GÝRÝÞ ve AMAÇ: Saðlýk okuryazarlýðý (SOY), kiþilerin bilinçli saðlýk kararlarý vermek için gerekli saðlýk bilgi ve hizmetlerini anlama, edinme ve iþleme kapasitesinin derecesidir. Araþtýrma Saðlýk Yüksekokulu öðrencilerinin saðlýk okuryazarlýðý düzeyini ve etkileyen faktörleri belirlemek amacýyla yapýldý.
YÖNTEM ve GEREÇLER: Tanýmlayýcý tipte planlanan araþtýrmanýn evrenini, Balýkesir Üniversitesi Balýkesir Saðlýk Yüksekokulu 2016-2017 yýlýnda hemþirelik ve ebelik bölümünde eðitim gören 1058 öðrenci oluþturdu. Örneklemi ise araþtýrmaya katýlmayý kabul eden 718 öðrenci oluþturdu. Veriler, sosyodemografik form ve saðlýklý yaþam biçimi davranýþlarý ölçeði uygulanarak toplandý. Verilerin deðerlendirmesinde frekans, yüzde, ki-kare testi, t testi ve tek yönlü varyans analizi (ANOVA) ve Benferoni testi kullanýldý.
BULGULAR: Araþtýrmada öðrencilerin TSOY-32 ölçeðinin genel puan ortalamasý 26.48±16.54 olarak belirlendi. Kýz öðrencilerin, ebelik bölümünde eðitimine devam edenlerin, 4. Sýnýflarýn TSOY-32 ölçeði toplam puanlarýnýn fazla olduðu saptandý (p<0.01). Araþtýrmada öðrencilerin saðlýk okuryazarlýk düzeyi “sorunlu – sýnýrlý saðlýk okuryazarlýðý” olarak belirlendi.
TARTIÞMA ve SONUÇ: Sonuç olarak, bu araþtýrmada öðrencilerin saðlýk okuryazarlýk düzeyi “sorunlu–sýnýrlý saðlýk okuryazarlýðý” olarak bulundu. Öðrencilerin saðlýk okuryazarlýðýný kavrama ve günlük hayatta uygulaným çabalarýnýn desteklenmesi önerilmektedir.

INTRODUCTION: Health Literacy (HL) is the degree to which individuals have the capacity to obtain, process, and understand the basic health information and services needed to make informed health decisions.This study aimed to find out the level of health literacy, and factors effecting health literacy among students at the School of Health in Balýkesir University.
METHODS: The research was a descriptive study. The universe of the study comprised 1058 nursing and midwifery students studying at the School of Health in Balýkesir University 2016-2017 academic year. The sample consisted of 718 students who accepted to participate in the study. Data was collected by applying the soci-demographic form and healthy life behaviour scale. Frequency, percentage, chi-square, t test and one-way ANOVA and Bonferroni test were used to analyse the results.
RESULTS: Mean score of TSOY-32 scale of the students was found as 26.48±16.54. Female students, midwifery students and fourth year students had higher TSOY-32 total points (p<0.01). It was found that the students had “problematic-limited health literacy level”.
DISCUSSION AND CONCLUSION: It was shown that students had “problematic-limited health literacy level. Students should be encouraged to understand the health literacy and practice it their daily life.

GÝRÝÞ ve AMAÇ: Giriþ: Cushing Hastalýðýnýn nüks oraný yüksektir; bu nedenle, nüksü öngören klinik özellikler, yüksek riskli hastalarý belirlemek için tanýmlanmalýdýr. Bu faktörler hastalýðýn yönetimini ve izlem sýklýðýný etkileyebilir.
Amaç: Nüks etmiþ CH (RD) ve uzun sürekli remisyon (SR) saðlanmýþ hastalarýn klinik özelliklerini karþýlaþtýrarak hastalýk nüksünü öngören klinik faktörleri belirlemeyi amaçladýk.

YÖNTEM ve GEREÇLER: Cerrahi tedavi uygulanan 85 CH olan hasta retrospektif olarak deðerlendirildi. Preoperatif taný testleri ve postoperatif hastalýk aktivitesi kaydedildi. Hipofiz tümör boyutu, invazyonu, p53 ve Ki-67 immünhistokimyasal boyama verileri ile postoperatif kortizol aksý geridönüþ zamaný deðerlendirildi.
BULGULAR: Çalýþmaya 16 RD ve 54 SR hastasý alýndý. Preoperatif ACTH düzeyleri RD grubunda daha yüksekti. RD hastalarýnda preoperatif adenom boyutu ve kavernöz sinüs invazyonu ile Ki-67 indeksi SR grubuna göre daha yüksekti. RD'li 11 hastada (% 69) hýzlý kortizol aksý geridönüþü görülürken SR grubunda sadece 6 hastada (% 11) vardý.
TARTIÞMA ve SONUÇ: Preoperatif ACTH yüksekliði, atmýþ tümör boyutu, kavernöz sinüs invazyonu ve yüksek Ki-67 indeksi, Cushing hastalýðýnda nüksü öngörebilir faktörlerdir. Bununla birlikte, hýzlý kortizol aksý geridönüþü de nüks ile iliþkili bulunmuþtur.

INTRODUCTION: Introduction: Cushing's Disease (CD) has high recurrence rate therefore clinical features predicting recurrence should be defined to discriminate patients with high risk. These factors can effect management and follow-up frequency.
Aim: We aimed to compare the clinical features of the patients with recurrent CD (RD) and sustained remission (SR) in order to determine clinical factors that might predict disease recurrence.

METHODS: Surgically treated 85 patients with CD were evaluated retrospectively. Preoperative diagnostic tests and postoperative disease activity were noted. Pituitary tumor size, invasiveness and features such as p53 and Ki-67 immunohistochemical staining data also postoperative cortisol axis recovery time were evaluated.
RESULTS: 16 RD and 54 SR patients were enrolled to the study. Preoperative ACTH but not cortisol levels were higher in RD group. RD patients had higher preoperative adenoma size and cavernous sinus invasion rate and Ki-67 index than SR group. Eleven (69%) patients with RD had early recovery time while 6 (11%) patients in SR group.
DISCUSSION AND CONCLUSION: Higher preoperative ACTH levels, tumor size, cavernous sinus invasion and Ki-67 immunostaining would predict recurrence in CD. Additionally, rapid recovery of cortisol axis was found to be related with recurrence.

GÝRÝÞ ve AMAÇ: Çocuðun korunduðu, mutlu ve güvenli bir þekilde yetiþtirildiði aile ortamý, bazen olumsuz yaþantýlarýn ve örseleyici davranýþlarýn ortaya çýktýðý bir ortama dönüþebilmektedir. Araþtýrmamýz çocuklarýn örselenmesine annelerinin örselenme yaþantýlarýnýn etkisini deðerlendirmek amacýyla yapýldý.
YÖNTEM ve GEREÇLER: Çalýþma 1-10 Aðustos 2017 tarihleri arasýnda Eskiþehir’deki bir hastanede çalýþan ve çocuðu olan kadýn temizlik personeli ve hastabakýcýlar ile yapýldý. Çalýþma evren içinden araþtýrmaya katýlmaya gönüllü 100 kiþi ile tamamlandý. Veri toplamak amacýyla; “Tanýmlayýcý Özellikler Formu”, “Çocukluk Örselenme Yaþantýlarý Ölçeði (ÇÖYÖ)” ve “Aile Ýçi Çocuk Ýstismarý Ölçeði-B Formu (AÝÇÝÖ-B)” kullanýldý. Verilerin analizi IBM SPSS 21 paket programý ile yapýldý.
BULGULAR: Annelerin çocukluk döneminde en fazla duygusal istismara maruz kaldýklarý ve çocuklarýna en fazla fiziksel istismarda bulunduklarý görüldü. Annelerin ÇÖYÖ puanlarý ve AÝÇÝÖ-B puanlarý arasýndaki iliþkiye bakýldýðýnda ise; aralarýnda istatistiksel olarak anlamlý bir iliþki olduðu (p<0.05) görüldü.
TARTIÞMA ve SONUÇ: Çocukluk döneminde örselenmeye maruz kalan annelerin kendi çocuklarýna daha fazla örselenme davranýþlarýnda bulunduklarý saptandý.

INTRODUCTION: The family environment where children are protected and raised healthily, happily and securely may turn into an environment in which adverse experiences and destructive behaviours which affect all the members of a family emerge. The study has been carried out with the purpose of identifying the effect of traumatic experiences of mothers on the trauma of children.

METHODS: The study has been carried out on cleaning and caregiving staff having a child and working in a hospital in Eskisehir between 1 and 10 August 2017. The study has been completed with 100 voluntary person from the population. The data has been collected through “Descriptive Characteristics Form”, “Childhood Trauma Questionnaire (CTQ)”, and “Scale of Child Abuse in the Family B-Form (SCAF-B)” and analysed via IBM SPSS Version 21.0.
RESULTS: The mothers primarily experienced emotional abuse during childhood. The mothers mostly applied physical abuse on their children. As a result of the analysis between the scores of CTQ and SCAF-B, it has been identified that there is a statistically significant relation between the scores of two scales (p<0.05).
DISCUSSION AND CONCLUSION: Mothers who were exposed to destructive behaviours during childhood have applied more destructive behaviours to their children.

GÝRÝÞ ve AMAÇ: Bu çalýþma, kanser ve otoimmün hastalýklarýn yönetiminde biyolojik hedeflenmiþ tedavi uygulayan hemþirelerin bilgi ve uygulamalarýný deðerlendirilmek amacýyla karþýlaþtýrmalý olarak yapýlmýþtýr.
YÖNTEM ve GEREÇLER: Kesitsel türde, tanýmlayýcý nitelikte bu araþtýrma Eskiþehir ve Çankýrý illerinde bulunan hastanelerin yetiþkin dahili poliklinik ve kliniklerinde çalýþan, çalýþmaya katýlmak isteyen hemþirelerle yürütüldü. Araþtýrmaya katýlan hemþireler iki gruba atandý; biyolojik ajan uygulayanlar A grubu, biyolojik ajan uygulamayanlar B grubu. Araþtýrmanýn verileri yüz yüze görüþme yöntemi kullanýlarak birey tanýtým formu, biyolojik ajan uygulama ve bilgi formu aracýlýðýyla toplandý. Veri analizi IBM SPSS 21 paket programý ile yapýldý. Sürekli deðiþkenlere ait deðerler ortalama±standart sapma, kategorik deðiþkenlere ait deðerler frekans ve yüzde olarak verildi. Kategorik deðiþkenler arasýndaki iliþki ki kare analizi ile deðerlendirildi.
BULGULAR: Çalýþmanýn örneklemini 204 hemþire oluþturdu (A grubu=%47.1; B grubu=%52.9). A grubu hemþireler B grubu hemþirelere göre biyolojik ajanlarýn maliyetinin yüksek olduðunu (p˂0.001), bazý biyolojik ajanlarýn soðuk zincir kuralýna göre saklanmasý gerektiðini (p˂0.001), tedavide hastanýn allerji öyküsünün belirleyici olduðunu (p=0.019), biyolojik ajanlarla tedaviye baðlý fýrsatçý enfeksiyonlarýn geliþebileceðini (p=0.008) istatistiksel olarak anlamlý düzeyde farklý doðru bildi.
TARTIÞMA ve SONUÇ: Araþtýrmamýzda biyolojik ajanlar hakkýnda deneyimi olan A grubu hemþirelerle bu konuda her hangi bir deneyimi ve eðitimi olmayan B grubu hemþirelerin biyolojik ajanlarla ilgili önermelere çoðunlukla doðru yanýt verdikleri saptandý.

INTRODUCTION: This study is conducted comparatively to evaluate the knowledge and practice of nurses applying biologically targeted therapy in the management of cancer and autoimmune diseases.
METHODS: This cross-sectional and descriptive study was conducted with volunteer nurses working in adult polyclinics and clinics of hospitals in Eskiþehir and Çankýrý provinces. The nurses who participated in the research were assigned to two groups: Group A; those who apply biological agents, Group B; those who do not apply biological agents. The data were collected using face-to-face interview method by means of individual identification form, biological agent application and information form. Data analysis was performed by using IBM SPSS 21 package program. Values of continuous variables are given as mean ± standard deviation, values of categorical variables are given as frequency and percentage. The relationship between the categorical variables was evaluated by chi square analysis.
RESULTS: The sample of the study consists of 204 nurses (Group A: %47,1; Group B: %52,9). Comparing to nurses of Group B, nurses of Group A are well informed about the following in the way that will create statistically significant difference: the cost of biological agents is high (p<0,001), some biological agents need to be stored according to the cold chain rule (p<0,001), the patients’ allergy story is the determining factor in the treatment (p=0,019), treatment related opportunistic infections may occur with biological agents (p=0,008).
DISCUSSION AND CONCLUSION: In our study, it was found that nurses of Group A, who had experience about biological agents and nurses of Group B, who had no experience and education in this regard mostly responded correctly to proposals related to biological agents.

GÝRÝÞ ve AMAÇ: Brugada Sendromu (BS) ani ölüm riskinin arttýðý kalýtsal bir hastalýktýr. Mevcut risk parametreleri yetersizdir. Artmýþ T dalga alternansý (TDA) ve uzamýþ T dalgasý pik-son süresi (Tp-e) ani kardiyak ölüm ile iliþkilidir. Bu çalýþmada TDA ve Tp-e süresinin BS hastalarýndaki rolü araþtýrýlmýþtýr.
YÖNTEM ve GEREÇLER: Çalýþmaya 13 BS hastasý ve 11 kontrol alýnmýþtýr. BS ve kontrollerde TDA ve EKG kaydedilmiþtir. Hastalar ve kontroler ventriküler aritmi açýsýndan takip edilmiþtir.

BULGULAR: BS ve kontrollerde TDA negatif saptanmýþtýr. Ancak BS hastalarýnda Tp-e süresi kontrollere göre daha uzun saptanmýþtýr. Ayrýca takipte ventriküler aritmi geliþen hastalarýn tümünde Tp-e 100 ms’ nin üzerindedir.

TARTIÞMA ve SONUÇ: BS hastalarýnda TDA uygun olmayan bir testtir, Tp-e süresinin uzamasý BS hastalarýnda artmýþ risk ile iliþkili olabilir.

INTRODUCTION: Brugada syndrome (BS) is a genetic disease with increased risk of sudden cardiac death. Increased T wave alternans (TWA) and prolonged T wave peak to end (Tp-e) interval are linked to sudden cardiac death. In the present study, we investigated the role of TWA and Tp-e interval in BS.

METHODS: Thirteen BS and 11 controls were included. TWA and ECG were recorded. Patients and controls were followed for ventricular arrhythmias.
RESULTS: TWA study was negative in BS and controls. Tp-e interval was longer in BS than controls. Furthermore, during f/u all patients with ventricular arrhythmiashad Tp-e interval longer than 100 ms.

DISCUSSION AND CONCLUSION: TWA is an inappropriate test for BS, prolonger Tpe may be related to increased risk in BS patients.

GÝRÝÞ ve AMAÇ: Pediatrik keratokonusta transepitelial korneal kollajen crosslinking (CXL) tedavisinin etkinliðinin klinik izlemlerimiz ve literatür bilgileri ýþýðýnda deðerlendirilmesi amaçlanmýþtýr.
YÖNTEM ve GEREÇLER: 2015-2016 yýllarý arasýnda Kocaeli Üniversitesi Týp Fakültesi Göz Hastalýklarý’na baþvurup progressif keratokonus tanýsýyla CXL tedavisi uygulanmýþ ve en az bir yýl takip edilmiþ 18 yaþ altý 18 hastanýn 33 gözü, retrospektif olarak incelendi. CXL öncesi ve postoperatif 1, 3, 6 ve 12. aylardaki en iyi düzeltilmiþ görme keskinliði (EÝDGK) ve Sirius topografi cihazý ile kaydedilen; merkezi kornea kalýnlýðý (MKK), en ince lokalizasyondaki kornea kalýnlýðý (EÝKK), keratometrik deðerler [simüle düz keratometri (sim K1), simüle dik keratometri (sim K2), en yüksek keratometri (Kmax)] ve korneal astigmatizma (Cyl) deðerleri karþýlaþtýrýldý.
BULGULAR: EÝDGK postperatif 12. ayda artmakla birlikte muayeneler arasýnda istatistiksel anlamlý bir deðiþim gözlenmedi (p=0.052). MKK, EÝKK açýsýndan takip boyunca bulgular benzerdi istatistiksel anlamlý bir deðiþim mevcut deðildi (p=0.806, p=0.063, sýrasýyla). Sim K1, sim K2, Kmax ve Cyl deðerlerinde sabitlenme olduðu ve preoperatif döneme kýyasla postopertif bir yýllýk izlemde anlamlý bir deðiþim olmadýðý görüldü (p=0.619, p=0.661, p=0.953, p=0.311, sýrasýyla).
TARTIÞMA ve SONUÇ: Transepitelyal crosslinking tedavisinin pediatrik yaþ grubu progresif keratokonuslarýnda kolay uygulanabilir, konforlu ve progresyonu durdurabilir bir yöntem olduðu düþünüldü.

INTRODUCTION: The aim of this study was to investigate the efficacy of transepithelial corneal collagen crosslinking (CXL) technique in patients with pediatric keratoconus.
METHODS: 33 eyes of 18 patients who were admitted to Kocaeli University Faculty of Medicine, Department of Ophthalmology for the treatment of progressive keratoconus under the age of 18 years who were admitted in 2015-2016 years and followed up at least one year were retrospectively evaluated. The best corrected visual acuity (BCVA), central corneal thickness (CCT), thickness of thinnest location (TTL), keratometric values [simulated flat keratometry (K1), simulated step keratometry (K2), maximum corneal steepness (Kmax)] and corneal astigmatism (Cyl) values were assessed by Sirius topography preoperatively and in postoperative 1, 3, 6 and 12 months.
RESULTS: There was no statistically significant difference between preoperative and postoperative examinations in terms of BCVA (p = 0.052). There was no statistically significant change in CCT and TTL findings during follow-up (p = 0.806, p = 0.063, respectively). It was seen that Sim K1, sim K2, Kmax and Cyl values were similar between preoperative and postoperative one year follow-up (p = 0.619, p = 0.661, p = 0.953, p = 0.311, respectively).
DISCUSSION AND CONCLUSION: Transepithelial crosslinking treatment was observed to be easy to apply, comfortable and prevent progression in pediatric age group of keratoconus

GÝRÝÞ ve AMAÇ: Biz bu çalýþmada apne veya hipopne belirgin obstrüktif uyku apne sendrom (OSAS)’lu hastalarda, uyku yapýsý baþta olmak üzere, vücut kütle indeksi (BMI), epworth uykululuk skalasý (ESS), eþlik eden hastalýklar ve üst hava yolu morfolojisindeki farklýlýklarý deðerlendirmeyi amaçladýk.
YÖNTEM ve GEREÇLER: Hipopne oraný %50' den fazla olan hastalar hipopne grubuna alýnýrken apne oraný %50' den fazla olan hastalar apne grubuna alýndý. Hastalarýn BMI, ESS ve polisomnografi (PSG) parametreleri kaydedildi. Hastalar anamnezlerinde sigara kullaným alýþkanlýðý, kronik obstrüktif akciðer hastalýðý (KOAH), hipertansiyon (HT), diyabetes mellitus (DM), koroner arter hastalýðý (KAH)’ nýn varlýðý açýsýndan tarandý ve üst solunum yolu patolojisi açýsýndan gözden geçirildi.
BULGULAR: Hipertansiyon oraný hipopne grubunda, apne grubundan anlamlý düzeyde yüksek bulundu (p=0,021; p<0,05). Rapid Eye Movement (REM) oraný hipopne grubunda, apne grubundan anlamlý düzeyde yüksek bulundu (p=0,016; p<0,05). Non-Rapid Eye Movement (NREM) apne-hipopne indexi (AHÝ) apne grubunda, hipopne grubuna göre anlamlý düzeyde yüksek bulundu (p=0,007; p<0,01). Supin AHÝ ölçümleri apne grubunda anlamlý düzeyde yüksek bulundu (p=0,047; p<0,05). Uvula deðerlendirmesinde apne grubunda elonge uvula oraný anlamlý düzeyde yüksek bulundu (p=0,043; p<0,05).
TARTIÞMA ve SONUÇ: Apne aðýrlýklý obstrüktif uyku apne sendromu, hipopne belirgin OSAS’ a göre daha aðýrdýr. Hipertansiyon obstrüktif uyku apne sendromunda, hipopne aðrýrlýklý hasta grubunda daha yaygýndýr.

INTRODUCTION: In this study, we aimed to evaluate the body mass index (BMI), epworth sleepiness scale (ESS), accompanying diseases and differences in upper airway morphology and sleep structure in particular in patients with apnea- or hypopnea-predominant obstructive sleep apnea syndrome (OSAS).
METHODS: Patients whose hypopnea ratio was more than 50% were taken to the hypopnea group and patients whose apnea ratio was more than 50% were taken to apnea group. BMI, ESS and polysomnography (PSG) parameters of the patients were recorded. Patients were screened for smoking habits, presence of chronic obstructive pulmonary disease (COPD), hypertension (HT), diabetes mellitus (DM), coronary artery disease (CAD) and upper respiratory pathology in their anamnesis.
RESULTS: Hypertension rate was found to be significantly higher in hypopnea group than in apnea group (p = 0.021, p <0.05). Hypopnea group was found to have significantly higher Rapid Eye Movement (REM) rate than apnea group (p = 0.016, p <0.05). Apnea-hypopnea index (AHI) of Non-Rapid Eye Movement (NREM) was significantly higher in apnea group than in hypopnea group (p = 0.007; p <0.01). Supine AHI measurements were significantly higher in apnea group (p = 0.047, p <0.05). In terms of uvula, elongated uvula rate was found to be significantly higher in apnea group (p = 0.043; p <0.05).
DISCUSSION AND CONCLUSION: Apnea-predominant sleep apnea syndrome is more severe than hypopnea-predominant OSAS. Hypertension is more common in patients with hypopnea-predominant obstructive sleep apnea syndrome

GÝRÝÞ ve AMAÇ: Subakromiyal sýkýþma sendromu; omuz aðrýsý ve hayat kalitesini kýsýtlayan en önemli omuz rahatsýzlýklarýndan olup, artroskopik cerrahinin geliþmesi ile birlikte tedavisinde artroskopik subakromiyal dekompresyon tercih edilir bir yöntem haline gelmiþtir. Bu çalýþmada Artroskopik subakromiyal dekompresyon uyguladýðýmýz hastalarýn klinik sonuçlarý deðerlendirildi.
YÖNTEM ve GEREÇLER: Çalýþmaya, izole subakromiyal sýkýþma sendromu tanýsýyla artroskopik subakromiyal dekompresyon uygulanan 58 hastanýn 59 omuzu (39 kadýn 19 erkek; ortalama yaþ 51,7; daðýlým 25-74) dahil edildi. 31 sol 28 sað omuz etkilenmiþti. Hastalar ameliyat öncesi ve son kontrollerinde omuz Constant skoru, UCLA skoru, VAS (görsel analog skala) ile deðerlendirildi. Ortalama takip süresi 28,6(12-44) ay idi.
BULGULAR: Ameliyat öncesi sýrasýyla ortalama Constant skoru 41(34-56), VAS(0-100) 70(60-90) iken ameliyat sonrasý son kontrolde sýrasýyla; 84(75-95) ve 14(0-30) olarak bulundu (p<0,05). Ameliyat sonrasý UCLA skorlamasýna göre 44 omuzda çok iyi, 15 omuzda iyi sonuç elde edildiði görüldü.
TARTIÞMA ve SONUÇ: Subakromiyal sýkýþma sendromu tedavisinde iyi seçilmiþ hastalarda, tecrübeli cerrah tarafýndan yapýldýðýnda, artroskopik subakromiyal dekompresyon baþarýlý sonuçlarý olan bir yöntemdir.

INTRODUCTION: Subacromial impingement is a common shoulder disorder causes shoulder pain and limited quality of life. Through the development of arthroscopic surgery, shoulder arthroscopy has been implemented as a valid method for the treatment of subacromial impingement. In this study; patients who underwent arthroscopic subacromial decompression for subacromial impingement were evaluated prospectively.
METHODS: In this study we evaluated 59 shoulders (31 left, 28 right) of 58 patients (39 female, 19 male) preoperatively and postoperatively with Constant score, UCLA score and VAS score. Mean age was 51.7 (25-74) years and the mean follow-up period was 28.6 (12-44) months.


RESULTS: Preoperatively the mean Constant score was 41 (34-56), VAS score (0-100) was 70 (60-90). Postoperatively the mean Constant score was 84 (75-95) and VAS score was 14 (0-30). For UCLA scoring 44 patients have excellent, 15 patients have good results.
DISCUSSION AND CONCLUSION: Arthroscopic subacromial decompression is a successful surgical treatment option for subacromial impingement, in selected patients performed by an experienced surgeon.

GÝRÝÞ ve AMAÇ: Kliniðimizde parsiyel fasyektomi yöntemi ile tedavi edilen Dupuytren kontraktürlü hastalarýn postoperatif sonuçlarýnýn deðerlendirilmesidir.
YÖNTEM ve GEREÇLER: Mart 2012- Mart 2016 yýllarý arasýnda kliniðimizde Dupuytren kontraktürü nedeniyle parsiyel fasyektomi ile opere edilen 20 hasta retrospektif olarak incelendi.
BULGULAR: Hastalarýn 14’ü erkek (%70); 6’sý (%30) kadýn idi (erkek/kadýn oraný: 2,33/1). Hastalarýn en küçüðü 23 yaþýnda; en büyüðü 78 yaþýnda idi. Erkeklerde yaþ ortalamasý 58,35 yaþ; kadýnlarda 56,16 yaþ olarak bulundu. 1 hasta (%5) çift taraflý el tutulumu nedeniyle opere edildi. 19 hasta ise (% 95) tek taraflý el tutulumu nedeniyle ameliyat edildiler. Tek taraflý el tutulumu olanlarýn 8 tanesi (%42, 1) sol elinden; 11 tanesi (%57,9) sað elinden opere edildi. Eksize edilen fibrosis dokusu ortalama 26,5 mm idi (min/max: 10-40 mm). Ortalama takip süresi 30,65 ay idi (11-50 ay). 2 hastada rekürrens görüldü (%10).
TARTIÞMA ve SONUÇ: Ýleri olgularda bile parsiyel fasyektomi tercihinin dupuytren kontraktürü tedavisinde güvenli ve baþarýlý bir yöntem olabileceði kanaatindeyiz.

INTRODUCTION: The aim of this study is analysing the Dupuytren’s Contracture patients retrospectively who underwent partial fasciectomy.
METHODS: We analyze 20 patients retrospectively who underwent surgery between March 2012 to March 2016 at our department.
RESULTS: 14 patients were men (70%); 6 patients were women (30%) (Male / female ratio 2,33/1). The youngest one of patients was 23 years old and the oldest one was 78 years old. Mean age was 58,35 in men and 56,16 in women. 1 patients had bilateral hand involvement (5%) and 19 patients had one hand involvement(95%). 8(42,1%) of them were operated from the left hand; 11 of them (57,9%) were operated by the right hand. The mean measure of excision material is 26,5 mm ( min/max: 10-40 mm ). Mean follow-up is 30,65 month (11-50 month). There was recurrence in 2 patients (10%).
DISCUSSION AND CONCLUSION: Even in advanced cases, we believe that partial fasciectomy may be a safe and successful method for the treatment of Dupuytren Contracture.

GÝRÝÞ ve AMAÇ: Radyofrekans katater ablasyon supraventriküler taþikardilerin tedavisinde etkin bir yöntemdir. Biz bu çalýþmamýzda yeni kurulan bir aritmi merkezinde supraventriküler taþikardi sebebiyle ablasyon uyguladýðýmýz ilk 269 hastalarýn sonuçlarýný deðerlendirmek istedik.
YÖNTEM ve GEREÇLER: Çalýþmamýzda Ocak 2013 ile Ocak 2016 tarihleri arasýnda yeni bir aritmi merkezinde supraventriküler taþikardi sebebiyle radyofrekans katater ablasyonu uygulanan 269 hastanýn verileri retrospektif olarak incelendi. Tüm hastalarýn demografik bilgileri, elektrofizyoloji bulgularý, uygulanan tedavi iþlemleri ve karþýlaþýlan komplikasyonlar ve 1 yýllýk takip sonuçlarý kayýt edildi.
BULGULAR: Çalýþmaya 269 hasta (109 erkek) dahil edildi. Ortalama yaþ 47,74 ± 14.87 idi. 196 hastada atrioventriküler nodal reenteran taþikardi (AVNRT), 35 hastada atrioventriküler reenteran taþikardi (AVRT), 18 hastada atrial taþikardi (AT), 20 hastada atrial flutter(AFL) ablasyonu uygulandý. 3 vaka iþlem sýrasýnda baþarýsýz olundu ( 1 AT, 1 AVNRT, 1 AVRT). 1 yýllýk takipte 7 hastada nüks görüldü (2 AT, 2 AVNRT, 2 AVRT, 1 AFL).
TARTIÞMA ve SONUÇ: RFCA kabul edilebilir bir baþarý oraný ve düþük komplikasyon oraný ile SVT tedavisinde güvenli ve etkili bir yaklaþýmdýr. Sonuçlarýmýz uluslararasý literatürle uyumludur.

INTRODUCTION: Radiofrequency catheter ablation (RFCA) is an effective method in the treatment of supraventricular tachycardia (SVT). In this study, we evaluated the results of the first 269 patients treated with RFCA of SVT in a our new arrythmia center
METHODS: 269 patients underwent RFCA for SVT between january 2013 and january 2016 were retrospectively evaluated in the study. Demographic and clinical characteristics of patients, electrophysilogical findings and techniques, treatment methods, complications and one year follow-up data were recorded.
RESULTS: 269 patients (109 male) were evaluated in the study. Mean age was 47,74 ± 14.87. 196;35;18;20 patients underwent RFCA procedure for AVNRT;AVRT;AT;AFL, respectively. 3 patients had unsuccessful procedure (1 AT, 1 AVNRT, 1 AVRT). In 7 patients recurrences occurred ( 2 AT, 2 AVNRT, 2 AVRT,1 AFL) within 12 months after the ablation procedure.
DISCUSSION AND CONCLUSION: RFCA is a safe and effective approach for the treatment of SVT with an acceptable success rate and low complication rate. Our results are compatible with internatinal literature.

GÝRÝÞ ve AMAÇ: Kliniðimizde kullandýðýmýz semirijit (4.5 F) üreterorenoskopun 3 yaþ altý çocuklarda üreter taþý tedavisindeki baþarýsýný deðerlendirmeyi hedefledik.
YÖNTEM ve GEREÇLER: 2012 Ocak-2017 Mart yýllarý arasýnda kliniðimizde üreter taþý nedeniyle endoskopik üreter taþý tedavisi yapýlan 12’i kýz, 13’si erkek toplam 25 hastanýn verileri retrospektif deðerlendirildi. Proksimal üreter yerleþimli taþý olan 7 hastanýn Üreterorenoskopi tedavisinden önce baþarýsýz Vücut dýþý þok dalga litotripsinin giriþimi mevcuttu. Ýþlem esnasýnda 4,5 F semirijid ultrathin Üreterorenoskopi ve litotiriptör olarak holmium: YAG lazer kullanýldý. Hastalarýn taþsýzlýk oranlarýnýn deðerlendirilmesi fragmantasyon esnasýnda vizüel olarak ve 1 hafta sonra üriner ultrasonografi ile yapýldý.
BULGULAR: Hastalarýn %52.0’i (n=13) erkek olup, %48’i (n=12) kýz hastaydý. Yaþ ortalamasý 2.08±0.9 (1–3 yaþ aralýðý) idi. Taþlarýn %64’ü (n=16) distal üreter, %8’i (n=2) orta üreter, %28’i (n=7) proksimal üreter yerleþimli idi. Hastalarýn %76’inde (n=19) taþlar sol üreterde, %24’ünde (n=6) sað üreterde idi. Ýlk üreterorenoskop prosedürü sonrasý taþsýzlýk oraný %92 (23/25) idi. Proksimal üreterde impakte taþý olan 2 hastaya 2. seans üreterorenoskop uygulandý.
TARTIÞMA ve SONUÇ: Kalibrasyonu 4.5 F olan üreterorenoskopi ile uygulanan endoskopik üreter taþý tedavisinde, çok küçük yaþtaki hastalarda bile yüksek baþarý ve düþük komplikasyon oranlarý ile güvenle uygulanabilmektedir.

INTRODUCTION: We aimed to evaluate the success of semirigid (4.5 F) ureterorenoscopy in our clinic in the treatment of ureteric stones in children under 3 years of age
METHODS: We retrospectively evaluated 25 patients (12 female, 13 male) who underwent endoscopic ureteral stone treatment for ureteral stones between January 2012 and March 2017 in our clinic. There were unsuccessful Extracorporeal Shock Wave Lithotripsy attempts before ureterorenoscopy treatment of the 7 patients with proximal ureteral stones. During the procedure 4.5 F semirigid ultrathin ureterorenoscopy and holmium: YAG laser as lithotripter were used. Evaluation of the stone-free status of the patients was made visually during the fragmentation and by urinal ultrasonography 1 week later.
RESULTS: 52.0% (n = 13) of the patients were male and 48% (n = 12) were female. The mean age was 2.08 ± 0.9 (range 1-3 years). 64% of the stones (n = 16) were located distally, 8% (n = 2) in the mid and 28% (n = 7) in the proximal ureter. The stones were in the left ureter in 76% of the patients (n = 19) and in the right ureter in 24% (n = 6). The stone-free rate after the first ureterorenoscopy procedure was 92% (23/25). Second ureterorenoscopy treatment was applied to 2 patients who had impacted stones in proximal ureter.
DISCUSSION AND CONCLUSION: In endoscopic ureteral stone treatment with a 4.5 F ultrathin ureterorenoscopy can applied safely with high success and low complication rates even in very young patients.

GÝRÝÞ ve AMAÇ: Çeþitli kanser tiplerinde yüksek nötrofil-lenfosit oranýnýn (NLO) kötü saðkalým sonuçlarý ile iliþkili olduðu bildirilmektedir. Çalýþmamýzda metastatik pankreas kanserli hastalarda NLO’nun prognostik önemini deðerlendirmeyi amaçladýk.
YÖNTEM ve GEREÇLER: Ocak 2013 ile Aralýk 2014 tarihleri arasýnda, metastatik pankreas karsinomu tanýsý alan 40 hasta retrospektif olarak incelendi. Hastalarda NLO ile genel saðkalým (OS) ve progresyonsuz saðkalým (PFS) iliþkisi Kaplan-Meier metodu kullanýlarak analiz edildi.
BULGULAR: Çalýþmaya dahil edilen 40 hastanýn ortanca yaþý 58.5 olup, %75 i erkekti. Hastalarýn 21’inde (%52.5) yüksek NLO (≥3.45) saptandý. Nötrofil/lenfosit oraný hem OS hem de PFS için önemli bir prognostik paremetre idi. Ortanca OS NLO yüksek ve normal hastalarda sýrasý ile 2.8 ay ve 11.1 ay (P<0.001) idi. Ortanca PFS ise NLO yüksek ve normal olan hastalarda sýrasý ile 1.6 ay ve 7.9 ay (P<0.001) idi. Ayný zamanda erkek (4.1 ay vs 0.9 ay; P=0.022) ve pankreas baþý yerleþimli tümöre sahip olan (5.8 ay vs 1.3 ay; P=0.046) hastalarda PFS anlamlý olarak daha uzundu.
TARTIÞMA ve SONUÇ: Yüksek NLO, metastatik pankreas kanseri olan hastalarda daha kýsa OS ve PFS' nin bir göstergesidir. Bu sonuçlar daha fazla hasta sayýsý ve diðer prognostik faktörler de dahil edilerek prospektif çalýþmalar ve çok deðiþkenli analiz ile doðrulanmalýdýr.

INTRODUCTION: In numerous types of malignancy it is reported that high neutrophil-to-lymphocyte ratio (NLR) is associated with poor outcomes. We aimed to investigate the prognostic significance of NLR in patients with metastatic pancreatic cancer in our study.
METHODS: Between January 2013 and December 2014, 40 patients with metastatic pancreas carcinoma were retrospectively reviewed. The association of NLR with progression-free survival (PFS) and overall survival (OS) was analyzed using the Kaplan–Meier method.
RESULTS: Forty patients were included in this study. The median age of patients was 58.5 years (range 44–80 years) and the majority of patients were male (75.0%). High NLR (≥3.45) were obtained in 21 patients. NLR was a significant prognostic factor for both OS and PFS. The median OS for patients with high and normal NLR was 2.8 and 11.1 months, respectively (p <0.001). The median PFS for patients with high and normal NLR was 1.6 and 7.9 months, respectively (p <0.001). At the same time, PFS was significantly longer in male patients and those with a pancreatic head-located tumor.
DISCUSSION AND CONCLUSION: High NLR is a predictor of shorter OS and PFS in patients with metastatic pancreatic cancer. These results should be confirmed by prospective studies and multivariate analyses including more patients and other prognostic factors.

Obstrüktif uyku apne sendromu (OUAS), tanýsý sýklýkla gecikerek konan acil bir sorundur. Klinik ve laboratuvar bulgularýyla OUAS tanýsý konan ve etyolojisinde juvenil myastenia gravis tanýsý alan 15 yaþýnda kýz olgunun sunulmasý ve konuya dikkat çekilmesi amaçlanmýþtýr. Hastamýzýn polisomnografi (PSG) sonucuna göre aðýr OUAS ile uyumluydu.( Apne index 96.7/saat, apne hipopne indeksi 148/saat ). Egzersizle artan kas güçsüzlüðü ve gün içinde de deðiþen kas gücü nedeniyle Myastenia gravis düþünülerek pridostigmine baþlandý, klinik yanýt baþarýlý olduðundan tanýsý kesinleþti. Uyku sýrasýnda da maske ile BIPAP baþlandýktan sonra karbondioksit retansiyonu geriledi.(pCO2: 46 mmHg)

Obstructive sleep apnea syndrome (OSAS) which is often diagnosed lately is an emergency. We present a 15 years old girl who is diagnosed as OSAS and juvenile myasthenia gravis (MG) with clinical and laboratuary findings to attract attention to the subject. Her polysomnography (PSG) result was consistent with severe OSAS (Apnea index 96.7/hour, apnea-hypopnea index 148/hour). MG was thought due to diurnal variation of muscle strength and increase of muscle weakness after exercise. Significant clinical response to pridostigmine supported diagnosis. After initiation BIPAP with mask during sleep, carbondioxide retantion decreased (pCO2: 46mmHg)

Çölyak hastalýðý gluten içeren gýdalarýn alýmýyla tetiklenen otoimmun bir bozukluktur. Farklý klinik tablolar oluþturabilir (1).Çoðunlukla çocukluk çaðýnda tipik bulgularla taný almasýna raðmen eriþkin yaþta da çok farklý klinik tablolar ile gelebilir.Tipik bulgularý karýnda þiþkinlik,glutenli gýda yemek sonrasý diyare ataklarý,kilo alamama iken hastalar atipik olarak eklem aðrýsý,demir eksikliði anemisi,nedeni bilinmeyen karaciðer hasarý,kadýnlarda abortus ve infertilite gibi bulgular ile gelebilir. ÇH toplumdaki sýklýðý %1-2 civarýndadýr(2). IVF tedavisi sonrasý asit, sarýlýk ve genel durum bozukluðu geliþen ve çölyak hastalýðý tanýsý konan bir olgu sunulmuþtur.

Celiac disease is an autoimmune disorder triggered by the intake of foods containing gluten. it can create different clinic tables. Although it is usually diagnosed with typical findings in childhood, it may come with very different clinical tables in adulthood. While bloating, diarrhea after gluten intake and inability to gain weight are its typical findings, patient can admit with its atypical findings as joint pain, iron deficiency anemia, abnormal liver function test, infertility and abortus in women.It's prevalance is about 1-2 %. We present a case who was taken diagnosis of celiac disease when presented with ascites, icterus and general statement disorientation after IVF treatment.

Kolsiþin gut artriti ataklarý, ailevi Akdeniz ateþi, Behçet hastalýðý gibi farklý hastalýklarýn tedavisinde kullanýlýr. Anti-mitotik bir ajan olan kolsiþinin en sýk yan etkisi ishal, bulantý, kusma, karýn aðrýsý gibi gastrointestinal semptomlardýr. Miyelosupresyon, miyonöropati ve multiple organ yetersizliðini içeren ciddi yan etkiler nadirdir. Bu yan etkiler overdozda veya tedavi dozunda kullanýmý olan böbrek yetmezliði ve karaciðer fonksiyon bozukluðundan dolayý kolsiþin atýlýmý azalan hastalarda meydana gelir

Colchine is used in the treatment of different diseases such as attacks of gout arthritis, familial Mediterannean fever, Behçet disease. As colchicine is a anti-mitotic agent, the most side effects of oral colchicine ara gastrointestinal symtoms including diarrhea, nausea, vomitting and abdominal pain. The most serious effects include myelosuppresyon, myoneuropathy and multiple organ failure which are rare. This occurs with overdose or therapeutic dosing in patients with reduced clerance of colchicine due to renal insufficiency and hepatic dysfunction.

Türkçe Lityum bipolar bozukluk tedavisinde oldukça sýk kullanýlan ve en etkin ilaçtýr. Lityum iliþkili nefrojenik diyabetes insipitus, kronik tübülointerstisyel nefrit ve akut tübüler nekroz tanýmlanmýþtýr. Burada bilinç bulanýklýðý ve akut böbrek yetmezliði tablosu ile olgu sunulmuþtur.

Ýngilizce özet:
Lithium is a psychiatric medication commonly used in the treatment of bipolar disorder. It has been implicated in inducing nephrogenic diabetes inspidus, chronic tubulointerstisial nehpropaty and acute tubuler necrosis. We describe a case of lithium induced acute kidney injury.

Tailgut (postnatal gut), hintgutun en kaudal parçasý olup anüsün gelecekteki distal kesimini oluþturur. Genelde embriyonik hayatýn 8. haftasýnda involüsyona uðrar. Tailgut kisti involüsyona uðramayan kalýntýlardan köken alýr. Tailgut kistinden malignensi geliþimi çok nadir olup en sýk adenokarsinom, nöroendokrin tümör ve sarkom geliþimi bildirilmiþtir. Biz burada tailgut kisti zemininde geliþen nöroendokrin tümörün bilgisayarlý tomografi (BT) bulgularýný sunmayý amaçladýk. Otuzbeþ yaþýnda endometriozis nedeniyle takipte olan kadýn hasta, karýn aðrýsý þikayeti ile baþvurdu. Hastaya ultrasonografi (US) ve kontrastlý abdominopelvik BT çekildi. BT’de presakral alanda büyüðü yaklaþýk 6.5x6x6.5 cm çapta solid heterojen düzgün sýnýrlý multiple nodüler kitleler mevcuttu. Hastaya yapýlan cerrahi operasyon sonrasýnda patoloji sonucu tailgut kisti zemininde geliþen nöroendokrin tümör olarak raporlandý. Tailgut kisti asemptomatiktir,en sýk presakral bölgede rektum ile sakrum arasýnda izlenir. Kadýnlarda daha sýk rastlanýr. Her yaþ grubunda görülebilse de orta yaþ grubunda (ortalama 35 yaþ) daha sýk taný alýr. Bizim hastamýz da kadýn ve 35 yaþýndaydý. Tailgut kisti ile diðer presakral kistik lezyonlarýn ayýrýcý tanýsý tailgut kistinin malign transformasyonu nedeniyle yapýlmalýdýr. Tailgut kisti nadiren malign transformasyon göstermekte olup; adenokarsinom,nöroendokrin tümör ve sarkom geliþimi bildirilmiþtir. Hastamýzda lezyonlarýn eksizyonu sonucu patoloji nöroendokrin tümör olarak gelmiþtir. Presakral bölgede saptanan kitlelerde tailgut kisti malignite potansiyeli nedeniyle ayýrýcý tanýda akýlda bulundurulmalýdýr.

The tailgut is the most caudal part of the hindgut, it forms the distal part of the anus. It normally involutes by the eighth week of gestational age. If a tailgut rest proceeds, it may give rise to a tailgut cyst. Malign transformation of the tailgut cyst is very rare. Adenocarcinoma, neuroendocrine carcinoma, and sarcoma developing within the tailgut cyst has been reported in the literature. We present a case of neuroendocrin tumor which is arised from a tailgut cyst in a middle aged woman with its computed tomography (CT) imaging findings. A 35 year-old woman with a history of endometriosis admitted to our hospital with abdominal pain. An ultrasonography (US) examination and contrast medium enhanced tomography of the abdomen and pelvis was performed. CT showed multiple well-defined solid heterojen masses in presacral space.The largest dimensions of the masses were 6.5x6x6.5 cm. The patient underwent surgery. Patology was reported as neuroendocrin tumor arising within tailgut cyst. It is usually detected as an asymptomatic mass in the presacral space between rectum and sacrum. Tailgut cyst is more common in female and usually presents in middle age(mean 35), but it can present at any age. Our patient was female and 35 years old. Discrimination of tailgut cyst from other presacral cysts is important because of the malignant potential of a tailgut cyst. Malign transformation is very rare. Adenocarcinoma, neuroendocrine carcinoma, and sarcoma developing within the tailgut cyst has been reported. In our case patology was reported as neuroendocrin tumor arising within tailgut cyst. It should be kept in mind the differential diagnosis of presacral masses because of the malignant potential of a tailgut cyst.

Primer Santral Sinir Sistemi Lenfomasý (PSSSL), Non Hodgkin Lenfoma (NHL)’ larýn %5’ den azýný oluþturur ve büyük çoðunluðu B-hücreli lenfomalardýr. Hastalar klinikte kafa içi basýnç artýþý, fokal nörolojik bulgular, nöropsikiyatrik semptomlar veya göz bulgularý ile karþýmýza gelebilir. PSSSL ayýrýcý tanýsýnda santral sinir sistemi gliomlarý, metastatik tümörler, demiyelinizan bozukluklar, subakut enfarkt ve yer kaplayan lezyonlar yer alýr. Bu raporda acil servise psikiyatrik bulgular ve inme benzeri bulgularla baþvuran fakat yapýlan ileri tetkik ve araþtýrmalar sonucu PSSSL tanýsý alan bir hasta sunuldu. PSSSL çeþitli klinik tablolarla karþýmýza çýkabilir. Ýnmelerin ve atipik psikiyatrik belirtilerin etyolojik deðerlendirilmesinde göz önünde bulundurulmaldýr.

Primer central nervous system lymphoma (PCNSL) constitutes of less than 5% of non-Hodgkin’s lymphoma (NHL) and the great majority is B-cell lymhomas. Patients may be came up with increased intracranial pressure, focal neurological signs, neuropsychiatric symptoms or eye symptoms in clinic. Central nervous system gliomas, metastatic tumors, demyelinating disorders, subacute infarcts and space-occupying lesions are among the differential diagnostics of PSSL. In this report, a patient who was admitted to emergency department with psychiatric findings and stroke-like findings, but after advanced examination and research who has got PSSL diagnosis, was presented. PSSL may be confronted with various clinical tables. It should be taken into account in the etiological evaluation of atypical psychiatric symptoms and strokes.