Amaç: Kýkýrdak yapýsýndaki mezenkimal kök hücre (MKH) benzeri progenitör hücrelerin rejeneratif özelliði kýkýrdaðýn sinirsiz ve damarsýz yapýsý nedeniyle oldukça düþüktür. Kýkýrdak hasarýndaki pro-enflamatuvar sitokinlerin artýþýnýn, nükleer faktör-κB (NF-κB) aracýlýðýyla apoptotik ve pro-enflamatuvar genlerin ve matriks degradasyonunda rol alan enzimlerin ifadelerini artýrdýðý bilinmektedir. Timokinonun farklý kanser hücre hatlarýnda TNF-α aracýlý NF-κB aktivasyonunu baskýladýðý daha önceki yayýnlarda gösterilmiþtir. Baskýlanan NF-κB’nin MKH’lerde osteojenik farklýlaþmayý baskýlayarak kondrojenik farklýlaþmayý artýrdýðý da bilinmektedir. Bu nedenle bu tanýmlayýcý çalýþmada timokinon gibi anti-enflamatuvar özelliði bilinen ajanlarýn insan mezenkimal kök hücrelerinin (iMHK) kondrojenik farklýlaþmasý üzerindeki potansiyel etkisi öngörülmektedir ve timokinonun iMKH’larýnýn farklýlaþmasý üzerindeki etkilerinin gösterilmesi amaçlanmaktadýr.
Yöntemler: Bu çalýþmada NF-κB sinyal yolaðý üzerindeki etkileri iyi bilinen etken madde timokinon iMHK farklýlaþtýrma deneylerinde kullanýlmýþtýr. Timokinonun iMKH farklýlaþmasý ve ilgili sinyal yolaklarý üzerindeki etkileri ilk kez bu çalýþma ile, immünositokimya ve Western blotlama yöntemleriyle belirlenmiþtir. Yine NF-κB ve mTOR yolaklarýndaki sinyal moleküllerinin fosforilasyon düzeyleri Western blotlama ile gösterilmiþtir.
Bulgular: Timokinon ile muamele edilmiþ iMKH’lerde kondrojenik farklýlaþma etkinliðinin düþtüðü ve bu farklýlaþma sýrasýnda NF-κB sinyal yolaðý bileþenlerinin aktivitelerinin azaldýðý belirlenmiþtir. Timokinonun NF-κB sinyal yolaðýnýn baskýlamasý sonucunda, literatürdeki bazý yayýnlardaki bulgularýn aksine, iMKH’lerin kondrojenik farklýlaþma potansiyellerinin azaldýðý belirlenmiþtir.
Sonuçlar: Bu çalýþmanýn sonuçlarý iMKH’lerin yönlendirilmiþ farklýlaþtýrmasýnýn saðlanmasý ve iMKH aracýlý tedaviler için büyük önem taþýmaktadýr.

Objective: The regenerative potential of mesenchymal stem cell (MSC)-like cells in the cartilage is relatively low because of the lack of innervation and vascularization. The increase in proinflammatory cytokines in cartilage damage can increase the expression of apoptotic and proinflammatory genes and the matrix degradation enzymes via nuclear factor-κB (NF-κB). Previous evidence suggested that thymoquinone (TQ) suppresses tumor necrosis factor-α-mediated NF-κB activation in different cancer cell lines. The suppression of the NF-κB pathway increases chondrogenic differentiation by inhibiting osteogenic differentiation in MSCs. Therefore, the current descriptive study aimed at highlighting the role of thymoquinone on the differentiation of human MSCs (hMSCs) since it is predicted that agents with known anti-inflammatory properties such as TQ have the potential to alter the chondrogenic differentiation of MSCs.
Methods: In this study, the bioactive component thymoquinone, with its well-documented effects on the NF-κB signaling pathway, was used in hMSC differentiation assays. The effects of thymoquinone on hMSC differentiation and the relevant intracellular signaling pathways were determined using immunocytochemistry and western blotting for the first time. Changes in the phosphorylation status of some signaling components involved in NF-κB and mTOR signaling were also evaluated.
Results: The chondrogenic differentiation potential of hMSCs treated with TQ decreased, concomitant with the decrease in the activity of NF-κB signaling pathway components. Thymoquinone triggered the suppression of NF-κB signaling, which interfered with the chondrogenic potential of hMSC, as opposed to some previous findings in the literature.
Conclusions: The results of this study are of great importance for the optimization of directed differentiation of hMSCs and hMSC-mediated cellular therapies.

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Amaç: Kolesteatom lokalizasyonunda bilgisayarlý tomografi (BT) ile difüzyon aðýrlýklý non-eko-planar manyetik rezonans görüntüleme (nEDAG) füzyonu son yýllarda tercih edilmektedir. Bu çalýþma, kolesteatom lokalizasyonunda BT ve nEDAG ile füzyon görüntülemenin rolünü araþtýrmayý amaçlamaktadýr.
Yöntemler: Bu retrospektif çalýþmaya, ameliyat öncesi yüksek çözünürlüklü temporal kemik BT ve nEDAG tetkikleri olan 39 kronik otitis media hastasý [ortalama yaþ 35,10±15,33 yýl (18-67 yýl), %64,1 kadýn, %35,9 erkek] dahil edildi. Görüntüler, füzyon için Advantage Workstation VolumeShare 7’ye gönderildi. Seçilen bu görüntüler iþ istasyonunda ayný düzlemlerde birleþtirildi ve radyolog tarafýndan manuel olarak düzeltildi. BT ve nEDAG birleþtirilmiþ görüntülerle kolesteatom varlýðý ve anatomik lokalizasyonlarýnýn duyarlýlýk, özgüllük, pozitif ve negatif prediktif deðerleri ve tanýsal doðruluklarý, cerrahi verilere dayalý olarak deðerlendirildi.
Bulgular: Kolesteatomlarý saptamada nEDAG’nin duyarlýlýðý, özgüllüðü, pozitif ve negatif prediktif deðerleri ve tanýsal doðruluklarý sýrasýyla %97,14, %75,00, %97,14, %75,00 ve %94,87 idi. nEDAG ile kolesteatom varlýðýnýn saptanmasýnda cerrahi sonuçlara göre üç gerçek negatif, bir yanlýþ pozitif ve bir yanlýþ negatif olgu gözlendi. Kolesteatom varlýðýnýn saptanmasýnda cerrahi ve radyolojik sonuçlar arasýnda önemli bir uyum vardý (k=0,721). Birleþtirilmiþ görüntülerde, lezyonlarýn lokalizasyonu cerrahi sonuçlarla karþýlaþtýrýldýðýnda, mastoid antrumda mükemmel (k=0,948), mastoid hücrelerde ve hipotimpanumda güçlü (k=0,894), epitimpanumda orta (k=0,653) düzeyde bir uyum varken, mezotimpanumdakilerde zayýf düzeyde uyum vardý (k=0,540).
Sonuçlar: Cerrahlarýn saptamalarý, temporal BT ve nEDAG’nin birleþtirilmiþ görüntülerinin rehberliðinde desteklenmektedir. Bu nedenle füzyon görüntüleme tekniðinin tercih edilmesi, gereksiz operasyonlarý azaltarak yaþam kalitesini artýrabilir.

Objective: In recent years, the fusion of computed tomography (CT) and non-echo-planar diffusion-weighted magnetic resonance imaging (non-EPI DWI) has been preferred in cholesteatoma localizations. This study aimed to investigate the role of CT and non-EPI DWI fusion imaging in cholesteatoma localizations.
Methods: This retrospective study included 39 patients who underwent chronic otitis media operation [mean age of 35.10±15.33 years (18-67 years), 64.1% female, and 35.9% male] and had preoperative high-resolution temporal bone CT and non-EPI DWI examinations. Images were sent to the Advantage Workstation VolumeShare 7 for fusion. These selected images were fused on the workstation and were manually corrected by the radiologist. The sensitivity, specificity, positive and negative predictive values, and diagnostic accuracies of fused images of CT and non-EPI DWI were evaluated according to anatomic cholesteatoma localizations based on surgical data.
Results: The sensitivity, specificity, positive and negative predictive values, and diagnostic accuracies of non-EPI DWI for detecting cholesteatomas were 97.14%, 75.00%, 97.14%, 75.00%, and 94.87%, respectively. Three true-negative, one false-positive, and one false-negative case were observed according to surgical results in detecting the presence of a cholesteatoma with non-EPI DWI. Moderate agreement was determined between the surgical and radiological results in detecting the presence of a cholesteatoma (k=0.721). Detecting the lesion of localization on the fused images compared to surgical found an almost perfect agreement in the mastoid antrum (k=0.948), strong agreement in the hypotympanum and mastoid cells (k=0.894), moderate agreement in the epitympanum (k=0.653), and weak agreement in those in the mesotympanum (k=0.540).
Conclusions: The surgeons’ determinations are supported by the guidance of temporal CT and non-EPI DWI fused images. Therefore, preferring the fusion imaging technique could increase the quality of life by reducing unnecessary operations.

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Amaç: Biyokütle yakýtý (BY), dünya genelinde kýrsal kesimlerde yemek piþirmek ve ýsýnmak için halen yaygýn olarak kullanýlmaktadýr. BY dumanýnýn solunmasý, solunum ve kardiyovasküler hastalýklarýn önemli bir nedenidir. Koroner yavaþ akým (KYA) fenomeni, koroner anjiyogramda uç koroner arterlerin gecikmiþ opaklaþmasý olarak bilinmektedir. KYA'nýn, kardiyovasküler morbidite ve mortalite ile iliþkili olduðu bilinmektedir. Bu nedenle, biz bu çalýþmada kadýnlarda BY'ye maruz kalma ile KYA arasýndaki iliþkiyi araþtýrmayý amaçladýk.
Yöntemler: Bu çalýþmaya koroner anjiyografi yapýlmýþ olan toplam 457 ardýþýk kadýn retrospektif olarak alýndý. Hastalar, doðumdan ileri yaþlarýna kadar yaþamlarý boyunca BY kullanýmlarýna göre hayvansal maruziyet grubu (HMG) ve maruz kalmayan grup olmak üzere iki gruba ayrýldý. KYA varlýðý, miyokard enfarktüsünde trombolizis kare sayýsýna göre hesaplandý.
Bulgular: HMG'de 259 hasta varken, maruz kalmayan grupta 198 hasta vardý. KYA prevalansý HMG'de maruz kalmayan gruba kýyasla daha yüksekti (sýrasýyla %47,9'a karþý %13,1, p<0,001). HY'ye maruz kalma varlýðý, vücut kitle indeksi, beyaz kan hücre sayýsý, düþük yoðunluklu lipoprotein kolesterol, C-reaktif protein, serum kreatinin ve hipertansiyon, KYA'nýn baðýmsýz öngörücüleriydi. KYA varlýðýný saptamak için yýl cinsinden biyokütle maruziyet süresinin optimal kesme noktasý 30 yýl idi (Eðrinin altýndaki alan: 0,71, duyarlýlýk: 0,65, özgüllük: 0,71).
Sonuçlar: Ev içi BY'ye maruz kalma, kadýnlarda KYA fenomeni ile iliþkiliydi.

Objective: Biomass fuel (BMF) is still widely used in rural areas for cooking and heating worldwide. BMF smoke inhalation is a prominent cause of respiratory and cardiovascular disease. The slow coronary flow (SCF) phenomenon is known as the delayed opacification of distal coronary arteries on a coronary angiogram. SCF is known to be related to cardiovascular morbidity and mortality. Thus, we aimed to investigate the relationship between exposure to BMF and SCF in women in this study.
Methods: A total of 457 consecutive women who underwent coronary angiography were retrospectively enrolled in this study. Patients were divided into two groups according to the use of BMF during their lives, from birth to older ages, as biomass exposure group (BEG) and non-exposure group. The presence of SCF was calculated based on thrombolysis in myocardial infarction frame count.
Results: Two hundred fifty nine patients were in the BEG, whereas 198 patients were in the non-exposure group. The prevalence of SCF was higher in the BEG compared to the non-exposure group (47.9% vs. 13.1%, respectively, p<0.001). The presence of biomass exposure, body mass index, white blood cell count, low-density lipoprotein cholesterol, C-reactive protein, serum creatinine, and hypertension were independent predictors of SCF. The optimal cutoff point of biomass exposure time in years to detect the presence of SCF was 30 years (Area under the curve: 0.71, sensitivity: 0.65, specifity: 0.71).
Conclusions: Exposure to indoor BMF was associated with a SCF phenomenon in women.

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Amaç: Pilonidal sinüs aðrýya neden olan, hayat kalitesini bozan kronik akýntýlý bir yaradýr. Fenol uygulanmasý düþük komplikasyon oraný, düþük tekrarlama oraný ile poliklinik þartlarýnda yapýlabilen bir uygulamadýr. Bu çalýþmada fenol uygulamanýn radyolojik, histopatolojik ve klinik sonuçlarý verilmiþtir.
Yöntemler: Kocaeli Üniversitesi Týp Fakültesi, Genel Cerrahi Kliniði’nde Aralýk 2015 ve Mart 2017 tarihleri arasýnda sakrokoksigial pilonidal sinüs nedeniyle fenol uygulanan 44 hasta çalýþmaya alýndý. Hastalarýn demografik bilgileri, þikayetleri, semptom süreleri, sinüs aðýz sayýlarý not edildi. Hastalar iþlem öncesi ve iþlemden 2 ay sonra ultrasonografi (USG) ile deðerlendirildi. Fenol uygulmasý yapýlan 4 hasta rhomboid eksizyon ve Limberg flap iþlemi istediði için çalýþma dýþý býrakýldý. Çýkarýlan dokular histolojik incelemeye alýndý.
Bulgular: Akýntý en sýk semptomdu. Tüm hastalarýn fenol iþlem öncesinde yapýlan USG incelemesinde sinüs içinde kýl görüldü. Ýþlem sonrasý incelemede sinüs içinde 5 hastada hala kýl izlendi. Bu hastalardan 4’ü iþlem sonrasý 2. ayda nüks ile baþvurdu. USG incelemede sinüs kavitesi ortalama %10 azalmýþtý. Histolojik incelemede sinüs dokusunda skleroz ve fibroz izlendi.
Sonuçlar: Bu çalýþmada tek doz fenol uygulamasý %90 baþarý elde etmiþtir. Fenol uygulamasý ile sinüs hacminde belirgin deðiþiklik olmamýþtýr.

Objective: Sacrococcygeal pilonidal disease is a chronic discharging wound that causes pain and loss of quality of life. Phenol application is an outpatient procedure with low complications and low recurrence rates. We evaluated the radiological, histological, and clinical results of phenol application.
Methods: A total of 44 consecutive patients with sacrococcygeal pilonidal disease underwent phenol application in Kocaeli University Faculty of Medicine, General Surgery Clinic between December 2015 and March 2017. Demographics, complaints, symptom duration, and the number of sinuses were recorded. Patients were examined using ultrasonography (USG) before surgery and two months after surgery. Four patients who wanted rhomboid excision and Limberg flap procedure underwent preoperative local phenol application and were excluded from the study. The excised tissues were used for pathological evaluation.
Results: Purulent discharge was the leading symptom. All of the patients had hair in the preoperative USG evaluation, whereas five patients had still hairs in the sinuses in the postoperative USG examination. Four of these cases had recurrences on a 2-month follow-up. After phenol application, a 10% volume decrease was observed. Pathological examination was performed in four cases with phenol application, and in pathological material, the sinuses looked sclerotic and fibrotic.
Conclusions: Our study revealed that a single phenol application achieved 90% success. However, no significant difference was observed in the cavity volume after phenol injection.

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Amaç: Bu çalýþma, T2 aðýrlýklý manyetik rezonans görüntüleme (MRG) radyomikslerine dayalý olarak hipofiz adenomlarýnda hormon salgýlama profillerini tespit etmek için sinir aðlarý geliþtirmeyi amaçlamaktadýr.
Yöntemler: Bu retrospektif model geliþtirme çalýþmasý, üçüncü basamak bir merkezde Ocak 2015 ile Ocak 2020 arasýnda hipofiz adenomu olan hastalardan oluþan bir kohortu içermektedir (n=130). Ortalama hasta yaþý 46,49±13,69 yýldýr ve 76/130’u (%58,46) kadýndýr. Üç gözlemci, koronal T2 aðýrlýklý MRG’de lezyonlarý segmente etti ve Dice katsayýsý kullanýlarak gözlemciler arasý uyum deðerlendirildi. Prediktörler radyomiks parametreleri olarak belirlendi (n=851). Parametre seçimi, sýnýf içi korelasyon katsayýsýna, katsayý varyansýna, varyans inflasyon faktörüne ve LASSO regresyon analizine dayanmaktadýr. Sonuçlar yedi farklý hormon salgýlama profili olarak tanýmlandý [non-fonksiyone hipofiz adenomu, büyüme hormonu salgýlayan adenomlar, prolaktinomalar, adrenokortikotropik hormon salgýlayan adenomlar, pluri-hormonal adenomlar (PLSA), folikül uyarýcý hormon ve luteinize edici hormon salgýlayan adenomlar ile tiroid uyarýcý hormon salgýlayan adenomlar]. Yedi hormon için yapay sinir aðlarý (YSA) ile çok deðiþkenli bir tanýsal tahmin modeli geliþtirildi. YSA performansý, alýcý iþletim karakteristik eðrisinin altýndaki alan (AUC) olarak sunuldu ve AUC >0,85 ve p deðeri <0,01 baþarýlý kabul edildi.
Bulgular: YSA, AUC=0,95, p<0,001, duyarlýlýk: %91, özgüllük: %98 deðerleri ile prolaktinomalarý diðer adenomlardan ayýrabildi. PLSA için AUC=0,74 ve p<0,001’di. Diðer beþ YSA için ise AUC deðerleri >0,85 ve p<0,001 idi.
Sonuçlar: Bu çalýþma, hipofiz adenomlarýnýn hormon salgýlama profilini ayýrt edebilen sinir aðlarýnýn eðitiminde baþarýlý olmuþtur.

Objective: This study aims to develop neural networks to detect hormone secretion profiles in the pituitary adenomas based on T2 weighted magnetic resonance imaging (MRI) radiomics.
Methods: This retrospective model-development study included a cohort of patients with pituitary adenomas (n=130) from January 2015 to January 2020 in one tertiary center. The mean age was 46.49±13.69 years, and 76/130 (58.46%) were women. Three observers segmented lesions on coronal T2 weighted MRI, and an interrater agreement was evaluated using the Dice coefficient. Predictors were determined as radiomics features (n=851). Feature selection was based on intraclass correlation coefficient, coefficient variance, variance inflation factor, and LASSO regression analysis. Outcomes were identified as 7 hormone secretion profiles [non-functioning pituitary adenoma, growth hormone-secreting adenomas, prolactinomas, adrenocorticotropic hormone-secreting adenomas, pluri-hormonal secreting adenomas (PHA), follicle-stimulating hormone and luteinizing hormone-secreting adenomas, and thyroid-stimulating hormone adenomas]. A multivariable diagnostic prediction model was developed with artificial neural networks (ANN) for 7 outcomes. ANN performance was presented as an area under the receiver operating characteristic curve (AUC) and accepted as successful if the AUC was >0.85 and p-value was <0.01.
Results: The performance of the ANN distinguishing prolactinomas from other adenomas was validated (AUC=0.95, p<0.001, sensitivity: 91%, and specificity: 98%). The model distinguishing PHA had the lowest AUC (AUC=0.74 and p<0.001). The AUC values for the other five ANN were >0.85 and p values were <0.001.
Conclusions: This study was successful in training neural networks that could differentiate the hormone secretion profile of pituitary adenomas.

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Amaç: Bu çalýþmada, koronavirüs hastalýðý-2019 (COVID-19) ile enfekte asemptomatik ve semptomatik gebelerin maternal, perinatal ve neonatal sonuçlarýnýn karþýlaþtýrýlmasý amaçlanmýþtýr.
Yöntemler: Çalýþmamýz COVID-19 ile enfekte gebelerin deðerlendirildiði retrospektif kohort çalýþmasýdýr. Gebeler hastaneye baþvurularýnda asemptomatik ve semptomatik olarak iki gruba kategorize edildi. COVID-19 tanýsý, orofaringeal ve nazofaringeal sürüntülerde gerçek zamanlý revers transkriptaz polimeraz zincir reaksiyonu ile konuldu. Asemptomatik ve semptomatik hastalar maternal ve perinatal sonuçlar açýsýndan karþýlaþtýrýldý.
Bulgular: Toplamda, laboratuvar tarafýndan tanýsý doðrulanmýþ 20 asemptomatik ve 41 semptomatik gebe vardý. Primer sezaryen oraný semptomatik grupta (%51,2) asemptomatik grubun (%20) iki katýndan fazlaydý (p=0,019). Her iki grup maternal [solunum desteði, COVID-19 ile ilgili tedavi, yoðun bakým ünitesine (YBÜ) yatýþ], perinatal (preterm doðum, preterm prematür erken membran rüptürü, preeklampsi, doðum þekli) ve yenidoðan sonuçlarý [doðum aðýrlýðý, Apgar skorlarý, yenidoðan YBÜ’ye (YYBÜ) yatýþ] açýsýndan oldukça benzerdi. Asemptomatik grupta total sezaryen oraný (%75), semptomatik grupla (%83) istatistiksel olarak benzerdi (p=0,464). Asemptomatik grup (%54,2) ve semptomatik grup (%50) arasýnda YYBÜ’ye yatýþ oranlarý benzer izlendi (p=0,858). Ancak solunum sýkýntýsý nedeniyle YYBÜ’ye yatýþ semptomatik grupta daha sýk izlendi (p=0,032). Emzirme oraný asemptomatik gebelerde beklendiði gibi daha yüksek izlendi (p=0,015). Asemptomatik grupta ferritin düzeyi anlamlý olarak daha düþük izlendi (p=0,006).
Sonuçlar: Bu çalýþmada COVID-19 ile enfekte semptomatik gebelerde primer sezaryen oranýnýn oldukça yüksek olduðu bulunmuþtur. Ayrýca toplam sezaryen oraný her iki grupta da son derece yüksekti. Çalýþmada semptomatik hastalarda daha olumsuz sonuçlar beklememize raðmen, her iki grup arasýnda benzer maternal, perinatal ve neonatal sonuçlar izledik.

Objective: This study aimed to compare the postpartum outcomes of asymptomatic and symptomatic patients with coronavirus disease-2019 (COVID-19).
Methods: This retrospective cohort study included pregnant women with COVID-19. Pregnant women were categorized into two sets as asymptomatic and symptomatic according to their clinics at the time of application. COVID-19 was diagnosed using the real-time reverse transcriptase-polymerase chain reaction on the oropharyngeal and nasopharyngeal swabs. Asymptomatic and symptomatic patients were compared in terms of maternal and perinatal outcomes.
Results: Our study population consisted of 20 asymptomatic and 41 symptomatic patients with laboratory-confirmed COVID-19. The rate of primary cesarean section was more than twice in the symptomatic group (51.2%) than that of the asymptomatic group (20%) (p=0.019). Both groups are quite similar in terms of maternal [respiratory support, COVID-19-related treatment, and intensive care unit (ICU) admission], perinatal (preterm delivery, preterm premature rupture of membrane, preeclampsia, and mode of delivery), and neonatal outcomes [birth weight, Apgar scores, neonatal ICU (NICU) admission]. The rate of total cesarean section in the asymptomatic group (75%) was statistically similar to the symptomatic group (83%) (p=0.464). The NICU admission rate was found to be similar in the asymptomatic (54.2%) and symptomatic groups (50%) (p=0.858). However, NICU admissions were more frequent in the symptomatic group due to respiratory distress (p=0.032). The breastfeeding rate is higher in the asymptomatic pregnant group as expected (p=0.015). Additionally, the ferritin level was significantly lower in the asymptomatic group (p=0.006).
Conclusions: The rate of primary cesarean section is quite high in symptomatic patients with COVID-19. Additionally, the total cesarean section rate was extremely high in both groups. We expected more adverse outcomes in symptomatic patients; however, we found similar maternal, perinatal, and neonatal outcomes between both groups.

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Amaç: 2020’de, þiddetli akut solunum sendromu koronavirüs-2’nin yarattýðý tahribat nedeniyle dünya durma noktasýna geldi. Hastalýkla mücadele sorumluluðu büyük ölçüde saðlýk çalýþanlarýna yüklenmiþtir. Bununla birlikte, polis ve temizlik iþçileri gibi toplumun diðer üyeleri de hastalýðýn önlenmesine büyük katký saðlamýþlardýr. Durmaksýzýn çalýþmalarýna raðmen, saðlýk açýðý oluþturan yanlýþ anlamalar ve yanlýþ bilgilerden kaynaklanan stigmayla karþý karþýya kalmaktadýrlar. Bu çalýþma, koronavirüs hastalýðý-2019 (COVID-19) savaþçýlarýna karþý stigma ve ayrýmcýlýk düzeyini belirlemeyi, etkilerini anlamayý ve stigmanýn nedenlerine iliþkin toplum algýsýný deðerlendirmeyi amaçlamýþtýr.
Yöntemler: Altý aylýk bir kesitsel çalýþma yapýldý. Örneklem boyutu zamana baðlýydý ve karma bir örnekleme yöntemi kullanýldý. Toplam 78 COVID-19 savaþçýsý ve toplumdan 68 katýlýmcý dahil edildi. Stigma deðerlendirmesi dört alana dayanýyordu: Öngörülen stigma, deneyimlenen stigma, içselleþtirilmiþ stigma ve ifþa endiþeleri. Ýlgili anlamlýlýk testleri uygulanmýþ ve veriler yüzde ve oranlar halinde sunulmuþtur.
Bulgular: Katýlýmcýlarýn %46,1’i 30-40 yaþ aralýðýnda, %47’si erkek, %81’i doktordu ve 2 hafta boyunca en az 6-12 saat görev yapýyordu. Çalýþma popülasyonunun %85,5’i stigmayý öngörürken, %72,2’si stigma deneyimlemiþ, %43,4’ü içselleþtirilmiþ stigma ve %76,3’ü ifþa endiþesi içindeydi. Ýçselleþtirilmiþ stigmanýn yaþ (p<0,05) ve kiþisel nitelikler (p<0,05) ile anlamlý þekilde iliþkili olduðu bulundu. Toplum katýlýmcýlarýnýn %47,1’inin çevrelerinde bir doktoru vardý ve çevrelerinde bir COVID-19 savaþçýsýnýn bulunmasý nedeniyle %44,1’inin birincil endiþesi COVID-19’a yakalanmaktý. Ek önlemler alma zorunluluðu ve sosyal mesafeden taviz verilmesi gibi diðer endiþeler de bildirildi.
Sonuçlar: COVID-19 savaþçýlarý, zihinsel saðlýklarý üzerinde olumsuz bir etkiye neden olan, anlamlý düzeyde bir stigma deneyimlemiþlerdi.

Objective: In 2020, the world came to a standstill due to the havoc created by severe acute respiratory syndrome coronavirus-2. The onus of tackling the disease relies largely on healthcare workers. However, other members of society, such as police personnel and sanitary workers, also made a major contribution in disease prevention. Despite working relentlessly, they face stigma caused by misconceptions and false information that create a health gap. This study aimed to determine the level of stigma and discrimination against coronavirus disease-2019 (COVID-19) warriors, understand its effects, and assess the community perception of the causes of stigmatization.
Methods: A cross-sectional study was conducted for 6 months. The sample size was time-bound, and a mixed method of sampling was employed. A total of 78 COVID-19 warriors and 68 participants from the community were enrolled. Stigma assessment was based on four domains: anticipated stigma, experienced stigma, internalized stigma, and disclosure concerns. Relevant tests of significance were applied, and the data are presented in percentages and ratios.
Results: Of the participants, 46.1% were in the age group of 30-40 years, 47% were males, and 81% were doctors by profession and were engaged in a minimum of 6-12 h of duty for 2 weeks. Of the study population, 85.5% had anticipated stigma, whereas 72.2% had experienced stigma, 43.4% had internalized stigma, and 76.3% had disclosure concerns. Internalized stigma was found to be significantly associated with age (p<0.05) and personal attributes (p<0.05). Of the community participants, 47.1% had a doctor in their neighborhood, and contracting COVID-19 was the primary concern of 44.1% due to the presence of a COVID-19 warrior in their vicinity. Other concerns, such as having to take extra precautions and social distancing being compromised, were also reported.
Conclusions: A significant level of stigma was experienced by COVID-19 warriors, causing a negative impact on their mental well-being.

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Amaç: Ýkinci trimester Down sendromu tarama testlerindeki düþük östriyol (uE3) seviyesi, fetal ölüm, konjenital anormallikler veya fetüsün çeþitli genetik hormonal bozukluklarýndan kaynaklanabilir. Steroid sülfataz (STS) eksikliðine neden olan ve hafif iktiyozla seyreden bir mikrodelesyon sendromu olan X’e baðlý iktiyoz en yaygýn genetik neden olmasýna raðmen, ikinci trimester tarama testleri daha az yaygýn ve daha þiddetli bir hastalýk olan Smith Lemli Opitz Sendromu (SLOS) için risk hesaplamaktadýr. Down sendromu taramasýnda uE3 düzeyi düþük olan gebeliklerin sonuçlarýný araþtýrmayý ve bu gibi durumlarda SLOS yerine STS eksikliðinin yüksek prevalansýný vurgulamayý amaçladýk.
Yöntemler: Tarama testlerinde uE3 seviyeleri çok düþük olan ve trizomi ve/veya SLOS açýsýndan yüksek risk taþýyan on beþ gebelik STS eksikliði ve SLOS açýsýndan deðerlendirilmiþ ve test edilmiþtir.
Bulgular: Gebeliklerin yedisinde STS mikrodelesyon sendromu bulunurken, ek iki olguda aile ve/veya doðum sonrasý öyküye dayanarak STS gen mutasyonu düþünüldü. Bir fetal ölüm tespit edildi. Ek kromozom anomalisi, SLOS veya konjenital malformasyon tespit edilmedi.
Sonuçlar: SLOS çok aðýr seyreden ve nadir görülen bir sendromdur. Tarama testlerinde SLOS için risk tahmini hamileler ve saðlýk çalýþanlarý için strese neden olmaktadýr. Anksiyeteyi önlemek için tarama testlerinde düþük bir uE3 seviyesi tespit edildiðinde STS eksikliði için risk tahmininin eklenmesini öneririz.

Objective: Low estriol (uE3) levels in the second-trimester screening for Down syndrome may be the result of fetal demise, congenital abnormalities, or some genetic hormonal disorders of the fetus. Although X-linked ichthyosis, a microdeletion syndrome with mild ichthyosis, which causes steroid sulfatase (STS) deficiency, is the most common genetic cause, second-trimester screening tests calculate the risk for a less common and severe disorder known as the Smith Lemli Opitz syndrome (SLOS). We aimed to investigate the outcomes of pregnancies with low uE3 levels in Down syndrome screening and emphasize the high prevalence of STS deficiency instead of SLOS in such cases.
Methods: Fifteen pregnancies with very low uE3 levels and high risk for trisomy and/or SLOS in screening tests were evaluated and tested for STS deficiency and SLOS.
Results: Seven of the pregnancies had STS microdeletion syndrome, while additional two cases were supposed to have STS gene mutation according to family and/or postnatal history. Although one fetal death was recorded, no chromosomal abnormality, SLOS, or congenital malformation was recorded in our series.
Conclusions: SLOS is a very severe and rare syndrome. The risk estimation for SLOS in screening tests causes stress for pregnant women and healthcare givers. We recommend the addition of risk estimation for STS deficiency when a low uE3 level is detected in the screening test.

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Amaç: Koronavirüs hastalýðý-2019 pandemisi ile rutin üroloji pratiði deðiþmiþtir. Bu çalýþmada pandemi sýrasýnda ürologlarýn fonksiyonel üroloji uygulamalarýný çevrimiçi bir anket kullanarak belirlemek amaçlanmýþtýr.
Yöntemler: Türk ürologlarýnýn pandemi sýrasýnda fonksiyonel üroloji pratiðini deðerlendirmek için çevrimiçi bir anket uygulandý. Bu ankette, katýlýmcýlarýn görev yeri, pandemi merkezi olarak konumlandýrýlmasý, pandemi kliniklerinde görev alma ve fonksiyonel ürolojiye ilgi hakkýnda sorular soruldu. Ayrýca pandemi sýrasýnda poliklinik hizmetleri, taný testleri ve elektif ameliyatlar, pandemi öncesi günlük uygulamalarýyla karþýlaþtýrarak sorgulandý.
Bulgular: Toplam 152 katýlýmcý anketi tamamladý. Katýlýmcýlarýn %32,2’si günlük uygulamalarýnýn yüzde ellisinden fazlasýnýn inkontinans, prolapsus ve nöroüroloji taný ve tedavisi ile ilgili olduðunu belirtti. Yüz yirmi üç katýlýmcýya (%80,9) göre poliklinik sayýsýnda azalma oldu. Üroflovmetri (%68,4) ve ürodinami (%81,3) gibi taný testleri de azaldý. Ankete katýlanlarýn çoðunluðu, botoks enjeksiyonu (%92,1), üriner inkontinans cerrahisi (%93,4) ve prolapsus cerrahisi (%85) gibi elektif ameliyatlarda azalma olduðunu bildirdi. Ankete katýlanlarýn yaklaþýk dörtte biri (%28,9) nöroüroloji hastalarý için taný yöntemlerinin farklýlýk göstermediðini belirtti.
Sonuçlar: Pandemi sýrasýnda ürolojide en çok etkilenen alanlardan biri fonksiyonel ürolojidir. Fonksiyonel ürolojiye yönelik testler ve ameliyatlar “opsiyonel” olarak sýnýflandýrýlsa da hastalarýn yaþam kalitesi geciken müdahalelerden etkilenecektir.

Objective: Routine urology practice has changed with the coronavirus disease-2019 pandemic. We aim to determine the urologists’ functional urology practice during the pandemic by an online questionnaire.
Methods: An online questionnaire was conducted to assess the functional urology practice of Turkish urologists’ during the pandemic. The workplace, positioning as a pandemic hospital, involvement in pandemic clinics, and the relevance to functional urology were questioned. We also inquired about outpatient services, diagnostic tests, and elective surgeries during the pandemic compared with their routine practice.
Results: One hundred and fifty-two participants completed the questionnaire. Of these, 32.2% replied that more than half of their daily practice was related to diagnosing and treating incontinence, prolapse, and neurourology. According to 123 participants (80.9%), there was a decrease in outpatient clinics. Diagnostic tests were also reduced, such as uroflowmetry (68.4%) and urodynamics (81.3%). The majority of respondents declared a decrease in elective surgeries as Botox injection (92.1%), surgery for urinary incontinence (93.4%), and surgery for prolapse (85%). Nearly one-quarter of respondents’ (28.9%) stated that their diagnostic methods for neurourology patients did not differ.
Conclusions: One of the most affected areas in urology during a pandemic is functional urology. Although diagnostic tests and surgery for functional urology are classified as “optional,” the quality of life of patients will be affected by the delayed intervention.

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Amaç: Bu çalýþmada en sýk kullanýlan anestezi tekniklerinden biri olan ketamin bazlý sedasyon ile kolonoskopi taramasý sýrasýnda adenom tespit oranýnýn (ADR) deðeri arasýndaki iliþkinin belirlenmesi amaçlanmýþtýr.
Yöntemler: Bu prospektif, gözlemsel çalýþmaya, iþlemden önce standart kolonoskopi hazýrlýðý yapýlan 140 hasta dahil edildi. Sedasyon rejimleri, 0,5 mg/kg ketamin ve 0,5 mg/kg propofol içeriyordu. Ramsey Sedasyon skalasýný korumak için 0,5 mg/kg’de ek propofol dozlarý uygulandý. Temel özellikler, ADR, Chicago barsak hazýrlýk (CHBP) ölçeðine göre baðýrsak hazýrlýðý kalitesi, çekal entübasyon, kolonoskopinin çýkarýlmasý ve komplikasyonlar analiz edildi.
Bulgular: Hastalarýn ortalama yaþý 55,76 yýldý; 40’ý (%28,6) erkek, 100’ü (%71,4) kadýndý. ADR, erkeklerde %15,71 ve kadýnlarda %27,86 olmak üzere %43,57 idi. %43,6 adenom, %17,9 biyopsi ve %22,9 polipektomi vardý. Adenomlarýn/poliplerin en büyük yeri rektumda ve sigmoid ve çýkan kolonda (p=0,11), sigmoid kolon ve ileum biyopsisinde (p<0,05), rektum ve sigmoidde ve çýkan kolonda polipektomi (p<0,05) idi. Çekal entübasyon, çoðu hastada (%80) >6 dakika olan bir geri çekme süresi ile %93.6 idi (p<0,05). CHBP ölçeði komplikasyonsuz iyi bir barsak hazýrlýðý (p<0,05) gösterdi.
Sonuçlar: Ketamin bazlý sedasyon, ADR ile genel olarak iyi bir korelasyon içindedir. Bu nedenle, gelecekteki çalýþmalarda ADR deðerlendirmesi için sedasyon tekniði dahil edilmelidir.

Objective: This study aimed to determine the relationship between one of the most commonly used anesthesia techniques, ketamine-based sedation, on the value of adenoma detection rate (ADR) during colonoscopy screening.
Methods: This prospective, observational study included 140 patients, who underwent a standard colonoscopy preparation before the procedure. Sedation regimens included ketamine at 0.5 mg/kg and propofol at 0.5 mg/kg. Additional doses of propofol were administered at 0.5 mg/kg to maintain the Ramsey Sedation scale. Baseline characteristics, ADR, bowel preparation quality according to the Chicago bowel preparation (CHBP) scale, cecal intubation, colonoscopy removal, and complications were analyzed.
Results: The mean age of patients was 55.76 years; 40 (28.6%) were males and 100 (71.4%) were females. The ADR was 43.57%, wherein 15.71% in males and 27.86% in females. There were 43.6% adenomas, 17.9% biopsies, and 22.9% polypectomies. The largest location of adenomas/polyps were in the rectum and sigmoid and ascending colon (p=0.11), a biopsy of the sigmoid colon and ileum (p<0.05), polypectomy of the rectum and sigmoid and ascending colon (p<0.05). The cecal intubation was 93.6% with a withdrawal time that is >6 min in most patients (80%) (p<0.05). The CHBP scale showed good bowel preparation (p<0.05) without complications.
Conclusions: Ketamine-based sedation is in good overall correlation with ADR. Therefore, the sedation technique should be included for ADR assessment in the future.

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Amaç: Diffüz büyük B-hücreli lenfomada (DBBHL) prognozu belirlemede internasyonel prognostik indeks (IPI) ve revize edilmiþ IPI (R-IPI) kullanýlmaktadýr. Ancak bu skorlama sistemleri çok yüksek riskli hastalarý belirlemede yetersiz kalmaktadýr. Son zamanlarda DBBHL’de prognozu belirlemede lenfosit ve albümin ile hesap-lanan prognostik nutrisyonel indeks (PNÝ) kullanýlmaya baþlanmýþtýr. Bu çalýþmada amaç; DBBHL’de yüksek riskli hastalarda PNÝ skorunun prognoz ve saðkalýma olan etkisini deðerlendirmektir.
Yöntemler: Çalýþmaya DBBHL tanýsý konmuþ ve rituksimab, siklofosfamid, doksorubisin, vinkristin, prednizolon tedavisi almýþ hastalar alýndý. Tedavi öncesi IPI, R-IPI ve PNÝ skorlarý ile progresyonsuz saðkalým (PS) ve toplam saðkalým (TS) süreleri hesaplandý. TS’ye göre PNÝ için sýnýr deðer X-Tile programý ile belirlendi.
Bulgular: Çalýþmaya alýnan 110 hastanýn medyan yaþý 63, medyan takip süresi 25 aydý. R-IPI’ya göre çok iyi riskli grup için medyan TS süresine ulaþýlamamýþken, iyi ve kötü riskli gruplarda medyan TS sýrasý ile 83 ve 17 aydý (p=0,001). PNÝ skoru için TS’de gruplar arasýnda fark yaratan sýnýr deðere göre kohort üç gruba ayrýldý: PNÝ<33 olan hastalar yüksek riskli, 33-42 arasý orta riskli, PNÝ≥42 olan hastalar iyi riskli olarak sýnýflandýrýldý. PNÝ’ye göre medyan PS ve TS süreleri sýrasýyla yüksek riskli grupta 2 ay ve 3 ay, orta riskli grupta 9 ay ve 19 aydý, iyi riskli grupta PS ve TS için medyan takip sürelerine ulaþýlamadý (p=0,001).
Sonuçlar: DBBHL’de prognozu belirlemede R-IPI kullanýlmaktadýr, fakat bizim kohortumuzda kötü riskli hasta grubunda R-IPI’ya göre hesaplanan TS 17 ay iken PNÝ’ye göre bu sürenin 3 ay olduðu belirlenmiþtir. Bu bulgu PNÝ’nin erken mortaliteyi baþarýlý bir þekilde öngörebileceðini göstermektedir.

Objective: The international prognostic index (IPI) and the revised IPI (R-IPI) are used to determine the prognosis in diffuse large B-cell lymphoma (DLBCL). However, these scoring systems are insufficient to identify very high-risk patients. Recently, the prognostic nutritional index (PNI) -calculated with lymphocyte count and albumin- has been used to determine the prognosis in DLBCL. This study aimed to evaluate the effect of PNI score on prognosis and survival in patients with high-risk DLBCL.
Methods: Patients diagnosed with DLBCL and treated with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone were included. Pre-treatment IPI, R-IPI, and PNI scores and progression-free survival (PFS) and overall survival (OS) times were calculated. The cut-off value for PNI according to OS was determined by using the X-Tile program.
Results: One hundred and ten patients were included, the median age was 63 years and the median follow-up period was 25 months. According to R-IPI, the me-dian OS could not be reached for the very good risk group, and the median OS values were 83 and 17 months in the good and poor-risk groups, respectively (p=0.001). The cohort was divided into three groups according to the cut-off value for the PNI: patients with PNI <33 were classified as high-risk, 33-42 intermediate-risk, and ≥42 as low-risk. According to PNI, the median durations of PFS and OS were 2 months and 3 months in the high-risk group, 9 months and 19 months in the inter-mediate-risk group respectively, and in the low-risk group the median duration for PFS and OS could not be reached (p=0.001).
Conclusions: The R-IPI is widely used to estimate the prognosis in DLBCL. But in our cohort, in the poor-risk patient group, the OS was 17 months according to R-IPI, while this period was 3 months according to PNI. This finding demonstrated that PNI might predict early mortality in DLBCL.

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Amaç: Koronavirüs hastalýðý-2019 (COVID-19) pandemisi döneminde alýnan maksimum izolasyon önlemlerine raðmen saðlýk kurumlarýnýn hasta yoðunluðu artmýþ-týr. Bununla iliþkili olarak bazý hastalýk gruplarýnýn baþvurduklarý bölüm ve baþvuru sayýlarýnda deðiþiklikler olduðu gözlemlenmiþtir. Çalýþmamýzda, pediatrik solunum yolu enfeksiyonlarý ve astým sýklýðýnda COVID-19 dönemine özgü deðiþiklikleri nicel olarak araþtýrmayý hedefledik.
Yöntemler: Hastanemiz çocuk acil, pediatri kliniði ve polikliniði ve çocuk yoðun bakým ünitesindeki (ÇYBÜ) iki yýllýk dönemde (pre- COVID bir yýl ve COVID pandemi-sinin ilk yýlý); influenza, üst ve alt solunum yolu enfeksiyonlarý (ÜSYE, ASYE), akut bronþiyolit ve astým tanýlarý alan çocuklarýn elektronik týbbi kayýt verileri incelendi.
Bulgular: Pandemi öncesindeki bir yýllýk dönemde 96.648 ve pandeminin ilk yýlýnda 15.848 çocuk hasta baþvurusu mevcuttu. Pandemi döneminde toplam acil servis baþvurularýnda %73, toplam poliklinik baþvurularýnda %70, toplam hastane yatýþ sayýsýnda %41,5 ve toplam ÇYBÜ yatýþ sayýsýnda %42 düþüþ olduðu tespit edildi. Ýnfluenza [%4,26’dan %0,37’ye (p=0,0001)] ve ÜSYE [%81,54’ten %75,62’ye (p=0,0001)] baþvurularýnýn toplam baþvuru sayýsý içindeki oranlarý azalýrken, ASYE [%8,22’den %10,01’e (p=0,0001)], akut bronþiyolit [%2,76’dan %3,07’ye (p=0,027)] ve astým [%5,96’dan %14’e (p=0,0001)] tanýlarýnýn toplam baþvuru sayýsý içindeki oranlarý artmýþtýr.
Sonuçlar: Genellikle akut bronþiyolit ve astým ataklarýna neden olan virüslerin azalmasý bu hasta grubunun acil servise baþvurularýný azaltmýþtýr. Bu dönemde ebeveynlerin acil servisi tercih etmemeleri daha þiddetli ASYE’nin geliþmesine zemin hazýrlamýþ olabilir.

Objective: Despite maximum isolation measures taken during the coronavirus disease-2019 (COVID-19) pandemic, the workload of health institutions has increased. Consequently, changes in the number of admissions in clinics and emergency departments by disease groups have been observed. We aimed to quantitatively investigate the changes in the frequency of respiratory infections and asthma in the pediatric population during the COVID-19 pandemic.
Methods: We analyzed electronic medical record data of patients who were admitted to the emergency department (ED), outpatient and inpatient clinics, and pediatric intensive care unit (PICU) because of influenza, upper and lower respiratory tract infections (URTI, LRTI), acute bronchiolitis, and asthma during the two-year period (one year pre- COVID period and first year of the pandemic).
Results: There were 96,648 admissions in the pre-COVID period and 15,848 during the pandemic. We observed a decline in ED admissions (-73%), outpatient clinic visits (-70%), hospitalizations (-41.5%), and PICU admissions (-42%). While the admission rates of patients with influenza [from 4.26% to 0.37% (p=0.0001)] and URTI [from 81.54% to 75.62% (p=0.0001)] decreased, the ratio of the number of admissions to the total number of admissions due to LRTI [from 8.22% to 10.01% (p=0.0001)], acute bronchiolitis [from 2.76% to 3.07% (p=0.027)], and asthma [from 5.96% to 14% (p=0.0001)] increased.
Conclusions: The decrease in viruses that cause acute bronchiolitis and asthma attacks lead to a reduction in admissions to ED of this patient group. The fact that parents preferred not to admit their child in ED during this period may have paved the way for the development of more severe LRTIs.

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Amaç: Çalýþmanýn amacý romatoid artritli (RA) hastalarda pedobarografik ölçüm ile deðerlendirilen plantar basýnç deðiþiklikleri ile hastalýk aktivitesi, radyolojik anormallikler ve ayak indeksleri arasýndaki iliþkinin araþtýrýlmasýdýr.
Yöntemler: Sosyodemografik veriler, ayak semptomlarý, anatomik daðýlým, aðrýnýn þiddeti ve süresi bilgileri toplandý. Hastalýk aktivitesi için 28 eklemde hastalýk aktivi-te skoru (DAS28) ve fiziksel aktivite için Saðlýk Deðerlendirme Anketi (HAQ) ve ayak fonksiyonlarýný deðerlendirmek için ayak fonksiyon indeksi (FFI) uygulandý. Radyo-lojik anormallikleri deðerlendirmek için modifiye Larsen skorlamasý kullanýldý. Ayak basýnç özelliklerini analiz etmek için pedobarografik ölçümler yapýldý.
Bulgular: Elli iki RA hastasýnýn toplam 104 ayaðý deðerlendirildi. DAS28 skorlarý plantar basýnç deðerleri ile korele deðildi (p>0,05). HAQ skorlarý ile sað orta ayak orta yükleme basýncý arasýnda anlamlý bir iliþki saptandý (r=0,355; p<0,01). FFI skorlarý, sað lateral orta ayak yükleme basýncý ile pozitif korelasyon gösterdi (r=0,302; p<0,05). Manchester Ayak Aðrýsý ve Disabilite Ýndeksi ve plantar yükleme özellikleri arasýnda bir iliþki saptanmadý. Radyolojik skorlar sol lateral arka ayak plantar basýncý ile korele idi (r=0,286; p<0,05).
Sonuçlar: Pedobarografik ölçümler, ayaðýn tüm bölümlerinin (ön ayak, orta ayak, arka ayak) deðerlendirilmesi için bir takip deðerlendirme aracý olarak düþünülebilir. Romatoid ayaklarýn pedobarografik incelenmesi, ayak tutulumunun hastalýk süresinden baðýmsýz olduðunu, orta ayak plantar basýnçlarýnýn vücut kitle indeksi ile iliþkili olduðunu ve DAS28’in ayak problemlerini ihmal ettiði için hastalýk aktivitesinin bir belirteci olarak yetersiz kalabileceðini göstermiþtir.

Objective: This study aimed to investigate the relationship between plantar pressure pedobarographic measurements and disease activity, radiological abnormali-ties, and foot indexes in patients with rheumatoid arthritis (RA).
Methods: Sociodemographics, foot symptoms, anatomical distribution, pain intensity and duration, and podiatry services access data were collected. Disease activity scale of 28 joints (DAS28) was used for the disease activity, and Health Assessment Questionnaire (HAQ) was used for the functional status. Foot function index (FFI) was used to measure the impact of foot pathology on its function. The Modified Larsen scoring was used to assess radiological abnormalities. Pedobarog-raphic measurements were used to analyze foot loading characteristics.
Results: A total of 104 feet of 52 patients with RA was evaluated. DAS28 scores did not correlate with the plantar pressure values (p>0.05). A significant correlation was found between HAQ scores and right medial midfoot loading pressure (r=0.355; p<0.01). FFI scores were positively correlated with right lateral midfoot loading pressure (r=0.302; p<0.05). No relationship was found between Manchester Foot Pain and Disability Index and plantar loading characteristics. The radiological scores were correlated with left lateral hindfoot plantar pressure (r=0.286; p<0.05).
Conclusions: Pedobarographic measurements can be considered as a follow-up evaluation tool for the evaluation of all foot parts (forefoot, midfoot, and hindfoot). Rheumatoid feet investigation showed that foot involvement is independent of the disease duration, whereas midfoot plantar pressures are associated with the body mass index. Additionally, DAS28 may fall short as a marker of disease activity because it neglects foot problems.

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Amaç: Serebral palsili (SP) bireylerin 13 yýllýk izlem süresince fonksiyonel durum, katýlým ve yaþam kalitelerindeki deðiþimin araþtýrýlmasý amaçlanmýþtýr.
Yöntemler: Geçmiþ veriler veritabanýndan elde edildi. Komorbiditeler, mobilite durumu, ortez kullanýmý, rehabilitasyon programý ve izlem bilgileri sorgulandý. Saðlýk-la iliþkili yaþam kalitesini ölçmek için EuroQol 5-Dimension 3-Level (EQ-5D-3L) kullanýldý.
Bulgular: On üç yýl önce katýlýmcýlarýn %38,4’ü baðýmsýz yürüyebiliyorken, günümüzde bu oran %51,2’ye yükselmiþti. Ortez kullanýmýnýn %48,7’den %25,6’ya, rehabili-tasyona devam etme oranýnýn %100’den %58,9’a düþtüðü tespit edildi. Ortalama EQ-5D-3L skoru 0,36±0,42, ortalama EQ-vizüel analog skala skoru 68±24,01 idi.
Sonuçlar: SP’li bireyler ve bakým verenlerinde, SP’nin ömür boyu süren bir hastalýk olduðu farkýndalýðý yaratýlmalý ve rehabilitasyon programlarýna devamlýlýklarý teþvik edilmelidir. Günlük yaþam aktivitelerinde baðýmsýzlýk hedeflenmeli, sosyal yaþama katýlýmlarý saðlanmalýdýr.

Objective: This study aimed to investigate the current status and changes in motor and functional status, participation, and quality of life of individuals with cerebral palsy (CP) during the 13-year follow-up.
Methods: Data from the database were retrospectively analyzed, including comorbidities, mobility status, orthotic usage, and information about the rehabilitation program and follow-up. The EuroQol 5-Dimension 3-Level (EQ-5D-3L) was used to measure the health-related quality of life.
Results: Of our participants, 38.4% could independently walk 13-years ago, which increased to 51.2% presently. The orthotic usage decreased from 48.7% to 25.6%, and the rate of continuing rehabilitation decreased from 100% to 58.9%. The mean EQ-5D-3L score was 0.36±0.42, and the mean EQ-visual analog scale score was 68±24.01.
Conclusions: Individuals with CP and their caregivers should be aware that CP is a lifelong disease and their continuity in rehabilitation programs should be encouraged. Independence in daily life activities should be aimed and participation in social life should be ensured.

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Ýntraparotid fasiyal sinir schwannomu, kesin biyopsi olmadan preoperatif olarak teþhis edilmesi zor olan, ancak cerrahi planlama ve fasiyal sinirin kazara yaralanmasýný önlemek için teþhis edilmesi önemli olan nadir bir durumdur. Schwannomlarýn benign indolent doðasý göz önüne alýndýðýnda, fasiyal sinir fonksiyonu ve fasiyal kozmetiklere özel dikkat gösterilerek, uzun süreli tümör kontrolünde yönetime öncelik verilmelidir. Mikroskop destekli intrakapsüler enükleasyon, bu tür lezyonlar için mükemmel bir tedavi seçeneðidir. Hastamýz ameliyattan sonra House-Brackmann derece II yüz fonksiyonunu gösterdi. Bu teknik güvenlidir ve olumlu bir fasiyal sinir fonksiyonu sonucunu sunar.

Intraparotid facial nerve schwannoma is a rare condition, which is difficult to preoperatively diagnose without a definite biopsy, yet the diagnosis is important for surgical planning and avoiding accidental injury to the facial nerve. Considering the benign indolent nature of the schwannomas, the management should be prioritized on the long-term tumor control with special attention to the facial nerve function and facial cosmesis. Microscope-assisted intracapsular enucleation is an excellent treatment option for such lesions. Our patient showed House–Brackmann grade II facial function after the surgery. This technique is safe and offers a favorable outcome of facial nerve function.

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Atriyal fibrilasyon (AF) en sýk görülen aritmidir ve amiodaron, AF'nin medikal kardiyoversiyonunda en sýk kullanýlan ve toksik etkileri nedeniyle dikkatli kullanýlmasý gereken ilaçlardan biridir. Amiodaron ile tedavi edilen hastalarda amiodaron ile indüklenen tirotoksikoz (AÝT) geliþebilir. Buna karþýlýk, bir tiroid fýrtýnasýna eþlik eden en yaygýn ritim bozukluðu AF'dir. Bu iliþki hem AF hem de tirotoksikoz tedavisini kýsýr bir döngüye sokabilir ve aritmi kaynaklý kardiyomiyopatiye yol açabilir. Burada hemodinamik bozukluða neden olan, medikal tedaviye ve kardiyoversiyona dirençli AF’si olan bir AÝT hastasýnda kurtarma tedavisi olarak atriyoventriküler düðüm ablasyonunu sunmayý amaçladýk.

Atrial fibrillation (AF) is the most common arrhythmia, and amiodarone is one of the most commonly used drugs for medical cardioversion of AF, which should be used carefully due to its toxic effects. Amiodarone-induced thyrotoxicosis (AIT) may develop in amiodarone-treated patients. In contrast, the most common rhythm disturbance accompanying a thyroid storm is AF. This association may put both AF and thyrotoxicosis treatment into a vicious circle, leading to AI cardiomyopathy. Herein, we aimed to present atrioventricular node ablation as a salvage therapy in a patient with AIT who had AF-causing hemodynamic impairment, resistance to medical therapy, and cardioversion.

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