GÝRÝÞ ve AMAÇ: Yoðun bakým üniteleri(YBÜ) nozokomiyal enfeksiyonlar ve bakteriyeminin en sýk görüldüðü alanlardýr. Sürveyans çalýþmasý ile etkenlerin belirlenmesi, özelliklerinin bilinmesi, direnç profilinin çýkarýlmasý, çapraz enfeksiyon, kontaminasyonun önlenmesi ile hastane enfeksiyonu oranlarý düþürülmesi hedeflenir. Bu çalýþmada Haseki Eðitim ve Araþtýrma Hastanesi YBÜ’de 2009-2013 yýllarý arasýnda izlenen hastalarda geliþen nozokomiyal bakteriyemilerde etkenlerin daðýlýmlarý ve duyarlýlýk oranlarýnýn incelenmesi amaçlanmýþtýr.
YÖNTEM ve GEREÇLER: Çalýþmamýz 1 Ocak 2009 ve 31 Aralýk 2013 tarihleri arasýnda YBÜ’ de yapýlmýþtýr. YBÜ’ye yatan hastalarýn bakteriyemi sürveyansý, sürveyans takip formu, invaziv araç sürveyansý izlem formuna göre deðerlendirilmiþtir. Kan kültürlerinde üreyen bakteriler BacT/Alert sisteminde inkübasyon sonrasý pozitif üreme sinyali olan þiþelerden konvansiyonel yöntemler ve Vitek 2 identifikasyon cihazýnda identifiye edilmiþtir. Antibiyotik duyarlýlýklarý Kirby Bauer disk diffüzyon yöntemine göre yapýlmýþ, CLSI kriterlerine göre yorumlanmýþtýr.
BULGULAR: YBÜ’de beþ yýllýk sürede 327 bakteriyemi epizodu saptanmýþtýr. Bunlarýn 181’i periferik kan örneði, 146’sý SVK iliþkili bakteriyemi, izole edilen bakteriyemilerin %76.2’si Gram negatif etkenler, %19.5’i Gram pozitif etkenler, %3.6’sý fungal etkenler olmuþtur. En sýk izole edilen bakteri Klebsiella spp. (%22.9) olmuþtur. Sýrasýyla Acinetobacter spp. (%19.8), Pseudomonas spp. (%17.7), Enterobacter spp. (%7.1), E. coli (%3.1) en sýk gözlenen Gram negatif bakteriler olmuþtur. Bakterilerin antibiyotik duyarlýlýklarýnda yýllara göre anlamlý deðiþiklikler saptanmýþtýr.
TARTIÞMA ve SONUÇ: YBÜ’de toplam nozokomiyal enfeksiyonlara göre kan dolaþýmý enfeksiyonu oraný yýllara göre anlamlý oranda azalmýþ olup SVK iliþkili kan dolaþýmý enfeksiyonunda yýllara göre artýþ gözlenmiþtir. YBÜ’de geliþen bakteriyemilerde etkenler daha dirençli olup, hastalar daha komplikedir. Hastane enfeksiyonlarýnýn kontrol altýna alýnmasýnda sürveyans çalýþmalarý büyük önem taþýmaktadýr.

INTRODUCTION: Intensive care units are the areas where nosocomial infections and bacteremia are most common. With the surveillance study, it is aimed to determine the agents, to know their characteristics, to create the resistance profile, to prevent cross-infection and contamination, and to reduce the rates of nosocomial infections. In this study, it was aimed to examine the distributions and susceptibility rates of the agents in nosocomial bacteremia in patients followed up in the Haseki Training and Research Hospital ICU between 2009 and 2013. Our study was carried out in ICU between January 1, 2009 and December 31, 2013.
METHODS: Bacteremia surveillance of the patients hospitalized in the ICU was evaluated according to the surveillance follow-up form and the invasive vehicle surveillance follow-up form. Bacteria grown in blood cultures were identified from vials with positive growth signal after incubation in the BacT/Alert system using conventional methods and Vitek 2 identification device. Antibiotic sensitivities were determined according to Kirby Bauer disc diffusion method and interpreted according to CLSI criteria.
RESULTS: In the ICU, 327 episodes of bacteremia were detected in a five-year period. Of these, 181 were peripheral blood samples, 146 were CVC-associated bacteremia, 76.2% of the isolated bacteremias were Gram-negative agents, 19.5% were Gram-positive agents, and 3.6% were fungal agents. The most frequently isolated bacteria is Klebsiella spp. (22.9%). Respectively, Acinetobacter spp. (19.8%), Pseudomonas spp. (17.7%), Enterobacter spp. (7.1%), E. coli (3.1%) were the most frequently observed Gram negative bacteria. Significant changes were found in the antibiotic susceptibility of bacteria by years.
DISCUSSION AND CONCLUSION: Compared to total nosocomial infections in the ICU, the rate of bloodstream infections decreased significantly over the years, and an increase was observed in CVC-related bloodstream infections over the years. In bacteremia developing in the ICU, the agents are more resistant and the patients are more complicated. Surveillance studies are of great importance in controlling hospital infections.

GÝRÝÞ ve AMAÇ: Eritrosit daðýlým geniþliðinin (RDW) primer miyelofibroz hastalarýnda arttýðý gösterilmiþtir ve Philadelphia-negatif miyeloproliferatif neoplazilerde (MPN) kemik iliði fibrozisi varlýðýný tahmin etmede biyopsi yerine RDW’nin kullanýlýp kullanýlamayacaðý ilgi çekicidir. Çalýþmamýzýn amacý: Polisitemi vera (PV), esansiyel trombositoz (ET) ve PMF alt tiplerini içeren MPN’li hastalarda myelofibroz derecesi ile RDW deðerleri arasýndaki iliþkiyi deðerlendirmektir.
YÖNTEM ve GEREÇLER: Hastanemizin Hematoloji Kliniði’nde 2010-2017 tarihleri arasýnda MPN tanýsýyla takip edilen 118 hastanýn verilerini retrospektif olarak inceledik
BULGULAR: Elli iki hastada PV, 60 hastada ET, 4 hastada PMF ve 2 hastada sýnýflandýrýlamayan MPN saptandý. Derece 0 ve derece 1 retikülin fibrozisi bulunan 29 hasta (% 24,6) myelofibrozisi olmayan olarak, kalan 2 ≥ derece retikülin fibrozisi olan 89 (% 75,4) hasta ise myelofibrozisi bulunan olarak kabul edildi. Medyan RDW deðeri %14,6 (%12,4-23,1) idi. Ortanca RDW deðeri myelofibrozisi olmayan hastalarda %14.1 (%12.4-17.8) ve myelofibrozisli hastalarda %15 (12.4-23.1) olarak ortaya sonuçlandý (p = 0.054). Derece 3 fibrozisi olup ileri myelofibrozisi olan 8 hastanýn alt grup analizinde medyan RDW deðeri % 18.45 (16.4-23.1) ve kalan 110 hastada % 14.45 (%12.4-23) saptandý (p = 0.008).
TARTIÞMA ve SONUÇ: Bu çalýþma, RDW ve myelofibroz arasýndaki iliþki hakkýnda kesin bir sonuç saðlamasa da, artmýþ RDW’nin MPN’li hastalarda ileri kemik iliði fibrozisi varlýðýna iþaret edebileceði görülmektedir.

INTRODUCTION: Red cell distribution width (RDW) was shown to be increased in primary myelofibrosis (PMF) patients and it is intriguing whether RDW could be used instead of biopsy in predicting presence of bone marrow fibrosis (BMF) to some extend in Philadelphia-negative myeloproliferative neoplasms (MPNs) comprising polycytemia vera (PV), essential thrombocytosis (ET) and PMF. Our aim is to evaluate the relationship between BMF degree and RDW values in patients with MPNs.
METHODS: We retrospectively reviewed the data of 118 patients, who were followed with the diagnosis of MPNs at our Hematology Clinic between 2010 and 2017.
RESULTS: 52 patients had PV, 60 had ET, 4 had PMF and 2 had unclassifiable MPN. Twentynine (24.6%) patients were with grade 0 and grade 1 reticulin fibrosis were considered to be free of BMF, and the remaining 89 (75.4%) patients with ≥ grade 2 reticulin fibrosis were considered to have BMF. The median RDW value was 14.6% (range 12,4-23,1%). The median RDW value revealed with 14.1% (range, 12.4-17.8) in patients without BMF and 15% (range, 12.4-23.1) in patients with BMF (p=0.054). In subgroup analysis of 8 patients with advanced BMF of grade 3, the median RDW value was 18.45% (range, 16.4-23.1) and it was 14.45% (range, 12.4-23) in the remaining 110 patients (p=0.008).
DISCUSSION AND CONCLUSION: Although the present study does not provide a precise conclusion about the association between RDW and BMF, it seems that increased RDW can point out the presence of advanced BMF in patients with MPNs.

Metastaz, kanser hücrelerinin anatomik olarak uzak organ bölgelerine yayýlmasýný ve daha sonra yabancý doku mikro ortamlarýna adaptasyonunu içeren metastaz kaskadý olarak adlandýrýlan çok aþamalý moleküler ve biyolojik bir süreçtir. Metastaz, kolorektal kanser (KRK) hastalarýnda baþlýca ölüm nedenidir. KRK’nin en yaygýn metastaz bölgeleri karaciðer ve peritondur. Metastaz kaskadýnda en önemli ve geniþ alaný epitelyal-mezenkimal geçiþ (EMT) oluþturmaktadýr. EMT, transkripsiyon faktörleri, sinyal yolaklarý ve miRNA’lar gibi birçok faktörün etkili olduðu bir süreçtir. Primer tümörün epitel özellikleri, integrinler ve ekzozomal integrinler, kanser kök hücre fenotipi, miRNA ekspresyonu, anjiogenez ve ekstravazasyonda etkili faktörler, organlarýn fizyolojik özellikleri ve vaskülarizasyon metastatik yolun belirlenmesine yani organotropizme katkýda bulunmaktadýr. Organotropizmde etkili olan bu mekanizmalar ayrýntýlý olarak bu derlemede ele alýnmaktadýr. KRK’de metastaz geliþiminin altýnda yatan mekanizmalarýn daha iyi anlaþýlmasý, metastatik KRK hastalarýnda hedefe yönelik tedavi açýsýndan büyük katký saðlayacaktýr.

Metastasis is a multistep molecular and biological process called the metastasis cascade that involves the anatomically spread of cancer cells to distant organ regions and their subsequent adaptation to foreign tissue microenvironments. Metastasis is the major cause of death in colorectal cancer (CRC) patients. Liver and peritoneum are the most common metastasis sites of CRC. The epithelial-mesenchymal transition (EMT) constitutes the most important and wide area in the metastasis cascade. EMT is a process in which many factors such as transcription factors, signal pathways and miRNAs are effective. Epithelial characteristics of the primary tumor, integrins and exosomal integrins, cancer stem cell phenotype, miRNA expression, factors affecting angiogenesis and extravasation, physiological characteristics of organs and vascularization contribute to the determination of the metastatic pathway, namely organotropism. These mechanisms that are effective in organotropism are discussed in detail in this review. A better understanding of the mechanisms underlying metastasis development in CRC will greatly contribute to targeted therapy in metastatic CRC patients.

GÝRÝÞ ve AMAÇ: Göz saðlýðý ile ilgili YouTube videolarýn güvenilirliðini, kalitesini ve popülerliðini deðerlendirmek.
YÖNTEM ve GEREÇLER: Bu çalýþma geriye dönük, kesitsel ve kayýt tabanlý bir çalýþmadýr. Ýnternet sistesinin standart arama tercihlerinde deðiþiklik yapmadan ‘’göz saðlýðý’’ anahtar kelimesi kullanýlarak bir YouTube aramasý yapýldý. Tüm videolar yayýncýlar, videoyu sunanlar ve konularýna göre ayrý ayrý kategorilendirildi. Videolarýn süresi, baþlýðý, izlenme sayýsý, yüklemeden beri geçen süre, izlenme oraný (görüntülenme/gün), yorum sayýsý, beðeni ve beðenmeme sayýsý ve beðeni oraný kayýt edildi. Video içeriðinin kalitesi ve güvenilirliði; mDISCERN anketi (0–5), Amerikan Tabipler Birliði Dergisi (Journal of the American Medical Association-JAMA) skoru (0–4) ve Küresel Kalite Puaný (Global Quality Score -GQS) (0–5) kullanýlarak ölçüldü. Videolarýn popülerliðini deðerlendirmek için, video güç indeksi (VPI) kullanýldý.
BULGULAR: Toplam 120 video analiz edildi, dahil edilme kriterlerini karþýlayan 103 video deðerlendirildi. Ortalama süre 17.85
±18.94 (aralýk; 0.30-59) dakika, ortalama görüntüleme sayýsý 27825.11±153493.35 (aralýk; 23-1302227) idi. Videolarýn ortalama
JAMA, mDISCERN, GQS ve VPI deðerleri sýrasýyla; 1.82±0.38 (aralýk; 1-2), 2.26±0.88 (aralýk; 0-4), 2.5±0.94 (aralýk; 1-4), 0,66±152,27 (aralýk; 0-1085) idi. Videoda anlatým yapanlarýn % 85.43’ü (n=88) göz doktoru idi. Videolar içeriklerine göre kategorize edildiðinde çocuklarda göz saðlýðý (%36.89) hakkýnda bilgi veren videolarýn sayýsý daha fazla idi. mDISCERN ile JAMA (ro=581 p<0.001), GQS ile JAMA (ro=582, p<0.001) ve mDISCERN ile GQS (ro=857, p<0.001) arasýnda istatistiksel olarak anlamlý pozitif korelasyon vardý.
TARTIÞMA ve SONUÇ: Bu çalýþma, göz saðlýðý ile ilgili YouTube videolarýnýn hastalarý bilgilendirmek için yetersiz olduðunu gösterdi. Bu nedenle hekimler çevrimiçi bilgilerin kalitesi ve içeriðindeki çeþitliliðin farkýnda olmalý ve hastalar ile birebir görüþmeleri sýrasýnda hatalý bilgileri düzeltmelidir.

INTRODUCTION: To evaluate the credibility, quality, and popularity of eye-health-related YouTube videos.
METHODS: This is a retrospective, cross-sectional, register-based study. A YouTube search was conducted using the keyword “eye health” without changing the website’s default search parameters. All of the videos were categorized based on their publishers, presenters, and topics. The duration of the videos, title, number of views, time since upload, view rate (views/day), number of comments, number of likes and dislikes, and rate of likes were all recorded. The mDISCERN questionnaire (0–5), Journal of the American Medical Association (JAMA) (0–4) score, and Global Quality Score (GQS) (0–5) were used to analyze the video content’s quality and reliability.
RESULTS: A total of 120 videos were analyzed, with 103 of them meeting the inclusion criteria. The mean viewing duration was
17.85 ±18.94 minutes(range: 0.30-59), and the mean number of views was 27825.11±153493.35(range; 23-1302227). The mean JAMA, mDISCERN, GQS, and VPI scores of the videos were 1.82±0.38(range: 1-2), 2.26±0.88(range: 0-4), 2.5±0.94(range: 1-4), and 0.66±152.27(range; 0-1085), respectively. 85.43% (n=88) of the narrators in the videos were ophthalmologists. According to the content of the videos, the number of videos related to pediatrics eye health was higher. (36.89%). There was a statistically significant positive correlation between mDISCERN and JAMA(ro=581 p<0.001), GQS and JAMA(ro=582, p<0.001) and mDISCERN and GQS(ro=857, p<0.001).
DISCUSSION AND CONCLUSION: This study showed that eye health videos on YouTube were insufficient to inform the patients. As a result, during patients interviews, physicians should be aware of the quality and diversity of online information and correct inaccurate information.

GÝRÝÞ ve AMAÇ: Kortikokansellöz kemik grefti ile rekonstrüksiyon yapýlan ve greftin kansellöz tarafýnýn daha iyi kanlanmaya sahip olan tarafa çevrilmesi yöntemi uygulanan hastalarýn erken ve geç dönem bulgularýnýn sunulmasý amaçlanmýþtýr.
YÖNTEM ve GEREÇLER: 2018-2019 yýllarý arasýnda alýcý bölgeye konarken ters çevrilerek kortikokansellöz kemik greftlemesi prosedürüyle onarýmý yapýlan hastalar retrospektif olarak incelendi. Defektlerin etiyolojisi ve lokalizasyonu, kemik greftinin boyutu, örtücü yumuþak doku tipi ve erken ve geç dönem komplikasyonlar araþtýrýldý. 6 ay sonra kemik sintigrafisi ile incelenerek greftlerin canlýlýðý kontrol edildi.
BULGULAR: Yaþ ortalamasý 42 olan 7 hasta vardý. Üç maksilla, iki mandibula ve iki frontal kemiðin etkilendiði 3x1,5 cm ile 10x4 cm arasýnda deðiþen defektler mevcuttu. Biri hariç tüm hastalarda kapama için random flep ve tespit için plak kullanýldý. Bir hastada greft enfekte oldu ve resorbe oldu,debridman sonrasý kemik rekonstrüksiyonu planý ertelendi. Bu hasta dýþýndaki tüm greftler sintigrafide osteoblastik aktivite gösterdi.
TARTIÞMA ve SONUÇ: Kan akýmýnýn nispeten daha iyi olduðu tarafa kansellöz tarafý çevrilerek uygulanmýþ kortikokansellöz kemik greftlemesi uygulamasý, kemik greftinin saðlamlýðý ve yaþayabilirliði açýsýndan iyi sonuçlar vermektedir.

INTRODUCTION: The aim was to present early and late period findings in patients who underwent reconstruction with corticocancellous bone grafts using the technique of inverting the cancellous side of the graft to the side with better blood supply.
METHODS: Patients repaired with corticocancellous bone grafts using this technique between 2018 and 2019 were retrospectively reviewed. The etiology and localization of the defects, the size of the bone graft, the type of soft tissue and early and late complications were documented. Six months later, bone scintigraphy was examined and the viability of the grafts was checked.
RESULTS: There were seven patients with an average age 42. Three patients had maxillary, two mandibular and two frontal bones have defects with the sizes between 3x1.5 cm and 10x4 cm. Random flaps for coverage and plates for fixation were used in all patients except one. Graft fail occurred for one patient and bone reconstruction was postponed until after debridement. All grafts show osteoblastic activity on scintigraphy, except the patient with osteomyelitis.
DISCUSSION AND CONCLUSION: Using the cancellous side of the corticocancellous bone grafts to be applied to the side where the blood supply is relatively better gives good results.

GÝRÝÞ ve AMAÇ: Konvelesant Plazma (KP) tedavisi ile pasif aþýlama, SARS-CoV-2 enfeksiyonu (COVID-19) olan hastalarda popülerlik kazanmýþtýr, ancak hasta grubunun hangi dozda ve hangi optimal zaman aralýðýnda yapýlacaðýna dair kontrollü bir çalýþma yoktur. Bu çalýþma, yoðun bakým ünitesindeki (YBÜ) kritik hastalarda erken ve geç KP tedavilerini etkinlik ve mortalite açýsýndan karþýlaþtýrmayý amaçladý.
YÖNTEM ve GEREÇLER: Kartal Dr. Lütfi Kýrdar Þehir Hastanesi Yoðun Bakým Ünitesine COVID-19 tanýsýyla baþvuran ve Nisan 2020-Haziran 2020 tarihleri arasýnda KP tedavisi verilen 20 hastayý retrospektif olarak deðerlendirdi. Erken KP tedavisi alan (Grup 1) ve geç KP tedavisi alan (Grup2) hastalarýn sonuçlarýný karþýlaþtýrdýk.
BULGULAR: 20 hastanýn 5’i (% 25.0) kadýn, 15’i (% 75.0) erkekti. Hastalarýn ortalama yaþý 61 ± 8.6 yýldý. Grup1’de mortalite oraný ve YBÜ’de kalýþ süresi Grup 2’ye göre anlamlý olarak daha düþüktü (sýrasýyla p = 0.025, p = 0.001). Taný konulduktan sonra KP’nin verildiði gün ile YBÜ’de geçirilen toplam gün sayýsý arasýnda pozitif korelasyon görüldü. KP uygulama günü arttýkça, YBÜ’de kalýþ süresi de arttý ve bu istatistiksel olarak anlamlýydý.
TARTIÞMA ve SONUÇ: Hýzlý ve ölümcül seyreden, saðkalýmý artýrmak için zamanla yarýþdýðýmýz COVID-19 hastalýðýnda seçilecek tedavi yöntemleri ve zamanlamasý çok önemlidir. Bu çalýþma, KP ile erken tedavi seçeneklerinin mortaliteyi ve YBÜ’de kalýþ süresini azaltabileceðini ve KP’nin son aþama kurtarma tedavisi olmadýðýný gösterdi.

INTRODUCTION: Passive vaccination with convalescent plasma(CP) therapy has gained popularity in patients with SARS-CoV-2 infection (COVID-19).However, there is no controlled study that will clearly define the use of this treatment in which the patient group, at what dose, and at what optimal time interval. The present study aimed to compare early and late CP treatments in critically ill patients in theintensive care unit (ICU) for efficacy and mortality.
METHODS: We retrospectively evaluated 20 patients who were admitted toICU of Kartal Dr. Lütfi Kýrdar City Hospital with the diagnosis of COVID-19 and given CP therapy between April and June 2020 and compared early (Group1) and late (Group2) outcomes of therapy.
RESULTS: Of 20 patients, 5(25.0%) were female and 15(75.0%) were male. The average age of patients was 61±8.6 years. In Group1, the mortality rate and the length of stay in ICU were significantly lower compared to Group2(p=0.025, p=0.001, respectively). A positive correlation was observed between the day that CP was given after diagnosis and total number of days spent in ICU. As CP administration day was delayed, the length of stay in ICU also increased and this was statistically significan.
DISCUSSION AND CONCLUSION: The treatment modalities and timing to be selected are very important in COVID-19, which is fast and deadly and competes with time to increase survival. This study showed that CP therapy is well-tolerated, that early treatment options can reduce mortality and length of stay in ICU and it is not a final stage rescue therapy.

GÝRÝÞ ve AMAÇ: Covid-19 hastalarýnda sýklýkla, ateþ ve kuru öksürük, boðaz aðrýsý, dispne gibi respiratuar sistemi etkileyen klinik bulgulara rastlanýr. COVID-19 hastalýðýna baðlý enfeksiyonlarýn her zaman solunum yollarýna sýnýrlý kalmadýðý ve nörolojik tutulumun da olabileceði gösterilmiþtir. Çeþitli mekanizmalarla virüsün santral sinir sistemine yayýlým sonucunda oluþabilecek nörolojik tablolar icerisinde; baþ aðrýsý, baþ dönmesi, nöbet, ensefalit, inme ve nöromuskuler bozukluklar, periferik sinir sistemi tutulumlarý yer almaktadýr.
YÖNTEM ve GEREÇLER: Bu çalýþmada COVID-19 pnömonisi olan 179 hastanýn eþlik eden nörolojik bulgu, muayene özellikleri ve laboratuar parametreleri retrospektif olarak deðerlendirildi.
BULGULAR: Çalýþmada hastalarýn 101’inde (%56,4) baþ aðrýsý, 33’ünde (%18,4) dizziness, 20’sinde (%11,2) bilinç deðiþikliði, 106’sýnda (%59,9) miyalji, 62’sinde (%34,6) koku kaybý tespit edilirken, 52 ‘sinde tat alma bozukluðu(%29 ) gözlenmiþtir. Akut iskemik serebrovasküler hastalýk 5 hastada (% 2,8), hemorajik serebrovasküler hastalýk ise 1 hastada(% 0,6)gözlenmiþtir. Hastalarýn laboratuar parametrelerini deðerlendirdiðimizde lenfopeni % 51’inde, trombosit deðerinde deðiþiklik ise %31’inde tespit edildi. Akut faz reaktanlarýndan C-reaktif protein (CRP) artýþý % 89’unda, ferritin düzeyinde artýþ ise %27’sinde gözlendi. Hastalarýn %17 ‘sinde kreatin kinaz (CK) düzeyinde, %20 sinde ise laktat dehiderogenaz (LDH) düzeyinde %34’ünde de D-dimer artýþý izlendi. Miyalji olan hastalarda CK seviyelerinde istatiksel anlamlý artýþ gözlendi.(p = 0.001).
TARTIÞMA ve SONUÇ: COVID-19 enfeksiyonuna baðlý klinik tablonun tek bir nörolojik belirti veya bulgu ile de prezente olabileceði akýlda tutulmalýdýr. Multidisipliner yaklaþýmla yapýlacak yeni çalýþmalarla geliþebilecek komplikasyon çeþitliliðinin, nörolojik hastalýklarla iliþkisinin ve hastalýk yönetiminin daha anlaþýlýr hale geleceði düþünülmektedir.

INTRODUCTION: The most frequent symptoms affecting the respiratory system in COVID-19 are fever, dry cough, sore throat, and dyspnea. It has been shown that infections due to COVID-19 disease are not always limited to the respiratory tract, there may also be neurologic involvement, which may occur as a result of the spread of the virus to the central nervous system through various mechanisms. Neurologic involvements include headache, dizziness, seizures, encephalitis, stroke, neuromuscular disorders, and peripheral nervous system involvement.
METHODS: In this study, neurologic findings,laboratory parameters and other characteristics of 179 patients with COVID-19
pneumonia were evaluated retrospectively.
RESULTS: Headache, dizziness, altered consciousness, myalgia, loss of smell, and taste disturbance were observed in 101/179 (56.4%), 33/179 (18.4%), 20/179 (11.2%), 80/179 (44.6%), 62/179 (34.6%), and 52/179 (29%) patients, respectively. Acute ischemic cerebrovascular disease was observed in 5/179 patients (2.8%) and hemorrhagic cerebrovascular disease was observed in one patient (0.6%). Lymphopenia was observed in 51% and thrombocytopenia was detected in 25.4%. Increased C-reactive protein, ferritin level, creatine kinase, lactate dehydrogenase, and D-dimer levels were observed in 89%, 27%, 17%, 20%, and 34% of the patients, respectively.We found a significant relationship between myalgia and increased CK levels (p = 0.001).
DISCUSSION AND CONCLUSION: Neurologic symptoms can be the first and only symptom of COVID-19. It is thought that the variety of complications that may develop, the relationship of COVID-19 with neurologic diseases, and disease management will become more understandable with future studies conducted with a multidisciplinary approach.

Amaç: Ýnsan immune yetmezlik virüsünün (HIV) kendisi veya HIV tedavisinde kullanýlan ajanlar romatizmal bulgulara neden olabilir. Bu bulgular arasýnda, sistemik lupus eritematozus (SLE) hastalarýnda da görülen artalji, artrit, fotosensitivite, oral ülser, sikka sendromu, ateþ, hipergamaglobulinemi, sitopeni, nöropati ve anti-nükleer antikor (ANA) pozitifliði yer almaktadýr. HIV, sadece SLE’yi taklit etmez, ayrýca SLE ile birlikte de olabilir.
Olgu: Oral ülser, bulanýk görme, vertigo, konuþma bozukluðu ve ataksik yürüme þikayetleri olan 40 yaþýndaki hasta kliniðimize baþvurdu. Serebellar testleri anormaldi ve tandem yürüyüþü yapamýyordu. Laboratuvarda lökopeni, lenfopeni, karaciðer fonksiyon testlerinde ýlýmlý yükseklik saptanmasý ve manyetik rezonans görüntülemede (MRG) ensefalit izlenmesi üzerine otoantikor ve viral panel istendi. Otoantikorlar negatif bulunurken, HIV enzim baðlý immunosorbent assay (ELISA) pozitifti. Sonuç: HIV, sistemik otoimmün ve otoinflamatuvar durumlara neden olabilir. Bu nedenle, özellikle romatizmal bulgular ile baþvuran hastalarda HIV dýþlanmalýdýr.

Background: Human immunodeficiency virus (HIV) can cause rheumatological manifestations due to infectious itself or treatment. Among these findings take part arthralgia, arthritis, photosensitivity, oral ulcer, sicca syndrome, fever, hypergammaglobulinemia, cytopenia, neuropathy and anti-nuclear antibody (ANA) positivity, which have been also observed in systemic lupus erythematosus (SLE). Not only does HIV imitate SLE, but also it might coexist with.
Case Report: A 40-year-old man who presented with oral lesions, blurry vision, vertigo, speech difficulty and ataxic gait admitted to the clinic. Cerebellar tests were abnormal. He could not walk in tandem gait. After observing leukopenia, lymphocytopenia and mildly increased liver function tests in laboratory and encephalitis on magnetic resonance imaging (MRI), autoantibodies and viral panel were requested. While autoantibodies were negative, HIV Enzyme-Linked Immunosorbent Assay (ELISA) was found positive.
Conclusion: HIV can lead to systemic autoimmune and autoinflammatory conditions. Notably, ruling out HIV in patients who have rheumatological findings is necessary.

GÝRÝÞ ve AMAÇ: Bu çalýþmada COVID-19 pandemi sürecinde Fiziksel Týp ve Rehabilitasyon(PMR) hekimlerinin (fiziatrist), mental saðlýk durumlarý ve uyku düzenlerinin incelenmesi amaçlanmýþtýr.
YÖNTEM ve GEREÇLER: Fiziatristlere online anket aracýlýðý ile ulaþýlmýþ ve demografik özellikleri, FTR ve pandemi polikliniklerindeki çalýþma koþullarý sorgulanmýþ, mental saðlýk ve uyku kalitesi deðerlendirmesi için sýrasýyla Depresyon, Anksiyete ve Stres Skalasý- Kýsa Form (DASS-21) ve Uykusuzluk Þiddet Ýndeksi (UÞÝ) uygulanmýþtýr.
BULGULAR: 309 FTR hekimi çalýþmaya dahil edilmiþtir. DASS-21 sonuçlarýna göre hekimlerin %58,6 depresyon, %40,5 stress ve %54,4 anksiyete, UÞÝ skorlarýna göre ise %45,3 ünde insomnia semptomlarý saptanmýþtýr. Pandemi döneminde DASS- 21 depresyon, anksiteye ve stres subskalasý ve UÞÝ skorlarýnýn istatistiksel anlamlý derecede arttýðý tespit edilmiþtir. Multipl regresyon analizleri toplam DASS-21 Skoru ile COVID-19 hakkýnda yeterli bilgilenme, hastaya yakýn temas gerektiren iþlem yapma, ailede kronik hastalýk bulunmasý ve kadýn cinsiyet arasýnda anlamlý iliþki saptanmýþtýr. Çalýþtýðý ortamýn hijyeninden memnun olmanýn UÞÝ skorlarýný anlamlý derecede azalttýðý bulunmuþtur.
TARTIÞMA ve SONUÇ: Fiziatristlerin mental saðlýðý ve uyku kalitesi pandemi döneminde belirgin etkilenmiþtir. Pandemi sürecinde fiziatristlerin stres ve anksiyetesini azaltmak için gerekli destek verilmelidir.

INTRODUCTION: The present study analyzes the mental health status and sleep patterns of Physical Medicine and Rehabilitation (PMR) physicians (physiatrists), as well as other associated factors, during the COVID-19 pandemic.
METHODS: The physiatrists that made up the sample were reached via an online questionnaire form collecting data on their demographic characteristics and the working conditions in PMR and pandemic outpatient clinics, while the Depression, Anxiety and Stress Scale-Short Form (DASS-21) and Insomnia Severity Index (ISI) were applied to measure mental status and sleep quality, respectively.
RESULTS: The study included 309 PMR physicians. The results of the DASS-21 identified symptoms of depression in 58.6%, stress in 40.5% and anxiety in 54.4% of the physicians during the pandemic, while the results of ISI revealed insomnia symptoms in 45.3%. The DASS-21 depression, anxiety and stress subscales, and the ISI scores of the physicians were found to have increased during the pandemic at a statistically significant degree. Multiple regression analyses revealed a strong relationship between total DASS-21 score, and the adequacy of information about COVID-19, performing procedures requiring close contact with patients, the presence of a person with chronic disease in the household and the female gender. Satisfaction with workplace hygiene, in turn, was found to significantly reduce the respondents’ ISI scores.
DISCUSSION AND CONCLUSION: The mental health and sleep quality of physiatrists have been affected significantly amid the pandemic. Necessary support should be provided to reduce the stress and anxiety experienced by physiatrists during and after the pandemic.

Kounis sendromu alerji, hipersensitivite, anafilaksi veya anafilaktoid durumlar ile birlikte akut koroner sendromun eþ zamanlý olarak meydana gelmesi olarak tanýmlanmaktadýr. Patofizyolojide ana enflamatuar hücreler olan mast hücrelerinin degranulasyonuyla baþta histamin olmak üzere çeþitli mediatörlerin salýnýmý rol almaktadýr. Klinik semptomlar ve bulgular alerjik reaksiyonlarýn eþlik ettiði kardiyak semptomlar ile birliktedir. Sendromun üç farklý varyantý tanýmlanmýþ olup, tanýda en önemli nokta öykü, klinik ve laboratuar bulgularýnýn birlikteliðiyle bu sendromdan þüphelenmektir. Tedavi protokolü kardiyak ve alerjik semptomlarýn eþ zamanlý olarak tedavi edilmesini gerektirmektedir.

Kounis syndrome is defined as the concurrent occurrence of acute coronary syndrome with allergy, hypersensitivity, anaphylaxis or anaphylactoid conditions. The degranulation of mast cells, which are the main inflammatory cells, and the release of various mediators, mainly histamine, play a role in the pathophysiology. Clinical symptoms and signs are associated with cardiac symptoms accompanied by allergic reactions. Three different variants of the syndrome have been defined and the most important point in diagnosis is to suspect this syndrome with the combination of history, clinical and laboratory findings.

GÝRÝÞ ve AMAÇ: Bu çalýþma saðlýk bilimleri fakültesi hemþirelik bölümü öðrencilerinin okuldan memnuniyet durumlarýný belirlemek ve memnuniyet durumlarý ile akademik baþarý puanlarý arasýndaki iliþkiyi incelemek amacýyla tanýmlayýcý olarak yapýlmýþtýr.
YÖNTEM ve GEREÇLER: Araþtýrma için gerekli izinlerden alýndýktan sonra, saðlýk bilimleri fakültesinde 2018-2019 güz yarýyýlýnda öðrenim gören, araþtýrmaya katýlmaya gönüllü olan ve formlarý eksiksiz dolduran 413 hemþirelik öðrencisi ile yapýlmýþtýr. Veri toplamý aracý olarak Sosyodemografik Veri Formu ve Öðrenci Doyum Ölçeði-Kýsa Formu kullanýlmýþtýr. Akademik baþarý puanlarý ise 2018-2019 yýlý güz döneminin tüm not giriþleri yapýldýktan sonra öðrenci bilgi sisteminden alýnmýþtýr. Verilerin incelenmesinde; Shapiro-Wilk testi, t-testi ve tek yönlü varyans analizi, Pearson korelasyon katsayýsý yöntemleri kullanýlmýþtýr.
BULGULAR: Öðrenci doyum ölçeði kýsa formundan alýnan toplam puan 181.18±29.55’ tir. Alt ölçekler bazýnda deðerlendirildiðinde; en yüksek puan ortalamasýný kararlara katýlým alt ölçeði (3.54± 0.64) almýþtýr ve sýrasýyla öðretim elemanlarý (3.51±0.61), eðitim ve öðretimin niteliði (3.43±0.64), okul yönetimi (3.36±0.66), bilimsel sosyal ve teknik olanaklar (3.28±0.67) alt ölçekleri takip etmektedir. Yapýlan istatistiksel analiz sonucunda öðrencilerin akademik ortalamalarý ile öðrenci doyum ölçeðinden aldýklarý puanlar arasýnda istatistiksel olarak anlamlý bir iliþki bulunmamýþtýr (p>0.05).
TARTIÞMA ve SONUÇ: Öðrencilerin memnuniyet durumlarý orta düzeyin biraz üzerinde tespit edilmiþtir ve akademik baþarýlarý ile iliþkisi bulunmamýþtýr.

INTRODUCTION: This study has been performed to determined the school satisfaction levels of nursing students and to investigate the relationship between academic success mean and school satisfaction mean.
METHODS: After obtaining the necessary permissions for Research, Faculty of Health Sciences of the Uludag University in Bursa 2018-2019 studying in fall semester, which volunteered to participate in the study and complete fill out forms that are made with 413 nursing students. In the data collection method, ýt was used Socio-demographic Form and Student Satisfaction Scale Form. The academic success mean was gathered from student information system after all grades data were entered into the system. To analyze the data, Shapiro-Wilk test, t-test, one dimensional variance analysis and Pearson correlation factor analysis were used
RESULTS: The total score obtained from student satisfaction scale form is 181,18±29,55 (minimum 65, maximum 265 points). When analyzed on the basis of sub-scales; the scores are decisional involvement scale (3,54± 0,64), instructor (3,51±0,61) and educational quality (3,43±0,64), school management (3,36±0,66), scientific, social and technical facilities (3,28±0,67), respectively. According to statistical analysis results, there is not a statistically significant relationship between student academic success scores and student satisfaction scores (p>0,05).
DISCUSSION AND CONCLUSION: As a result; the satisfaction level of the students was found to be slightly above the middle level and it was not associated with academic achievement.

GÝRÝÞ ve AMAÇ: Vazovagal senkop, çocuklarda ve ergenlerde hayat kalitesini bozan yaygýn bir problemdir. Taný aþamasýnda eðik masa testi (HUTT) standart taný prosedürüdür. Günümüze kadar farklý protokoller kullanýlmýþtýr. Bu çalýþmamýzda 20 dakika veya 45 dakika pasif faz sonrasý sublingual nitrogliserin ile provakasyon uygulanan iki ayrý eðik masa testi protokolü karþýlaþtýrýldý.
YÖNTEM ve GEREÇLER: Tekrarlayan senkop öyküsü olan 6-18 yaþlarý arasýnda toplam 293 hasta incelendi. Fizik muayene, laboratuvar parametreleri ve ekokardiyografik incelemeleri normal olan hastalar çalýþmaya dahil edildi. Grup 1’de (n =143) 20 dakikalýk pasif fazlý kýsa bir protokol kullanýlýrken, grup 2’de (n =150) 45 dakikalýk pasif fazlý uzun bir protokol kullanýlmýþtýr. Aktif Fazda tüm hastalara sublingual nitrogliserin uygulandý.
BULGULAR: Ýki grup arasýnda yaþ, cinsiyet ve ilk senkop ile tilt testi arasýnda geçen süre açýsýndan anlamlý fark yoktu. Kýsa protokol grubunda, 43’ünde (% 30,1) pasif fazda, 40’ýnda (% 28) aktif fazda olmak üzere hastalarýn %58’inde test pozitif saptandý. Uzun protokol grubunda ise pasif fazda 65 (%43,3), aktif fazda 32 (%21,3) toplamda 97 (%64,7)hastada test pozitif saptandý. Uzun protokol grubunda pasif fazda senkop geliþen 32 hastadan 26’sýnda (% 81,5) senkop ilk 20 dakika içinde geliþti.
TARTIÞMA ve SONUÇ: Kýsa pasif fazlý HUTT protokolü, çocuklarda ve ergenlerde uzun protokolle kýyaslanabilir sonuçlar verirken zamandan da tasarruf etme avantajý sunar.

INTRODUCTION: Vasovagal syncope is a common clinical problem in children and adolescents, for which the head-up tilt test (HUTT) is the standard diagnostic procedure. In this study, we evaluated sublingual nitroglycerine-stimulated HUTT protocols, comparing the results with passive phases of 20 minutes versus 45 minutes.
METHODS: A total of 293 patients aged 6 to 18 years with a history of recurrent syncope were studied. Physical examination, laboratory parameters, and echocardiographic examination were normal in all. The patients underwent standard HUTT with sublingual nitroglycerin used in the active phase. A short protocol was used for one group (n=143) with a passive phase of 20 minutes, while testing in the others (n=150) comprised a long protocol, with a passive phase of 45 minutes.
RESULTS: There were no significant differences between the two groups in terms of age, sex, and length of time between the first syncope and the tilt test. In the short protocol group, HUTT results were positive in 43(30.1%) in the passive phase, 40(28%) in the active phase, and 83(58%) overall, compared with 65(43.3 %), 32(21.3%), and 97(64.7%), respectively, in the long protocol group. Among those in the long protocol group, 26 of 32 (81.5%) who had a positive response in the passive phase developed syncope within the first 20 minutes.
DISCUSSION AND CONCLUSION: The HUTT protocol with a short passive phase has the advantage of saving time while providing results comparable with the long protocol, which might be preferable in children and adolescents.

GÝRÝÞ ve AMAÇ: Gastrointestinal stromal tümörlerin tanýsýnda genel itibariyle immünohistokimyasal boyanma yöntemleri kullanýlmktadýr. Bu çalýþmanýn amacý bu parametreler haricinde immünohistokimyasal boyanma özelliklerinin risk gruplarýnýn belirlenmesindeki yerini saptamaktýr.
YÖNTEM ve GEREÇLER: 2008-2019 yýllarý arasýnda genel cerrahi kliniðine baþvuran 66 hasta çalýþmaya dahil edildi ve dosyalarý geriye dönük olarak tarandý. Yaþ, cinsiyet, klinik prezentasyon, tümör boyutlarý, patolojik verileri, mitotik indeksi parametreleri deðerlendirildi.
BULGULAR: GÝST tanýsý almýþ 66 hastada kadýn/erkek oraný 31/55 olup, yaþ ortalamasý 62 idi. Tümör lokalizasyonlarýna bakýldýðýnda en sýk mide ve ince barsak lokalizasyonu saptandý. Hastalarýn patoloji sonuçlarýnýn immünohistokimyasal olarak incelenmesini takiben hastalarýn tümünde CD117’nin pozitif ve desmin’nin negatif olarak boyandýðý saptandý. Maximum tümör çapý 40 cm, minimum tümör çapý 6 cm, ortalama tümör çapý 13.9 cm olarak saptandý. ortalama mitotik indeks 14.1 olarak saptandý.
TARTIÞMA ve SONUÇ: Tümör karakteresteðinin net olarak anlaþýlamadýðý ve zaman içinde bu karakterestiðin modifiye olduðu göz önünde bulundurulursa tanýya yardýmcý ve tedavide yol gösterici parametrelerin önemi daha iyi anlaþýlmaktadýr. Yapýlmakta olan ve yapýlacak olan çalýþmalar prognoz ve survi tahmininde yeni ve spesifik kriterlerin bulunacaðýný, bulunmasý gerektiðini düþünmekteyiz.

INTRODUCTION: Immunohistochemical staining methods are generally used in the diagnosis of gastrointestinal stromal tumors. Apart from these parameters, immunohistochemical staining characteristics are determined in determining the risk groups.
METHODS: In the 2008-2019 study, 66 patients who applied to the general surgery clinic were followed up and their files were scanned retrospectively. Age, gender, clinical presentation, tumor extinguishing, pathological purpose, mitotic index were evaluated.
RESULTS: The ratio of women / men with a diagnosis of GIST was 31/55, and the mean age was 62. When tumor localizations were examined, the most common localization was found to be stomach and small intestine. Following the immunohistochemical examination of the pathology results of the patients, it was found that CD117 was stained as positive and desmin was negative in all of them. The maximum tumor diameter was 40 cm, the minimum tumor diameter was 6 cm, and the mean diameter was
13.9 cm. the mean mitotic index was determined as 14.1.
DISCUSSION AND CONCLUSION: Considering that the tumor characteristic is not clearly understood and this characteristic has been modified over time, the importance of diagnostic and guiding parameters in treatment is better understood. We think that new and specific criteria will be found in the prognosis and survival prediction of the studies that are being done and to be done.

GÝRÝÞ ve AMAÇ: C-reaktif protein (CRP), birçok kanser türünde saðkalým için prediktif deðere sahip inflamatuar bir belirteçtir.
Bu çalýþmanýn amacý, hastalýðýn rezektabl olup olmadýðýna peritoneal karsinomatozise baðlý cerrahide prediktif biyo-belirteç olarak preoperatif CRP düzeyini incelemektir.
YÖNTEM ve GEREÇLER: 2014- 2019 yýllarý arasýnda sitoredüktif cerrahi ve HÝPEK için laparotomi yapýlan 126 hasta çalýþmaya dahil edildi.
BULGULAR: Karþýlaþtýrmalý analizde ameliyatlý ve rezeke edilemeyen hastalarda ameliyat öncesi ayný hafta ölçülen CRP deðerlerinin ameliyat için istatistiksel olarak anlamlý belirteçler olduðu görüldü. CRP deðerleri sýrasýyla 4.3 ve 18 g / L bulundu. Bu fark istatistiksel olarak anlamlý bulundu (p = 0.03). Sonraki alt grup analizinde PCI ≥9 olan hasta grubunda CRP deðeri PCI <9 grubuna göre anlamlý olarak yüksek bulundu (p = 0.006).
TARTIÞMA ve SONUÇ: CRP’nin bu hasta grubunda basit ve ucuz bir biyobelirteç olarak bize fikir verebileceðini öne sürüyoruz. CRP’nin bu hasta grubunda basit ve ucuz bir biyobelirteç olarak bize fikir verebileceðini öne sürüyoruz. KRS + HÝPEK planlanan hastalarda preoperatif CRP deðeri yüksek ise hastanýn rezeke edilemeyebileceði unutulmamalýdýr. Sitoredüktif cerrahi ve HÝPEK geçiren hastalarda, yüksek CRP düzeylerinin daha yüksek PCI ve daha düþük saðkalým ile iliþkili olduðu bulunmuþtur.

INTRODUCTION: C-reactive protein (CRP) is an inflammatory marker that has predictive value for survival in many types of cancer. The aim of this study is to examine the preoperative CRP level as a predictive biomarker for surgery due to peritoneal carcinomatosis whether the disease is resectable or not.
METHODS: A total of 126 patients who underwent laparotomy for cytoreductive surgery and HIPEC between 2014- 2019 were included in this study
RESULTS: In the comparative analysis, for operated and unresectable patients, CRP values measured in the same week preoperatively were found to be statistically significant markers for operability. The CRP values were found 4.3 and 18 g/L, respectively. This difference was found to be statistically significant (p = 0.03) In the subsequent subgroup analysis, in patient group with PCI ≥9, the CRP value was found to be significantly higher than the PCI <9 group (p = 0.006).
DISCUSSION AND CONCLUSION: We suggest that CRP can give us an idea as a simple and cheap biomarker in these group of patients. We suggest that CRP can give us an idea as a simple and cheap biomarker in these group of patients. It should be kept in mind that if the preoperative CRP value is high in patients who are planned to have CRS + HIPEC, patient could be unresectable. In patients undergoing cytoreductive surgery and HIPEC, high CRP levels were found to be associated with higher PCI and lower survival.

GÝRÝÞ ve AMAÇ: Bu çalýþma; cerrahi planlanan yaþlý hastalarýn spiritüel iyi oluþ düzeylerinin cerrahi korkuya etkilerini incelemek amacýyla yapýldý.
YÖNTEM ve GEREÇLER: Bu çalýþma, 1-28 Þubat 2021 tarihleri arasýnda 110 yaþlý hastanýn katýlýmý ile bir araþtýrma ve uygulama hastanesinin genel cerrahi kliniðinde, tanýmlayýcý ve kesitsel olarak gerçekleþtirildi. Veri toplamada Kiþisel Bilgi Formu, Spiritüel Ýyi Oluþ Ölçeði ve Cerrahi Korku Ölçeði kullanýldý. Veriler araþtýrmacýlar tarafýndan kodlandýktan sonra, Statistical Packed For The Social Sciences 25 IBM ile veri analizleri yapýldý. Verilerin analizinde tanýmlayýcý istatistikler, Kolmogorov-Smirnov testi, Ki-kare testi, tek yönlü varyans analizi (ANOVA), regresyon ve korelasyon analizi yapýldý.
BULGULAR: Bu çalýþmada elde edilen verilere göre; hastalarýn yaþ ortalamasý 70.60±6.94 ve %84.5’i 65-75 yaþ aralýðýnda yer almaktadýr. Hastalarýn, %56.4.’ü erkek, %47.3’ü geçmiþ operasyon deneyimine sahip olduðu saptandý. Hastalarýn %29.1’inin apendektomi geçirmek üzere hastaneye yattýðý belirlendi. Bu analiz ile hastalarýn spiritüel iyi oluþlarýnýn cerrahi iþleme baðlý yaþadýklarý cerrahi korku üzerindeki etkisi istatistiksel olarak anlamsýz bulundu.
TARTIÞMA ve SONUÇ: Saðlýk bakým profesyonellerinde spritüel iyi oluþa iliþkin farkýndalýk geliþtirilmesi gerekir, ayrýca hastalarýn manevi ve sosyal yönden desteklenmesini saðlayan saðlýk bakýmý sunmalarý önerilir.

INTRODUCTION: This study; It was performed to examine the effects of the spiritual well-being of elderly patients scheduled for surgery on surgical fear.
METHODS: This study was conducted in a descriptive and cross-sectional manner in the general surgery clinic of a research and practice hospital with the participation of 110 elderly patients between 1-28 February 2021. Personal Information Form, Spiritual Well-being Scale and Surgical Fear Scale were used in data collection. After the data were coded by the researchers, data analysis was performed with Statistical Packed For The Social Sciences 25 IBM.
Descriptive statistics, Kolmogorov-Smirnov test, Chi-square test, one-way analysis of variance (ANOVA), regression and correlation analysis were used in the analysis of the data.
RESULTS: This study was conducted in a descriptive and cross-sectional manner in the general surgery clinic of a research and practice hospital with the participation of 110 elderly patients between 1-28 February 2021. Personal Information Form, Spiritual Well-being Scale and Surgical Fear Scale were used in data collection. After the data were coded by the researchers, data analysis was performed with Statistical Packed For The Social Sciences 25 IBM.
Descriptive statistics, Kolmogorov-Smirnov test, Chi-square test, one-way analysis of variance (ANOVA), regression and correlation analysis were used in the analysis of the data.
DISCUSSION AND CONCLUSION: Awareness of spiritual well-being should be developed in health care professionals, and it is recommended that they provide health care that provides moral and social support to patients.

GÝRÝÞ ve AMAÇ: Önceki çalýþmalar, koroner arter hastalýðý (KAH) ile prokalsitonin (PCT) seviyeleri arasýnda bir iliþki olduðunu göstermiþti. ST segment yükselmeli miyokard infarktüsü (STEMI) olan hastalarda PCT düzeyleri ile uzun dönem majör kardiyovasküler olaylar (MACE) ve tüm nedenlere baðlý mortalite arasýndaki iliþkiyi deðerlendirmeyi amaçladýk.
YÖNTEM ve GEREÇLER: Hastalar serum PCT deðerlerine göre iki gruba ayrýldý. PCT düzeyi <0.05 ng / ml olan hastalar düþük PCT grubu (n=235) ve PCT düzeyi> 0.05 ng / ml olanlar yüksek PCT grubu (n=87) olarak kabul edildi. MACE, kardiyovasküler mortalite, reinfarktüs veya hedef damar revaskülarizasyonu (TVR) olarak tanýmlandý. Çalýþmaya dahil edilen hastalarýn ortalama 55 aylýk takip süreleri boyunca MACE ve tüm nedenlere baðlý mortalite geriye dönük olarak dosyalarýndan tarandý. Demografik ve laboratuvar deðerleri SPSS’ye kaydedildi.
BULGULAR: MACE ve tüm nedenlere baðlý mortalite, yüksek PCT grubunda düþük PCT grubuna göre anlamlý olarak daha yüksek bulundu (sýrasýyla p=0.003 ve p=0.002). Çok deðiþkenli analizde, yüksek PCT seviyeleri ve yaþ, diðer risk faktörleri için ayarlama yapýldýktan sonra uzun vadeli tüm nedenlere baðlý ölümlerin anlamlý baðýmsýz prediktörleri olarak tanýmlandý. Ayrýca, yüksek PCT grubunda beyaz kan hücresi, C-reaktif protein, glukoz ve Hemoglobin A1c daha yüksekti.
TARTIÞMA ve SONUÇ: STEMI’li hastalarda hastaneye yatýþ sýrasýnda yüksek PCT seviyeleri, uzun süreli MACE ve tüm nedenlere baðlý mortalite ile iliþkilidir. PCT, enfeksiyon hastalýklarda yaygýn olarak kullanýlmasýna raðmen, STEMI’li hastalarda uzun vadeli olumsuz sonuçlar için ideal bir inflamasyon belirtecidir.

INTRODUCTION: Previous studies have suggested that there is a relationship between coronary artery disease (CAD) and procalcitonin (PCT) levels. We aimed to evaluate the relationship between PCT levels and long-term major adverse cardiovascular events (MACE) and all-cause mortality in patients with ST segment elevation myocardial infarction (STEMI).
METHODS: Patients were divided into two groups based on their serum PCT values. Patients with PCT levels <0.05 ng/ml were accepted as low PCT group (n=235) and those with PCT levels >0.05 ng/ml as high-PCTgroup (n=87). MACE were defined as cardiovascular mortality, reinfarction, or target vessel revascularization (TVR). MACE and all-cause mortality were retrospectively screened from their files during the mean follow-up of 55 months of the patients included in the study. Demographic and laboratory values were recorded in SPSS.
RESULTS: MACE and all-cause mortality were found to be significantly higher in the high-PCT group than in the low-PCT group (p=0.003 and p=0.002, respectively). In multivariate analysis, high PCT levels and age were identified as significant independent predictors of long-term all-cause mortality after adjusting for other risk factors. Moreover, white blood cell, C-reactive protein, glucose, and Hemoglobin A1c were higher in the high-PCT group.
DISCUSSION AND CONCLUSION: High PCT levels during hospitalization in patients with STEMI are associated with long-term MACE and all- cause mortality. Although PCT is widely used in infectious diseases, it is an ideal inflammation marker for long-term adverse outcomes in patients with STEMI.

GÝRÝÞ ve AMAÇ: Bu çalýþmada NLR ve PLR deðerlerinin rektal kanser olgularýnda hem tanýda hem de 2 ve 3 yýllýk kýsa dönem saðkalým hakkýnda prognostik belirteç olarak kullanýlabilirliðinin araþtýrýlmasý amaçlanmýþtýr.
YÖNTEM ve GEREÇLER: Çalýþmaya Ocak 2015 ile Aralýk 2019 arasýnda rektum kanseri nedeniyle opere olan ve hastanemiz Genel Cerrahi kliniðinde takip edilen 121 hasta ve çeþitli amaçlarla kliniðimize baþvuran 120 saðlýklý birey dahil edilmiþtir.
BULGULAR: Ortalama yaþ 61,7±11,5 (aralýk: 35-86) yýl idi. 2 ve 3 yýllýk saðkalým oranlarý sýrasýyla %63,2 ve %54,9 idi. Ortalama NLR ve PLR sýrasýyla 3,6±5,2 (aralýk 0,2-55) ve 171,8±169,7 (aralýk 29,4-2000) idi. Ortalama 2 ve 3 yýllýk saðkalým süreleri
19,6±8,3 ay ve 26,2±13,9 ay idi.
Hasta grubunda medyan nötrofil sayýsý, trombosit sayýsý, NLR ve PLR kontrol grubuna göre anlamlý yüksekti, medyan lenfosit sayýsý ise anlamlý düþüktü (her biri için p<0,001). Hem genel, hem 2 yýllýk hem de 3 yýllýk saðkalým durumuna göre hayatta kalan hastalar ile ölenler arasýnda ortanca laboratuvar deðerleri açýsýndan anlamlý fark saptanmadý. Laboratuvar deðerleri ile nüks, genel saðkalým, 2 yýllýk saðkalým ve 3 yýllýk saðkalým arasýnda anlamlý korelasyon saptanmadý (her biri için p>0,05).
TARTIÞMA ve SONUÇ: Çalýþmamýzda elde edilen bulgular rektum kanseri hastalarýnda NLR ve PLR deðerlerinin rektum kanserinin saptanmasýnda belirteç olarak kullanýlabileceðini ancak 2 ve 3 yýllýk saðkalým konusunda anlamlý bilgi vermediðini iþaret etmektedir.

INTRODUCTION: It was aimed to investigate the use of NLR and PLR values both in diagnosis and as prognostic markers for 2- and 3-year short-term survival in rectal cancer cases.
METHODS: The study included 121 patients who were operated for rectal and followed up in the General Surgery clinic of our hospital, and 120 healthy individuals who applied to our clinic for various purposes.
RESULTS: The mean age was 61.7±11.5 (min.-max.: 35-86) years. The 2- and 3-year survival rates were 63.2% and 54.9%, respectively. The mean NLR and PLR were 3.6±5.2 (min.-max.: 0.2-55) and 171.8±169.7 (min.-max.: 29.4-2000), respectively. The mean 2- and 3-year survival times were 19.6±8.3 and 26.2±13.9 months, respectively.
In the patient group, the median neutrophil count, platelet count, NLR and PLR were significantly higher than the control group, while the median lymphocyte count was significantly lower (p<0.001 for each). No significant difference was found in terms of median laboratory values between patients who survived and those who died according to overall, 2-year and 3-year survival. There was no significant correlation between laboratory values and recurrence, overall survival, 2-year survival and 3-year survival (p>0.05 for each).
DISCUSSION AND CONCLUSION: The findings obtained in the present study show that NLR and PLR values can be used as markers in the detection of rectal cancer, however that they do not provide significant information about 2- and 3-year survival.

Prepubertal testis dokusunun fertilite restorasyon için kullanýmýnda, ýþýk mikroskobik incelemelerinin nasýl daha iyi görünür hale getirilebileceðini kendi deneyimlerimizi de ekleyerek irdelemek istedik.
Kanser tedavisi görecek erkek çocuklarýn ilerde kendi hücreleri ile nesillerinin devam etmesi için testis dokularý üzerinde araþtýrmalar sürdürülmektedir. Prepubertal testis dokularý dondurularak ileride kullanýlmak üzere saklanmaktadýr. Günümüzde yapýlmakta olan in vitro çalýþmalarla bu dokularýn nasýl kullanýlacaðý belirlenmeye çalýþýlmaktadýr. Ýlerleyen çalýþmalar prepubertal testis doku elemanlarýnýn etkin þekilde incelenmesini gerekli kýlmaktadýr.
Prepubertal testis dokusu, seminifer tubuluslarda, intratubuler Sertoli hücreleri, az sayýda gonositler/ spermatogonyal kök hücreler, interstisyel alanda ise miyoid hücreler ve leydig hücrelerini içermektedir. Bu testislerde, kök hücreler dýþýnda eriþkindeki gibi germinal seri hücreleri bulunmamaktadýr. Ayrýca eriþkin testis dokusuna göre hücrelerin bulunduðu alanlar da farklýlýklar göstermektedir. Sertoli hücreleri daðýnýk yerleþimlidir. Sertoli hücreleri arasýnda sýký baðlantý kompleksleri ve kan-testis bariyeri henüz oluþmamýþtýr. Gonositler henüz bazal membrana yerleþmemiþ lümen bölgesinde ya da bazala doðru göç eder durumdadýr. Özellikle Sertoli hücreleri ile gonositleri/spermatogonyumlarý ýþýk mikroskobi incelemeler ile birbirinden ayýrt edebilmek zorluk göstermektedir. Yapýlan uygulamalarýn sonuçlarýný deðerlendirmek için bu dokularýn ýþýk mikroskobunda hücrelerin tanýnabilir preparatlarýnýn hazýrlanmasý gereklidir.
Rutin doku takibiyle hazýrlanan parafin kesitleri, özellikle intratubuler hücrelerin incelenmesi ve ayýrt edilmesinde yetersiz kalmaktadýr.
Prepubertal testis dokularý için epon bloklardan hazýrlanan yarý ince kesitler, parafin kesitlere oranla intratubuler hücrelerin birbirinden ayýrt edilmesinde ve morfolojilerinin belirlenmesinde daha uygun görülmektedir.
Elektron mikroskop doku takibi özel iþlem gerektirmesi nedeniyle elektron mikroskobu bulunan merkezlerde uygulanabilmektedir.

The aim of this study is to examine how light microscopic examinations can be made better visible in the use of prepubertal testicular tissue in fertility restoration by adding our own experiences.
Researches go on testicular tissues to ensure that boys who will receive cancer treatment continue to have their own generations in the future. Prepubertal testicular tissues are frozen and stored for later use. In vitro studies continue for the use of these tissues. Therefore, further researches necessitate for the effective determination of prepubertal testicular tissue elements.
Prepubertal testis tissue contains Sertoli cells and few gonocytes / spermatogoniums in seminiferous tubules, myoid and leydig cells in the interstitial area. Prepubertal testes, there aren’t germinal serial cells other than stem cells as in adults. The areas where the cells are located different from the adult testicular tissue. Sertoli cells are dispersed. Tight junction complexes and blood-testis barrier have not yet formed.
Gonocytes aren’t yet settled in the basement membrane or just migrating towards the base. Especially, it can be difficult to distinguish between Sertoli cells and gonocytes / spermatogoniums by light microscopy examinations. In order to evaluate the results of the applications, it is necessary to prepare the recognizable preparations of these tissues under the light microscope.
Paraffin sections prepared are insufficient in examining and distinguishing especially intratubular cells.
Semi-thin sections from epon blocks are more appropriate than paraffin sections for these morphology definitions.
Electron microscopy can be performed in centers with electron microscope because tissue monitoring requires special application.

GÝRÝÞ ve AMAÇ: Klinik olarak metastatik lenf nodu tespit edilmemiþ erken evre oral kavite skuamöz hücreli karsinomlarýna yaklaþým tartýþmalýdýr. Bekle-gör, elektif boyun diseksiyonu ve sentinel node örneklemesi uygulanabilecek 3 ana yöntemdir.
YÖNTEM ve GEREÇLER: Biz bu araþtýrma için retrospektif kohort çalýþmasý planladýk. Hastalar klinik nod negatif ve patolojik nod negatif (grup 1) ve klinik nod negatif ve patolojik nod pozitif (grup 2) olarak gruplandýrýldý. Yaþ, tümör çapý, tümör kalýnlýðý, perinöral invazyon, lenfovasküler invazyon ve farklýlaþma gibi gizli metastazý etkilediði düþünülen faktörler, Mann-Whitney U testi, Ki- kare testi ve Fisher’in kesin testi kullanýlarak araþtýrýldý.
BULGULAR: Çalýþmaya dahil edilen 27 hastadan 12 (% 44.4)’si kadýn ve 15 (% 66.6)’i erkekti. Grup 1’de 16 hasta, grup 2’de 11 hasta deðerlendirildi. Hastalarýn yaþ ortalamasý 58.20 ± 14.05 yýldý. Gizli metastaz oranlarý T1 ve T2 tümörler için sýrasýyla% 34 ve% 51 idi. Ortalama tümör çapý 24,78 ± 12,79 mm ve ortalama tümör kalýnlýðý 11.37 ± 7.62 mm idi. Gruplar arasýnda ortalama tümör kalýnlýðý deðerleri arasýndaki fark anlamlýydý (p = 0.024), ancak yaþ (p = 0.622) ve tümör çapý (p = 0.443) anlamlý olarak farklý deðildi. Yaþ, tümör çapý ve tümör kalýnlýðý için ROC analizi kesme deðerleri sýrasýyla 60 yýl, 23 mm ve 9.5 mm idi. Tümör kalýnlýðý ve lenfovasküler invazyon gruplar arasýnda anlamlý olarak farklýydý, ancak yaþ, farklýlaþma, klinik T evresi ve perinöral invazyon farklý deðildi.
TARTIÞMA ve SONUÇ: Çalýþmamýzdaki yüksek gizli metastaz oranlarý, elektif boyun diseksiyonunun erken evre oral kavite skuamöz hücreli karsinomu için bekle-gör yerine daha uygun bir seçim olduðunu göstermektedir.

INTRODUCTION: Management of clinical node-negative neck in early-stage oral cavity squamous cell carcinoma is still controversial. There are three main options to consider as watch-and-wait, elective neck dissection, and sentinel node biopsy.
METHODS: Patients were grouped as clinical node-negative and pathologic node-negative (group 1) and clinical node-negative and pathologic node-positive (group 2). Factors thought to affect occult metastasis such as age, tumor diameter, tumor thickness, perineural invasion, lymphovascular invasion, and differentiation were investigated using the Mann-Whitney U test, the Chi- square test, and Fisher’s exact test.
RESULTS: From 27 eligible patients, there were 12 (44.4%) females and 15 (66.6%) males. Sixteen patients were evaluated in group 1 and 11 were evaluated in group 2. The mean age of the patients was 58.20±14.05 years. The occult metastasis rates were 34% and 51% for T1 and T2 tumors, respectively. The mean tumor diameter was 24.78±12.79 mm, and the mean tumor thickness was 11.37±7.62 mm. The difference in mean values of tumor thickness between the groups was significant (p=0.024), but age (p=0.622) and tumor diameter (p=0.443) were not significantly different. The ROC analysis cut-off values for age, tumor diameter, and tumor thickness were 60 years, 23 mm, and 9.5 mm, respectively. Tumor thickness and lymphovascular invasion were significantly different between the groups, but age, differentiation, clinical T stage, and perineural invasion were not different.
DISCUSSION AND CONCLUSION: The high rates of occult metastasis in our series imply that elective neck dissection seems a more appropriate choice for early-stage oral cavity squamous cell carcinoma rather than watch-and-wait.

GÝRÝÞ ve AMAÇ: Patellofemoral aðrý sendromu olan hastalarda deðiþen kýkýrdak yapýsý ile ilgili çok az þey bilinmektedir. Biyobelirteçler, açýk morfolojik deðiþiklikler geliþmeden önce kýkýrdak hasarýnýn erken aþamalarýný belirleyebilir. Bu çalýþma ile patellofemoral aðrý sendromunda kýkýrdak hasarýný ortaya çýkarmak için kýkýrdak yýkým biyobelirteçlerini araþtýrdýk.
YÖNTEM ve GEREÇLER: Patellofemoral aðrý sendromu olan yirmi hasta ve yirmi saðlýklý kontrol deneðinin serum örnekleri alýndý ve dört farklý test kullanýldý: Serum seviyeleri C-terminali çapraz baðlý telopetid tip II kollajen (sCTX-II), kýkýrdak oligomerik matriks proteini ( sCOMP), Kollajen Tip II'ye özgü neopeptit (sC2M) ve Kondroitin sülfat epitopu 846 (sCS846). Aðrý durumu ve fonksiyonel durum VAS, The Western Ontario ve McMaster Universities Artritis Index (WOMAC), Kujala patellofemoral skorlama sistemi (PFSS) ve time up and go testi (TUG) ile deðerlendirildi.
BULGULAR: Patellofemoral aðrý sendromunda sCTX-II dýþýnda serum kýkýrdak degradasyon biyobelirteçlerinde önemli artýþlar gözlendi. Korelasyon analizinde, aðrý skorlarý, fonksiyonel durum ve biyobelirteç seviyeleri arasýnda anlamlý bir iliþki yoktu.
TARTIÞMA ve SONUÇ: Patellofemoral aðrý sendromu olan hastalarda saptanan yüksek kýkýrdak yýkým belirteçleri seviyeleri, patellofemoral aðrý sendromu olan hastalarda deðiþmiþ kýkýrdak kompozisyonunu ve bu hastalarda devam eden kýkýrdak yýkýmýný ortaya çýkarmýþtýr.

INTRODUCTION: Little is known regarding the altered cartilage composition in patients with patellofemoral pain syndrome. Biomarkers can identify early stages of cartilage damage before the overt morphological changes develop. We investigated cartilage degradation biomarkers in order to reveal cartilage damage in patellofemoral pain syndrome.
METHODS: Serum samples of twenty patients with patellofemoral pain syndrome and twenty healthy control subjects obtained and four different assays were used: Serum levels of C-terminal cross-linked telopetides of type-II collagen (sCTX-II), cartilage oligomeric matrix protein (sCOMP), Collagen Type II- specific neopeptide (sC2M) and Chondroitin sulfate epitope 846 (sCS846). Pain status and functional status were assessed with VAS, The Western Ontario and McMaster Universities Arthritis Index (WOMAC), Kujala patellofemoral scoring system (PFSS) and timed up and go test (TUG).
RESULTS: Significant increases in serum cartilage degradation biomarkers except sCTX-II were observed in patellofemoral pain syndrome. In correlation analysis, there were not any significant association between pain scores, functional status and biomarker levels except, a reverse relationship between sC2M levels and the TUG scores.
DISCUSSION AND CONCLUSION: Higher levels of cartilage degradation markers revealed ongoing cartilage destruction in patients who suffer patellofemoral pain syndrome and reflect altered cartilage composition in these patients.

GÝRÝÞ ve AMAÇ: Covid-19 hastalarýnda sýklýkla, ateþ ve kuru öksürük, boðaz aðrýsý, dispne gibi respiratuar sistemi etkileyen klinik bulgulara rastlanýr.
COVID-19 hastalýðýna baðlý enfeksiyonlarýn her zaman solunum yollarýna sýnýrlý kalmadýðý ve nörolojik tutulumun da olabileceði gösterilmiþtir. Çeþitli mekanizmalarla virüsün santral sinir sistemine yayýlým sonucunda oluþabilecek nörolojik tablolar icerisinde; baþ aðrýsý, baþ dönmesi, nöbet, ensefalit, inme ve nöromuskuler bozukluklar, periferik sinir sistemi tutulumlarý yer almaktadýr.
YÖNTEM ve GEREÇLER: Bu çalýþma yenidoðan yoðun bakým ünitesinde (YYBÜ) yatan ve COVID-19 tanýsý alan annelerden doðan 65 yenidoðanýn özelliklerinin incelendiði tanýmlayýcý tipte bir araþtýrmadýr. COVID-19 tanýlý annelerin, anne sütünde de COVID-19 PCR bakýldý. p<0.05 istatistiksel olarak anlamlý kabul edildi.
BULGULAR: COVID-19’lu 65 anneden 45’i (%69.2) ayaktan, 17’si (%26.2) yatýrýlarak ve 3’ü (%4.6) ise yoðun bakýmda izlendi. Aðýr COVID-19 enfeksiyonuyla yoðun bakýmda izlenen üç anneden ikisi (%3.1) öldü. Bebeklerin 63’ü (%96.9) COVID-19 PCR negatif iken sadece iki bebekte (%3.1) COVID-19 PCR pozitifti. Bebeklerin 10’unda (%15.4) solunum desteði verildi. COVID-19’lu anne bebeklerinde eozinofil deðeri (p=0.002) ve kreatin kinaz daha düþüktü (p<0.001). Bebeklerin 64’ü (%98.5) þifa ile taburcu edildi. COVID-19 tanýlý yeni doðum yapan 40 annenin, anne sütünde COVID-19 PCR negatif bulundu.
TARTIÞMA ve SONUÇ: COVID-19 tanýlý annelerden doðan bebeklerde vertikal bulaþma ve COVID-19’ un tipik klinik semptomlarý bulunmadý. Anne sütünde COVID-19 PCR pozitifliði saptanmadý. Annedeki COVID-19 pozitifliðinin yenidoðanda ciddi hastalýk riski oluþturmayacaðý düþünüldü.

INTRODUCTION: It was aimed to determine the characteristics, clinical and laboratory findings, treatment requirements and post-discharge situation of newborns that mothers with a diagnosed COVID-19 infection.
METHODS: This is a descriptive study examining the characteristics of 65 newborns born to mothers diagnosed with COVID-19 in the neonatal intensive care unit (NICU). COVID-19 was analyzed by PCR in the breast milk of mothers with a diagnosis of COVID-19. p<0.05 was considered statistically significant.
RESULTS: Of 65 mothers with COVID-19, 45 (69.2%) were followed in outpatient, 17 (26.2%) hospitalized and 3 (4.6%) intensive care units. Two (3.1%) of the three mothers who were followed in the intensive care unit with severe COVID-19 infection died. While 63 (96.9%) of the infants were COVID-19 PCR negative, only two (3.1%) infants were COVID-19 PCR positive. Respiratory support was given in 10 (15.4%) of the infants. Eosinophil values (p=0.002) and creatine kinase were lower in infants of mothers with COVID-19 (p<0.001). 64 (98.5%) of the infants were discharged with good recovery. COVID-19 PCR was found to be negative in the breast milk of 40 mothers who had just given birth with a diagnosis of COVID-19.
DISCUSSION AND CONCLUSION: Vertical transmission and typical clinical symptoms of COVID-19 were not found in infants born to mothers with COVID-19. No COVID-19 PCR positivity was detected in breast milk. It was thought that COVID-19 positivity in the mother would not pose a risk of serious illness in the newborn.

GÝRÝÞ ve AMAÇ: Akut kolesistit için güncel tedavi yöntemi laparoskopik kolesistektomidir. Bazý durumlarda özellikle de Grade III hastalarda perkütan kolestostomi (PK) gibi alternatif yöntemlerin kullanýlmasý gerekebilir. Bu sorundan yola çýkarak çalýþmamýzýn amacý, Grade III akut kolesistitli hastalarda erken (ilk 72 saat) veya geç (72 saat ve sonrasý) dönemlerde uygulanan perkütan kolestostominin mortalite ve morbidite üzerine etkilerini belirlemektir.
YÖNTEM ve GEREÇLER: Ocak 2012 ile Aralýk 2018 arasýnda tedavi edilen akut kolesistitli hastalar deðerlendirildi. Hastalar semptomlarýn baþladýðý ilk 72 saatte PK yerleþtirilen grup (Grup-I, n = 19) ve 72 saat sonra PK yerleþtirilen grup (Grup-II, n = 13) olarak 2 gruba ayrýldý.
BULGULAR: Bu dönem arasýnda perkütan kolestostomi uygulanan Grade-III akut kolesistitli hastalar çalýþmaya dahil edildi. Erken morbidite 7 hastada (% 21.87), hastane mortalitesi 11 hastada (% 34.37) gözlendi. Grade-III akut kolesistitli hastalarda erken PK (ilk 72 saat, Grup-I) ve geç PK (72. saat ve sonrasý, Grup-II) arasýnda morbidite açýsýndan anlamlý bir fark gözlenmez iken (p = 0.67), Grup-II’ ye göre Grup-II’ de mortalitede istatistiksel olarak anlamlý farklýlýk saptanmýþtýr (p = 0,001).
TARTIÞMA ve SONUÇ: Çalýþma sonuçlarýmýza göre PK yerleþtirilmesinin multidisipliner verilen karar ile hýzlý bir þekilde ilk 72 saat içinde gerekli hastalara uygulanmasýný þiddetle tavsiye ediyoruz.

INTRODUCTION: The current treatment modality for acute cholecystitis is laparoscopic cholecystectomy. In some cases, it may be necessary to use alternative methods such as percutaneous cholecystostomy (PC), especially in grade III patients. Based on this problem, the aim of our study is to determine the effects of percutaneous cholecystostomy placed in the early (first 72 hours) or late (72 hours and later) periods, on mortality and morbidity, in patients with Grade III acute cholecystitis.
METHODS: Patients with acute cholecystitis treated between January 2012 and December 2018 were evaluated. The patients were divided into 2 groups as the group with PC placement in the first 72 hours of the symptoms started (Group-I, n= 19) and the group with PC placement after 72 hours (Group-II, n=13).
RESULTS: A total of 32 patients with grade III acute cholecystitis who underwent percutaneous cholecystostomy between this period were included in the study. Early morbidity was observed in 7 (21.87%) patients, while hospital mortality was observed in 11 patients (34.37%). While there was no significant difference in morbidity between early PC (first 72 hours, Group-I) and late PC (72. hour and later, Group-II) in patients with grade III acute cholecystitis (p=0.67), there was a significant difference in mortality in Group-II compared to Group-I ( p=0.001).
DISCUSSION AND CONCLUSION: According to our study results, we strongly recommend that the procedure be applied to the required patients within the first 72 hours by making a quick decision on the implantation of a PC in a multidisciplinary manner.

GÝRÝÞ ve AMAÇ: Bu çalýþmanýn amacý, Coronavirus hastalýðý-2019 (COVID-19) salgýnýnýn ilk aþamasýnda romatizmal ve kas-iskelet sistemi hastalýklarý (RMDs) olan ve immunsupresif ilaç kullanan hastalarda COVID-19 salgýnýna baðlý anksiyete yaygýnlýðýný tespit etmek ve anksiyeteye sebep olan risk ve koruyucu faktörleri tanýmlamaktýr.
YÖNTEM ve GEREÇLER: 18 yaþýndan büyük, RMDs’i olan ve düzenli immunsupresif ilaç kullanan 145 hasta ve 95 saðlýklý kontrol çalýþmaya dahil edildi. COVID-19 salgýný ile ilgili sorularý içeren anonim bir anket ve katýlýmcýlarýn anksiyete düzeylerini ölçmek için Beck anksiyete envanteri (BAI) kullanýldý. Demografik veriler, mevcut RMDs’i, kullandýðý immunsupresif ilaç, COVID-19 hakkýnda bilgi ve endiþeler, COVID-19 hakkýndaki bilgileri nereden öðrendiði gibi ek bilgiler toplandý.
BULGULAR: Hastalarýn %42,1’i kullandýklarý ilaç nedeniyle salgýnýn endiþe yarattýðýný bildirdi ve hastalarýn %33,8’i endiþelerini orta ve þiddetli olarak derecelendirdiler. Hastalarýn BAI skorlarý 4 (0-52) ve saðlýklý kontrollerin BAI skorlarý 3 (0-18) olarak saptandý. BAI skorlarýna göre hastalarýn %16,5’i orta ile þiddetli anksiyete belirtileri göstermiþtir. Ýmmunsupresif ilaç kullanan hastalarýn %38,6’sýnda anksiyete saptanýrken kontrol grubunun %18,9’unda anksiyete mevcuttu. Gruplar karþýlaþtýrýldýðýnda hasta grubunun anksiyetesi anlamlý yüksek saptandý (p=0.001). Hasta ve kontrol gruplarýnda kadýn cinsiyet daha fazla anksiyete belirtileri göstermektedir (p<0.005). Ayrýca hasta grubunda eðitim düzeyi yüksek olanlarda anksiyete daha düþük saptandý (p=0.039).
TARTIÞMA ve SONUÇ: Kadýn cinsiyet ve immunsupresif ilaç kullanan hastalarda anksiyete düzeyleri daha yüksek saptanmýþtýr. Bu süreçte riskli grupta yer alan bu hastalarýn yanlýþ bilgilerden kaçýnmasýný saðlamalý, hastalar tek tek bilgilendirilerek tedavi ekibine güvenmeleri saðlanmalýdýr. Anksiyeteleri yüksek olan bu hasta grubu için çevrimiçi veya akýllý telefon tabanlý psikoeðitim ve psikolojik müdahaleler saðlanmasý düþünebilir.

INTRODUCTION: The purpose of this study was to determine the prevalence of anxiety due to Coronavirus disease-2019 (COVID-19) pandemic in patients with rheumatic and musculoskeletal diseases (RMDs) who used immunosuppressive drugs during the initial stage of the COVID-19 pandemic and to identify the risk and protective factors that cause anxiety.
METHODS: A total of 145 patients with RMDs who used regular immunosuppressive drugs and 95 healthy controls were included. An anonymous survey comprising questions regarding the COVID-19 pandemic was used, and the Beck anxiety inventory (BAI).
RESULTS: About 42.1% patients reported that the epidemic caused concern due to the drug they were using, 33.8% rated their concerns as moderate and severe. According to the BAI scores, 16.5% patients had moderate to severe anxiety symptoms; and comparison of the groups showed that the anxiety level of the patient group was significantly higher (38.6% vs. 18.9%, p=0.001). Female had more anxiety symptoms in both groups (p<0.005). In addition, anxiety was lower in patients with higher education levels (p=0.039).
DISCUSSION AND CONCLUSION: It should be ensured that patients in the high-risk group are not provided false information, the patients are individually informed, and they trust the treatment team. Providing online or smartphone-based psychoeducation and psychological interventions may be considered for these patients with high anxiety levels.

GÝRÝÞ ve AMAÇ: Amacýmýz, Coronavirus disease 2019 (Covid-19) tedavisi ve karantina süreci tamamlandýktan sonra Kardiyoloji Polikliniðine baþvuran hastalarýn geç dönemde hangi kardiyak þikayetler ile baþvurduðunu ve biyokimyasal parametrelerde, kardiyak biyobelirteçlerde, elektrokardiyografi (EKG) ve transtorasik ekokardiyografide (TTE) hangi kardiyak bulgularýn olduðunu tespit etmekti.
YÖNTEM ve GEREÇLER: Bu retrospektif çalýþmaya ardýþýk 132 hasta dahil edildi. EKG çekildi, TTE yapýldý. Tüm hastalarda baþvuruda hemogram, biyokimyasal parametreler, kardiyak biyobelirteçler; yüksek duyarlýklý kardiyak troponin T, N terminal pro B tipi natriüretik peptid ve D-dimer çalýþýldý.
BULGULAR: Kardiyoloji Polikliniðine baþvuran hastalarda en sýk görülen ko-morbidite hipertansiyon 39 (%29,50), en sýk görülen kardiyak þikayet göðüs aðrýsý 48 (%36,40), en sýk EKG bulgusu sinüs taþikardisi 11 (%8,3), en sýk TTE bulgusu hafif triküspit yetersizliðiydi 63 (%47,70). Bu çalýþmada sistolik pulmoner arter hipertansiyon oranýn %6,10 bulduk ve bu oran normal popülasyona göre daha yüksekti. Perikardiyal hiperekojenitenin 18 (%13,60) hastada saptanmasý dikkat çekiciydi. Yüksek D-dimer seviyesi 24 (%18,20) hastada, yüksek NT-pro BNP seviyesi 15 (%11,40) hastada ve yüksek hs-cTn seviyesi 9 (%6,80) hastada tespit edildi.
TARTIÞMA ve SONUÇ: Hastalar, Covid-19’un geç dönem kardiyak etkilerinin olup olmadýðýný araþtýrmak için Kardiyoloji Polikliniðinde deðerlendirilmelidir.

INTRODUCTION: Our aim was to determine late-term which cardiac effects were in hemogram, biochemical parameters, cardiac biomarkers, Electrocardiography (ECG) and Transthoracic echocardiography (TTE) and which cardiac complaints were in the patients admitted to the Cardiology outpatient clinic after the Coronavirus disease 2019 (COVID-19) treatment and quarantine process was completed.
METHODS: 132 consecutive patients included in this retrospective study. ECG and TTE were performed, hemogram, biochemical parameters, cardiac biomarkers; high sensitive cardiac troponin T (hs-cTn), N terminal Pro B type natriuretic peptid (NT-pro BNP) and D-dimer were studied in all patients on admission.
RESULTS: In this study, we found the following findings in the patients: the most common co-morbidite was hypertension in 39 (29.5%) patients, the most common complaints of the patients presenting to the Cardiology outpatient clinic was chest pain in 48 (36.40%) patients, the most common EGG finding was sinus tachycardia in 11 (8.3%) patients, the most common TTE finding was mild tricuspid regurgitation in 63 (47.70%) patients. In this study we have found systolic pulmonary artery systolic hypertension rate 6.10% and the rate was higher than compared to the normal population. It was remarkable that pericardial hyperechocenicity was detected in 18 (13.60%) patients. We detected elevated D-dimer levels were detected in 24 (18.20%) patients, elaveted NT-pro BNP levels in 15 (11.40%) patients and elevated hs-cTn levels in 9 (6.8 %) patients.
DISCUSSION AND CONCLUSION: The patients should be evaluated in the Cardiology outpatient clinic to investigate whether they have late-term cardiac effects due to COVID-19 infections.

GÝRÝÞ ve AMAÇ: Hemþirelik bireylerle doðrudan temasý ve yüz yüze iletiþimi gerektiren bir meslektir. Bununla birlikte, son yýllarda hemþireler ve hemþirelik öðrencileri arasýnda sosyal medya baðýmlýlýðý giderek yaygýnlaþmaya baþlamýþtýr. Sosyal medyada geçirilen etkin olmayan zamanýn verilen hemþirelik hizmetlerinin kalitesini negatif yönde etkileyeceði aþikardýr. Bu nedenle hemþirelik öðrencilerine eðitimleri sýrasýnda, bilgi teknolojileri baðlamýnda, sosyal medyayý etkin kullanmalarý konusunda dersler verilmesi önerilmektedir. Bunun için öncelikle hemþirelik öðrencilerinde sosyal medya kullanýmýnda baðýmlýlýk sorununun olup olmadýðýnýn ortaya konmasý gerekir. Bu eksiklikten yola çýkarak planlanan mevcut çalýþmada hemþirelik öðrencilerinde sosyal medya baðýmlýlýðý ve etkileyen faktörlerin incelenmesi amaçlanmýþtýr.
YÖNTEM ve GEREÇLER: Bu tanýmlayýcý araþtýrmanýn örneklemini 197 hemþirelik öðrencisi oluþturmuþ; veriler Sosyal Medya Baðýmlýlýk Ölçeði ile toplanmýþtýr. Ýstatistiksel test olarak baðýmsýz eþleþtirilmemiþ t testi, one way ANOVA, ki-kare testi ve Pearson korelasyon katsayýsý kullanýlmýþtýr.
BULGULAR: Öðrencilerin büyük çoðunluðu (%74.6) sosyal medya baðýmlýsý olup, sosyal medyaya çoðunlukla akýllý telefonlar yoluyla baðlanmaktadýrlar. Sosyal medyada harcanan zaman arttýkça baðýmlýlýk artmakta (P=0.000); sosyal medya baðýmlýlýðý akademik baþarýyý (P=0.000); olumsuz yönde etkilemektedir.
TARTIÞMA ve SONUÇ: Hemþirelik öðrencilerinde sosyal medya baðýmlýlýðý yaygýndýr. Teorik, laboratuvar ve klinik hemþirelik eðitiminde mobil telefonlarýn kullanýmýnýn sýnýrlandýrýlmasý sosyal medya baðýmlýlýðýný önleme ve en aza indirmede yararlý olabilir.

INTRODUCTION: Nursing is a profession which is in direct contact with people and requires face-to-face communication. However, in recent years, social media addiction (SMA) has become widespread among nurses and nursing students. It is obvious that the inactive time spent on social media will negatively affect the quality of the nursing service provided. For that reason, nursing students should be taught to use social media effectively in the context of information technology during their education. To do this, first of all, it is necessary to determine whether there is an addiction problem in the use of social media in nursing students. Therefore, this study aims to investigate SMA and the affecting factors among Turkish nursing students.
METHODS: In this descriptive study, 197 nursing students were completed the Social Media Addiction Scale. Independent unpaired t-tests, one-way ANOVA test, chi-square test, and Pearson’s correlation coefficient were used as statistical tests.
RESULTS: In this descriptive study, 197 nursing students were completed the Social Media Addiction Scale. Independent unpaired t-tests, one-way ANOVA test, chi-square test, and Pearson’s correlation coefficient were used as statistical tests.
DISCUSSION AND CONCLUSION: Social media addiction was commong among nursing students. The limitation of the use of mobile telephones in theoretical, laboratory and clinical practice in nursing education may be a useful to prevent or minimize SMA.

GÝRÝÞ ve AMAÇ: Dispepsi, epigastrik aðrý ya da rahatsýzlýk hissi, postprandial dolgunluk ve erken doyma semptomlarýnýn bir veya daha fazlasýnýn mevcut olduðu sindirim sisteminin üst kýsmýný ilgilendiren semptomlar olarak tanýmlanabilir. Dispeptik hastalarda en sýk kullanýlan tetkikler gastroskopi ve ultrasonografidir. Çalýþmamýzýn amacý fonksiyonel dispepsi tanýlý olgularýn batýn ultrosonografi (US) bulgularýnýn retrospektif olarak deðerlendirilmesidir.
YÖNTEM ve GEREÇLER: Çalýþmaya Haziran 2019 - Aralýk 2020 tarihleri arasýnda çocuk gastroenteroloji polikliniðinde fonksiyonel dispepsi tanýsý alan ve batýn ultrasonografisi yapýlan hastalar dahil edildi. Hastalarýn yaþlarý, cinsiyetleri, antropometrik ölçümleri ve ultrasonografik bulgularý deðerlendirildi
BULGULAR: Çalýþmaya 103 hasta (62 kýz, 41 erkek) dahil edildi ve ortalama yaþ 140.8 aydý. Hastalarýn %75.7’sinde (n=78) normal batýn ultrasonografi bulgularý mevcuttu. Kolelitiyazis %5.8 (n = 6) ile ultrasonografide saptanan en yaygýn patolojiydi.
TARTIÞMA ve SONUÇ: Dispepsi, saðlýk kuruluþlarýna baþvuru nedenleri arasýnda yaygýn ve önemli bir saðlýk sorunudur. Ultrasonografi, organik ve fonksiyonel dispepsiyi ayýrt etmede etkili, pratik, ekonomik ve non-invaziv bir incelemedir.

INTRODUCTION: Dyspepsia is a condition involving the upper digestive tract and is characterized by one or more upper abdominal symptoms such as epigastric pain or discomfort, unusual postprandial fullness, bloating, nausea, heartburn, and early satiety. Gastroscopy and ultrasonography are the most frequently used examinations in dyspeptic patients. The aim of our study is to retrospectively evaluate the abdominal ultrasonography (US) findings of cases with functional dyspepsia.
METHODS: Patients who were diagnosed with dyspepsia and had abdominal ultrasonography between June 2019 and December 2020 in the pediatric gastroenterology outpatient clinic were included in the study. The patients’ ages, genders, anthropometric measurements and ultrasonographic findings were evaluated.
RESULTS: 103 patients (62 girls, 41 boys) were included in the study and the mean age was 140.8 months. Normal abdominal ultrasonography findings were present in %75.7 (n=78) of the patients. Cholelithiasis was the most common pathology detected in ultrasonography with %5.8 (n=6).
DISCUSSION AND CONCLUSION: Dyspepsia is a common and important health problem among the reasons for applying to health institutions. Ultrasonography is an effective, practical, economical and non-invasive examination in distinguishing organic and functional dyspepsia.

GÝRÝÞ ve AMAÇ: Stabil anjina pektoris(SAP), mortalite ve yaþam kalitesi üzerinde önemli etkisi olan kronik bir hastalýktýr. Ranolazin, bir antianjinal olarak onaylanan bir piperazin türevidir. Öncelikle stabil koroner arter hastalýðýnda ikinci basamak antianjinal olarak kullanýlýr. Ranolazin geç sodyum kanallarýný (INa) bloke ederek etki eder ve sitosolik kalsiyumun yükselmesini önler. Çalýþmamýz ranalozinin, perioperatif dönemde iskemiyi azaltabileceði ve miyokard hasarýný azaltabileceði düþünülerek tasarlanmýþtýr.
YÖNTEM ve GEREÇLER: Çalýþmaya 1ocak 2015 ile 30 haziran 2016 tarihleri arasýnda Kartal Koþuyolu Yüksek Ýhtisas Eðitim Araþtýrma Hastanesi Kardiyoloji Anabilim Dalýnda koroner anjiyografi (KAG) uygulanmýþ ve çok damar hastalýðý veya LMCA hastalýðý tespit edilip, daha sonra Kardiyoloji- Kalp Damar Cerrahisi ortak konseyinde CABG kararý verilen stabil angina pektorisli hastalar alýndý. CABG dýþýnda baþka bir cerrahi prosedür (mitral kapak onarýmý, mitral kapak deðiþimi aort kapak deðiþimi gibi) uygulanan hastalar çalýþmadan dýþlandý. Araþtýrma protokolü için hastanemiz etik kurulundan gereken izin alýndý.
BULGULAR: Ranolazin alan grupta ortalama yaþ 61,2±8,6 iken standart tedavi alan hastalarýn ortalama yaþý 57,9±8,8 olarak saptandý. (p=0,073). Hastalarýn operasyon öncesi deðerlendirilen ve iþlem sýrasýndaki mortaliteyi öngörmek amacýyla kullanýlan EuroSCORE’ larý benzerdi. 1.Grup hastalarýn ortalama 0. Saat troponin deðeri 1.70 (1.13-2.77) iken 2. Grup hastalarýn 0. Saat troponin deðeri 2.76(1.69-6.20) (p=0,01).
TARTIÞMA ve SONUÇ: Çalýþmamýzda postoperatif olarak hemen bakýlan troponin 0 deðeri ranolazin alan grupta daha düþük saptandý. 12. Ve 24. Saatte bakýlan troponin deðerleri bakýmýndan istatistiksel fark saptanmadý. Çalýþmamýzda erken dönem miyokard hasarýnýn ranolozýn tedavisi ile anlamlý olarak azaldýðýný gösterdik.

INTRODUCTION: Ranolazine is a piperazine derivative that has been approved as an antianginal agent. It is primarily used as a second- line antianginal agent in stable coronary artery disease. The study was designed considering that the active ingredient ranalozine, which has antiischemic effects through ischemic sodium channels, can reduce ischemia in the perioperative period and reduce the frequency of perioperative myocardial infarction.
METHODS: The study included patients with stable angina pectoris who underwent coronary angiography between January 1, 2015 and June 30, 2016 at Koþuyolu Training and Research Hospital and who were diagnosed with multi-vessel disease or LMCA disease, and then for whom the joint council of Cardiology-Cardiovascular Surgery made a decision in favor of coronary artery bypass grafting.
RESULTS: The mean age was 61.2 ± 8.6 years in the ranolazine group, while the mean age of the patients receiving standard therapy was 57.9 ± 8.8 years (p = 0.073).The EuroSCOREs of the patients before the operation which were used to predict intraoperative mortality were similar. Mean troponin value of Group 1 patients at 0 hour was 1.70 (1.13-2.77), while mean troponin value of the patients in Group 2 at 0 hour was 2.76(1.69-6.20) (p=0,01).
DISCUSSION AND CONCLUSION: In the present study, the immediate postoperative troponin 0 value was found to be lower in the ranolazine group. There was no statistical difference in terms of troponin values measured at 12 and 24 hours. In this study, we showed that early myocardial damage was significantly reduced with ranolazine treatment.

GÝRÝÞ ve AMAÇ: Pilomatriksomalar (PM) kýl foliküllerinin pluripotent prekürsör matriks hücrelerinden geliþen, sýklýkla deri altýnda iyi sýnýrlý kitle olarak prezente olan tümörlerdir. Histopatolojik incelemede çekirdeklerini korumuþ bazaloid hücreler ve çekirdeklerini kaybetmiþ, eozinofilik görünümde, silüet halinde hayalet hücreleri olmak üzere iki farklý tipte hücre görülür. Hayalet hücrelerinde distrofik kalsifikasyon, osseöz metaplazi, lezyon çevresinde ise keratine karþý geliþen yabancý cisim tipi multinükleer dev hücre reaksiyonu ve inflamasyon görülebilmektedir. En sýk baþ ve boyunda lokalize olur.
YÖNTEM ve GEREÇLER: Süleyman Demirel Üniversitesi Týp fakültesi Týbbi Patoloji Anabilim Dalýmýzda 2007-2019 yýllarý arasýnda PM tanýsý konulan 78 olgu çalýþmaya dahil edildi. Olgulara ait Hematoksilen&Eozin boyalý preparatlar histopatolojik olarak kalsifikasyon, osseöz metaplazi, kistik odak varlýðý, mitoz sýklýðý açýsýndan retrospektif olarak deðerlendirildi. Olgularýn yaþ, cinsiyet, tümörün lokalizasyonu ve çapý ile histopatolojik özellikler arasýndaki iliþki istatistiksel olarak karþýlaþtýrýldý.
BULGULAR: Olgularýn yaþý 1-80 yaþ arasýnda deðiþkenlik göstermekte olup çoðunun 2. dekatta (%33.3) olduðu gözlendi. Kadýn ve erkek cinsiyet oraný 1.3/1 olarak izlendi. PM’ler en sýk baþ-boyun (%48.7) bölgesinde lokalize olup lezyonlarýn ortalama çapý 1.25 cm idi. Histopatolojik incelemede 16 (%20.5) olgunun çevresinde yabancý cisim reaksiyonu ve inflamasyon, 7 (%9) olguda osseöz metaplazi gösteren alanlar, 12 (%15,3) olguda kalsifikasyon, 11 (%14.1) olguda kistik alanlar, 2 (%2.6) olgunun yüzeyinde ülserasyon ve 1 (%1.3) olguda ise bazaloid hücrelerde proliferasyon, pleomorfizm ve hafif artmýþ mitoz izlendi. Tümör lokalizasyonu ile yaþ, cinsiyet ve histopatolojik bulgular arasýnda istatistiksel olarak anlamlý bir iliþki saptanmadý.
TARTIÞMA ve SONUÇ: Pilomatriksomalar sýklýkla benign davranýþ gösteren, günlük patoloji pratiðinde sýk rastlanan tümörlerdir. Özellikle 2. dekatta baþ ve boyunda deri altýnda lokalize olan lezyonlarda PM ayýrýcý tanýda akýlda tutulmalýdýr.

INTRODUCTION: Pilomatrixoma (PM) is a tumor that arises from the pluripotent precursor matrix cells of hair follicles. Including two different types of cell are seen in histopathological examination which are basaloid cells with nuclei and ghost cells with eosinophilic appearance that have lost their nucleus. In ghost cells, dystrophic calcification, osseous metaplasia, and foreign body type multinuclear giant cell reaction and inflammation developing against keratin can be seen around the lesion. It often presents as a well-circumscribed mass under the skin. It is most often localized in the head and neck.
METHODS: Between 2007-2019, 78 cases diagnosed with PM were included in the study the Hematoxylin&Eosin stained preparations of the cases were evaluated retrospectively.
RESULTS: The age of the cases ranged from 1 to 80 years old, and most of them were observed in the 2nd decade (33.3%). The female / male ratio is 1.3 / 1. The most common localization was determined as head and neck (48.7%). The average diameter of the lesions was 1.25 cm. Histopathological examination revealed foreign body reaction and inflammation in 16 (20.5%) cases, osseous metaplasia in 7 (9%) cases, calcification in 12 (15.3%) cases, cystic areas in 11 (14.1%) cases. Ulceration was observed on the surface of 2 (2.6%) cases and proliferation, pleomorphism and slightly increased mitosis were observed in 1 (1.3%) case in basaloid cells.
DISCUSSION AND CONCLUSION: Pilomatrixoma is benign tumor and it should be kept in mind in differential diagnosis of subcutaneous lesions, especially in head and neck localization in young patients.

GÝRÝÞ ve AMAÇ: Çocuklarda manyetik rezonans görüntüleme esnasýnda derin bir sedasyona ihtiyaç vardýr. Bu amaçla birçok farklý anestezik ilaç kullanýlmýþtýr. Bu çalýþmada pediatrik hasta grubunda, manyetik rezonans görüntülemede, sedasyon için sevofluran kullanýmýnýn retrospektif olarak deðerlendirilmesi amaçlandý.
YÖNTEM ve GEREÇLER: Çalýþma için, Derince Eðitim ve Araþtýrma Hastanesinde 2018 ocak-2019 þubat aylarý arasýnda manyetik rezonans görüntüleme yapýlan 0-12 yaþ aralýðýndaki hasta kayýtlarý tarandý. Hastalarýn demografik bilgileri, hemodinamik verileri, iþlem türleri, iþlem süresi, komplikasyonlar ve derlenme süresi istatistiksel olarak deðerlendirildi.
BULGULAR: Çalýþmaya American Society of Anesthesiologists (ASA) 1-2 risk grubundan toplam 187 hasta dahil edildi. Ortalama anestezi süresi 19.88 dk+11.73 dakikaydý. Hastalarýn kalp tepe atýmý, soluk sonu karbondioksit basýncý ve periferik oksiken satürasyonu baþlangýç ve bitiþ deðerleri arasýnda anlamlý bir farklýlýk saptanmadý (p>0,05). Aldrete derlenme skoru 8 ve üstü olma süreleri 1.42+0.68 dakikaydý. 2 hastada %88 düzeyinde satürasyon düþüþü olduðu görüldü.
TARTIÞMA ve SONUÇ: Sevofluran kullanýmýnýn deðerlendirildiði bu çalýþmada hastalarýn iþlem süresince hemodinamik açýdan stabil seyrettiði görüldü. Hastalarýn %99.8 inde hiçbir komplikasyon geliþmemiþ olmasý ve hastalarýn derlenme sürelerinin kýsa olmasý önemli bulgular olarak deðerlendirildi. Sonuç olarak sevofluranýn pediatrik manyetik rezonans görüntülemede, güvenle kullanýlabilecek bir yöntem olduðu kanýsýna varýldý.

INTRODUCTION: Deep sedation is needed in children during magnetic resonance imaging (MRI). A lot of different anesthetic drugs have been used for this purpose. In this study, it was aimed to retrospectively evaluate the use of sevoflurane for sedation during MRI in pediatric patients.
METHODS: For the study, the records of patients aged 0-12 years who underwent MRI between January 2018 and February 2019 at Derince Training and Research Hospital were examined. Patients demographic information, hemodynamic data, procedure types, procedure time, complications and recovery time were statistically evaluated.
RESULTS: 187 patients who were classified as American Society of Anesthesiologists (ASA) 1-2 risk groups were included in the study. The average duration of anesthesia was 19.88 minutes + 11.73 minutes. There was no significant difference between the beginning and end values of the patients heart rate, end-tidal carbon dioxide pressure, and peripheral oxygen saturation
(p>0,05). The time to get an Aldrete recovery score of 8 and above was 1.42+0.68 minutes
No complications were observed in 99% of the patients, only in two patients saturation is decreased to 88%.
DISCUSSION AND CONCLUSION: In this study, in which the use of sevoflurane was evaluated, findings such as the patients were hemodynamically stable during the procedure, no complications developed in 99% of the patients, and the shortness of recovery period were evaluated as important findings
As a result, it was concluded that sevoflurane is an anesthetic agent that can be used safely in pediatric MRI.