Amaç: Endometrioid endometriyal karsinomlar (EEK) kadýn genital sistemin en sýk karþýlaþýlan maligniteleridir. Myometrium invazyon derinliði en önemli patolojik prognostik parametrelerden birisidir. Farklý morfolojik invazyon paternleri tanýmlanmýþtýr. Biz çalýþmamýzda EEk olgularýnda mikrokistik elonge fragmante (MELF) myometirum invazyon paterninin prognostik önemini ve klinikopatolojik parametrelerle iliþkisini araþtýrmayý amaçladýk.
Yöntemler: 2011-2020 yýllarý arasýnda kurumumuzda EEK tanýsý alan 101 hasta çalýþmaya dahil edildi. Hematoksilen eozin kesitlerde MELF paterni deðerlendirildi. Lenf nodu metastazý izlenmeyen olgularda lenf nodu bloklarýna pan-sitokeratin uygulandý.
Bulgular: Yirmi dokuz hastada (%29,8) MELF paterni izlendi. MELF paterni lenfovasküler invazyon (p<0,001), patolojik evre (p=0,048), infiltratif patern (p<0,001), ve nekroz (p=0,005) ile anlamlý iliþkili izlendi. Genel ve hastalýksýz saðkalýmda MELF paterni istatistiksel olarak anlamlý iliþkili izlenmedi.
Sonuçlar: MELF paterni diðer prognostik parametrelerle iliþkili olup tek baþýna prognostik önemi saptanmamýþtýr. Ancak ilk cerrahi sýrasýnda lenf nodu diseksiyonu yapýlmayan EEK hastalarýnda histerektomi materyalinde MELF paterni saptanmasý durumunda yüksek lenfovasküler invazyon ve lenf nodu metastaz riski nedeniyle ek cerrahi iþlem ya da adjuvan terapi kararýnda MELF paterni varlýðýnýn dikkate alýnmasý gerektiðine inanýyoruz.

Objective: Endometrioid endometrial carcinomas (EEC) are the most commonly diagnosed malignancies of the female genital tract. Myometrial invasion depth is one of the most significant pathological prognostic parameters. Different morphological invasion patterns have been characterized. This study aimed to investigate the prognostic significance of the microcystic elongated and fragmented (MELF) myometrium invasion pattern in patients with EEC and its relationship with other clinicopathological parameters.
Methods: This study included 101 patients with EEC in our institution between 2011 and 2020. The MELF pattern was evaluated in hematoxylin-eosin-stained sections. Pan-cytokeratin staining was performed on paraffin-embedded blocks of lymph nodes for cases without lymph node metastasis.
Results: The MELF pattern was observed in 29 (29.8%) patients. It was significantly associated with lymphovascular invasion (p<0.001), pathologic stage (p=0.048), infiltrative pattern (p<0.001), and necrosis (p=0.005). No significant correlation was observed between the MELF pattern and overall and disease-free survival rates.
Conclusions: The MELF pattern is associated with other prognostic parameters, but its prognostic significance for survival has not been found. If the MELF pattern is observed in the hysterectomy material for cases without lymph node dissection during the first surgery, these patients may need additional surgery or adjuvant therapy due to the high risk of lymphovascular invasion and lymph node metastasis.

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Amaç: Akut miyokard enfarktüsünde (MI) risk faktörleri 3 kategoriye ayrýlýr. Deðiþtirilemeyen risk faktörleri, deðiþtirilebilir risk faktörleri ve yaþam tarzý ile ortaya çýkabilen risk faktörleridir. Bu çalýþmada kalbin duvar kalýnlýklarý ve koroner arter týkanýklýklarýnýn akut MI üzerinde bir etkisinin olup olmadýðý araþtýrýlmýþtýr.
Yöntemler: Retrospektif olarak yapýlan çalýþmada otopsilerin patolojik incelemesinde akut MI tanýsý almýþ 28 olgu ile ölüm nedeni kalp hastalýðý olmayan ve kalp patolojisi tespit edilmeyen 28 olgu seçildi. Ýki grup oluþturuldu. Aðýrlýk, boy, vücut kitle indeksi ve yaþ iki grup için de yakýn olacak þekilde yapýldý. Sol ve sað ventrikül duvar kalýnlýklarý ve sirkumfleks, ön inen, sað ve sol koroner damaralarýn týkanýklýk dereceleri karþýlaþtýrýldý.
Bulgular: Sol ventrikül duvar kalýnlýðý akut MI grubunda ortalama 1,461±0,2767, kontrol grubunda ise 1,386±0,2460 olup istatistiksel olarak anlamlý deðildi (p=0,289). Koroner arter týkanýklýklarýnýn derecelerinin de iki grup arasýnda farklý idi ve bu farkta istatistiksel olarak anlamlýydý.
Sonuçlar: Kalbin duvar kalýnlýklarý ortalamalarý, akut MI olgularýnda daha yüksek olsa da gruplar arasýnda anlamlý istatistiksel fark saptanmamýþtýr.

Objective: The risk factors for myocardial infarction (MI) can be separated into three general categories: non-modifiable factors, modifiable risk factors, and lifestyle. This study aimed to investigate whether or not there was any effect of cardiac wall thickness and coronary artery obstructions on acute MI.
Methods: In this retrospective study of histopathological examinations of autopsies, two groups were formed. The first contained 28 cases diagnosed with acute MI and the second 28 cases with no heart pathology and the cause of death was reasons other than heart disease. The subjects in the two groups were similar in age, height, weight, and body mass index. The groups were compared in terms of the left and right ventricular wall thicknesses and the degree of obstruction of the right, left, anterior descending, and circumflex coronary arteries.
Results: The mean left ventricular wall thickness was 1.461±0.2767 cm in the acute MI group and 1.386±0.2460 cm in the control group, with no statistically significant difference found between the two groups (p=0.289). A statistically significant difference in the degree of obstruction of the coronary arteries was found between the groups.
Conclusions: Although the mean cardiac wall thickness was greater in the acute MI cases, no statistically significant difference was found between the two groups.

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Amaç: Down sendromlu çocuklarda majör malformasyon ve düzeltici cerrahi insidansý yüksektir. Bazý olgular birden fazla endikasyon için ameliyat olurken, bazý hastalar ameliyat gerektiren bir sorun yaþamaz. Anne yaþýnýn artmasý Down sendromlu çocuk doðurmak için bilinen bir risk faktörüdür, ancak anne yaþýnýn bu çocuklarýn fenotipi üzerindeki etkisini araþtýran fazla çalýþma yoktur. Çalýþmamýzda Down sendromlu çocuklarda majör malformasyon ameliyatlarýnýn insidansýný ve doðumdaki anne yaþý ile iliþkisini araþtýrmayý amaçladýk.
Yöntemler: Down Sendromlu 218 çocuðun dosyalarýný, doðumdaki anne yaþý ve cerrahi müdahaleler açýsýndan retrospektif taradýk.
Bulgular: En az bir ameliyat geçiren çocuk sayýsý 84, insidansý %38,5 idi. Çocuklarýn 49’u kalp ameliyatý, 16’sý gastrointestinal, 17’si baþ boyun bölgesi, 12’si göz, 12’si genitoüriner, 5’i fýtýk ve 2’si ortopedik ameliyat geçirdi. Ortalama anne yaþý 32,7 (minimum: 15, maksimum: 44) idi ve opere olan ve olmayan gruplar arasýnda ortalama anne yaþý açýsýndan anlamlý fark yoktu (sýrasýyla 32,41 ve 32,93, p=0,89). Anne yaþý 35 ve üzeri olan ve 35 yaþ altý olan gruplar arasýnda herhangi bir ameliyat türü açýsýndan anlamlý fark bulunmadý.
Sonuçlar: Down sendromlu çocuklarda en sýk yapýlan operasyonlar kalp, gastrointestinal ve baþ boyun bölgesi operasyonlarýdýr. Doðumda anne yaþýnýn Down sendromunda malformasyon insidansý ve operasyon olasýlýðý üzerine etkisi izlenmemektedir.

Objective: Children with Down syndrome have a high incidence of major malformations and corrective surgery. Some patients do not need any surgery, while some cases are operated for several indications. There are few studies investigating the effect of maternal age on the phenotype of these children, despite the fact that increasing maternal age is a known risk factor for giving birth to Down syndrome. We aimed to investigate the incidence of surgery for major malformations and disorders in children with Down syndrome and its relationship with maternal age at birth.
Methods: We revised the records of 218 children with Down syndrome for maternal age at birth and for surgical interventions.
Results: There were 84 children who had at least one operation with 38.5% incidence. A total of 49 children had cardiac surgery, 16 had gastrointestinal, 17 had head and neck area, 12 had ophthalmological, 12 had genitourinary, 5 had hernia, and 2 had orthopedic surgeries. The mean maternal age was 32.7 (minimum: 15; maximum: 44), and there was no significant difference between operated and non-operated groups for mean maternal ages (32.41 and 32.93, respectively; p=0.89). For any type of surgery, there was no significant difference between the groups with maternal ages 35 and over and those under 35.
Conclusions: Maternal age at birth has no effect on the incidence of malformations and the probability of operation in Down syndrome.

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Amaç: Bu çalýþmada amaç, Türkiye’de toplumda yaþayan yaþlýlarda Malnütrisyonda Küresel Liderlik Giriþimi (GLIM) kriterlerine göre malnütrisyon prevalansýný araþtýrmaktýr.
Yöntemler: Malnütrisyon, GLIM kriterlerine göre deðerlendirildi ve tarama için Mini-Nutrisyonel Deðerlendirme-Kýsa Formu kullanýldý. Malnütrisyonun þiddeti GLIM fenotipik kriterlerine göre þiddetli veya orta olarak belirlendi.
Bulgular: Bu çalýþmaya 569 (%69 kadýn, ortalama yaþ 74,42±6,58 yýl) toplum içinde yaþayan yaþlý katýldý. Katýlýmcýlarýn eðitim durumu %17,2 okur-yazar deðil, %13,3 okur-yazar iken; %35,3 ilkokul, %7,0 ortaokul, %11,1 lise ve %16,2 üniversite mezunu þeklindeydi. Katýlýmcýlarýn %16,4’ü yalnýz yaþarken; %43,9’u eþiyle birlikte yaþamaktaydý. Popülasyonun geri kalaný geniþ aileleriyle yaþýyordu. GLIM kriterlerine göre bireylerin %24,5’inde (n=139) malnütrisyon vardý. Tüm katýlýmcýlarýn %13,9’u þiddetli malnütrisyona sahipti. Yaþ, malnütrisyonla anlamlý þekilde iliþkiliydi [olasýlýk oraný: 1,064, %95 güven aralýðý (CI): 1,034-1,096, p<0,0001]. Cinsiyet (p=0,207), farklý eðitim gruplarý (p=0,323) ve yaþam durumu (p=0,434) arasýnda malnütrisyon açýsýndan istatistiksel olarak anlamlý fark yoktu. Bununla birlikte, kadýnlarda erkeklere kýyasla malnütrisyon oraný daha yüksekti (%26,0’a karþý %21,0) (risk oraný: 0,757, %95 CI: 0,494-1,160, p=0,207).
Sonuçlar: Sonuç olarak, toplumda yaþayan yaþlýlarda malnütrisyon prevalansý %24,5 iken þiddetli malnütrisyon oraný %13,9 idi. Kadýn cinsiyette malnütrisyon daha yüksekti. Ek olarak, yaþ malnütrisyon ile iliþkiliydi. Araþtýrmacýlara ve klinisyenlere, malnütrisyon deðerlendirmesinde ortak bir dil oluþturmak için GLIM kriterlerini uygulamalarýna entegre etmelerini öneririz.

Objective: This study aimed to investigate the prevalence of malnutrition according to the Global Leadership Initiative on Malnutrition (GLIM) criteria in community-dwelling older adults in Turkey.
Methods: Malnutrition was assessed based on the GLIM criteria, and Mini-Nutritional Assessment-Short Form was used for screening. The severity of malnutrition was determined as severe or moderate based on the phenotypic criteria of GLIM.
Results: Five hundred sixty-nine (69% female, mean age 74.42±6.58 years) community-dwelling older adults participated in this study. The educational statuses of the participants were as follows: 17.2%, illiterate; 13.3%, literate; 35.3%, primary school; 7.0%, secondary school; 11.1%, high school; and 16.2%, university graduates. Among the participants, 16.4% were living alone, whereas 43.9% of them were living with their spouses. The rest were living with their extended families. According to the GLIM criteria, 24.5% (n=139) of the participants had malnutrition, and 13.9% of the total population had severe malnutrition. Age was significantly associated with malnutrition [odds ratio 1.064, 95% confidence interval (CI) 1.034-1.096, p<0.0001]. No significant difference was found between genders (p=0.207), education groups (p=0.323), and living status (p=0.434) in terms of malnutrition. However, women had higher malnutrition rates than men (26.0% vs. 21.0%) (risk ratio 0.757, 95% CI 0.494-1.160, p=0.207).
Conclusions: The prevalence of malnutrition was 24.5%, whereas the rate of severe malnutrition was 13.9% in community-dwelling older adults. Women had higher rates of malnutrition, and age was associated with malnutrition. We recommend for researchers and clinicians to integrate the GLIM criteria into their practices to create a common language in malnutrition assessment.

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Amaç: Uzun süreli total parenteral beslenme (TPN), erken doðan yenidoðanlarýn kritik bir geliþim aþamasýnda optimal beslenmeyi saðlamalarý için çok önemlidir. Morbiditeleri azaltmak için TPN çözümlerini optimize etmeye ihtiyaç vardýr. Bu çalýþma, zeytinyaðý (ClinOleic®) ve balýk yaðý (SMOFlipid®) tedavilerinin neonatal morbidite sýklýklarý üzerine etkilerini araþtýrmayý amaçlamýþtýr.
Yöntemler: Yenidoðan yoðun bakým ünitesinde yatan ve en az 14 gün total parenteral beslenme alan prematüre yenidoðanlar çalýþmaya dahil edildi. Hastaneye yatýrýlan ve zeytinyaðý bazlý lipid (ClinOleic®) verilen yenidoðanlar zeytinyaðý grubuna, hastaneye yatýrýlan ve multi-lipid içeren omega 3 (SMOFlipid®) verilen yenidoðanlar SMOF lipid grubuna alýndý.
Bulgular: Bu çalýþmaya toplam 222 çok düþük doðum aðýrlýklý prematüre yenidoðan kaydedildi. Zeytinyaðý tedavisi gören yenidoðanlarda emzirme oraný diðer gruba göre anlamlý derecede düþüktü (p<0,05). Zeytinyaðý tedavisi alan yenidoðanlarda nekrotizan enterokolit (NEK) oraný diðer gruba göre anlamlý derecede yüksekti. SMOFlipid grubu alan yenidoðanlarda bronkopulmoner displazi (BPD) oraný zeytinyaðý tedavisi alan yenidoðanlara göre daha düþüktü (p<0,05).
Sonuçlar: Balýk yaðý grubunda BPD ve NEK oranlarýmýz daha düþük bulundu. Bu durumda balýk yaðý tedavisi BPD ve NEK geliþimine karþý koruyucu olabilir. Bunun kullanýlan lipid tedavisinin sonucundan mý yoksa anne sütünün etkisinden mi kaynaklandýðýný belirlemek için ileriye dönük çalýþmalara ihtiyaç vardýr.

Objective: Total parenteral nutrition (TPN) is very important for providing optimal nutrition during the critical developmental period of preterm newborns. Thus, there is a need to optimize TPN solutions to reduce morbidities. This study aimed to examine the effects of olive oil (ClinOleic®) and fish oil (SMOFlipid®) therapies on the frequencies of neonatal morbidities.
Methods: Premature newborns hospitalized in the neonatal intensive care unit and receiving TPN for at least 14 days were included in the study. Newborns who were hospitalized and received olive oil-based lipid (ClinOleic®) were included in the olive oil group, and those who received omega-3 containing multi-lipid (SMOFlipid®) were included in the SMOFlipid group.
Results: This study enrolled a total of 222 very-low-birth-weight premature newborns. The breastfeeding rate in the olive oil group was significantly lower than that in the SMOFlipid group (p<0.05). The rate of necrotizing entercolitis (NEC) in the olive oil group was significantly higher than that in the SMOFlipid group (p<0.05). The rate of bronchopulmonary dysplasia (BPD) in the SMOFlipid group was lower than that in the olive oil group (p<0.05).
Conclusions: The rates of BPD and NEC were lower in the fish oil group. In this situation, fish oil therapy may provide protection against the development of BPD and NEC. Prospective studies are needed to determine whether this is caused by lipid therapy or an effect of breast milk.

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Amaç: Bu çalýþma, bakýcýlarýn çocuklar için koronavirüs hastalýðý-2019 (COVÝD-19) aþýlamasýna iliþkin algý ve tercihlerini belgelemeyi amaçlamýþtýr.
Yöntemler: Bu kesitsel çalýþmada, Þubat-Mart 2022 tarihleri arasýnda kýrsal bir bölgedeki hastaneye baþvuran 347 çocuðun (1-18 yaþ arasý) 272 bakýcýsý incelendi.
Bulgular: Aþý kabul oraný yüksekti (%93,4). Yan etki korkusu aþýlatmamanýn en yaygýn nedeni olmasýna raðmen, çocuklarý aþýlatmak isteyen bakýcýlarýn yüksek bir oraný yan etkilerle ilgili sorularý netleþtirmek için saðlýk personeline danýþmýþtýr. Devlet hastaneleri gibi çocuklarýn daha önce rutin aþý (RI) olduklarý tanýdýk aþýlama yerleri ve aþýlarýn tüm iþ günlerinde ücretsiz olarak sunulduðu Anganwadis (topluluk temelli çocuk bakým merkezleri) ve ardýndan okullar COVÝD-19 aþýsý için en çok tercih edilen yerlerdi. Bakýcýlarýn sadece %5,5’i özel hastaneleri tercih ettiler. Kronik hasta ve okula gitmeyen çocuklarýn evde aþýlanmasý istendi. Yaþa göre RI, aþýlatma isteði ile iliþkilendirildi. COVÝD-19’dan korunmaya ek olarak, aþýlatmaya istekli ebeveynlerin diðer tercih nedenleri çocuklarýn aþý sonrasý okula, eðlenceye ve seyahate devam edebilmeleriydi.
Sonuçlar: Okula gitmeyen çocuklar, IR’de býrakýlan veya gözden kaçan çocuklar ve kronik hastalýðý olan çocuklar COVÝD-19 aþýsý açýsýndan dýþlanma riski altýnda olabilirler ve yetiþkinlerde olduðu gibi evde aþýlama hizmetleri geniþletilerek dahil edilebilirler. Medya katýlýmý ve iletiþim ile, yan etki korkusu gibi sorunlar ele alýnýp, aþýlamanýn ek faydalarý teþvik edilebilir.

Objective: This study aimed to document caregivers’ perceptions and preferences regarding coronavirus disease-19 (COVID-19) vaccination among children.
Methods: This cross-sectional study analyzed 272 caregivers with 347 children (aged 1-18 years) attending a subdistrict rural hospital in February-March 2022.
Results: Vaccine acceptance was high (93.4%). Although fear of side effects was the most common reason not to vaccinate, a higher proportion of caregivers willing to vaccinate children had consulted healthcare personnel to clarify queries related to side effects. Familiar vaccination sites, where children had previously received routine immunization (RI), such as government hospitals, and Anganwadis (community-based childcare centers) where vaccines were available free of cost on all working days, were the most preferred for COVID-19 vaccination, followed by schools. Only 5.5% of the caregivers preferred private hospitals. Vaccination at home was desired for chronically ill and out-of-school children. RI as per age was associated with the willingness to vaccinate. In addition to protection from COVID-19, other benefits identified by willing parents were being able to attend schools, recreation, and travel.
Conclusions: Out-of-school children, children left or missed out in RI, and children with chronic illness can be at risk of being left out for COVID-19 vaccination and can be included by expanding vaccination services house-to-house as in adults. Media engagement and communication must be interactive to address issues, such as fear of side effects, and promote additional benefits of vaccination.

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Amaç: Bu çalýþma, makine öðrenmesi yöntemlerinden XGBoost yöntemi kullanýlarak hepatit B virüsü iliþkili hepatosellüler karsinom (HBV + HCC) ve HCC’siz kronik HBV (tek baþýna HBV) olan hastalarýn açýk eriþimli gen ekspresyon verilerini sýnýflandýrmayý ve HCC’ye neden olabilecek önemli genleri ortaya çýkarmayý amaçlamaktadýr.
Yöntemler: Bu olgu-kontrol çalýþmasýnda, yalnýzca HBV + HCC ve HBV’li hastalarýn açýk eriþimli gen ekspresyonu verileri kullanýlmýþtýr. Bu amaçla, çalýþmaya HBV + HCC’li 17 hastadan ve tek baþýna HBV’li 36 hastadan alýnan veriler dahil edildi. Sýnýflandýrma için on katlý çapraz geçerlilik yoluyla XGBoost modeli oluþturuldu. Model performansý için doðruluk, dengelenmiþ doðruluk, duyarlýlýk, seçicilik, pozitif tahmin deðeri, negatif tahmin deðeri ve F1 skor performans metrikleri deðerlendirildi.
Bulgular: Özellik seçim yöntemine göre 18 gen seçilmiþ ve bu girdi deðiþkenleri ile modelleme yapýlmýþtýr. XGBoost modelinden elde edilen doðruluk, dengelenmiþ doðruluk, duyarlýlýk, özgüllük, pozitif prediktif deðer, negatif prediktif deðer ve F1 skoru sýrasýyla %98,1, %98,6, %100, %97,2, %94,4, %100 ve %97,1 idi. XGBoost’tan elde edilen deðiþken önemliliði deðerlerine göre, RNF26, FLJ10233, ACBD6, RBM12, PFAS, H3C11 ve GKP5 genleri, HBV ile iliþkili HCC için potansiyel biyobelirteçler olarak kullanýlabilir.
Sonuçlar: Araþtýrma sonucunda, makine öðrenmesi temelli tahmin yaklaþýmý ile HBV ile iliþkili HCC için olasý biyobelirteç olabilecek genler belirlendi. Elde edilen genlerin güvenilirliði sonraki araþtýrmalarda klinik olarak doðrulandýktan sonra, bu genlere dayalý olarak terapötik prosedürler oluþturulabilir ve bunlarýn klinik pratikteki yararlarý belgelenebilir.

Objective: This study aimed to classify open-access gene expression data of patients with hepatitis B virus-related hepatocellular carcinoma (HBV + HCC) and chronic HBV without HCC (HBV alone) using the XGBoost method, one of the machine learning methods, and reveal important genes that may cause HCC.
Methods: This case-control study used the open-access gene expression data of patients with HBV + HCC and HBV alone. Data from 17 patients with HBV + HCC and 36 patients with HBV were included. XGBoost was constructed for the classification via 10-fold cross-validation. Accuracy, balanced accuracy, sensitivity, selectivity, positive-predictive value, and negative-predictive value performance metrics were evaluated for model performance.
Results: According to the feature-selection method, 18 genes were selected, and modeling was performed with these input variables. Accuracy, balanced accuracy, sensitivity, specificity, positive-predictive value, negative-predictive value, and F1 score obtained from XGBoost model were 98.1%, 98.6%, 100%, 97.2%, 94.4%, 100%, and 97.1%, respectively. Based on the predictor importance findings acquired from XGBoost, the RNF26, FLJ10233, ACBD6, RBM12, PFAS, H3C11, and GKP5 can be employed as potential biomarkers of HBV-related HCC.
Conclusions: In this study, genes that may be possible biomarkers of HBV-related HCC were determined using a machine learning-based prediction approach. After the reliability of the obtained genes are clinically verified in subsequent research, therapeutic procedures can be established based on these genes, and their usefulness in clinical practice may be documented.

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Amaç: Bu çalýþmada, genel anestezi altýnda sezaryen uygulanan hastalarda intraabdominal salin ile irrigasyonun postoperatif gastrointestinal fonksiyonlar ve kýsa dönem komplikasyonlar üzerindeki etkinliði araþtýrýldý.
Yöntemler: Bu prospektif randomize klinik çalýþmaya Mart 2022 ile Mayýs 2022 arasýnda elektif sezaryen operasyonu geçiren 60 hasta dahil edildi. Katýlýmcýlar iki gruba ayrýldý; abdominal irrigasyon (n=30) ve kontrol grubu (n=30). Katýlýmcýlara standart sezaryen prosedürü uygulandý ve genel anestezi tercih edildi. Hastalar operasyon sonrasýnda bulantý, kusma, aðrý skorlamasý ve gaz gaita deþarj süresi açýsýndan sorgulandý.
Bulgular: Her iki grup arasýnda istatistiksel fark bulunmamakla birlikte (p>0,05), irrigasyon yapýlan grupta gaz ve gaita çýkýþý üzerinden incelenen baðýrsak fonksiyonlarýnýn süre olarak daha kýsa zamanda geri döndüðü görülmüþtür (19,53 ve 34,63’e ile 16,73 ve 33,7). Ýki grup karþýlaþtýrýldýðýnda, vizüel analog skala (VAS) 4-6 skoru hariç, postoperatif VAS skorlarý iki grupta benzer sonuçlanmýþtýr. Postoperatif dönemde kusma þikayeti kontrol hastalarýnda daha yaygýn görülmüþ olmakla birlikte; iki grup istatistiksel olarak karþýlaþtýrýldýðýnda postoperatif kusma, bulantý ve antiemetik ihtiyacý açýsýndan anlamlý fark bulunamamýþtýr (p>0,05).
Sonuçlar: Operasyon sýrasýnda batýn yýkamanýn gastrointestinal fonksiyonlarý ve kýsa dönem maternal morbidite üzerine etkisi olmadýðýný ve ek fayda saðlamadýðýný tespit ettik.

Objective: This study aimed to investigate the effectiveness of intraabdominal irrigation with saline on postoperative gastrointestinal functions and short-term complications in patients who underwent cesarean section under general anesthesia.
Methods: This prospective randomized controlled clinical trial was conducted between March 2022 and May 2022 and included 60 patients who underwent elective cesarean. The participants were randomized into two groups: abdominal irrigation (n=30) and control group (n=30). Participants undergo a standard cesarean procedure, and general anesthesia was preferred. The patients were questioned regarding nausea, vomiting, highest pain scores, time of flatus, and stool passage during the postoperative period.
Results: Although no significant differences were found between the two groups (p>0.05), the return of bowel functions, i.e., passage of flatus and stool, occurred in a shorter period in the irrigation group (19.53 and 34.63 versus 16.73 and 33.7). The postoperative visual analog scale (VAS) scores of the two groups were comparable; VAS score of 4-6 was the sole difference when comparing both groups. Although postoperative vomiting was more common in the control group, no significant difference in postoperative vomiting, postoperative nausea, and postoperative antiemetic need was found between the two groups (p>0.05).
Conclusions: The results revealed that intraoperative abdominal irrigation did not affect gastrointestinal functions and short-term maternal morbidity and did not provide additional benefits.

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Amaç: Aralýk 2019’da Çin’in Wuhan kentinde ortaya çýkan ve þiddetli akut solunum sendromu koronavirüs-2 olarak adlandýrýlan patojen hýzla yayýlarak pandemiye yol açmýþtýr. Bilindiði gibi koronavirüs hastalýðý-2019 (COVÝD-19), deri de dahil olmak üzere farklý organ sistemlerini etkileyebilir. Son zamanlarda, farklý klinikopatolojik özelliklere sahip deri lezyonlarý olan COVÝD-19 olgularý yayýnlanmýþtýr. Burada sunulan makalenin amacý deri bulgularý olan 19 COVÝD-19 pozitif olgunun histopatolojik özelliklerini sunmak ve literatür ýþýðýnda tartýþmaktýr.
Yöntemler: COVÝD-19 enfeksiyonu sýrasýnda deri döküntüsü olan 19 hastanýn deri biyopsisi örnekleri histopatolojik ve klinik olarak deðerlendirildi.
Bulgular: COVÝD-19 ile enfekte sekiz kadýn, yedi erkek ve dört çocuk hastada geliþen döküntülerin klinik belirtileri; ürtiker/ürtikeryal vaskülit (n=7), makülopapüler döküntü (n=7), pannikülit (n=2), purpurik döküntü (n=2) liveoid benzeri paterndeydi. Histopatolojik olarak enflamatuvar bulgularýn yaný sýra en çarpýcý özellik, hemen bütün olgularda damarlarýn az ya da çok etkilenmiþ olmasýydý.
Sonuçlar: COVÝD-19 ile iliþkili deri lezyonlarý giderek daha fazla rapor edilmektedir. Pek çok bilinmeyeni olan bu hastalýk hakkýnda sunulan her bilginin ileride yapýlacak araþtýrmalara ýþýk tutacaðýna inanýyoruz. Her olgu bize yeni bir yol gösterebilir.

Objective: In December 2019, severe acute respiratory syndrome coronavirus-2, which emerged in Wuhan, China, spread rapidly and created a pandemic. Coronavirus disease-2019 (COVID-19) can affect different organ systems, including the skin. Recently, COVID-19 cases with skin lesions of different clinicopathological features have been published. This study aimed to present the histopathological features of 19 COVID-19 cases with cutaneous findings and discuss them in light of the literature.
Methods: Skin biopsy specimens of 19 patients with skin rashes associated with COVID-19 were evaluated histopathologically and clinically.
Results: Clinical manifestations of rashes developed in eight female, seven male, and four pediatric patients with COVID-19. Urticaria/urticarial vasculitis (n=7), maculopapular eruption (n=7), panniculitis (n=2), purpuric eruptions (n=2), and livedoid-like lesions were noted. Histopathologically, besides the inflammatory findings, the most striking feature was that the vessels were more or less affected in almost all cases.
Conclusions: Cutaneous lesions associated with COVID-19 are increasingly being reported. We believe that every data presented about this disease, which has many unknowns, will shed light on future research. Every case can lead us a new way.

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Amaç: Manyetik rezonans görüntülemede görünür difüzyon katsayýsý (ADC) radyomiks verilerine dayalý sinir aðlarý ile meme kanseri moleküler alt tiplerini tahmin etmek ve lezyon boyutunun radyomiks özelliklerin stabilitesi ile iliþkisini saptamaktýr.
Yöntemler: Bu retrospektif çalýþma, Ocak 2015 ile Ocak 2020 tarihleri arasýnda görüntüleme yapýlan meme kanserli hasta kohortunu (n=221, 224 lezyon) içermektedir. Lezyon boyutu ile radyomiks özelliklerinin stabilitesi arasýndaki iliþkiyi incelemek için, tümör boyutuna dayalý (deney 1: tüm durumlar, deney 2: >1 cm3 ve deney 3: >2 cm3) üç grup oluþturulmuþtur. Üç farklý gözlemci, difüzyon aðýrlýklý görüntüleme ile oluþturulan ADC haritalarýnda tümörleri segmentlere ayýrmýþ ve bu segmentasyonlarýn hacimsel uyumu, Dice katsayýsý kullanýlarak deðerlendirilmiþtir. Radyomiks özellik (n=851) seçimi, sýnýf içi korelasyon katsayýsýna (ICC), varyasyon katsayýsýna (CoV), varyans inflasyon faktörüne (VIF) ve en küçük mutlak küçülme ve seçim operatörü regresyonuna dayandýrýlmýþtýr. Sonuçlar moleküler alt tipler olarak tanýmlanmýþtýr (Luminal A, Luminal B, HER2 ile zenginleþtirilmiþ ve üçlü negatif). Sinir aðý baþarý performansý, eðri altýndaki alan olarak sunulmuþtur.
Bulgular: Sekiz yüz elli bir radyomiks özelliðinden 611’i ICC >0,75 idi. Bu özelliklerden CoV ve VIF analizi ile 37’si birincide, 49’u ikincide ve 59’u üçüncü deneyde sabit kaldý. Ýlk deneyde Luminal B, HER2 ile zenginleþtirilmiþ ve üçlü negatif alt tipler için geliþtirilen tahmin modellerinin doðruluðu yüksekti (>%80). Ýkinci deneyde tüm modeller ve üçüncü deneyde ise HER2 ile zenginleþtirilmiþ ve üçlü negatif modeller yüksek doðruluða sahipti.
Sonuçlar: Radyomiks özellikler, artan lezyon boyutuna baðlý olarak pozitif stabilite göstermektedir. Yapay sinir aðlarý, 1 cm3 üzerindeki meme kanserlerini yüksek doðrulukla tahmin edebilmektedir.

Objective: To predict breast cancer molecular subtypes with neural networks based on magnetic resonance imaging apparent diffusion coefficient (ADC) radiomics and to detect the relation of lesion size with the stability of radiomics features.
Methods: This retrospective study included 221 consecutive patients (224 lesions) with breast cancer imaged between January 2015 and January 2020. Three sample size configurations were identified based on tumor size (experiment 1: all cases, experiment 2: >1 cm3, and experiment 3: >2 cm3). The tumors were segmented by three observers based on diffusion-weighted imaging-registered ADC maps, and the volumetric agreement of these segmentations was evaluated using the Dice coefficient. Stability of radiomics features (n=851) was evaluated with intraclass correlation coefficient (ICC, >0.75) and coefficient of variation (CoV, <0.15). Feature selection was made with variance inflation factor (VIF, <10) and least absolute shrinkage and selection operator regression. Outcomes were identified as molecular subtypes (Luminal A, Luminal B, HER2-enriched, triple-negative). Neural network performance was presented as an area under the curve and accuracies.
Results: Of the 851 radiomics features, 611 had ICC >0.75, and 37 remained stable in the first experiment, 49 in the second, and 59 in the third based on CoV and VIF analysis. High accuracy was demonstrated by the Luminal B, HER2-enriched, and triple-negative models in the first experiment (>80%), all models in the second experiment, and HER2-enriched and triple-negative models in the third experiment.
Conclusions: A positive stability is indicated by an increased lesion size related to radiomics features. Neural networks may predict moleculer subtypes of breast cancers over 1 cm3 with high accuracy.

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Dermatomiyozit (DM), ekstremitelerde simetrik ve aðýrlýklý olarak proksimal kas güçsüzlüðüne ve tipik deri lezyonlarýna neden olan nadir bir otoimmün hastalýktýr. Koronavirüs hastalýðý-2019 (COVÝD-19) pandemisi sýrasýnda prevalansý artmýþtýr. Viral enfeksiyonlar otoimmüniteye neden olabilir ve miyozit patogenezini tetikleyebilir. Çalýþmamýzda uzun bir miyalji ve kas güçsüzlüðü öyküsü olan, baþlangýçta COVÝD-19 sonrasý miyalji tanýsý konan ve ardýndan ilerleyici kas güçsüzlüðü geliþen bir erkek olgusunu sunuyoruz. Biyokimyasal ve kas biyopsisi sonuçlarý DM’yi doðruladý. Hasta steroid tedavisine olumlu yanýt verdi.

Dermatomyositis (DM) is a rare autoimmune disease that causes symmetrical and predominantly proximal muscle weakness in the limbs and typical skin lesions. Its prevalence increased during the coronavirus disease-2019 (COVID-19) pandemic. Viral infections may cause autoimmunity and trigger the pathogenesis of myositis. We present the case of a man with a long history of myalgia and muscle weakness, who was initially diagnosed with post-COVID-19 myalgia and subsequently developed progressive muscle weakness. Biochemical and muscle biopsy results confirmed DM. The patient responded favorably to the course of steroid treatment.

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Endometriyal stromal sarkom (ESS) genç kadýnlarda nadiren infertiliteye neden olmaktadýr. Çalýþmamýzda 15 yýllýk primer infertilite ile baþvuran 30’lu yaþlarýnda bir nulligravida sunmaktayýz. Histeroskopisinde submukozal nekrotik fibroid polip saptandý. Ultrasonografi birden fazla intramural fibroid olduðunu ortaya koydu. Polipektomi ile açýk myomektomi yapýldý. Histopatoloji, fibroid polip içinde düþük dereceli ESS (LGESS) ortaya çýkardý. Ardýndan hastaya tamamlayýcý cerrahi uygulandý. Nihai tanýsý östrojen reseptörü pozitif LGESS evre IIIB idi ve hastaya anastrozol adjuvan tedavisi ve uzun süreli gözetim önerildi. Anormal perimenopozal kanamalý ESS, en yaygýn semptom olmasýna raðmen her zaman gözlenmeyebilir. Bu nedenle, nadir de olsa uterin fibroid polipinde ESS þüphesi yüksek bir ayýrýcý taný olarak daima akýlda tutulmalýdýr. ESS ile ilgili daha kapsamlý çalýþmalarýn azlýðý göz önüne alýndýðýnda, olgularýn raporlanmasý yönetim protokollerinin formüle edilmesine yardýmcý olacaktýr.

Endometrial stromal sarcoma (ESS) rarely causes infertility in young women. We report a nulligravida in her 30s who presented with primary infertility of 15 years. Hysteroscopy revealed a submucosal necrotic fibroid polyp. Ultrasonography detected multiple intramural fibroids. Open myomectomy with polypectomy was performed. Histopathology revealed low-grade ESS (LGESS) within the fibroid polyp. Subsequently, the patient underwent completion surgery. Her final diagnosis was estrogen-receptor positive LGESS stage IIIB, and she was suggested anastrozole adjuvant therapy and long-term surveillance. ESS with abnormal perimenopausal bleeding, though the most common presentation, may not always observed. Hence, a high index of suspicion of ESS should always be kept as a differential diagnosis in uterine fibroid polyp, though rare. Considering the scarcity of more extensive studies on ESS, reporting of cases will aid in formulating management protocols.

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