bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparison of the effect of supine and prone positions on physiological parameters of preterm infants under nasal continuous positive airway pressure (N-CPAP): a cross over clinical trial
Authors: BABAEİ Homa , MOHAMMADİ PİRKASHANİ Leila , SOLEİMANİ Behzad
Published: September 2019

Purpose: The aim of this study was to compare the effect of supine and prone positions on physiological parameters of preterm infants under nasal continuous positive airway pressure (N-CPAP). Materials and Methods: This cross-over clinical trial was conducted on 62 hospitalized preterm infants under N-CPAP in the neonatal intensive care unit of Imam Reza Hospital Kermanshah, Iran. Neonates were placed in supine position at first for 180 minutes and then their position was changed into prone position for another 180 minutes. During this period, heart rate (HR), respiratory rate (RR) and arterial oxygen saturation (So2) were assessed once every 15 minutes in two positions. Results: There was significant difference observed in the means of HR in two positions. The RR in the prone position was significantly lower than that in the supine position; however, the So2 in the prone position was significantly higher than the supine position.Conclusion: The results of this study showed in preterm infants with respiratory distress syndrome under N-CPAP, there was lower RR and higher So2 in prone position when compared to the supine position. Therefore, preterm infants have better physiological stability in prone position.
Evaluation of statistical significance of randomized controlled trials using diagnostic imaging techniques with fragility index
Authors: DERİCİ YILDIRIM Didem , TAŞDELEN Bahar
Published: September 2019

Amaç: Bu çalışmanın amacı kırılganlık indeksinin  (Kİ) başarısını, tanı amaçlı görüntüleme yöntemleri kullanılan randomize kontrollü çalışmalar (RKÇ) için değerlendirmektir.  Gereç ve Yöntem: Pubmed veri tabanında “Randomize Kontrollü Çalışma”, “Kesin Test” ve “Tanısal Görüntüleme” terimlerini içeren bir sistematik araştırma yapılmıştır. İki araştırmacı birbirinden bağımsız olarak özetleri ve çalışmaları seçim kriterlerine göre incelemiştir.Bulgular: Kİ medyan değeri 4.0 [1.0-4.0] ve örnek genişliğinin medyan değeri 83.5[36.0-148.0] olarak bulunmuştur. Dahil edilen çalışmaların %50’sinin p değeri 0.001 ile 0.05 arasında yer almaktadır. Bir kişi daha eklendiği durumda çalışmaların %94,4’ünün p değeri anlamsız hale gelmiştir. Kİ ile örnek genişliği ve ilgilenilen olayın gözlendiği kişi sayısı arasında anlamlı bir ilişki yoktur.  (r=0.144, p=0.570; r=0.169, p=0.504) Rapor edilen p değeri grupları arasında Kİ değerleri bakımından istatistiksel olarak anlmalı bir farklılık vardır. (Sonuç: İkili sonuç değişkenleri için Kİ p değeri ile birlikte verilmelidir. Araştırmacılar Kİ’yi yorumlarken dikkatli olmalıdır çünkü Kİ sadece çalışmanın kanıt değerini ve istatistiksel gücünü göstermektedir.
Prematüre retinopatisinde diod lazer fotokoagülasyon tedavisi
Authors: FAİZ TURAN Miray , ALYAMAÇ SUKGEN Emine
Published: September 2019

Amaç: Bu çalışmanın amacı prematüre retinopatisinde uygulanan diod lazer ablasyon tedavisinin parametrelerini ve sonuçlarını değerlendirmektir.Gereç ve Yöntem: Adana Numune Eğitim ve Araştırma Hastanesi’ne başvuran ve prematüre retinopatisi nedeniyle fotokoagülasyon tedavisi uygulanan hastalar geriye dönük olarak incelendi. Hastaların demografik özellikleri, klinik bulguları, tedavi parametreleri ve sonuçları değerlendirildi.Bulgular: Prematüre retinopatisi saptanan 142 bebeğin 283 gözüne diod lazer fotokoagülasyon uygulanmıştır. Hastaların 70’i (%49,3) kız, 72’si (%50,7) erkekti. Olguların ortalama doğum ağırlığı 1316±457gr iken ortalama postmenstruel doğum haftası 29,4±2,7 idi. Tedavinin yapıldığı ortalama postmenstruel hafta 38±3,2 olarak gözlendi. Lazer enerji seviyesi ortalama 167,8±21,6 mW (100-280 mW), lazer spot sayısı ise 1728,1±789,4 (100-5600) olarak tespit edildi. Regresyon olmaması nedeniyle 24 göze (%8,5) ek lazer tedavisi uygulandı. İlk takipleri kliniğimizde yapılmayan ileri evre 8 göze (%2,8) lazer tedavisi sonrası dış merkezde vitreoretinal cerrahi uygulanmıştır. 275 hastada (%97,2) ise diod lazer tedavisi etkili biçimde uygulanarak anatomik başarı sağlanmıştır.Sonuç: Diod lazer fotokoagülasyon prematüre retinopatisi tedavisinde yüksek anatomik başarı sağlamaktadır. Bu hastaların dikkatli ve yakın izlemi, zamanında tedavi açısından yönlendirilmesi önemlidir.
Cardiac and pulmonary late side effects after Hodgkin lymphoma
Authors: KÜPELİ Serhan
Published: September 2019

Current treatment of childhood cancers has developed as a risk-oriented approach considering clinical, biological, genetic factors and treatment response. Cardiac diseases are the most common cause of non-cancer death in long-term childhood cancer patients. Cardiomyopathy, congestive heart failure, pericardial effusion, constrictive pericarditis, coronary artery disease, myocardial infarction, and arrhythmias may develop with the toxic effects of chemotherapy and radiotherapy. Pulmonary complications such as radiation pneumonitis, pulmonary fibrosis and spontaneous pneumothorax, which are seen in previous years due to high dose radiotherapy are currently rarely seen. Long-term follow-up of patients who are treated with mediastinal radiotherapy and/or cardiotoxic agents, such as patients with Hodgkin lymphoma, is of vital importance. Left ventricular and heart valve functions should be monitored by echocardiography, QTc and rhythm abnormalities should be monitored by electrocardiography and other factors that may affect cardiovascular health and pulmonary function tests should be evaluated periodically. Computerized tomography angiography has a role of in the early identification of possible coronary  abnormalities in Hodgkin lymphoma patients at risk for coronary artery disease due to the treatments they received, especially mediastinal radiotherapy.
Eosinophilia as an adverse drug reaction secondary to thalidomide therapy in Lepra type 2 reactions: a mandate responsibility
Authors: THANGARAJU Pugazhenthan , VENKATESAN Sajitha , CHANDU Deeptanshu Nirmal , VARTHYA Shoban Babu
Published: September 2019

Limited data are available on eosinophilia as a drug adverse event with immunosuppressant and modulator. We report a case  of 40 year old male patient treated with thalidomide for lepra reaction developed thalidomide induced eosinophilia. Eosinophil count rose during thalidomide treatment and decreased in the periods when the patient was off the treatment. Eosinophilia as an adverse event due to thalidomide has been described rarely except in a case of congener Lenalidomide. This case shows a clear temporal relationship between thalidomide and eosinophilia. With reference to this case, monitoring of patients receiving similar treatment can be increased to detect and prevent any possible adverse drug reactions before it adds up to the suffering of the patient in turn improving the quality of medical services and patient care as well. Thus the quality has been improved and managed in the current case.
Does selective IgA deficiency have a good prognostic role on juvenile dermatomyositis? a case report.
Authors: BALCI Sibel , KIŞLA EKİNCİ Rabia Miray , DOĞRUEL Dilek , SERBES Mahir , ALTINTAŞ Derya Ufuk , YILMAZ Mustafa
Published: September 2019

Juvenile dermatomyositis is a multisystemic autoimmune disease with uncertain etiology. Both innate immunity and adaptive immunity play a role on the pathogenesis of the disease. Selective immunoglobulin A deficiency is the most common primary immunodeficiency. Association between immunoglobulin A deficiency and autoimmune diseases including few juvenile dermatomyositis patients have been reported. A previously healthy 15-year old girl was diagnosed with juvenile dermatomyositis according to Bohan and Peter criteria and selective immunoglobulin A deficiency due to the low level of immunoglobulin A (<6 mg/dl). After 3 months of immunosuppressive treatment, her physical examination revealed no muscle weakness, no rashes, and normal muscle enzyme levels. While she has been treated with low dose methylprednisolone and subcutaneous methotrexate, muscle strength and muscle enzymes remained in normal levels at 12 months follow-up. Our knowledge about the co-occurrence of immunodeficiency and autoimmunity emerge that patients diagnosed with autoimmunity should have investigations for immunodeficiency or vice versa.
Tekrarlayan gebelik kayıplarında FAS ve FASLG polimorfizmlerinin TaqMan SNP genotiplendirme yöntemi ile belirlenmesi
Authors: AY Mustafa Ertan , İZCİ AY Özlem , ÇEVİK Kenan , DOĞRU Gurbet , SÖYLEMEZ Fatma , ÇAYAN Filiz Evşen , ERDAL Mehmet Emin
Published: September 2019

Amaç: Bu çalışmada apoptotik uyarıcı Fas hücre yüzey ölüm reseptörü (FAS) ve FAS ligandı genleri (FASLG) polimorfizmlerinin tekrarlayan gebelik kaybı (TGK) etiyolojisindeki yeri araştırıldı.Gereç ve Yöntem: Bu vaka-kontrol çalışmasında, TGK tanısı almış 70 kadın ve kontrol grubu olarak 70 kadından genomik DNA izole edildi. Her iki gruptaki FAS -670 A>G, FAS -1377 G>A ile FASLG -124 A>G polimorfizmlerinin genomik dağılımı ve allel frekansları real-time PCR yöntemi ile belirlenerek karşılaştırıldı.Bulgular: Çalışmamızda, FASLG -124 A>G polimorfizmi için TGK ve kontrol gruplarının genotip frekans farkının istatistiksel olarak anlamlı olduğu saptandı. Ancak FAS −670 A>G ve FAS-1377 G>A genotipleri ile TGK arasında istatistiksel düzeyde anlamlı bir ilişki saptanmadı. FASLG −124 A>G polimorfizmi için A allelini taşıyanlarda hastalığın görülme olasılığı A allelini taşımayanlara göre 3,94 kat daha yüksek bulundu.Sonuç: Bulgularımız, apoptozla ilişkili FASLG -124 A>G polimorfizminin TGK oluşumuna katkısı olabileceğini düşündürmektedir.
Asymptomatic respiratory dysfunction in patients with thalassemia major
Authors: KAZGAN Tuğçe , YAĞCI KÜPELİ Begül , KONT ÖZHAN Aylin
Published: September 2019

Purpose: Regular transfusions cause progressive iron deposition in critical organs such as heart, liver and lungs in transfusion-dependent thalassemia (TDT). We aimed to evaluate respiratory dysfunction and factors affecting respiratory dysfunction in patients with TDT.Materials and Methods: Patients with TDT treated at department of Pediatric Hematology/Oncology of Sağlık Bilimleri University, Adana Education and Research Center were evaluated retrospectively.  Results: Respiratory function tests were performed in 40 patients (19 female; 21 male) with TDT. The mean age at diagnosis was 6.63±5.74 months, mean body mass index was 18.57±2.27 kg/m², mean transfusion program duration was 151.67±50.48 months. Splenectomy rate was 48%. All of the patients were using iron chelation therapy. Respiratory function tests reveled normal findings in 57.5%, restrictive lung dysfunction with small airway obstruction findings in 27.5% and isolated restrictive dysfunction in 15% of patients. There was no statistically significant difference in respiratory dysfunction according to age, gender, transfusion program duration, ferritin and hemoglobin levels, presence of splenectomy, or type of chelation therapy. Patients with ferritin levels above 2500 ng/dl had significantly lower values for forced expiratory volüme (FEV1) and forced vital capacity (FVC) Conclusion: In our study, restrictive respiratory dysfunction was detected in nearly half of the patients with TDT who had no respiratory symptoms. Higher ferritin levels may indicate the need for close follow-up for respiratory symptoms.
Relationship between lower urinary system complaints and healthy life behaviors among women aged 50 and over
Authors: ÖZCAN Handan , KIZILKAYA BEJİ Nezihe
Published: September 2019

Purpose: This study was planned to determine the lower urinary tract complaints and healthy lifestyle behavior of women aged 50 and over living in Gümüşhane, Turkey. Materials and Methods: The population of this cross-sectional design study consisted of the female population aged 50 and over in Gümüşhane (5430), and the sample comprised of 543 women calculated using stratified sampling method according to age groups. In order to collect the data, a questionnaire investigating participants’ socio-demographic characteristics, obstetric gynecological, chronic disease stories and general health behavior, The Bristol Female Lower Urinary Tract Symptoms Scale (B-FLUTS) and Healthy Life Style Behavior Scale (HLSBS) were used. The data were evaluated with a statistical package program.Results: The mean age of the women was 64.55±11.197, the mean age of menopause was 47.72±5.11. The BLUTS total score was 16.43±11.06, and the total score of HLSBS scale was 125.76±22.74. The BFLUTS total score was associated with the women’s work status (those who are employed are less likely to have symptoms), advanced age, marital status (those living apart have more symptoms), low income status, low educational status, having unemployed spouse, having given birth at home, constipation, chronic disease history, daily pad use, increased pregnancy, birth and miscarriage. Conclusion: As the mean of HLSBS total score increased, Spiritual Development BFLUTS score decreased. Before any medical treatment, the women with lower urinary tract complaints should be analyzed by evaluating their lifestyle in order to reduce the complaints.
Şiddetli restriktif akciğer hastalığı olan hastada kolesistektomi operasyonu için kombine spinal epidural anestezi
Authors: GENEZ Meltem , BÖLÜK Salih
Published: September 2019

Restriktif akciğer hastalıklarında genel anestezi uygulaması titizlikle yapılmalıdır. Volatil anestezikler atelektazi oluşumuna ve fonksiyonel rezidüel kapasite (FRC)’de azalmaya (%16-0.5 litre) neden olarak intraoperatif hipoksi oluşturabilirler. Bu hasta grubunda operasyon için uygun olduğunda rejyonel anestezi veya periferik sinir blokları en iyi seçim gibi görünmektedir. Yapılan epidural veya spinal anestezinin solunum kasları ve diyafragmayı etkilemeyecek düzeyde uygulanması gereklidir. Özellikle kolesistektomi gibi üst batın cerrahisi uygulanacak hastalarda rejyonel yöntemlerin kullanımı tercih edilebilir. Bu olgu sunumunda laparoskopik kolesistektomi yapılması planlanan şiddetli restriktif akciğer hastalığı olan 80 yaşında, fiziksel durum sınıflaması American Society of Anesthesiologists (ASA) III hastanın kombine spinal-epidural anestezi uygulamamızı paylaştık.
Laparaskopik gastrik kanser cerrahisinde erken dönem sonuçları
Authors: YALAV Orçun , TOPAL Uğur , ÜNAL Ayşe Gizem , RENCÜZOĞULLARI Ahmet , ERAY İsmail Cem , SARTIAŞ Ahmet Gökhan
Published: September 2019

Amaç: Bu çalışmada bir üniversite kliniğinde gerçekleştirilen laparoskopik gastrektomilerin erken dönem sonuçlarının paylaşılması amaçlanmıştır.Gereç ve Yöntem: Eylül 2015- Eylül 2018 tarihleri arasında yapılan laparoskopik gastrektomiler total ve distal olmak üzere iki gruba ayrılmış,  teknik, patolojik sonuç ve erken postoperatif komplikasyonlar açısından incelenmiştir.Bulgular: Çalışmaya 11’i erkek, 7’si kadın olmak üzere 18 hasta dahil edilmiştir. Yaş ortalaması 57,4 olup, ortalama BMI 26,3 idi. 13 hastada cerrahi ilk planda tutulmuş sadece beş hastaya neoadjuvan tedavi protokolü uygulanmıştır. Total gastrektomi 14 hastada, distal gastrektomi 4 hastada tercih edilen ameliyat yöntemidir. Tüm hastalara tümör yerleşimine göre standart D2 lenf disseksiyonu uygulandı ve Total gastrektomi grubunda Ortalama 33,2 distal gastrektomi grubunda 32 lenf nodu disseke edildi. Ortalama oral başlama süresi ve Total gastrektomi grubunda 6,4 gün distal gastrektomi grubunda 2,5 gün idi. Duodenal güdük kaçağı 4 hastada, özefagojejunostomi kaçağı 2 hastada tespit edilirken 1 hastada da dren yerinde kanama görüldü.Sonuç: Laparoskopik gastrektomi ve lenfatik disseksiyonun yeterliliğini gösteren birçok çalışma bulunmaktadır. Ancak öğrenim süreci uzun, teknik zorlukları fazla olan bu ameliyatlarda deneyim ve tecrübe arttıkça ameliyat sürenin kısalacağını ve komplikasyon oranının azalacağını düşünmekteyiz.
Seasonal differences in the treatment of childhood asthma
Authors: ÖZDEMİR Ali , DOĞRUEL Dilek
Published: September 2019

Purpose: The purpose of the current study was to examine the frequency of respiratory symptoms in children with asthma who were off their medication during summer season.Materials and Methods: The records of 212 children with mild and moderate asthma were retrospectively analyzed between June and September 2017 at the pediatric pulmonary section, Mersin City Training & Research Hospital. Demographic characteristics, severity of asthma symptoms, current treatment, summer and fall season asthma attacks were compared among groups.Results: Data for a total 212 children at ages between 31/2 and 18 years were analyzed. Most patients did not report any asthma exacerbations (77.7% in preschool group and 87.0% in school-aged group) during summer. Approximately 42.6% of patients in preschool group and 32.6% of patients in school group showed variable asthma symptoms at the time of their fall clinic visit. Most patients did not report any asthma exacerbations (72.0% in preschool group and 70.9% in school-aged group) during summer. Approximately 44.0% of patients in preschool group and 56.2 % of patients in school group showed variable asthma symptoms at the time of their fall clinic visit.Conclusion: Most children with mild persistent asthma and moderate persistent asthma did not show any exacerbation in the absence of asthma controller treatment during summer. However, such a practice resulted an increase of asthma exacerbations during the subsequent fall season.
Mantar zehirlenmesine bağlı rabdomiyoliz zemininde ağır böbrek, karaciğer ve kalp hasarı
Authors: TABAN Sema , DURSUN Belda
Published: September 2019

Mantar zehirlenmelerinin mortalitesi yüksektir, sıklıkla amanita türlerine bağlı gelişir. Elli sekiz yaşında kadın hasta üç gün önce mantar yeme öyküsü ve bulantı, kusma, idrar miktarında azalma şikayetleriyle başvurdu. Değerlendirme sonucunda mantar zehirlenmesine bağlı rabdomiyoliz zemininde akut böbrek, karaciğer ve kardiak hasar olarak değerlendirildi. Hastaya medikal destek tedavi yanı sıra hemodiyaliz ve plazmaferez tedavisi uygulandı, izleminde klinik ve laboratuvar olarak tam düzelme sağlandı. Bu olgu raporunda mantar zehirlenmesinin geniş klinik spektrumu ve ölümcül potansiyeli açısından taşıdığı önemi vurgulamayı amaçladık.
Neutrophil-to-lymphocyte ratio independently predicts the epicardial fat thickness in diabetic patients
Authors: TURAN Yaşar , TURAN Elif
Published: September 2019

Purpose: The aim of this study was to investigate neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and epicardial fat thickness (EFT)  in diabetic and non-diabetic patients, and to determine the factors affecting EFT in diabetic patients.Materials and Methods: In this cross-sectional study, 92 diabetic patients and 40 healthy volunteers without diabetes, admitted to our outpatient clinic, were included. Demographic data, anthropometric measurements, biochemical and hematological results, echocardiography findings and EFT were recorded. NLR and PLR were calculated. These values were compared statistically between the two groups.Results: The two groups were similar in terms of age, gender, smoking status, diastolic blood pressure, total cholesterol, high-density lipoprotein (HDL), low-density lipoprotein and PLR. Body mass index (BMI), frequency of hypertension, systolic blood pressure, serum glucose, HbA1C, serum creatinine, triglyceride, total cholesterol/HDL, NLR and EFT were significantly higher in the diabetic group than the control group. Ejection fraction was significantly lower in diabetic group than the controls. NLR and BMI were independent predictors of EFT in diabetic patients.Conclusion: We suggest that echocardiographic EFT measurement, NLR and BMI might be useful in the evaluation of cardiovascular risk in diabetic patients.
Relationship between platelet distribution width and hospital stay in incarcerated inguinal hernia treated by open surgery
Authors: ULUTAŞ Kemal Türker , DAL Mehmet Burak
Published: September 2019

Purpose: The study aimed to investigate the value of platelet distribution width (PDW) in incarcerated inguinal hernia which was treated with graft to illuminate its inflammatory role in surgery-related disorders.Materials and Methods: We perormed a case-control study by retrospective screening data of the 88 patients with inguinal hernia and 75 healthy. Patients data included demographics, hernia location, hospital stay, and hemogram parameters. Platelet-related parameters were anayzled with automated devices from EDTA samples.Results: The mean defect size was 25.3±17 mm for inguinal hernia, which ranged 6 to 75 mm. The PDW value was higher in group A as compared with that of group B. Also, the platelets were statistically higher in group A than group B. In the Pearson correlation analysis, PDW showed a strong and positive relationship with a hospital stay. Conclusion: We suggest that a strong positive correlation of platelet distribution width with hospital stay can be useful in incarcerated inguinal hernia which we treated with grafted by open surgery.
Biyolüminesans ışıma ve biyolüminesans görüntüleme tekniklerinin moleküler biyoloji araştırmaları bakımından önemi
Authors: TUNÇ Erdal
Published: September 2019

Canlı bünyesinde meydana gelen reaksiyonlar sonucunda kimyasal enerjiden görünür ışık üretilmesine ve buna bağlı olarak meydana gelen ışımaya biyolüminesans ışıma denir. Biyolminesans gösteren organizmaların sentezledikleri lusiferaz enzimler ve kimyasal dönüşümlerini katalizledikleri ilgili substratların oluşturdukları reaksiyonlar neticesinde biyolüminesans ışıma meydana gelmektedir. Farklı canlı türlerinde çeşitli lusiferaz enzimleri bulunmaktadır. Lusiferaz enzimlerden seçilecek olan birini kodlayan reporter gen, cDNA aracılığıyla herhangi bir proteini kodlayan genle kaynaştırılmak suretiyle, ilgili proteinin lokasyonu veya etkileşimleri in vivo olarak izlenebilmektedir. İlgilenilen virüs, bakteri, parazit ve maya türlerine aktarılan lusiferaz enzim genleri sayesinde, bu türlerin oluşturdukları enfeksiyonların seyir süreçleri izlenebilmektedir. İzleme düzeneği, ilgili denek hayvana lusiferaz geninin aktarılması, hayvana substratın enjekte edilmesi ve CCD kamera (foton-elektron etkileşimli kamera) ile izlemenin yapılması basamaklarından oluşmaktadır. Özellikle protein-protein etkileşim çalışmalarında kullanılan BRET (biyolüminesans ışımaya dayalı rezonans enerji transferi) tekniği ile biyolüminesans ve floresan ışımalar bir arada izlenebilmektedir. Diğer protein saptama/izleme teknikleri ile kıyaslandığında in vivo biyolüminesans görüntüleme denek hayvana girişimde bulunmayı gerektirmeyen, basit, ucuz ve oldukça elverişli bir tekniktir. Bu çalışmada biyolüminesans ışımanın temel prensipleri, biyolüminesans ışıma üreten enzim-substrat sistemleri ve biyolüminesans ışımaya dayalı çeşitli in vivo izleme düzenekleri hakkında genel bilgiler verilmiş ve bu konularla ilgili önemli çalışmaların sonuçları derlenmiştir.
Hepatosellüler karsinomada bridging veya downstaging sonrası karaciğer transplantasyonu ile direkt transplantasyon stratejilerinin sağkalım üzerine etkilerinin karşılaştırılması
Authors: BALLI Tuğsan , ÜLKÜ Abdullah
Published: September 2019

Amaç: Bu çalışmanın amacı kadaverik karaciğer transplantasyonu yapılmış hepatosellüler karsinomalı hastalarda downstaging ve bridging tedavilerinin transplantasyon sonrası sağ kalım süreleri üzerine etkilerini araştırmaktır.Gereç ve Yöntem: Çalışmamıza hepatosellüler karsinoma tanısı almış ve kadaverik karaciğer transplantasyonu yapılmış 33 hasta dahil edilmiştir. Bu hastalar downstaging, bridging ve kontrol olmak üzere 3 gruba ayrılmıştır. Bridging ve downstaging gruplarına transplantasyon öncesi transarteriyal kemo-embolizasyon, transarteriyal radyo-embolizasyon, radyofrekans ablasyon veya mikrodalga ablasyon tedavileri uygulanırken kontrol grubuna herhangi bir tedavi uygulanmadı. Transplantasyon sonrası sağ kalım süreleri hesaplanırken  Kaplan-Meier yaşam analizi kullanıldı.Bulgular: Ortalama takip süresi 37,5±32,1 ay olarak hesaplandı. Genel sağ kalım oranı %48,5 idi. En yüksek sağ kalım oranı bridging grubunda (%54,5), daha sonra kontrol grubunda (%50,0) ve en düşük olarak (%41,7) downstaging grubunda olduğu tespit edildi. Her ne kadar gruplar arasında farklılıklar olsa da istatistiksel olarak anlamlı sonuçlar elde edilemedi.Sonuç: Bu çalışma ile bridging ve downstaging yöntemlerinin transplantasyon yapılacak hepatosellüler karsinomalı hastaları Milan Kriterleri içinde tutmaya yarayan etkili staratejiler olduğu, downstaging yöntemi uygulanan bazı hastalarda sağ kalım sürelerinin ortalamanın üstüne çıktığı sonucu elde edilmiştir.
Determination of clonal relationships and virulence genes of vancomycin-resistant enterococcus spp. isolated from colonized and infected patients
Authors: GÜVEN GÖKMEN Tülin , NAGİYEV Togrul , AKÇİMEN Beril , KAYAR Begüm , MERAL Melda , KÖKSAL Fatih
Published: September 2019

Purpose: In this study, we investigated the possible relationship between virulence factors and clonal relationship between Vancomycin-resistant colonization and infection isolates. Materials and Methods: A total of 156 Vancomycin-resistant Enterococcus spp. (VRE) were collected and grouped as infection and colonization isolates. A multiplex polymerase chain reaction analysis was performed to screen specific virulence genes (esp, hyl, asa1, cylA and gelE) and vancomycin resistance genes (vanA, vanB). The clonal relationship among isolates was investigated by the Pulsed Field Gel Electrophoresis (PFGE) method. Results: The vanA gene was determined in 86 infection and 64 colonization isolates. esp was the most common virulence gene for both groups (55.8% and 56.25%), followed by hyl (51.1% and 35.9%) that statistically differed between the two groups. The 150 E. faecium isolates carrying the vanA resistance gene were divided into 24 main clusters (A-Y) in PFGE analysis. Conclusion: When the distribution of virulence genes or genes combinations of the infection and colonization groups was examined, there was no statistical significance of cluster distribution in the two groups. However, hyl gene was found to be more common in infection isolates.
Kompulsif satın alma bozukluğu ve dikkat eksikliği hiperaktivite bozukluğu ilişkisi
Authors: ZENGİN EROĞLU Meliha , DEMİRKOL Mehmet Emin , TAMAM Lut , GELEGEN Volkan
Published: September 2019

Amaç: Bu çalışmada kompulsif satın alma bozukluğu (KSAB) tanısına sahip bireylerde dikkat eksikliği hiperaktivite bozukluğunda (DEHB) sıklığı ve KSAB ile dürtüsellik ilişkisinin araştırılması amaçlanmıştır.Gereç ve Yöntem: Çukurova Üniversitesi Tıp Fakültesi Balcalı Hastanesi Ruh Sağlığı ve Hastalıkları Anabilim Dalı’na başvuran ve KSAB tanısı konan 82 hastanın tıbbi kayıtları retrospektif olarak incelendi. Hastalara ait DSM-IV (Diagnostic and Statistical Manual of Mental Disorders IV) Eksen I Bozuklukları İçin Yapılandırılmış Klinik Görüşme Ölçeği (SCID-I), Minnesota Dürtü Kontrol Bozuklukları Görüşme Ölçeği (MIDI), Barratt Dürtüsellik Ölçeği–11 (BİS–11) ve Erişkin DEB/DEHB Tanı ve Değerlendirme Envanteri verileri değerlendirildi.Bulgular: Hastaların %50’sinde (n=41) KSAB’a komorbid en az bir başka türlü adlandırılamayan (BTA) dürtü kontrol bozukluğu (DKB) tanısı mevcuttu. Hasta grubunun %42.7’sinde (n=35) çocukluk döneminde, %30.5’inde (n=25) erişkin dönemde DEHB tanısı mevcuttu. DEHB tanısı olan hastalarla, DEHB tanısı olmayan hastaların BİS-11 ölçek puanlarının karşılaştırmasında; motor dürtüsellik alt ölçek puanı dışında DEHB tanısı olanların istatistiksel olarak daha yüksek puanlar aldıkları görüldü.Sonuç: KSAB daha çok kadınlarda görülen, DEHB ve diğer dürtü kontrol bozukluklarının sıklıkla eşlik ettiği bir ruhsal bozukluktur. KSAB ve DEHB tanıları birlikte görüldüğünde genel dürtüsellik, dikkatsizlik ve plan yapmama gibi özelliklerin daha da belirginleştiği görülmektedir.
Assessment of myocardial function by tissue Doppler imaging myocardial performance index in patients with acute ischemic stroke
Authors: ÖZTÜRK Ünal , ÖZTÜRK Önder , TAMAM Yusuf
Published: September 2019

Purpose: The aim of this study is to investigate the relationship between myocardial function assessed by tissue Doppler imaging myocardial performance index (TDI-MPI) and National Institutes of Health Stroke Scale (NIHSS) score in patients with acute ischemic stroke. Materials and Methods: The study comprised 128 patients (males, 55; females, 73; 68 ± 19 years) with acute ischemic stroke. 20 patients were excluded. Patients were divided into two groups based on the calculated NIHSS score (Group 1, NIHSS score < 16; Group 2, NIHSS score ≥ 16). Demographic, clinical, and laboratory data for all patients were collected. Cardiac function was evaluated by transthorasic echocardiography within 48 hours of admission to the neurology care unit.Results: There were no significant differences among demographic parameters of patients. Tissue Doppler myocardial performance index was significantly higher in Group 2 patients than in Group 1 patients (0.62±0.28 vs 0.46±0.16).Conclusion: Our results suggest that TDI-MPI is associated with stroke severity on admission in patients with acute ischemic stroke. TDI-MPI is an indicator of global myocardial dysfunction with a different from LVEF. TDI-MPI, which includes both systolic and diastolic time intervals to assess the global cardiac dysfunction.
Acute angle closure glaucoma induced by selective serotonin reuptake inhibitor, and reversed by agomelatine
Authors: KARAYTUĞ Mahmut Onur , DEMİRKOL Mehmet Emin , TAMAM Lut
Published: September 2019

Agomelatine, a MT1 (Melatonin) and MT2 receptor agonist and 5-HT2C (5-Hidroksitriptamin)  antagonist, is an antidepressant agent used in the treatment of major depressive disorders. Intraocular pressure lowering effect of melatonin and its analogues have been demonstrated in a few experimental studies. In the present case report, we have documented the reversal of angle closure glaucoma by oral agomelatine in a patient with major depressive disorder under selective serotonine reuptake inhibitor treatment.  The patient, who had previously been diagnosed with glaucoma, was also receiving antiglaucomatous treatment.
İntrahepatik kolanjiyosellüler karsinomlarda transarteriyel radyoembolizasyon tedavisinin sağkalım üzerine etkisi
Authors: BALLI Hüseyin Tuğsan , GÜNEY İsa Burak , PİŞKİN Ferhat Can , AİKİMBAEV Kairgeldy
Published: September 2019

Amaç: Bu çalışmanın amacı, cerrahi tedaviye uygun olmayan ve transarteriyel radyoembolizasyon yöntemi ile tedavi edilen intrahepatik kolanjiyosellüler karsinom hastalarının sağkalım sonuçlarını sunmaktır.Gereç ve Yöntem: Bu çalışmaya intrahepatik kolanjiyosellüler karsinom tanısı almış ve cerrahi tedaviye uygun olmayan 28 hasta dahil edildi. Hastaların tamamı transarteriyel radyoembolizasyon yöntemi ile tedavi edildi. Tanı konduktan sonra takipleri başlayan hastaların sağkalım süreleri kayıt altına alındı. Sağkalım süreleri hesaplanırken Kaplan-Meier yaşam analizi kullanıldı.Bulgular: Çalışmada toplamda 28 hasta değerlendirilmiştir. Ortalama yaş 60,46 yıl olup minimum yaş 36 yıl, maksimum yaş ise 84 yıldır. Hastaların medyan takip süresi 14 ay olarak hesaplandı (min:3– maks:33). Hastaların medyan sağkalım süresi 22 (min:3 ay, max:33 ay) aydır. Ayrıca kemoterapi almış hastalar ile almamış hastalar, soliter tümörü olan hastalar ile multifokal tümörü olan hastalar, tümörü unilobar olan hastalar ile bilobar olan hastaların sağkalım süreleri hesaplandı ve gruplar arasında anlamlı bir farklılık bulunmadı.Sonuç: Modern kemoterapi uygulamaları bu sağkalım oranında artış sağlamış olsa da medyan sağkalımı 12 ayın üzerine çıkaramamıştır. Bu veriler dikkate alındığında transarteriyel radyoembolizasyon tedavisinin sağkalım süresini uzattığı görülmektedir.
Üniversite yaşamının cinsel mit ve tutumlara etkisi
Authors: ERİŞ Özge , ERTEKİN YAZICI Aylin
Published: September 2019

Amaç: Çalışmamızın amacı kişisel gelişimin ve örgün eğitimin en üst basamağı olan üniversite eğitiminin genç yetişkinlerin kendileri ile ilgili cinsellik konularına, başkalarının seçimlerine, toplumsal bir konu olan imam nikâhına bakış açılarını, cinselliğe dair tutumları ve cinsellikle ilgili mitler üzerine etkilerini değerlendirmektir. Gereç ve Yöntem: BU çalışma için hazırlanmış olan anketin yanısıra standardize bir ölçek olan Cinsel Mitler Ölçeği, Mersin Üniversitesi 1. ve 4. sınıf öğrencilerine uygulanmış, sonuçları karşılaştırılmıştır. Bulgular: Çalışmamıza 337 1. Sınıf ve 329 4. Sınıf öğrencisi toplam 666 öğrenci katılmıştır. Katılımcıların %54.1’i kadın, %45.6’sı erkektir. Üniversite eğitiminde geçen sürecin cinsel mit ve tutumlara pozitif yönde bir etkisi olduğu belirlenmiştir. İlerleyen yaş, olgunlaşan ilişkiler, bireysel gelişim, araştırma, bilgiye daha kolay erişme gibi faktörler de etkili olmuştur.Sonuç: Üniversite yaşamının cinsel tutumları değiştirici ve cinsel mitleri azaltıcı etkisi olduğu sonucuna varılmıştır. Sonuçların toplumsal önlemler almak, yeni politikalar üretilirken yol gösterici olmak açısından fayda sağlayacağı düşünülmektedir.
Targeted neonatal echocardiography in neonatal intensive care unit
Authors: MERT Mustafa Kurthan
Published: September 2019

Purpose: The aim of the study is determining the frequency of use, and the patient characteristics and indications.Materials and Methods: This retrospective cohort study included all neonates who underwent targeted neonatal echocardiography in the neonatal unit of Adana Şehir Training and Research Hospital between September 2016 and September 2018. All newborns who underwent echocardiography according to clinical findings within 24 months were included in the study. Data including gestational age, birth weight, respiratory support, timing and diagnosis of echocardiography were obtained from the review of clinical notes.Results: A total of 355 echocardiographic evaluations were performed in 186 newborns. The most common indications for targeted echocardiography were patent ductus arteriosus (n = 148, 41.7%) followed by evaluation of myocardial performance and systemic blood flow (n = 99, 27.9%) and pulmonary hypertension (n= 72, 20.3%). The median time of echocardiographic evaluation was postnatal 22 (1-178) hours. More than half (59.7%) of the newborns received respiratory support (continuous positive pressure ventilation (21%), conventional mechanical ventilation (27.4%), and high frequency oscillation ventilation (11.3%).Conclusion: Targeted echocardiography is often used and it can be a useful tool in guiding treatment. Assessment of patent ductus arteriosus, myocardial performance and systemic blood flow are the most common indications for use. Large, well-coordinated prospective studies are needed to confirm its usefulness.
Pentoxyfilline treatment in nosocomial sepsis of preterm infants
Authors: MERT Mustafa Kurthan , ÖZLÜ Ferda , YAPICIOĞLU YILDIZDAŞ Hacer , SATAR Mehmet
Published: September 2019

Purpose: Nosocomial sepsis is the most common acquired infection. Despite appropriate antibiotic treatment, mortality and morbidity of sepsis are still high. We aimed to evaluate the effect of pentoxifylline on prognosis of neonatal nosocomial sepsis in premature infants hospitalized in the neonatal intensive care unit.Materials and Methods: Eighty newborns diagnosed as nosocomial sepsis were included in this study. Forty of them received pentoxifylline treatment in addition to antibiotics, while the other 40 did not receive additional treatment and formed the control group. The sex, mode of delivery, gestational age, birth weight, Apgar scores at the 1st and 5th minutes, surfactant therapy, ventilator therapy and presence of early onset sepsis were compared between the case group and the control.Results: There was no statistical difference between groups according to gestational week, gender, birth weight, mortality, neutrophil count or procalcitonin level at the time of diagnosis. Also, there was not any statistical difference according to duration of hospitalization between the bronchopulmonary dysplasia or necrotizing enterocolitis groups.Conclusion: Pentoxifylline has no significant impact on mortality and morbidity of preterm nosocomial sepsis.
Uso de residuos agroindustriales para fabricar proteínas a partir de la microalga Chlorella vulgaris
Authors: Parra María Alejandra , Murcia Leidy Johanna , Rubio Fernández Diego , Sandoval Herrera Juan
Published: September 2019

Nitrogen, a limiting factor of microalgal growth, is used for synthesis of proteins. Finding low-cost and unconventional sources of nitrogen for the crops, can enhance the yield and viability of the process. In this project, first at all, a theoretical selection of the potential wastes to be evaluated was carried out; then, the growth of the crop, productivity of the biomass and yield of the protein in the cultures of Chlorella vulgaris enriched with sources of organic and inorganic nitrogen, milk serum and NaNO3, with photoperiods of 12h light:12h darkness at 20±1 ºC, for 7 days, were evaluated. The highest growth rates of the crop were obtained with 0,041 gL-1 of nitrogen enriched with organic source, with a productivity of 0,07828 gL-1d-1. The most of the protein was obtained for the culture with whey: 55,63% in dry biomass, concluding that the enrichment with this source allowed a cellular and protein increase.
Surgical Treatment of Ischemic Cardiomyopathy: Current State of the Problem
Authors: Shipulin V. M. , Pryakhin A. S. , Andreev S. L. , Shipulin V. V. , Kozlov B. N.
Published: September 2019

In this article we present discussion of the current state of the problem of surgical treatment of ischemic cardiomyopathy (ICM). The pathophysiological aspects of left ventricular remodeling in patients with ICM are also covered. A detailed characterization of methods for assessing the myocardial viability is given and their role in patients with ICM is shown. The problem of right ventricular dysfunction in ICM is discussed. Main attention is focused on the methods of surgical treatment of ICM. Limitations of the Surgical Treatment for Ischemic Heart Failure (STICH) study are analyzed. The article is intended for cardiologists, general practitioners and cardiac surgeons.
Spontaneous Coronary Artery Dissection
Authors: Zhukova N. S. , Shakhnovich R. M. , Merkulova I. N. , Sukhinina T. S. , Pevzner D. V. , Staroverov I. I.
Published: September 2019

During several recent decades spontaneous coronary artery dissection (SCAD) has been known as one of causes of development of acute coronary syndrome (ACS). It has been assumed that this condition is extremely rarely met and is associated with pregnancy and postpartum period. The use in clinical practice of high sensitivity troponin, coronary angiography (CAG) in early period of ACS, in conjunction with the growing awareness of doctors about this pathology led to a revision of the viewse on prevalence of the disease. At present SCAD is considered as one of the causes of ACS in young and middle-aged women. In this review we present results of studies of pathogenesis, diagnostics, and treatment of SCAD, describe various angiographic types of this disease, and discuss problems of choice of optimal strategy of management of patients with SCAD.
Features of Cardiovascular Risk Factors, Target Organ Damage in Patients with Diabetes Mellitus Type 2 and Arterial Hypertension
Authors: Mehdiyev S. Kh. , Mustafaev I. I. , Mamedov M. N.
Published: September 2019

Aim: to investigate relationship between arterial hypertension (AH) and risk factors / subclinical damage of target organs in patients with type 2 diabetes mellitus (DM2). Methods. We included into this clinical epidemiological study 528 patients with DM2 (30.5 % men, 69.5 % women; mean age 54.1±0.3 years; 80.3 % with AH, 19.7 % without AH), who answered questions of the ARIC study questionnaire related to risk factors. Also, we studied features of target organ damage and laboratory indicators. Results. In comparison with normotensives patients with AH more frequently had ischemic heart disease (12.7±1.6 % vs. 5.8±2.3 %, p<0.05), chronic heart failure (CHF) (30.9±2.2 % vs. 9.6±2.9 %, p<0.001), atherosclerosis of vessels of lower extremities (69.8±2.2 % vs. 53.8±4.9 %, p<0.01) and cerebral vessels (50.9±2.4 % vs. 28.8±4.4 %, p<0.001), history of stroke (5.0±1.1 % vs. 0 %, p<0.05), hypertonic angiopathy (14.5±1.8 % vs. 6.5±2.5 %, p<0.05), low level of high density lipoprotein (87.3±2.2 % vs. 74.5±6.4 %, p<0.05), electro- and echocardiographic signs of left ventricular hypertrophy (75.6±2.1 % vs. 45.4±5.1 %, p<0.001; 61.1±2.6 % vs. 24.4±4.7 %, p<0.001, respectively), lowering of left ventricular ejection fraction (12.5±1.7 % vs. 7.8±2.8 %, p<0.001), diastolic disfunction of the left ventricle (52.6±2.7 % vs. 23.2±4.7 %, p<0.001), atherosclerosis of the aorta (38.0±2.6 % vs. 20.7±4.5 %, p<0.01), lowering of the ankle-brachial index (left – 29.8±2.3 % vs. 14.9±3.5 %, p<0.01; right – 31.5±2.3 % vs. 9.9±3.0 %, p<0.001, respectively), increased intima-media thickness of the right carotid artery (84.6±5.0 % vs. 60.0±11.0 %, p<0.05). Conclusion. In patients with type 2 diabetes and AH, in order to develop strategy of macro- and microvascular complications prevention, it is necessary to conduct early screening of risk factors and subclinical damage of target organs.
Long-Term Survival of Patients with Ischemic Heart Disease After Surgical Correction of Moderate Ischemic Mitral Regurgitation
Authors: Karevа Yu. E. , Efendiev V. U. , Rakhmonov S. S. , Chernyavsky A. M. , Lukinov V. L.
Published: September 2019

Aim: to assess effect of correction of moderate ischemic mitral regurgitation (IMR) in patients with ischemic cardiomyopathy (IMC) in immediate and remote period. Materials and methods. We included in a single center prospective study 76 patients with IMC, left ventricular ejection fraction ≤35 %, and moderate IMR. Patients with indications to postinfarction aneurism repair were not included. For randomization we used the method of envelopes. Thirty-eight patients were randomized in the group where coronary artery bypass grafting (CABG) was combined with of mitral valve repair (MVR), and 38 patients in the control group of isolated CABG. Mean age of patients was 57±8 (from 30 to 75 лет) years. For IMR correction we used rigid MEDENG ring. Results. Inhospital mortality was 5.4 % (n=2) after isolated CABG and 10.81 % (n=4) after CABG + MVR. Main cause of death was acute heart failure. One- and 2‑year survival was 84 and 78 %, respectively, after CABG+MVR, and 84 and 71 % after isolated CABG. There was significant difference in three-year survival between groups (hazard ratio [HR] of death 0.457, p=0.04). Five-year survival was 45 and 74 % after isolated CABG and CABG+MVR, respectively (р=0.037). Factors associated with inhospital mortality were pulmonary hypertension (HR 2.177, 95 % confidence interval [CI] 2.299 to 9.831; p=0.043), NYHA class IV chronic heart failure (HR 3.027, 95 % CI 1.605 to 5.707; р=0.001), negative result of stress test echocardiography (HR 0.087, 95 %CI 0.041 to 0.186; р<0.001), atrial fibrillation (HR 4.754, 95 %CI 2.299 to 9.831; р<0.001). Conclusion. Correction of moderate IMR in patients with IMC leads to improvement of parameters of survival in remote period. Five-year survival after isolated CABG was 45 %, while after CABG+MVR – 74 % (р=0.037).
The Strategy of Management Patients with non-ST Elevation Acute Coronary Syndrome
Authors: Prilutskaya Yu. A. , Dvoretski L. I.
Published: September 2019

The review covers issues of epidemiology, diagnostics, management strategy, and treatment outcomes in patients with non-ST elevation acute coronary syndrome. Numerous factors affecting the choice of an invasive strategy are analyzed as well as its correspondence to existing recommendations of patient’s management. The stratification of risk of development of adverse coronary events, which is a part of the formation of a treatment strategy, is discussed.
The Case of Fulminant Myocarditis
Authors: Titov V. A. , Shishkova A. A. , Mitrofanova L. B. , Ivanova S. V. , Zverev D. A. , Marichev A. O. , Moiseeva O. M.
Published: September 2019

Fulminant myocarditis (FM) is a severe form of inflammatory myocardial injury rapidly developing as acute heart failure, cardiogenic shock, or life-threatening disturbances of cardiac rhythm. FM requires intensive treatment including drug therapy, mechanical circulatory support, and in some cases – heart transplantation. Echocardiography can be used as a screening method of diagnostics. Magnetic resonance imaging of the heart often cannot be performed because of hemodynamic instability of a patient, therefore endomyocardial biopsy with histological and immunohistochemical studies as well as molecular-genetic analysis of obtained samples is required for final diagnosis. Prognosis of the disease is determined by histological picture. In most cases, after cessation of acute stage of the inflammatory process, FM has a favorable long-term prognosis. In this article we present a clinical case of FM and review of current literature on diagnosis and treatment of this disease.
The Possibility of Correcting Anxiety Symptoms in Cardiac Patients in Primary Care Settings: Results of the Therapeutic Part of a Russian Multicenter Study COMETA
Authors: Pogosova N. V. , Yufereva Y. M. , Ausheva A. K. , Kursakov A. A. , Arutyunov A. A. , Boytsov S. A.
Published: September 2019

Purpose: to assess efficacy of correction of anxiety states by anxiolytic drug fabomotizole in ambulatory patients with arterial hypertension (AH) and / or ischemic heart disease (IHD).

Materials and methods. In the framework of multicenter cross-sectional study with participation of patients aged ≥55 years with verified AH / IHD we conducted the therapeutic part of the COMETA program in which we included patients with comorbid anxiety state (≥11 points on the Hospital Anxiety and Depression Scale Anxiety [HADS-A] and clinically expressed anxiety state) without clinically expressed depressive symptoms (<11 points on the HADS-Depression). Participants were randomized into main and control groups. Patients in the main group in addition to therapy prescribed because of AH / IHD were given a recommendation to take fabomotizole (10 mg thrice a day), patients of control group received standard therapy. Efficacy of therapy was evaluated by HADS and visual analog scale after 6 and 12 weeks of observation.

Results. We included 182 and 104 in the main and control groups, respectively. Most patients in main and control groups had AH (97.3 and 95.2 %, respectively, about one third had IHD (36.8 and 30.8 %, respectively). Social-demographic, clinical characteristics, and recommended for AH / IHD treatment of participants of both groups were similar. Portion of patients with complete reduction of anxiety symptoms (<8 points on HADS-A) was significantly higher already after 6 weeks of fabomotizole therapy (37.9 and 19.2 %, respectively, p<0.001). Analogous picture was noted by the end of observation (66.9 and 32 %, respectively; p<0.001). Mean estimate of chronic psychoemotional stress in the main group decreased by 25 % after 6 weeks (from 6.45±2.20 to 5.05±1.96 points; р<0.001) and by 40 % after 12 weeks (from 6.45±2.20 to 3.98±1.99 points; р<0.001). In the control group it also decreased but degree of lowering was 2 times less than in the main group (11.1 % vs. 25 % after 6 weeks, р=0.016; and 20 % vs. 40 % after 12 weeks, р<0.001, respectively).

Conclusion. The use of fabomotizole by patients with AH / IHD provided improvement of psychological status (reduction of anxiety symptoms and lowering of the level of chronic psychoemotional stress).