ve OAB-8 sorgulama formu skoru açýsýndan anlamlý fark bulundu. VAI ile PMRÝ, detrüsor aþýrý aktivitesi (DAA), idrar sýklýðý, urge inkontinans, noktüri ve OAB-8 skoru arasýnda pozitif korelasyon, MMK ve ilk iþeme arzusu açýsýndan negatif korelasyon tesbit edildi.
TARTIÞMA ve SONUÇ: VAI düzeyi yüksek olan hastalarda daha fazla aþýrý aktif mesane semptomu olduðunu ve daha kötü ürodinamik bulgularý olduðunu gözlemledik. VAI ayrýca aþýrý aktif mesane semptomlarýný öngörmede bir belirteç olarak kullanýlabilir.

INTRODUCTION: To investigate the association between visceral adiposity index (VAI) and overactive bladder (OAB) symptoms in postmenopausal female patients aged over 45 years.
METHODS: Between March 2017 and December 2017, 76 postmenopausal female patient with OAB symptoms were evaluated. Anthropometric indices serum cholesterol levels, fasting glucose levels, urodynamic findings and OAB-8 scores were recorded. VAI was calculated according to gender-specific formula. Participants were divided into three groups according to VAI levels. The relationship between VAI and OAB symptoms were statistically compared in terms of urodynamic outcomes and OAB-8 scores.
RESULTS: Mean age of the patients were 57.2+/-8.3 years and mean BMI was 32.3+/-2.8 kg/m2. Statistical significance was observed in terms of abdominal pressure (Pabd), post voiding residual urine mounts (PVR), maximum bladder capasity (MBC) and OAB-8 scores between groups. VAI correlated positively with PVR, detrusor overactivity (DOA), urinary frequency, urge incontinence, nocturia and OAB-8 scores whereas a negative correlation existed MBC and first desire to void.
DISCUSSION AND CONCLUSION: We observed that patients with higher levels of VAI had more OAB symptoms and worse urodynamic findings.VAI may also be used as a marker for predicting overactive bladder symptoms.

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DRESS (Drug Rash with Eosinophilia and Systemic Sypmtoms) Sendromu, solid organ tutulumu, cilt tututlumu, hematolojik tutulumu yapan ilaç reaksiyonudur. Tedavi edilmezse mortal seyredebilir. En sýk sebep olan ilaçlar aromatik antikonvülzanlardýr. Biz bu çalýþmada nadir görülen menenjit tanýlý hastada geliþen DRESS sendromu olgusunu sunduk. Hastalýk sistemik tutulum yapmasý ve mortal seyredebilmesi nedeniyle erken taný ve tedavi önemlidir.

DRESS (Drug Rash with Eosinophilia and Systemic Sypmtoms) Syndrome, solid organ involvement, skin immunity, hematological involvement is the drug reaction. If not treated, it may be mortal. The most common drugs are aromatic anticonvulsants. In this study, we present a rare case of DRESS syndrome with diagnosis of meningitis. Early diagnosis and treatment are important because of the systemic involvement and mortality.

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GÝRÝÞ ve AMAÇ: Bu çalýþmanýn amacý akut diz yaralanmasý olan hastalarda artroskopi sonuçlarý ile fizik muayene ve manyetik rezonans görüntüleme (MRG) sonuçlarýný karþýlaþtýrmaktýr. Ýkinci amaç yaralanmadan 3 hafta, 3 ve 6 ay sonra artroskopik meniscetomi uygulanan hastalarýn klinik sonuçlarýný karþýlaþtýrmaktý.

YÖNTEM ve GEREÇLER: Ocak 2003'ten Kasým 2008'e kadar, dizde artroskopik cerrahi geçiren 159 hasta vardý. Akut yaralanma olan 121 hasta, 99 erkek ve 22 kadýn, 13-62 yaþ, 67 sað diz / 54 sol diz. Ortopedik cerrah, menisküsün gözyaþý incelemesi için test yapmýþ, anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), medial kollateral ligament (MCL) ve lateral kollateral ligament (LCL) stabilitesini test etmek için test yapmýþtýr. Ayrýca, hareket aralýðý (ROM) hakkýnda bilgi toplandý ve hastalar Lysholm diz anketini yerine getirmek zorunda kaldý. Postoperatif ayný ölçümler yapýldý.

BULGULAR: Sonuçlar, klinik muayene ile MRG arasýnda baþlangýç ​​tanýsýnýn doðruluðu açýsýndan istatistiksel bir farklýlýk göstermedi (p = 0,640). Sonuçlar menisküs rüptürü (p = 0.948) ve menisküs ve ACL (p = 1.000) için benzerdi.

TARTIÞMA ve SONUÇ: Klinik ve MRG testlerinin kesinliði, duyarlýlýðý, özgüllüðü, prediktif pozitif ve negatif deðerlerinin karþýlaþtýrýlmasý ve bunlarýn artroskopinin sonuçlarý ile karþýlaþtýrýlmasýnda istatistiksel olarak anlamlý bir fark bulunmadý. Lysholm ve ROM sonuçlarý, üç grup arasýnda istatistiksel olarak anlamlý bir fark göstermedi ve tüm gruplarda ameliyat öncesi sonuçlarla karþýlaþtýrýldý- ðýnda postoperatif sonuçlarda istatistiksel olarak anlamlý iyileþme görülmedi.

INTRODUCTION: The aim of this study was to compare the physical exam and magnetic resonance imaging (MRI) results, with results of arthroscopy, in patients with acute knee injury. The second aim was to compare the clinical results of patients who underwent arthroscopic meniscetomy after 3 weeks, 3 and 6 months from injury.

METHODS: From January 2003 to November 2008, there were 159 patients which underwent arthroscopic surgery on the knee. 121 patients with acute injury, 99 men and 22 women, age 13 to 62 years, 67 right knee/54 left knee. The orthopaedic surgeon performed test to examine the meniscus for tear, test to examine for stability of the anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), medial collateral ligament (MCL) and lateral collateral ligament (LCL). Also were collected information of range of movement (ROM), and patients had to fulfil the Lysholm knee questionnaire. Postoperatively were done the same measurements.

RESULTS: The results showed no statistical difference for the accuracy of the initial diagnosis between clinical examination and MRI (p = 0.640). The results were similar for the rupture of the meniscus (p = 0.948) and meniscus and ACL (p=1.000).

DISCUSSION AND CONCLUSION: Comparing the results of precision, sensibility, specificity, predictive positive and negative value of clinical and MRI tests and comparing them to the results of arthroscopy, there was no statistically significant difference. The results of Lysholm and ROM showed no statistical difference between three groups and statistically significant improvement of postoperative results when comparing them with preoperative results in all groups.

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GÝRÝÞ ve AMAÇ: Çalýþmamýzda kolorektal polip olgularýnda Kronik Obstrüktif Akciðer Hastalýðý sýklýðý (KOAH) ve bu durumun sistemik inflamasyonla iliþkisi araþtýrýlmýþtýr.
YÖNTEM ve GEREÇLER: Aralýk 2016 -2017 tarihleri arasýnda Gastroenteroloji kliniðinde kolonoskopi yapýlan ve kolorektal polipozis tanýsý konulan olgulardan özgeçmiþ sorgulamasýnda KOAH tanýsý olan 35 olgu ile yine özgeçmiþ sorgulamasýnda herhangi bir kronik hastalýðý olmayan 163 kontrol olgu alýndý. Tüm olgularýn yaþ, sigara öyküsü (paket-yýl) gibi demografik verileri, patoloji sonuçlarý, lezyonun anatomik yeri ile lökosit, nötrofil lenfosit oraný (NLO) ve ortalama trombosit hacmi (MCV) parametrelerinden oluþan hemogram verileri kaydedildi.
BULGULAR: Olgularýn 137 (%69,2)’si erkek, 61 (%30,8)’i kadýn ve yaþ ortalamasý 63,56±11,68 (20-89) olarak bulundu. 129 olgunun sigara öykülerine ulaþýlabildi ve bunlardan 62 (%48,1)’sinin sigara öyküsü vardý. Son 1 yýlda kolorektal polipozis tanýsý konulan olgular arasýnda KOAH sýklýðý %8 olarak bulundu. KOAH olanlarda kontrol grubuna göre lökosit, NLO ve MCV deðerleri istatistiksel olarak anlamlý olarak daha yüksek bulundu (sýrasýyla p= 0,001, <0,001, <0,001). Polipler histopatolojik olarak neoplastik ve non-neoplastik olarak karþýlaþtýrýldýðýnda bu inflamasyon deðerleri iki grupta da benzer bulundu. Lökosit, NLO ve MCV deðerlerinin sigara öyküsü ile pozitif korele olduðu görüldü.
TARTIÞMA ve SONUÇ: KOAH ve adenomatöz polipler sistemik inflamasyonla iliþkili olup, çalýþmamýzda adenomatöz polip saptanan olgular arasýnda sýklýðý %8 bulunmuþtur ve bu olgularda sistemik inflamasyon belirgin yüksektir. KOAH tanýsý olan polipli olgularda neoplastik ve non-neoplastik polip alt grubunda inflamasyon deðerlerinin inceleneceði prospektif çalýþmalara ihtiyaç vardýr.

INTRODUCTION: The prevalence of chronic obstructive pulmonary disease (COPD) in patients with colorectal polyps and its relationship with systemic inflammation was investigated in our study.
METHODS: A total of 35 cases with COPD diagnosis (COPD group) and 163 control groups without chronic disease in medical history among patients who were diagnosed colorectal polyposis by colonoscopy between December 2016-December 2017 were included to the study. Demographic data such as age, smoking history, pathology results, anatomic location of the lesion, hemogram data such as leukocyte, neutrophil lymphocyte ratio (NLR) and mean platelet volüme (MPV) were recorded.
RESULTS: 137 (69.2%) of the cases were male and the mean age was 63.56 ± 11.68 (20-89) years. Smoking history was available in 129 cases, of which 62 (48.1%) had a smoking history. The prevalence of COPD was 8% among patients with colorectal polyposis in the previous year. Leukocyte, NLR and MPV values were statistical significantly higher in patients with COPD compared to healthy group (p = 0.001, <0.001, <0.001, respectively). When the polyps were histopathologically categorized as neoplastic and non-neoplastic polyps, no significant difference was found in the comparisons of inflammation parameters between the groups.
DISCUSSION AND CONCLUSION: COPD and adenomatous polyps are associated with systemic inflammation and its prevalance among adenomatous polyps was found to be 8%. Prospective studies are needed to examine the inflammation values of neoplastic and non-neoplastic polyp subgroups in patients with polyps with COPD.

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Ýnflamatuar fibroid polipler tüm gastrik poliplerin içinde oldukça nadir görülürler Genellikle submukozadan köken alýrlar ve boyutlarý sýklýkla 1-3 cm' dir. Ýmmünhistokimyasal boyamada da dendritik hücre kökenli olduðunu düþünülmektedir. Patogenezi bilinmemektedir. Ayýrýcý tanýda diðer mezenkimal tümörlerle ve gastrointestinal stromal tümörlerle karýþabilmektedir. En sýk mide antrumundan köken almakla birlikte gastrointestinal sistemin her yerinde görüIülebilir. Taný obstrüksiyona baðlý yakýnmalarla veya genellikle rastlantýsal olarak konulmaktadýr. Özellikle ince barsak yerleþimli poliplerin bir komplikasyon geliþmeden tespit edilmesi oldukça zordur. Biz de burada invajinasyona neden olan bir inflamatuar fibroid polip olgusunu sunmayý amaçladýk.

Inflammatory fibroid polyp is a rare polypoid lesion of the gastrointestinal tract that generally originates from the submucosa. It is 1-3 cm in size. Immunohistochemical staining is also thought to be of dendritic cell origin. Pathogenesis of inflammatory fibroid polyp is unknown. In differential diagnosis may be confused with other mesenchymal tumors and gastrointestinal stromal tumors. Although it originates mostly from the stomach antrum, it can also be found elsewhere throughout the gastrointestinal tract. Diagnosis is complaints related with obstructions or usually detected coincidentally by complaints. Especially, it is difficult to detect in small intestine located polyps without developing a complication. We aimed to present a case of inflammatory fibroid polyp causing invagination.

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Splenik arter psödoanevrizmasý nadir ancak potansiyel olarak ölümcül bir bozukluktur. Transarteriyel embolizasyon bu bozukluðun tedavisinde tercih edilen yöntem haline gelmiþtir, ancak psödokistlerin de içerisinde yer aldýðý duvarlý pankreatik sývý birikimlerinin varlýðý bu tedavi yöntemini zorlaþtýrabilir. Bu yazýda, splenik arter psödoanevrizmasýnýn duvarlý bir pankreatik nekrotik sývý birikimi içerisine yýrtýlmasýndan dolayý senkop þeklinde bulgu veren 40 yaþýnda kadýn olguyu sunuyoruz. Yýrtýlmayý takiben daha büyük boyutta yeniden ortaya çýkan psödoanevrizma, baþarýsýz bir giriþimin arkasýndan endovasküler yöntemle dolaþýmdan uzaklaþtýrýlmýþtýr.

Splenic artery pseudoaneurysms are rare but potentially lethal disorder. Transarterial embolization has become the preferred mode of therapy for the disorder, however, accompanying walled-off pancreatic fluid collections including pseudocysts can make the management more challenging. Herein, we present the case of a 40-year-old woman presenting with syncope due to the rupture of a splenic artery pseudoaneurysm into a walled-off pancreatic necrotic collection. The pseudoaneurysm that re-emerged at a larger size following the rupture was endovascularly excluded from circulation after a failed attempt.

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GÝRÝÞ ve AMAÇ: Poliklinik þartlarýnda daha rahat ve az aðrýlý endometrial örnekleme iþlemleri yapýlabilmesi için farklý analjezi/lokal anestezi rejimleri kullanýlmaktadýr. Bu çalýþmada aspirasyon küretaj ile endometrial örnekleme yapýlan hastalarda aðrý kontrolunde lidokain ile paraservikal anestezinin, lidokain ile intrauterin anestezinin ve rektal indometazinin etkinliðini deðerlendirmeyi amaçladýk.
YÖNTEM ve GEREÇLER: Çalýþmaya toplam 166 kadýn dahil edildi. Ýntrauterin lidolain(IUL) grubu 43 kadýndan, paraservikal lidokain(PCL) grubu 40 kadýndan, rektal indometazin(RI) grubu 41 kadýndan ve kontrol grubu 42 kadýndan oluþmaktadýr. Aspirasyon küretaj iþlemi yapýldýktan sonra hastalarýn iþlem sýrasýnda hissettikleri aðrý, görsel aðrý skalasýyla (VAS), iþlemden hemen sonra (VAS 0) ve iþlemden 30 dakika sonra (VAS 30) olarak deðerlendirildi.
BULGULAR: Hastalarýn VAS skorlarý karþýlaþtýrýldýðýnda, gruplar arasýnda VAS 0 skorlarý bakýmýndan anlamlý fark varken VAS 30 skorlarý bakýmýndan anlamlý fark yoktu. Aspirasyon kürtaj iþlemi sýrasýnda hissedilen aðrý gruplar arasýnda farklý bulundu. Gruplar arasýndaki farklýlýklar deðerlendirildiðinde, IUL&PCL&RI gruplarý arasýnda VAS 0 skorlarýna göre anlamlý fark bulunmazken, IUL&PCL&RI gruplarý ile kontrol grubu arasýnda anlamlý fark bulundu. Kontrol grubunun VAS 0 skrlarý,IUL&PCL&RI gruplarýndan daha yüksek bulundu. Gruplar arasýnda anlamlý farklýlýk bulunan diðer parametre müdahale süresi olarak belirlendi. Gruplar müdahale süresine göre karþýlaþtýrýldýðýnda RI&IUL, RI&PCL, C&PCL, C&IUL gruplarý arasýnda anlamlý fark bulundu. Rektal indometazin ve kontrol grubundaki hastalar, intrauterin lidokain ve paraservikal lidokain gruplarýna göre daha kýsa müdahale sürelerine sahipti.
TARTIÞMA ve SONUÇ: Aspirasyon kürtajla yapýlan endometrial örnekleme iþleminde aðrý kontrolu için uygulanan lidokain ile paraservikal blok, intrauterin lidokain uygulamasý ve rektal indometazin uygulamasý eþit derecede etkili bulundu. Analjezi/anestezi tipinin seçimi cerrahlarýn tercih ve deneyimlerine, hastalarýn ve hastanelerin koþullarýna baðlýdýr.

INTRODUCTION: Different analgesia/local anesthesia regimens are used during endometrial sampling procedures in the outpatient settings. The aim of this study was to evaluate the effectiveness of paracervical/ intrauterine anesthesia with lidocaine and rectal indomethacine for pain control in patients having endometrial sampling with suction curretage.
METHODS: 166 women were included to the study. Intrauterine lidocaine(IUL) group consisted of 43 women, paracervical lidocaine(PCL) group consisted of 40 women, rectal indomethacine(RI) group consisted of 41 women and control(C) group consisted of 42 women. After completing the suction curretage procedure, all of the patients were evaluated for their pain scores during the intervention with VAS (visual analog scale) immediately(VAS 0) and 30 minutes later(VAS 30).
RESULTS: Pain felt during the suction curretage (VAS 0) was different but it was not different for VAS 30 between the groups. When intergroup differences were evaluated, there was not any significant difference betweeen IUL&PCL&RI groups according to VAS 0 scores while there was significant difference between IUL&PCL&RI groups and control group. The control group had higher VAS 0 scores than the IUL&PCL&RI groups. When the groups were compared according to the intervention time, there was significant difference between RI&IUL, RI&PCL, C&PCL, C&IUL groups as well. The patients in the rectal indomethacine and control group had shorter intervention times than the intrauterine lidocaine and paracervical lidocaine groups.
DISCUSSION AND CONCLUSION: Paracervical block with lidocaine, intrauterine lidocaine installation and rectal indomethacine administration were equally effective in pain control during endometrial biopsy with suction curretage.

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GÝRÝÞ ve AMAÇ: Artan insan ömrü nedeniyle dünyadaki yaþlý popülasyon hýzla artmaktadýr. Yaþlanma ile ilgili yeni parametreler yaþlanmanýn fizyopatolojisini ve kardiyovasküler hastalýklardan korunmada fayda saðlayabilir. Bu çalýþmanýn amacý yaþlanma ve yaþlanma ile iliþkili hastalýklar ile desendan aorta CW doppler sistolik pik gradient arasýndaki iliþkiyi saptamaktýr.
YÖNTEM ve GEREÇLER: Çalýþmaya 372 katýlýmcý dahil edildi. Aort koarktasyonu olan hastalar ve 18 yaþ altý katýlýmcýlar çalýþma dýþý býrakýldý. Yatar pozisyonda, suprasternal pencereden desendan aortaya paralel olarak sürekli dalga doppler ölçümleri kaydedildi. Aortik sürekli dalga doppler sistolik pik gradienti tüm katýlýmcýlardan elde edildi. Katýlýmcýlarýn karakteristikleri, ekokardiyografik, biyokimyasal parametreleri ile yaþ arasýndaki iliþki deðerlendirildi.
BULGULAR: Desendan aortik sürekli dalga doppler sistolik pik gradyaný incelendiðinde yaþ ile negatif (r =-0.499,p<0.001);kreatinin (r=-0.217,p <0.001); üre (r =-0.289,p<0.001); Hba1c (r = -0.252 p <0.001); LVEDD (r =-0.188, p<0.001); LVESD (r =-0.200,p <0.001); IVS (r=-0.259,p<0.001); PW (r =-0.248, p<0.001); LA (r=-0.272, p<0.001); PAP (r=-0.217, p<0.001); E / E '(r =-0.185, p<0.001), eGFR (Cockcroft-Gault mL / dk) (r =0.395,p <0.001) ve EF (r =0.266 p<0.001) ile pozitif korelasyon saptandý.
MannWhitney U analizinde desendan aorta sürekli dalga doppler sistolik pik gradyaný hipertansiyon (p<0.001), koroner arter hastalýðý (p <0.001), atrial fibrilasyon (p<0.001), ve sistolik kalp yetmezliði hastalarýnda (p<0.001) anlamlý olarak daha düþük saptandý.
Stepwise lineer regresyon analizinde, desendan aorta sürekli dalga doppler sistolik pik gradientin ile yaþ arasýnda baðýmsýz korelasyon saptandý (p<0.001).

TARTIÞMA ve SONUÇ: Desendan aorta sürekli dalga doppler sistolik pik gradientinin ölçümü yaþlanma ile iliþkili noninvaziv, pratik, tekrarlanabilir ve basit bir yöntemdir. Bu parametre klinik pratikte yaþlanmanýn bir göstergesi olarak kolayca kullanýlabilir.

INTRODUCTION: The world inhabitants increasing to grow older fastly, due to rising longevity.A new parameters related to cardiovascular aging may help to understand cardiac pathophysiology and prevention of cardiac disorders.The aim of the study was to find out a possible relationship between descending aortic continuous wave doppler systolic peak gradient and aging,age related illnesses.
METHODS: The study group was composed of 372 people.Aortic coarctation patients and under 18 years old participants exluded to the study.Continuous wave doppler measurements from suprasternal window at supine position were recorded with the cursor parallel to main flow of direction in descending aorta.Descending aortic continuous wave doppler systolic peak gradient was obtained from all participants and correlations were evaluated between participants caracteristics,echocardiographic,biochemical parameters and age.
RESULTS: When descending aortic continuous wave doppler systolic peak gradient was analyzed,there was negative correlations with age (r= -0.499,p<0.001);creatinine (r=-0.217,p<0.001);urea (r=-0.289,p<0.001);Hba1c (r=-0.252,p<0.001);LVEDD (r=-0.188,p<0.001);LVESD (r=-0.200,p<0.001);IVS (r=-0.259,p<0.001);PW (r=-0.248,p<0.001);LA (r=-0.272,p<0.001);PAP (r=-0.217,p<0.001); E/E’(r=-0.185,p<0.001); ascending aortic diameter (r=-0.269,p<0.001) and positive correlations with eGFR (r=0.395,p<0.001),EF (r= 0.266,p<0.001).
In Mann Whitney U test, descending aortic continuous wave doppler systolic peak gradient was significantly lower in hypertension (p<0.001); coronary artery disease (p<0.001); atrial fibrillation (p<0.001); systolic heart failure patients (p<0.001) when compared to those without this disease.In stepwise linear regression analysis, significant independent correlates of descending aortic continuous wave doppler systolic peak gradient was only age (p<0.001).

DISCUSSION AND CONCLUSION: Measurement of descending aortic continuous wave doppler systolic peak gradient is noninvasive,practical,repeatable and simple method and independently related to the aging.This parameter can be easily feasible in clinical practice as an indicator of aging.

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GÝRÝÞ ve AMAÇ: Bu çalýþmada, yakýn zamanda geliþtirilen enflamasyon dayalý risk indeksi olan C-reaktif proteinin (CRP) /Albümin oranýnýn (CAR), pompa yetersizliðine baðlý kardiyojenik þok ile komplike olmuþ ST yükselmeli miyokard enfarktüs hastalarýnda (STYME) prognostik bir deðere sahip olup olmadýðýný araþtýrmayý amaçladýk.

YÖNTEM ve GEREÇLER: Primer perkutan koroner giriþim uygulanmýþ ve kardiyojenik þok ile komplike olmuþ 79 ardýþýk STYME hastasý geriye dönük olarak çalýþmaya alýndý.

BULGULAR: Hastane içi takip sýrasýnda 79 hastanýn 40'ý (% 50,6) öldü. Ortalama CAR deðeri sað kalýmý olmayanlarda sað kalanlarýna göre anlamlý derecede yüksekti (8.58 [4.68–12.25] vs. 4.67 [4.21–6.03]; p <0.001). Çok deðiþkenli regresyon analizi, CAR'ýn hastane içi mortalitenin baðýmsýz bir belirleyicisi olduðunu ortaya koydu (HR: 1.053, % 95 CI: 1.006-1.101; p = 0.027). Kaplan-Meier analizi, CAR ≥8.4 olan hastalarýn ölüm sýklýðý CAR <8.4 olanlara göre anlamlý derecede yüksek olduðunu gösterdi (p <0.001).

TARTIÞMA ve SONUÇ: Bu çalýþma, kardiyojenik þok ile komplike olmuþ STYME hastalarýnda CAR'ýn hastane içi mortalite için prognostik bir deðere sahip olduðunu gösteren ilk çalýþmadýr.

INTRODUCTION: In this study, we aimed to investigate whether C-reactive protein (CRP) to albumin ratio (CAR), recently developed inflammation based risk index, has a prognostic value in patients with ST elevation myocardial infarction (STEMI) complicated by cardiogenic shock due to a pump failure.

METHODS: We retrospectively enrolled 79 consecutive STEMI patients who underwent a primary percutaneous coronary intervention and complicated by cardiogenic shock.
RESULTS: During the in-hospital course, 40 of the 79 patients (50.6%) died. The mean value of CAR was significantly higher in patients with non-survivors than those who survived (8.58 [4.68–12.25] vs. 4.67 [4.21–6.03]; p<0.001). A Cox multivariate regression analyses revealed that the CAR was an independent predictor of the in-hospital mortality (HR: 1.053, 95%CI: 1.006-1.101; p=0.027). Kaplan-Meier analysis showed that the patients with CAR≥8.4 had a significantly higher the incidence of death compared to those with CAR<8.4 (p<0.001).

DISCUSSION AND CONCLUSION: The present study is the first to demonstrate that the CAR may have a prognostic value for the in-hospital mortality in patients with STEMI complicated by cardiogenic shock.

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GÝRÝÞ ve AMAÇ: Üçüncü basamak bir hastanede epilepsi polikliniðine baþvuran hastalarýn klinik ve demografik bulgularýný araþtýrmak.
YÖNTEM ve GEREÇLER: Ocak 2016 - Þubat 2018 tarihleri arasýnda epilepsi polikliniðine baþvuran aktif epilepsili 187 hasta retrospektif olarak incelendi. Demografik özelliklerin yaný sýra; nöbet sýklýðý, hastalýk süresi, nöbet tipi, antiepileptikler, elektroensefalografik (EEG) ve manyetik rezonans görüntüleme (MRG) bulgularý kaydedildi.
BULGULAR: Hastalarýn yaþ ortalamasý 36,9 ± 13,1; ve % 54,5'i erkekti. Ailede epilepsi öyküsü 48 hastada (% 25.7) bulundu. 35 hastada (% 18.7) ebeveynler arasýnda akrabalýk vardý. En sýk görülen risk faktörleri kafa travmasý, febril konvülsiyon ve perinatal problemler idi. Fokal nöbetler % 67.9, jeneralize nöbetler% 29.3, sýnýflandýrýlamayan nöbetler% 2.7 idi. 107 hastanýn (% 57.2) beyin MR'ý ve 57 hastanýn (% 30.5) interiktal EEG'si normaldi. Hastalarýn toplam 116'sý (% 62) monoterapi alýrken, 71'i (% 38) polyterapiye almaktaydý.
TARTIÞMA ve SONUÇ: Bu çalýþmada, hastalarýn klinik ve demografik verileri literatür ile uyumlu idi. Kapsamlý epilepsi kliniklerinde düzenli takip ile yapýlan ayrýntýlý muayenenin nöbetlerin önlenmesinde ve daha iyi sonuç alýnmasýnda potansiyel bir fayda saðlayacaðýna inanýyoruz.

INTRODUCTION: To investigate the clinical and demographic findings of patients at epilepsy outpatient clinic of a tertiary care hospital.
METHODS: We retrospectively analysed one hundred and eighty-seven patients with active epilepsy who admitted to our epilepsy clinic between January 2016 and February 2018. In addition to demographic characteristics, we evaluated clinical variables such as; seizure frequency, duration of illness, type of seizures, antiepileptics, electroencephalographic (EEG) and magnetic resonance imaging (MRI) findings.
RESULTS: The mean age of the patients were 36,9 ± 13,1 years; and 54.5% were male. Family history of epilepsy was found in 48 patients (25.7%), and 35 patients (18.7%) had a kinship between parents. The most frequent risk factors were head trauma, febrile convulsions and perinatal problems. Partial seizures was seen in 67.9 %, generalised seizures in 29.3% and unclassified seizures in 2.7%. Brain MRI of 107 patients (57.2%) and interictal EEG of 57 patients (30.5%) was normal. A total of 116 (62%) received monotherapy, while 71 (38%) continued on polytherapy.
DISCUSSION AND CONCLUSION: In this study, clinical and demographic data of the patients were consistent with the literature. We believe that detailed examination with regular follow- up in comprehensive epilepsy clinics would provide a potential benefit in preventing seizures and better outcome.

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GÝRÝÞ ve AMAÇ: Nüfustaki yaþam süresinin artmasý, yaþlý kadýn oranlarýnda hýzlý bir artýþa neden olmakta; bu da artan yaþla birlikte pelvik tabandaki deðiþikliklerin neden olduðu pelvik taban fonksiyon bozukluklarýnýn önlenmesini ve tedavisini gerektirmektedir. Pelvik taban deðiþikliklerine baðlý pelvik taban disfonksiyonu, yetiþkin nüfusun yarýsýný oluþturan kadýnlar için önemli bir saðlýk sorunudur. Bu çalýþmanýn amacý, farklý yaþlardaki kadýnlarda pelvik taban bozukluklarýnýn yaþ aralýðý, frekanslarý ve evrelerini araþtýrmaktýr.
YÖNTEM ve GEREÇLER: Bu çalýþmada 20 ila 70 yaþ arasýndaki 30 kadýna anket uygulanmýþtýr. Elde edilen sonuçlara göre, bu bozukluðun yaþ aralýðý, sýklýðý ve evreleri araþtýrýlmýþtýr.
BULGULAR: En yüksek þikayet oranýnýn (%30) aciliyet hissi olduðu, bunu idrar kaçýrma (%26.7), kitle þikayeti (%20) ve idrar bozukluðu (%16.7) takip ederken þikayetlerin en düþük oraný (%6.7) dýþký inkontinansý için kaydedilmiþtir. T-testi, kadýnlarýn menopoz öncesi ve sonrasý þikâyetlerinin istatistiksel olarak anlamlý olduðunu ortaya koymuþtur.
TARTIÞMA ve SONUÇ: Bulgular, aciliyet hissinin pelvik taban bozukluklarýnýn neden olduðu en yaygýn þikâyetlerden biri olduðunu ve menopoz durumunun bu bozukluðun erken teþhisi ve uygun þekilde ilgilenilmesi için dikkatle izlenmesi gerektiðini göstermektedir.

INTRODUCTION: The increasing life span in the population leads to a rapid increase in the proportion of older women, which in turn requires the prevention and treatment of pelvic floor dysfunctions caused by changes in the pelvic floor with the advancing age. Pelvic floor dysfunction due to pelvic floor changes is an important health problem for women who make up half of the adult population. The objective of this study was to investigate the age range, frequencies and the phases of pelvic floor disorders in women of different ages.
METHODS: In this study, a questionnaire was applied to 30 women in ages ranging from 20 years to 70 years. In line with the results obtained, the age range, the intervals and stages of this disorder were explored.
RESULTS: The highest rate (30%) of complaints was observed to be feeling of urgency which was followed by urinary incontinence (26.7%), mass complaint (20%) and urination disorder (16.7%), while the lowest rate (6.7%) of the complaints was recorded for fecal incontinence. T-test analysis revealed that complaints of women before and after menopause were statistically meaningful.
DISCUSSION AND CONCLUSION: The results suggest that feeling urgency is one of the most common complaints caused by pelvic floor disorders and menopausal status needs to be watched carefully for early detection and proper attention of this disorder.

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GÝRÝÞ ve AMAÇ: Ýnguinal herni genel cerrahlar tarafýndan en sýk yapýlan ameliyattýr. Açýk ve laparoskopik olmak üzere iki ana cerrahi tedavi seçeneði mevcuttur. Bu çalýþmanýn amacý laparaskopik ve açýk yöntemle yaptýðýmýz tek taraflý inguinal herni ameliyatý sonuçlarýný karþýlaþtýrmaktýr.
YÖNTEM ve GEREÇLER: Ocak 2012 ocak 2018 tarihleri arasýnda hastanemizde inguinal herni tanýsý açýk yada laparaskopik ameliyat edilen hastalarýn kayýtlarý retrospektif olarak incelendi. Yaþ, cinsiyet, ameliyat þekli, ameliyat süresi, yatýþ süresi, takip süresi, günlük aktiviteye dönüþ süresi, nüks ve diðer komplikasyonlar incelendi.
BULGULAR: Çalýþmaya 539 (%53,5) açýk ameliyat, 469 (%46,5) laparoskopik uygulanan toplam 1008 hasta alýnmýþtýr. Ortalama takip süreleri 28,4±20,2 aydýr. Açýk ameliyat uygulanan hastalarýn ameliyat süresi laparoskopi uygulanan hastalarýn ameliyat süresinden daha kýsadýr. Laparoskopi uygulanan hastalarda seroma oraný (%5.8) açýk ameliyat uygulanan hastalara göre (%3,7) daha yüksektir (p: 0,896). Laparoskopi uygulanan hastalardaki nüks oraný (%3,84) açýk ameliyat uygulanan hastalara göre (%2,23) daha fazladýr (p: 0,038). Laparoskopi uygulanan hastalarýn yatýþ süresi ve iþe dönüþ süreleri açýk ameliyat uygulanan hastalara göre daha kýsadýr.
TARTIÞMA ve SONUÇ: Laparoskopik inguinal herni onarýmý kýsa hastane yatýþý, kýsa iþe dönme süresi, daha az postoperatif aðrý ve hissizlik açýsýnda avantajlý, nüks ve diðer komplikasyonlar açýsýnda açýk inguinal herni onarýmý kadar güvenlidir. Ancak son yýllarda kýsalmasýna raðmen ameliyat süresi hala uzundur.

INTRODUCTION: Inguinal hernia is the most common surgical operation done by general surgeons. There are two main surgical therapeutic options: open surgery and laparoscopic surgery. The aim of this study is to compare the outcome of unilateral inguinal hernia operations either by open surgery or by laparoscopic surgery.
METHODS: We have retrospectively reviewed patient charts of patients with inguinal hernia who were operated in our hospital between January 2012 - January 2018 by open surgery or laparoscopic surgery. Age and sex of the patients, type of operation, duration of operation, post-op hospital stay, follow up time, time to return to normal daily activities, and recurrence and other complications were reviewed.
RESULTS: Total 1008 patients have been operated: 539 patients (53.5%) by open surgery, 469 patients (46.5%) by laparoscopic surgery. Mean follow up time was 28,4±20,2 months. Duration of operation is shorter in patients who have undergone open surgery compared to laparoscopic surgery patients. Seroma rate (5.8%) was higher in laparoscopic surgery patients compared to open surgery patients (3.7%) (p: 0,896). Recurrence rate was higher in laparoscopic surgery patients(3,84%) compared to open surgery patients (2,23%)(p: 0,038). In laparoscopy patients post-op hospital stay and time to return to work was shorter compared to open surgery patients.
DISCUSSION AND CONCLUSION: Laparoscopic inguinal hernia repair is more favorable in terms of shorter hospital stay, shorter time to return to work, less postoperative pain and numbness compared to open inguinal hernia repair and it’s as safe as open inguinal hernia repair in terms of recurrence or other complications. However, duration of operation in laparoscopic surgery is still longer, although it became shorter in recent years.

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GÝRÝÞ ve AMAÇ: Çocukluk çaðýnda sýklýkla görülen intermittan ekzotropya tedavisinde sýklýkla cerrahi dýþý teknikler tercih edilmektedir. Mevcut çalýþmayla okülo-motor egzersizlerin intermittan ekzotropya tedavisi ve hasta-ebeveyn memnuniyet düzeyleri ile yaþam kaliteleri üzerine etkisini deðerlendirmek hedeflenmiþtir.
YÖNTEM ve GEREÇLER: Ýntermittan ekzotropya tanýlý 51 hastanýn demografik özellikleri, yaþlarý, doðum aylarý, açýk alanda geçirdiði süreler, sikloplejik refraksiyon ölçümleri, snellen eþeli ile elden düzeltilmiþ ve düzeltilmemiþ görme keskinlikleri, yakýn ve uzak olmak üzere alternan prizma örtme testleri (PÖT), Titmus testleri ve konverjans ölçümleri yapýldý. Fizyoterapist tarafýndan 6 hafta süre ile her gün 2 seans olacak þekilde bakýþ stabilizasyonlu okülo-motor egzersizler hastalara ev programý olarak verildi. Egzersiz öncesi ve sonrasý memnuniyet ve yaþam kalitesi testleri uygulandý.
BULGULAR: Yapýlan analizlerde sol göz görme keskinliði [p=0.076],sað göz skiaskopi [p<0.001],sol göz skiaskopi [p=0.009], ve Prizma Örtme Testi uzak tahsisli ölçümleri [p=0.003], egzersiz eðitimi sonrasý artýþ gösterirken, proksi anket [p=0.004] puanlamasýnda azalma izlendi. Sol göz görme keskinliði ile yaþ [p<0.001], açýk alan süre [p=0.024] ve egzersiz günlüðü [p=0.038] iliþkili bulunurken, Prizma Örtme Testi uzak tahsisli ile sadece yaþ [p=0.039] arasýnda anlamlý bir iliþki bulundu.
TARTIÞMA ve SONUÇ: Çalýþmamýzda egzersiz uygulamalarýnýn uygulama miktarýndan baðýmsýz olarak, sol göz görme keskinliði hariç diðer ölçüm deðerleri üzerine etkisinin olmadýðý sonucuna ulaþýlmýþtýr. Daha güvenilir sonuçlar için mevcut limitasyonlarýn giderildiði geniþ ölçekli ve kontrol grubu olan çalýþmalara ihtiyaç olduðu düþünülmektedir.

INTRODUCTION: In the treatment of intermittent exotropia, which is frequently seen in childhood, non-surgical techniques are often preferred. The present study aims to evaluate the effect of oculo-motor exercises on intermittent exotropia treatment and patient-parent satisfaction levels and quality of life.
METHODS: 51 patients diagnosed with intermittent exotropia were performed demographic characteristics, age, months of birth, outdoor time, cycloplegic refraction measurements, corrected and uncorrected visual acuity with snellen chart, and close and distant alternan prism covering tests (PÖT), Titmus tests and convergence measurements. Oculo-motor exercises with gaze stability as home exercise protocols were given to all participitans for two sessions per day for six weeks by the physiotherapist. Satisfaction and quality of life tests were performed before and after exercise.
RESULTS: In the analysis, left eye visual acuity [p=0.076], right eye sciascopy [p<0.001], left eye sciascopy [p=0.009], and Prism Covering Test with distant measurements [p=0.003], showed increas after exercises trainning, proxy questionnaire scores [p=0.004] is decreased. While the left eye was associated with visual acuity, age [p<0.001], outdoor activities duration [p=0.024] and exercise exercise diary [p=0.038], the Prism Covering Test [p=0.039] was found to be significantly associated with age only.
DISCUSSION AND CONCLUSION: In our study, regardless of the application amount of exercise, it was concluded that there was no effect on other measurement values except left eye visual acuity. For more reliable results, large scale and control group studies are needed to eliminate the existing limitations.

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GÝRÝÞ ve AMAÇ: Ankilozan spondilit (AS) olan bireylerde týkayýcý uyku apne sendromu (TUAS) normalden sýk görülebilir. Çalýþmamýzýn amacý AS tanýsý bulunan hastalarda TUAS varlýðýný Müller manevrasý ve Epworth Uykululuk Skalasý ile araþtýrmaktýr.
YÖNTEM ve GEREÇLER: Çalýþmaya 22 AS hastasý ile benzer cinsiyet ve yaþ daðýlýmýnda bulunan 18 saðlýklý kontrol dahil edildi. Her iki grubun baþ ve boyun muayenesi yapýldý ve palatin tonsil büyüklüðünün derecesi ile mallampati derecesinin büyüklüðü kaydedildi. Buna ek olarak, fleksibl fiberoptik muayenede Müller manevrasý ile hipofarenks ve dil kökü seviyelerinin obstrüksiyon dereceleri kaydedildi. TUAS varlýðýný belirlemek amacý ile tüm katýlýmcýlara Epworth Uykululuk Skalasý uygulandý. Hasta ve kontrol grubunun palatin tonsil büyüklüðü, mallampati derecesi, Müller manevrasý deðerleri ile Epworth Uykululuk Skalasý deðerleri karþýlaþtýrýldý. Ayrýca AS hasta grubunda Epworth Uykululuk Skalasý ile hastalýk süresi ve Bath Ankilozan Spondilit Hastalýk Aktivite Ýndeksi (BASDAI) skorlarý ile ölçülen hastalýk aktivitesi arasýndaki iliþki deðerlendirildi.
BULGULAR: AS tanýsý bulunan hastalarýn fizik muayene bulgularý ve Müller manevrasý deðerleri kontrol grubu ile istatistiksel benzer olarak bulunmuþtur. AS tanýsý bulunan hasta grubunda Epworth Uykululuk Skalasý deðeri 8.45±3.73 iken, kontrol grubunda 3.72±2.34 olarak bulunmuþtur ve istatistiksel olarak anlamlý fark saptanmýþtýr (p< 0.001). Epworth Uykululuk Skalasý ile hastalýk süresi ve BASDAI skorlarý arasýnda istatistiksel olarak anlamlý fark saptanmamýþtýr.
TARTIÞMA ve SONUÇ: AS hastalarýnda, TUAS açýsýndan yüksek risk olabileceði söylenebilir. Daha güvenilir sonuçlar için, objektif deðerlendirme olan polisomnografi ile yapýlan geniþ hasta serili çalýþmalara ihtiyaç vardýr.

INTRODUCTION: OSAS can be seen more frequently in individuals with ankylosing spondylitis than in normal. Aim of the study is to investigate the presence of OSAS with Müller maneuver and Epworth Sleepiness Scale in patients with AS.
METHODS: Patients with AS (n= 22) and healthy control subjects (n= 18) with similar sex and age distribution were evaluated. Head-neck examination was performed in both groups and the degree of palatine tonsil size, the degree of mallampati were recorded. In addition, Müller maneuver and the degree of obstruction of the hypopharynx and tongue root levels were recorded in the flexible fiberoptic examination. Epworth Sleepiness Scale was applied to all participants to determine the presence of OSAS. The values of palatine tonsil size, mallampati degree, Müller maneuver and Epworth Sleepiness Scale were compared between patient and control groups. In addition, the relation between Epworth Sleepiness Scale and disease duration and disease activity measured by BASDAI scores were evaluated in AS patient group.
RESULTS: The results show that AS and healthy controls do not differ statistically in physical examination findings and the Müller maneuver values. Epworth Sleepiness Scale was found 8.45 ± 3.73 in the patient group, 3.72 ± 2.34 in the control group and a statistically significant difference was found (p <0.001). There was no statistically significant difference between Epworth Sleepiness Scale and disease duration and BASDAI scores.
DISCUSSION AND CONCLUSION: It can be considered that there may be high risk for OSAS in patients with AS. For more reliable results, large patient series studies with polysomnography are required.

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GÝRÝÞ ve AMAÇ: Koroner arter ektazisinin (KAE) patofizyolojisi açýkça tanýmlanamamýþtýr. Dislipidemi, kardiyovasküler hastalýk (KVH) için baðýmsýz bir risk faktörü olarak kabul edilir. Her ne kadar aterojenik dislipidemi ile KVH arasýndaki iliþki iyi bilinse de, izole KAE ile aterojenik dislipidemi hakkýnda bilgi yoktur. Bu çalýþmanýn amacý, izole KAE'li hastalarda aterojenik dislipidemiyi deðerlendirmektir.
YÖNTEM ve GEREÇLER: Hasta grubunda izole KAE olan 91 hasta vardý ve kontrol grubu normal koroner anjiyogramlarý olan 90 ardýþýk kiþiden oluþuyordu. Serum total kolesterol (TK), trigliserit (TG), düþük yoðunluklu lipoprotein kolesterol (LDL-K), yüksek yoðunluklu lipoprotein kolesterol (HDL-K) ve aterojenik endeksler (aterojenik dislipidemi indeksi, HDL-K olmayan, aterojenik katsayýsý, kardiyak risk oranlarý 1 ve 2) analiz edildi.
BULGULAR: Aterojenik dislipidemi indeksi, HDL-K olmayan, aterojenik katsayýsý ve kardiyak risk oranlarý 1 ve 2 izole KAE hastalarýnda kontrollerden anlamlý olarak daha yüksekti (p <0.001; p = 0.001; p = 0.001; p = 0.001; p <0,001, sýrasýyla). Çok deðiþkenli lojistik regresyon modelleri, aterojenik dislipidemi endeksinin izole KAE'yi öngören baðýmsýz faktör olduðunu ortaya koymuþtur (p <0.001, Odds oraný (OR) = 1.329,% 95 Güven aralýðý (C.I.) = 1.110-1.591).
TARTIÞMA ve SONUÇ: Bu çalýþma, aterojenik dislipidemi ile izole KAE arasýndaki iliþkiyi deðerlendiren ilk çalýþmadýr. Bulgularýmýz, artmýþ aterojenik endekslerin (aterojenik dislipidemi indeksi, HDL-K olmayan, aterojenik katsayýsý, kardiyak risk oranlarý 1 ve 2) izole KAE'nin erken dönem patogenezinde rol oynayabileceðini göstermektedir.

INTRODUCTION: The pathophysiology of coronary artery ectasia (CAE) has not been clearly identified. Dyslipidemia is considered an independent risk factor for cardiovascular disease (CVD). Although the relationship between atherogenic dyslipidemia and CVD is well known, there is no information about atherogenic dyslipidemia with isolated CAE. The aim of the present study was to evaluate the atherogenic dyslipidemia in patients with isolated CAE.
METHODS: The patient group included 91 patients with isolated CAE and the control group consisted of 90 consecutive subjects who proved to have normal coronary angiograms. Serum levels of total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), and atherogenic indices (atherogenic dyslipidemia index, non HDL-C, atherogenic coefficient, cardiac risk ratios 1 and 2) were analyzed.
RESULTS: The atherogenic dyslipidemia index, non HDL-C, atherogenic coefficient, and cardiac risk ratios 1 and 2 were significantly greater in the isolated CAE patients than in the controls (p < 0.001; p = 0.001; p = 0.001; p = 0.001; p < 0.001, respectively). The multivariate logistic regression models revealed that atherogenic dyslipidemia index was found to be independent factor predicting isolated CAE (p < 0.001, Odds ratio (OR) = 1.329, 95% Confidence interval (C.I.) = 1.110–1.591).
DISCUSSION AND CONCLUSION: This is the first study that evaluates the relationship between the atherogenic dyslipidemia and isolated CAE. Our findings suggest that increased atherogenic indices (atherogenic dyslipidemia index, non HDL-C, atherogenic coefficient, cardiac risk ratios 1 and 2) may be involved in the early pathogenesis of the isolated CAE.

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GÝRÝÞ ve AMAÇ: Acil servise baþvuran hastalarda akut koroner sendrom ve kardiyak / kardiyak olmayan göðüs aðrýsýnýn ayýrýcý tanýsý ile kritik vaskuler stenozun öngörülmesinde mortalite üzerine baðýmsýz bir belirteç olarak mean platelet volum (MPV) ve trombosit / MPV oranýnýn etkinliðini araþtýrmak.
YÖNTEM ve GEREÇLER: Retrospektif gözlemsel çalýþmaya göðüs aðrýsý ile acil servise baþvuran 45 yaþ ve üstü hastalar dahil edildi. Hastalar kardiyak / kardiyak olmayan göðüs aðrýsý olarak gruplara ayrýldý. MPV, trombosit/ MPV oraný, koroner anjiyografi sonuçlarý, hastane içi ve 1 aylýk hastane mortalitesi kaydedildi.
BULGULAR: Çalýþmaya katýlan 753 hastanýn %37,46'sýnda kardiyak patoloji tespit edildi. Tüm hastalarýn yaþ ortalamasý 60,1 ve tüm hastalarýn % 59'u erkekti. Kardiyak ve kardiyak olmayan hastalar arasýnda trombosit, Mean platelet volum (MPV) ve trombosit / MPV deðerleri açýsýndan istatistiksel olarak anlamlý bir fark saptanmýþtýr (sýrasýyla p = 0.005, p <0.001 p <0.001).MPV, trombosit / MPV deðerlerinin majör kardiyak advers olay geliþimini gösteren ROC eðrisi; eðri altýnda kalan alan MPV için 0.677 ve trombosit / MPV için 0.366 olarak bulunmuþtur. Major kardiyak olay görülen hasta grubunda STEMI olan hastalara göre, STEMI-AKS olmayan hastalarda ortalama MPV deðeri istatistiksel olarak anlamlý derecede düþüktü (p = 0.003). Kritik stenoz saptanmayan hastalara göre MPV deðeri istatistiksel olarak anlamlý derecede yüksek ve ortalama trombosit / MPV deðeri istatistiksel olarak anlamlý derecede düþüktü (p≤0.001).
TARTIÞMA ve SONUÇ: MPV ve trombosit düzeyinin tek baþýna kullanýmlarýnýn yetersiz olmasýna raðmen, literatürde açýklanan diðer risk faktörleri ile birlikte kullanýldýðýnda akut koroner sendrom tanýsý için baðýmsýz belirteçler olarak kullanýlabileceðini düþünmekteyiz.

INTRODUCTION: We aimed to investigate effectiveness of mean platelets volume (MPV) and platelet/MPV ratio as an independent marker on mortality for prediction of critical vascular stenosis in the differential diagnosis of acute coronary syndrome and cardiac/non-cardiac chest pain in patients presenting to the emergency department.
METHODS: Retrospective observational study included patients of 45 years of age and above presented to the ED with chest pain. Patients were divided into groups with cardiac/non-cardiac chest pain. MPV, platelets/MPV ratio, coronary anjýography results, in-hospital and 1-month hospital mortality were recorded
RESULTS: A total of 753 patients; Cardiac pathology was determined in 282 (37.46%). The mean age was determined as 60.1 years and 59% were male. A statistically significant difference was detected between cardiac and non-cardiac patients with regard to platelet, MPV and plt/MPV values (p=0.005, p<0.001 p<0.001, respectively).
ROC curve, which plots Major cardiac advers event (MACE) estimation of MPV, Platelets/MPV values; AUC was found as 0.677 for MPV and 0.366 for Plt/MPV. Mean MPV value was statistically significantly low in patients with Non-STEMI-ACS (p=0.003) compared to the patients with STEMI in MACE+ group. MPV value was statistically significantly higher and the mean Platelets/MPV value was statistically significantly lower in patients with critical stenosis compared to none critical stenosis (p≤0.001)
DISCUSSION AND CONCLUSION: Although MPV values and platelet/MPV ratio are not sufficient to use alone in routine daily practice, we consider that MPV and the platelets/MPV ratio are significant as dependent markers for the diagnosis of ACS when used together with the other described risk factors in the literature.

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GÝRÝÞ ve AMAÇ: Önceden, koroner yavaþ akýþýn (KYA) erkek cinsiyet, yüksek BMI ve sigara kullanýmý ile ilgili olduðu bildirilmiþti. Ancak KYA, kadýnlarda da görülen bir klinik durumdur ve bu konuda herhangi bir çalýþma yapýlmamýþtýr. Bu çalýþmada kadýn hastalarda KYA ‘nýn belirleyicilerini araþtýrmayý amaçladýk.
YÖNTEM ve GEREÇLER: 40'ý normal (ortalama yaþ: 51.9 ± 5.2 yýl) ve 40 ‘I KYA (ortalama yaþ: 54.6 ± 7.7 yýl) toplam 80 kadýn hasta seçildi. TIMI frame sayýlarý hesaplandý ve demografik özellikler, komorbiditeler ve ilaç kullanýmý ile ilgili veriler toplandý. CSF, frame sayýsý> 27 olarak tanýmlandý.
BULGULAR: KYA grubunda diyabetes mellitus (DM) yüzdesi anlamlý olarak yüksekti (% 52.5'e karþýlýk% 22.5; p: 0.005). DM, çok deðiþkenli lojistik regresyon analizinde KYA 'lý kadýn hastalarýn anlamlý belirleyicisi olarak bulundu (O.R: 3.44,% 95 CI: 1.14–10.36; p: 0.028).
TARTIÞMA ve SONUÇ: KYA 'lý kadýn hastalarda DM'nin anlamlý derecede arttýðýný ve çok deðiþkenli analizde KYA ‘nýn baðýmsýz belirleyicisi olduðunu bulduk.

INTRODUCTION: Previously, the coronary slow flow (CSF) has been reported to be related to male sex, high BMI, and smoking. However, CSF is a clinical condition seen in women and no studies have been conducted on this subject. We aimed to investigate predictors of coronary slow flow in female patients.
METHODS: A total of 80 female patients, 40 of whom were normal (mean age: 51.9±5.2 years) and 40 with coronary slow flow(mean age: 54.6 ±7.7 years) were selected. TIMI frame counts were calculated, and data on demographics, comorbidities, and medication use were collected. CSF was defined as frame count >27. 
RESULTS: Percentage of diabetes mellitus (DM) was significantly higher in the CSF group ( 52.5 % vs. 22.5 %; p: 0.005). DM was found to be significant predictor of female patients with CSF in the multivariate logistic regression analysis (O.R: 3.44, 95%CI: 1.14–10.36; p: 0.028).
DISCUSSION AND CONCLUSION: We found that DM was significantly increased and only independent predictor of CSF in female patients with CSF.

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GÝRÝÞ ve AMAÇ: Kontakt lens kullanýmýna uyumu deðerlendirmek, kontakt lens kullananlarýn demografik profillerini ve temel uyumsuz davranýþlarýný belirlemek.
YÖNTEM ve GEREÇLER: 257 kontakt lens kullanýcýsý, bir anket formu kullanýlarak tek bir göz doktoru tarafýndan deðerlendirildi. Sorular kontakt lens kullanýcýlarýnýn, kontakt lens hijyen davranýþlarýný, lens bakýmýna yönelik tutumlarýný ve demografik özelliklerini ele aldý.
BULGULAR: Lens kullananlarýn yaþ ortalamasý 29'du ve çoðunluðu kadýnlardan oluþmaktaydý (% 78). Bildirilen baþlýca uyumsuz davranýþlar lenslerle uyumak (% 70.5), lenslerle su aktivitelerine katýlmak (% 52.5), lens kaplarýný düzgün bir þekilde temizlememek (% 44) ve lensleri önerilen lens deðiþtirme sýklýðýna göre deðiþtirmemekti (% 47,5). Katýlýmcýlarýn kontakt lens kullanýmýna uyumu ile yaþ, cinsiyet, kontakt lenslerin günlük kullaným süreleri, kontakt lens toplam kullaným süresi, göz muayenesi sýklýðý, eðitim düzeyi, kontakt lens bakýmý ile ilgili bilgi kaynaðý arasýnda istatistiksel olarak anlamlý bir iliski tespit edilmedi.
TARTIÞMA ve SONUÇ: Lenslerle uyumak, lenslerle su aktivitelerine katýlmak, lens kutularýný düzgün bir þekilde temizlememek ve lensleri önerilen lens deðiþtirme sýklýðýna göre deðiþtirmemek, lens kullananlardaki yaygýn uyumsuz davranýþlardý.

INTRODUCTION: To identify the demographics profile of lens wearers, to evaluate compliance to contact lens use, and to determine major noncompliant behaviours.
METHODS: 257 contact lens wearers were sequentially interviewed by a single ophthalmologist by using a questionnaire. The questions addressed the demographics of contact lens wearers, contact lens hygiene behaviors and attitudes towards lens care.
RESULTS: The mean age of lens wearers was 29 years with the majority of females (78%). Major reported forms of noncompliance were sleeping with lenses (70.5%), participating in water activities with lenses (52.5%), not cleaning lens cases properly (44%), and not replacing the lenses according to the recommended lens replacement frequency (47.5%). There was not statistically significant difference in compliance levels between participants in regard to age, gender, contact lens wearing hours per day, duration of contact lens use, frequency of eye examinations, education level, source of knowledge about contact lens care, and different types of contact lens purchase.
DISCUSSION AND CONCLUSION: Sleeping with lenses, participating in water activities with lenses, not cleaning lens cases properly, and not replacing the lenses according to the recommended lens replacement frequency are the common noncompliant behaviors in lens wearers.

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GÝRÝÞ ve AMAÇ: Varfarin tedavisi alan hastalarda kronik venöz yetmezliðinin perkütan tedavisi sonuçlarýný araþtýran çalýþma sayýsý özellikle glue ablasyon açýsýndan yetersizdir. Çalýþmamýzýn amacý, siyanoakrilat ile glue ablasyon veya radyofrekans ile endovenöz termal ablasyon tedavilerinin, erken ve orta dönem sonuçlarýný deðerlendirmek ve bu teknikleri varfarin tedavisi alan hasta grubunda karþýlaþtýrmaktýr.
YÖNTEM ve GEREÇLER: Ocak 2013 ile Ocak 2018 tarihleri arasýnda, kronik venöz yetmezliði tanýsý ile büyük safen venin tümesan veya lokal anestezi altýnda, siyanoakrilat ile glue ablasyon veya radyofrekans ile endovenöz termal ablasyon tedavisi yapýlan toplam 306 hasta çalýþmaya dahil edildi. 306 hastanýn 30'una (12 erkek, 18 kadýn; ort. yaþ 63,28 ± 3.46 yýl; daðýlým 51-72 yýl) varfarin tedavisi altýnda glue ablasyon (11 hasta) veya endovenöz termal ablasyon (19 hasta) tedavisi uygulandý.
BULGULAR: Takip süresi içerisinde 5 hastada (% 16.6) rekanalizasyon gözlendi. Bu 5 hastadan 4'üne (% 21) radyofrekans ile endovenöz termal ablasyon, 1'ine (% 9) ise glue ablasyon tedavisi uygulanmýþtý. Siyanoakrilat ile glue ablasyon ve radyofrekans ile endovenöz termal ablasyon tedavilerinin bir yýllýk baþarý oranlarý sýrasýyla % 90,9 ve% 78,9 bulundu (P = 0,047). Rekanalizasyon geliþen beþ hasta ise glue ablasyon ile % 100 baþarý ile tedavi edilmiþtir.
TARTIÞMA ve SONUÇ: Ýþlem sonrasý kanama veya derin ven trombozu olmaksýzýn glue ablasyon iþlemi varfarin tedavisi altýnda güvenli ve etkili bir þekilde yapýlabilmekle beraber, radyofrekans ile endovenöz termal ablasyon tedavisine kýyasla orta dönem sonuçlarý daha üstün bulunmuþtur.

INTRODUCTION: The number of articles examining the percutaneous treatment of chronic venous insufficiency in patients receiving warfarin therapy is insufficient especially for glue ablation. The aim of our study was to evaluate the early and midterm postprocedural outcomes of glue ablation with cyanoacrylate closure and endovenous thermal ablation with radiofrequency and to compare these techniques in a group of patients with uninterrupted warfarin therapy.
METHODS: From January 2013 to January 2018, a total of 306 patients who underwent glue ablation or endovenous thermal ablation with radiofrequency of the great saphenous vein under either tumescent or local anesthesia due to chronic venous insufficiency were included in this study. Of 306 patients, 30 patients (12 males, 18 females; mean age 63,28±3,46 years; range 51 to 72 years) underwent either glue ablation (11 patients) or endovenous thermal ablation (19 patients) under warfarin therapy.
RESULTS: Recanalization was observed in 5 patients (16.6%) during the follow-up period. Of these 5 patients, 4 patients (21%) underwent endovenous thermal ablation with radiofrequency and 1 patient (9%) underwent glue ablation. One-year success rate of glue ablation with cyanoacrylate closure and endovenous thermal ablation with radiofrequency were 90,9% and 78,9%, respectively (P=0.047). Five patients with recanalization have treated with glue ablation with 100% success.
DISCUSSION AND CONCLUSION: Glue ablation could be safely and effectively performed in patients with uninterrupted warfarin therapy without postprocedural bleeding or deep vein thrombosis and, it was associated with superior mid and long-term results compared to the endovenous thermal ablation with radiofrequency.

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GÝRÝÞ ve AMAÇ: Bu çalýþmada, kronik total týkanýklýðý (KTO) olan hastalarda koroner arter ektazisi (KAE) ile koroner koleteral dolaþým (KKD)geliþme arasýndaki iliþkiyi araþtýrdýk
YÖNTEM ve GEREÇLER: Þubat 2015 ve Haziran 2018 arasýnda, stabil angina pektoris ve / veya pozitif efor testi için koroner anjiyografi yapýlan ardýþýk 403 KTO hastasý çalýþmaya dahil edildi. Koroner kollateral akým, Rentrop nitel sýnýflamasý kullanýlarak bazal anjiyogramlarda derecelendirildi. Çalýþma hastalarý iyi KKK (Rentrop 2-3) ve kötü KKK (Rentrop 0-1) açýsýndan 2 gruba ayrýldý. Anjiyografik olarak, epikardiyal koroner arterler; segmental veya diffüz 1.5-2 kat geniþleme KAE olarak tanýmlandý
BULGULAR: Çalýþmaya ortanca yaþ 68 (61-75) yýl olan ardýþýk 403 KTO hasta dahil edildi. Güçlü KKD grubunda 168 hasta, zayýf KKD grubunda 235 hasta vardý. KAE, zayýf KKD grubunda 60 (% 25.5), güçlü KKD grubunda 24 hasta (% 14.3) anjiyografik incelemede saptandý (p = 0.006). Ek olarak, diyabetes mellitus (DM) (p = 0.032) ve stabil anjina pektoris insidansý (p = 0.011) zayýf KKD olan grupta anlamlý olarak arttý. SYNTAX skoru, güçlü KKD olan grupta anlamlý olarak yüksekti (p = 0.002). Çok deðiþkenli lojistik regresyonda Stabil anjina pektoris [OR: 0.37 (0.22-0.62), p = 0.002], KAE [OR: 0.51 (0.26-0.98), p = 0.046] ve SYNTAX skoru [OR: 1.31 (1.11-1.56), p = 0.001], güçlü KKD 'nin varlýðý ile güçlü bir þekilde iliþkili olduðu bulundu.
TARTIÞMA ve SONUÇ: Çalýþmamýzda KTO'lu hastalarda KAE varlýðý ile zayýf KKK varlýðý arasýnda anlamlý bir iliþki bulduk.

INTRODUCTION: In this study, we investigated the relationship between coronary ectasia (CAE) and coronary colleteral (CCC) development in patients with chronic total occlusion (CTO).
METHODS: Between February 2015 and June 2018, 403 consecutive CTO patients who underwent coronary angiography for stable angina pectoris or positive effort testing were included in the study. CCC was graded on baseline angiograms with the use of qualitative classification by Rentrop. The study patients were divided into 2 groups with respect to good CCC (Rentrop 2-3) and poor CCC ( Rentrop 0-1). Angiographically, segmental or diffuse expansion 1.5-2 fold in coronary arteries is defined as CAE
RESULTS: The study included consecutive 403 Patients with CTO, median age 68 (61-75) years were included in the study. There were 168 patients in the good CCC group and 235 patients in the poor CCC group. CAE was identified 60 patients (25.5%) in the poor CCC group and 24 patients (14.3%) in the good CCC group at angiographic examination (p=0.006). In addition, diabetes mellitus (DM) (p = 0.032) and the incidence of stable angina pectoris (p = 0.011) were significantly increased in the group with poor CCC. SYNTAX score was significantly higher in the group with good CCC (p = 0.002). In multivariable logistic regression, Stable angina pectoris [OR: 0.37(0.22-0.62), p=0.002], CAE [OR: 0.51(0.26-0.98), p=0.046] and SYNTAX score [OR: 1.31(1.11-1.56), p=0.001], were found to be associated with presence of good CCC
DISCUSSION AND CONCLUSION: In our study, we found a significant relationship between the presence of CAE and poor CCC in patients with CTO.

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GÝRÝÞ ve AMAÇ: Fiziksel ve ruhsal nedenler yaþanan, çalýþma ortamlarý olumsuz etkileyen anksiyete ve tükenmiþlik sendromu hem bireyi hem de örgütü olumsuz etkileyen kavramlardýr. Son zamanlarda yoðun olarak yaþanan bu kavramlar “baþaramama, yýpranma, çalýþma istek ve arzusunun azalmasý veya tatmin edilemeyen istekler sonucunda bireyin iç dünyasýnda meydana gelen tükenme ile bireyin hayatýnda gerçekleþen deðiþimleri ifade etmektedir. Bu araþtýrma ile yoðun çalýþma ortamýnda bulunan hemþirelerin anksiye düzeyleri ve bu düzeylerin tükenmiþlik sendromu ile iliþkisinin varlýðýný ortaya çýkarmak amaçlandý
YÖNTEM ve GEREÇLER: Araþtýrmanýn evrenini Ý iki devlet hastanesinde çalýþan 387,örneklemini ise194 hemþire oluþturdu.Ýliþkisel tipte olan bu araþtýrma Temmuz 2018-Eylül 2018 tarihleri arasýnda gerçekleþtirildi. Verilerin toplanmasýnda“Kiþisel Bilgi Formu” ile“Beck Anksiyete Ölçeði” ve “Maslach Tükenmiþlik Sendromu Ölçeði” kullanýldý.Çalýþmada; güvenilirlik analizi, baðýmsýz örneklemler için t testi (independent samples t-test), tek yönlü varyans analizi (one way anova), Tukey çoklu karþýlaþtýrma testi, pearson korelasyon ve regresyon analizleri yapýldý.
BULGULAR: Çalýþmada hemþirelerin duygusal tükenme ve duyarsýzlaþma alt boyutlarý açýsýndan orta, kiþisel baþarý alt boyutu açýsýndan ise yüksek düzeyde tükenmiþlik ve yüksek düzeyde ansiyete yaþadýklarý belirlendi
TARTIÞMA ve SONUÇ: Sonuç olarak, hemþirelerin yaþadýðý anksiyete ve buna baðlý bozukluklar, tükenmiþlik düzeylerini arttýrmaktadýr. Saðlýk çalýþanlarýndaki tükenmiþlik düzeylerini azaltmaya yönelik olarak yapýlacak iyileþtirmeler de anksiyete ve buna baðlý bozukluklar göz ardý edilmemeli ve her iki durum içinde gerekli olan iyileþtirme faktörleri birlikte harekete geçirilmelidir.

INTRODUCTION: Anxiety and burnout syndrome, which affects physical and mental causes and negatively affects the working environment, are the concepts that negatively affect both the individual and the organization. These concepts, which have been experienced intensively in recent times, refer to the changes in the life of the individual through the depletion in the inner world of the individual as a result of failure, failure, desire to work and diminished desire or desire. The aim of this study was to reveal the anxiety levels of nurses in intensive work environment and the relationship between these levels and burnout syndrome.
METHODS: The population of the study consisted of 387 nurses and sample of 194 nurses.This research was conducted between July 2018 and September 2018. “Personal Information Form” and “Beck Anxiety Inventory” and “Maslach Burnout Syndrome Scale” was collected using. In study, reliability analysis, independent samples t-test, one-way ANOVA, Tukey multiple comparison test, pearson correlation and regression analysis were performed.
RESULTS: In the study, it was determined that nurses experienced moderate exhaustion and depersonalization sub-dimensions, high level of burnout and high level of disability in terms of personal achievement sub-dimension.
DISCUSSION AND CONCLUSION: As a result, anxiety and nursing problems of nurses increase burnout levels. Improvements to reduce burnout levels in health care workers should not ignore anxiety and related disorders, and the improvement factors required in both cases should be mobilized together.

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GÝRÝÞ ve AMAÇ: Ýlaçlar ruhsatlandýrýlmadan önce deney hayvanlarýnda ve gönüllü insanlarda denenmelerine raðmen, güvenlilik profilleri tam olarak tanýmlanmamýþ olabilir. Bu nedenle advers ilaç reaksiyonlarý (AÝR)’nýn spontan bildirilmesi, daha önce saptanamamýþ AÝR’nin raporlanmasýnda ve gerekli önlemlerin alýnmasýnda önem taþýr. Bu çalýþmada, Farmakovijilans Ýrtibat Noktasý’na AÝR ile ilgili yapýlan spontan bildirimler deðerlendirilmiþtir.
YÖNTEM ve GEREÇLER: 2015-2017 yýllarý arasýndaki spontan bildirimlerde yer alan 45 hastanýn verileri incelendi. Birinci kýsýmda hastanýn demografik bilgileri, ikinci kýsýmda AÝR’nin tanýmý, iliþkili laboratuvar tetkikleri, AÝR’nin sonucu, etkinin ciddiyet kriterleri ve hastanýn özel durumlarý kaydedildi. Üçüncü kýsýmda ilacýn jenerik ve ticari adý, veriliþ yolu, günlük dozu, intervali, ilaç maruziyet tarihi ve endikasyonu yazýldý. Dördüncü kýsýmda raporlayan bireyin bilgileri kaydedildi.
BULGULAR: Çalýþmadaki AÝR spontan bildirim dönemlerinin iki hastada 2015 yýlý, 18 hastada 2016 yýlý ve 25 hastada 2017 yýlý içinde olduðu saptandý. AÝR %48,9 oranýnda makülopapüler erüpsiyon, %22,2 ürtiker ve/veya anafilaksi, % 15,6 kýrmýzý boyun sendromu, %4,4 çarpýntý, %2,2 DRESS (eozinofili ve sistemik semptomlarla izleyen ilaç reaksiyonu) sendromu, %2,2 kaþýntý, %2,2 konuþma bozukluðu ve %2,2 titreme olarak saptandý. Reaksiyonlar %95,6 iyileþme, %2,2 advers etkinin devam etmesi ve %2,2 ölüm ile sonuçlandý. Tüm vakalarýn %75,6’sý ciddi olmayan, %24,4’ü ise ciddi AÝR olarak rapor edildi.
TARTIÞMA ve SONUÇ: AÝR spontan bildirim formunda yer alan her bir parametre, nedensellik iliþkisini kuvvetlendirmesi açýsýndan önemlidir. Ülkemizde spontan bildirimlerin yýllara göre artýþ eðiliminde olmasý farmakovijilans farkýndalýðýnýn artmakta olduðunu göstermekle birlikte, raporlama iþleminin geliþmiþ ülkelere göre yaygýn olmamasý dikkat çekicidir.

INTRODUCTION: Although drugs are tested in animals and volunteers before they are licensed, safety profiles may not be fully defined. Therefore, reporting of adverse drug reactions (ADR) is important in previously unrecognized ADR and taking necessary precautions. In this study, spontaneous ADR to Pharmacovigilance Contact Point were evaluated.
METHODS: The data of 45 patients between 2015-2017 were included. First part included patients’ demographic data, second part included information about ADR, the related laboratory tests, outcome of ADR, severity of the effect and special issues of the patient. In the third part, drugs’ generic and commercial names, route of administration, daily dose, interval, drug exposure date and indications were recorded. In the fourth part, information of the reporting individual was recorded.
RESULTS: We found that two patients in 2015, 18 patients in 2016 and 25 patients in 2017 were reported as ADR. Reactions were 48.9% maculopapular eruption, 22.2% urticaria and/or anaphylaxis, 15.6% red neck syndrome, 4.4% cardiac palpitations, 2.2% DRESS (drug reaction with eosinophilia and systemic symptoms), 2.2% itching, 2.2% speech impairment and 2.2% tremor. 95.6% of reactions resulted in improvement, 2.2% continued adverse effect and 2.2% resulted in death. 75.6% of all cases were reported as non-serious, while 24.4% were reported as severe.
DISCUSSION AND CONCLUSION: Each parameter in ADR form is important in strengthening the causality. Spontaneous reports in our country tend to increase indicates that awareness of pharmacovigilance is increasing, but it is noteworthy that reporting process is not as common as the developed countries.

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