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Öğe Assessment of p-wave dispersion and atrial electromechanical delay in patients with non-obstructive coronary artery myocardial infarction(Springer International Publishing, 2025) Keleşoğlu, Şaban; Yılmaz, Yücel; Elçik, Deniz; İnci, Sinan; Gül, Murat; Kalay, NihatWe investigated p-wave dispersion (Pd) and atrial electromechanical delay (EMD) in patients diagnosed with non-obstructive coronary artery disease and myocardial infarction (MINOCA). Background: The clinical importance and recognition of MINOCA are increasing. However, there is a gap in knowledge regarding the risk of atrial fibrillation in patients with MINOCA. Methods: Forty-three patients with MINOCA (average age 48.69 ± 5.83 years) and thirty-four patients with non-obstructed coronary artery disease (INOCA) (average age 49.82 ± 10.22 years) were enrolled in the study. Echocardiographic studies were conducted in the MINOCA and INOCA groups in the left lateral decubitus position using a medical ultrasound device. Atrial electromechanical coupling (PA) and intra-atrial and interatrial EMD were measured using tissue Doppler echocardiography. Pd was measured using 12-lead electrocardiography. Results: Clinical and demographic characteristics were similar between groups. The maximum P-wave (Pmax) time and Pd values of patients diagnosed with MINOCA were significantly longer than those of patients diagnosed with INOCA (Pmax times: 109.72 ± 7.09 ms and 95.17 ± 7.50 ms, respectively, p < 0.01; Pd: 47.30 ± 8.99 ms and 34.14 ± 11.31 ms, respectively, p < 0.01). Tissue Doppler Imaging (TDI) revealed significantly longer atrial EMD parameters (PA lateral and PA septum) in patients diagnosed with MINOCA than in those diagnosed with INOCA (69.60 ± 8.79 ms and 57.08 ± 11.54 ms, respectively, p < 0.01; 54.83 ± 6.45 ms and 45.35 ± 8.50 ms, respectively, p < 0.01). Conclusion: This study showed that the duration of atrial EMD and Pd was prolonged in patients with MINOCA, suggesting a potential susceptibility to atrial conduction abnormalities.Öğe PET-CT indications and contributions to diagnosis in the rheumatology clinic: a retrospective analysis(Springer Science and Business Media Deutschland GmbH, 2025) Kahraman Denizhan, Tuğba; Kaplan, Hüseyin; Kızıltepe, Melih; Kökoğlu, Emel Oğuz; Cengiz, Celil Barlas; Abdulrezzak, Ümmühan; Şenel, Abdurrahman SonerPositron emission tomography-computed tomography (PET-CT) is a valuable imaging modality in both oncology and autoimmune or inflammatory diseases. This study evaluates the indications for PET-CT in rheumatology patients, compares PET-CT findings with other imaging modalities, and assesses its contribution to definitive diagnosis. Methods: Between January 2022 and December 2023, 63 patients (38 women, 25 men) who underwent PET-CT at Erciyes University Rheumatology Clinic were retrospectively analyzed. Clinical, laboratory, and imaging findings—including prior CT, magnetic resonance imaging (MRI), and angiographic evaluations—were reviewed. PET-CT findings were classified based on metabolic uptake patterns indicating malignancy, vasculitis, inflammatory involvement, lymphadenopathy, and IgG4-related diseases. PET-CT results were statistically compared with final diagnoses. Results: The most common indications for PET-CT were suspected vasculitis (42.9%), fever/inflammation of unknown origin (30.2%), and suspected malignancy (27.0%). PET-CT detected inflammation in 65.1% of cases, lymphadenopathy in 52.4%, nodules in 41.3%, malignancy in 31.7%, and vasculitis in 20.6%. Vasculitis findings were significantly higher in patients with pre-existing rheumatic disease (p = 0.012), while malignancy-related findings were more frequent in those without (p = 0.025). Anti-SSA and anti-Scl70 positivity were significantly associated with malignancy (p = 0.003 and p = 0.030, respectively). PET-CT effectively detected malignancy (p < 0.001) but showed limited diagnostic accuracy for vasculitis (47.6%). Conclusion: PET-CT complements conventional imaging in evaluating vasculitis, inflammation, and malignancy in rheumatic diseases. However, it is insufficient for diagnosing vasculitis alone, necessitating a comprehensive clinical and laboratory approach. While PET-CT is highly effective in malignancy detection, autoantibody presence should be carefully considered in suspected cases.Öğe The correlation between systemic immune-inflammatory index and helicobacter pylori infection and its severity(Galenos Publishing House, 2025) Ordu, Melike; Öztürk, Gülfidan; Ergin, MustafaThe systemic immune-inflammatory index (SII), derived from routine hemogram parameters, has recently emerged as a novel marker reflecting the balance between host immune status and inflammatory burden and may offer information about the severity of Helicobacter pylori (H. pylori) associated gastric inflammation. We investigated whether there was a correlation between H. pylori inflammation, its severity, and this index. Methods: This single-center, retrospective study was conducted between January and December 2021. A total of 1137 H. pylori-positive and 401 H. pylori-negative patients who underwent upper gastrointestinal endoscopy were included. Participants were grouped based on gastric tissue activity and chronicity scores, which reflect the histological severity of inflammation and mononuclear infiltration, respectively, as defined by the updated Sydney system. The SII and other inflammatory markers were statistically compared between groups. Correlation analysis was also performed to evaluate the relationship between histological severity and inflammatory parameters. Results: Lymphocyte, neutrophil, platelet, SII, neutrophil-to-lymphocyte ratio, and platelet-to-lymphocyte ratio were compared between the groups. No significant differences were observed. There was no significant difference in terms of the SII and other parameters in the H. pylori (+) group when the “1(+)” and “2(+) and 3(+)” subgroups were compared. No significant relationship was found between tissue activity and chronicity score values and inflammatory markers. Conclusion: No correlation was found between the presence and severity of H. pylori and the SII. This is the first study to compare inflammatory markers in the blood with activity and chronicity findings in the tissue.Öğe Reliability of categorization of the shape of the lateral edge of the first metatarsal head in hallux valgus(Lippincott Williams and Wilkins, 2025) Akgün, Ulaş; Özkan, Deniz; Gültaç, Emre; Canbek, UmutHallux valgus is a triplanar deformity with rotation being a significant contributing factor. Several methods exist for evaluating rotational deformity of the first ray, one of which involves assessing the shape of the lateral edge of the first metatarsal head. This study aimed to investigate the interobserver and intraobserver reliabilities of circle measurements on weight-bearing anteroposterior radiographs to categorize the shape of the lateral edge of the first metatarsal head. A power analysis determined that a minimum of 128 radiographs was required to assess observer agreement for categorical data (alpha = 0.05, beta = 0.2, power = 80%). Patients diagnosed with hallux valgus at our institution between January 2015 and December 2019 were retrospectively reviewed and 128 radiographs were randomly selected. Two foot and ankle surgeons and 2 radiologists evaluated the radiographs on 2 separate occasions, classifying the first metatarsal head shape into 3 categories (angular, intermediate, and round) using circular measurements. Interobserver reliability was assessed using Fleiss' kappa, whereas intraobserver reliability was evaluated using Cohen kappa. Interobserver reliability for classifying the shape of the lateral edge of the first metatarsal head was found to be very good in both assessments (Fleiss' kappa = 0.83 and 0.84, respectively). The subcategory analysis revealed the highest agreement for the angular type, followed by the round type, with the lowest agreement observed for the intermediate type. The intraobserver Cohen kappa values ranged from 0.78 to 0.91. The level of interobserver agreement was found to be very good for the classification of the shape of the first metatarsal, and the intraobserver agreements were substantial to very good. In our opinion, this method is reliable and may be useful in determining the necessity for rotation-correcting surgery and advanced imaging with weight-bearing computed tomography.Öğe Validation of Turkish psoriatic arthritis screening tool for psoriatic arthritis: A cross-sectional comparative study(Lippincott Williams and Wilkins, 2025) Başar Kılıç, Şeyma; Kulu, Huzeyfe; Salman, Hüseyin; Bektaş, MuratPsoriasis (PsO) is a chronic immune-mediated disease that affects the skin and nails. Several screening tools such as psoriasis epidemiology screening tool, psoriatic arthritis screening and evaluation, early arthritis for psoriatic patients (EARP), STRIPP, SIPAS, and TOPAS have been developed and validated for identifying patients with suspected psoriatic arthritis (PsA) in dermatology clinics. Herein, we aim to validate and evaluate the performance of TurPAS in patients with PsO compared to the EARP questionnaire. This cross-sectional study was carried out in collaboration between dermatology and rheumatology clinics at Aksaray University Hospital, a tertiary referral center. All patients were examined for dermatologic aspects in the dermatology outpatient clinic and TurPAS and EARP questionnaires were performed by the same dermatologist. The patients who met the CASPAR criteria were classified as PsA in addition to appropriate clinical findings. In our study, 119 patients (n=72; 60.5% female) with PsO were included. Mean±standard deviation age of the patients was 44.9±14.3 (range; 18-83) years and the median (IQR) PsO duration was 10 (14) years. Median (IQR) TurPAS and EARP scores were 2 (3) and 3 (5), respectively. Overall, 39 patients (32.8%) met the CASPAR criteria and were classified as PsA. The best diagnostic accuracy was observed in≥3 positive items with 82% and 70% sensitivity and specificity (positive predictive value: 57.1%, negative predictive value: 89%, likelihood ratio: 2.7, diagnostic accuracy: 74%) for TurPAS and≥4 items with 74.4% and 86.3% (positive predictive value: 72.5%, negative predictive value: 87.3%, likelihood ratio: 5.4, diagnostic accuracy: 82.4%) for EARP. In our study, approximately one-third of patients with PsO were diagnosed as PsA. TurPAS had acceptable diagnostic performance compared to the EARP questionnaire. © 2025 the Author(s).Öğe Association between air pollution and climate parameters exposure during the periconceptional period and hypospadias risk in Turkish offspring: A case-control study(Elsevier B.V., 2025) Demirtaş, Mehmet Semih; Yalçın, Sıddıka Songül; Tusat, Mustafa; Özmen, İsmail; Başar, Dilek; Calapoğlu, Ahmet Salih Calapoglu, Ahmet Salih lu, Ahmet Salih; Siyve, Serdar; Demirtaş, Orhan; Altıntaş Ural, DilanWe aimed to investigate the associations between hypospadias and contact to air pollutants and climate parameters during the pre- and post-conceptional periods. This study has been carried out as a multicentre case-control study involving 340 children with hypospadias between the ages of 0–3 years and 357 children in the same age range who applied for circumcision. A total of 7 air pollutant (PM2.5, PM10, NO, NO2, SO2, CO, O3), 5 climate parameters [air temperature, relative humidity (RH), air pressure (AP), wind speed (WS) and precipitation amounts data were obtained. In the multivariate logistic regression analysis, younger maternal age (reference: >35 years) and maternal smoking (reference: no exposure) were significantly associated with a higher likelihood of hypospadias. Conversely, folic acid supplementation intake during pregnancy (reference: no supplementation) and maternal BMI in the range of 25–30 (reference: <25) were associated with a lower likelihood of its occurrence. After adjusting for child-family characteristics, increased interquartile ranges (IQR) of CO, mean temperature, minimum temperature, RH, and AP were positively associated with hypospadias, whereas SO2 levels and diurnal temperature range (DTR) were inversely associated. Comprehensive analysis of individual and environmental factors further highlighted that younger maternal age, smoking exposure, PM10, and air pressure were positively associated with hypospadias, while a greater DTR was inversely associated. Younger maternal age, smoking exposure, and specific air pollutants, such as PM10 and CO, as well as climatic factors like AP, were positively associated with hypospadias. These findings underscore the importance of mitigating environmental exposures and promoting maternal health interventions to reduce the risk of congenital anomalies like hypospadias. Further longitudinal studies are warranted to confirm these associations and explore underlying mechanisms.Öğe Prognostic importance of the pan-immune-inflammation value and potential serological biomarkers of complicated peritonsillar abscesses(MediHealth Academy Yayıncılık, 2025) Sanalp Menekşe, Tuğba; Şirin, İlker; Güçlü Utlu, Sibel; Sert, Ekrem TahaA peritonsillar abscess (PTA) is the most common deep infection of the head and neck and can sometimes be associated with life-threatening complications. Clinical symptoms in patients with a complicated peritonsillar abscess (CPTA) may not always reflect the severity of this disease. Therefore, monitoring these patients with inexpensive and easily accessible hematological parameters is essential. Recently, certain inflammatory monitoring markers have gained acceptance. In this study, we aimed to determine the role of the pan-immune-inflammation value (PIV) in patients with a PTA at a high risk of complications. Methods: Patients aged 18 years and older who were diagnosed with a PTA and hospitalized in our clinic between October 10, 2022, and October 1, 2024 were retrospectively analyzed. The patients were divided into the CPTA group and the uncomplicated peritonsillar abscess (UPTA) group. Demographic characteristics, laboratory findings, and complications observed in the emergency department were evaluated. Results: A total of 104 patients were included in the study, with 71 in the UPTA group and 33 in the CPTA group. PIV values were significantly higher in the CPTA group compared to the UPTA group. The diagnostic value of PIV in predicting PTA-related complications was assessed using receiver operating characteristic curve analysis. A PIV cutoff value of 989.6 (AUC: 0.838; 95% confidence interval: 0.753-0.903) demonstrated a sensitivity of 72.7% and a specificity of 85.9%, indicating superior predictive power for PTA-related complications compared to NLR, MLR, and SII. Conclusion: Our findings suggest that the PIV is a rapid, simple, and reliable marker for predicting the severity of PTAs and potential complications.Öğe Covid-19 pandemi döneminde inflamatuar bağırsak hastalığı olanlarda hastalık aktivitesi, yaşam kalitesi ve anksiyete düzeyinin belirlenmesi(Jülide Gülay Özler, 2025) Demir, Beril; Karataş, Ali; Demir, Emre; İbiş, Mehmet; Arhan, MehmetBu çalışma ile, COVID-19 pandemisinin inflamatuvar bağırsak hastalığı olan bireylerin yaşam kalitesi, hastalık aktivitesi ve anksiyete düzeyleri üzerindeki etkilerinin değerlendirilmesi amaçlanmaktadır. Gereç ve Yöntem: Çalışma, Gazi Üniversitesi Gastroenteroloji Polikliniğinde, 62 inflamatuvar bağırsak hastası ve 60 sağlıklı bireyden oluşan bir kontrol grubuyla gerçekleştirilmiştir. Katılımcılara, Beck Anksiyete Ölçeği ve Dünya Sağlık Örgütü Yaşam Kalitesi Ölçeği uygulanmıştır. İnflamatuvar bağırsak hastalarının hastalık aktivitesi, Crohn Hastalığı Aktivite İndeksi ve Mayo Klinik Skoru ile değerlendirilmiştir. Bulgular: İnflamatuvar bağırsak hastalarının genel sağlık, fiziksel, psikolojik ve sosyal alan- lardaki yaşam kalitesi puanlarının kontrol grubuna kıyasla anlamlı derecede düşük olduğu bulunmuştur (p < 0.05). Çevresel alan puanlarında ise anlamlı bir fark tespit edilmemiştir. Anksiyete düzeyleri, inflamatuvar bağırsak hastalığı grubunda belirgin bir artış göstermiş ve hastalık aktivitesi ile pozitif korelasyon göstermiştir. Hastaların %80.6’sı COVID-19’un hastalıklarıyla ilgili risk oluşturduğunu belirtmiş, %35.5’i hastane takiplerini aksat- mış ve %11.3’ü ilaçlarını bırakmıştır. Ayrıca, hastalık aktivitesi ile yaşam kalitesi arasında negatif bir ilişki olduğu, buna karşın anksiyete düzeyi ile pozitif bir ilişki olduğu saptanmıştır. Sonuç: COVID-19 pandemisi inflamatuvar bağırsak hastalarının yaşam kalitesinde belirgin bir düşüşe ve ank- siyete düzeylerinde artışa neden olmuştur. Hastalık aktivitesinin, bu etkilerde belirgin bir rol oynadığı tespit edilmiştir. Bu bulgular, hasta-hekim il- etişiminin güçlendirilmesi, teletıp uygulamalarının yaygınlaştırılması ve psikososyal destek sağlanmasının önemini ortaya koymaktadır. Olağanüstü durumlarda inflamatuvar bağırsak hastalığı yönetimine yönelik yeni stratejilerin geliştirilmesi gerekliliğinin mevcut olduğu düşünülmüştür.Öğe Clinical outcomes of patients transported to the obstetric emergency department directly by ambulance and via inter-hospital transfer(Effect Publishing Agency ( EPA ), 2025) Kaya, Seray; Genç, Murat; Bulut, Bensu; Akkan Öz, Medine; Yazıcı, Ramiz; Mutlu, Hüseyin; Önder Gönen, MustafaThe aim of this study was to investigate the characteristics of pregnant patients transported directly by ambulance or by transfer between hospitals to the obstetric emergency department. The study was conducted among patients aged 18 years and over who were presented to the obstetric emergency department by ambulance between January 2024 and June 2024. Patients were divided into two groups as direct admission and inter-hospital transfer. Demographic characteristics, triage categories, indications for transfer, hospitalisation rates and length of hospital stay were recorded. Data were statistically analysed. A total of 600 patients were included in the study. In the inter-hospital transfer group, the hospitalisation rate and mean length of stay were significantly higher than in the direct admission group (30% vs 15% and 7 days vs 3 days, respectively). The rate and length of stay of patients in the Code Red triage category were higher in the transfer group. The most common indication for transfer was the need for a specialist. The rate and length of stay for patients requiring intensive care were higher than for other indications of transfer. Inter-hospital transfer is an important factor that may affect patient outcomes in the obstetric emergency department. Transferred patients were found to be more likely to be hospitalised and to have a longer length of stay. Optimising the transfer process is essential to ensure patient safety and minimise adverse outcomes.Öğe Evaluation of progression predictability with systemic inflammatory biomarkers in keratoconus patients(Effect Publishing Agency ( EPA ), 2025) Akbulut Yağcı, Betül; Erdal, Hüseyin; Uyar, Enes; Deniz, MelikeThis research aimed to assess the association between keratoconus (KC) progression and systemic inflammation markers. Additionally, we aimed to identify which specific systemic inflammation markers have a predictive effect on the progression of KC. 111 patients, including 69 with stable KC, and 42 with progressive KC were diagnosed and subsequently followed up between 2020-2023 at the Ophthalmology Clinics. This retrospective study also included 52 gender and age-matched healthy individuals who underwent examination at the Ophthalmology department. From the hemogram parameters, neutrophils, lymphocytes, platelets, and monocytes levels were used to calculate the systemic inflammation markers. When the KC patients and the healthy control group were related, significant differences were found in keratometry values (K1, K2, Kmax), astigmatism, central cornea thickness (CCT), and Baiocchi Calossi Versaci (BCV) values. No significant difference was detected when hemogram parameters except for neutrophils and platelets were compared in all groups (p>0.05). However, statistically significant differences were detected among the groups in the inflammatory values (pÖğe Lifelong premature ejaculation and attentio(IMR Press, 2022) Beşiktepe Ayan, Ülkü; Gıynaş Ayhan, MedineIn males, one of the most common sexual dysfunction is lifelong premature ejaculation. Sexual dysfunctions, including premature ejaculation, are highly prevalent in adults with attention-deficit hyperactivity disorder. This study aimed to examine the prevalence and symptoms of attention-deficit hyperactivity disorder in patients with lifelong premature ejaculation. Methods: In this study, 48 patients diagnosed with lifelong premature ejaculation and 40 controls were included. All patients and controls were asked to fill out Wender– Utah Rating Scale-25 and Adult Attention-Deficit Hyperactivity Disorder Self-Report Scale. Patients also filled out the Arabic Index of Premature Ejaculation and Premature Ejaculation Diagnostic Tool. Results: Totally 20 patients (41.66%) with lifelong premature ejaculation and 2 (5%) controls were diagnosed with attention-deficit hyperactivity disorder. The mean scores of the Wender–Utah Rating Scale-25, Adult Attention-Deficit Hyperactivity Disorder Self-Report Scale, and Adult Attention-Deficit Hyperactivity Disorder Self-Report Scalehyperactivity– impulsivity subscale were higher in the case group (P = .001, P = .001, and P < .001, respectively). No difference was found between the 2 groups in terms of the Adult Attention-Deficit Hyperactivity Disorder Self-Report Scale-Inattention subtype (P = .492). In the lifelong premature ejaculation group, 13 patients (65%) diagnosed with attention-deficit hyperactivity disorder were found to be attention-deficit hyperactivity disorder-predominantly hyperactivity/impulsivity subtype. Conclusions: The findings of the current study reveal that patients with lifelong premature ejaculation should be assessed carefully in terms of attention-deficit hyperactivity disorder, especially hyperactive and impulsive characteristics, and the relationship between lifelong premature ejaculation and attention-deficit hyperactivity disorder should be examined by further studies with large samples.Öğe Burnout and job satisfaction among family physician(Aile Hekimliği Akademisi Derneği, 2022) Gökdemir, Özden; Dağbağlı, Gamze; Aygün, Olgu; Bulut Batur, Ülkü; Güldal, DilekBurnout syndrome is a major problem, especially among health care workers. The higher the sense of individual skills and achievement, the lower the likelihood of burnout syndrome. The objective of the study is to measure the level of burnout and job satisfaction of family physicians. Methods: Both data of the Family Physicians (FPs) who are working in rural and urban has been included in the study. The study is designed to measure their level of burnout and job satisfaction using the Maslach Burnout Inventory, Minnesota Work Satisfaction Questionnaire. Their relationship with the working area and other factors is also analyzed. Results: Maslach depersonalization subscale was found to be significantly higher in those who lived alone, those who defined their location as rural, and those who did not participate in continuing medical education (CME) (p=0.02, p=0.01, p=0.03). While Maslach personal achievement score was low in those who define their location as rural (p=0.01) it was found to be higher in women and those who did not participate in CME (p=0.02, p=0.03). In addition, as age increases, Maslach emotional burnout and depersonalization scores decrease and personal success scores increase (r =-0.169, -0.205, 0.163 and p=0.00, p=0.00, p=0.00). Conclusions: Emotional and total burnout scores decreased with age, and that attending CME increased personal achievement. CME could be a beneficial tool not only to support FPs but also to prevent burnout.Öğe The role of regional block and sedation accompanied thoracoscopy on the diagnosis and treatment of post-trauma patients chest tube inserted(Eskişehir Osmangazi Üniversitesi Rektörlüğü, 2022) Mehmet Ali Eryazgan; Karaca, Onur; Zengin, Musa; Koçer, BülentTraumatic hemothorax/pneumothorax; is a pathological condition seen in blunt and sharp thoracic traumas and can generally be treated by tube thoracostomy. While patients are being followed up with tube thoracotomy, analgesics support, and respiratory exercise support; emergency thoracotomy is usually not required. Early thoracoscopy is a method that has come to the fore in recent years. This thoracoscopy is known to have therapeutic and diagnostic benefits. In our study; the files of 40 patients who underwent tube thoracostomy after traumatic hemothorax/pneumothorax were reviewed retrospectively. Twenty of these patients, whose radiological and clinical improvement could not be achieved after tube thoracostomy, underwent thoracoscopy with sedo-analgesia on the first day after the procedure. The remaining 20 patients were followed up without any additional procedures. Patients' age, gender, trauma type, tube thoracostomy indication, presence of additional trauma, length of chest tube stay, length of hospital stay, WBC, RDW, %Neu, pO2, pCO2, SO2, presence of tube malposition, and complications were recorded from patient files. Demographic data of the two groups were similar. While tube withdrawal time was 4.7±1.5 days in the thoracoscopy group, it was 6.9±1.9 days in the control group. This difference was statistically significant (p < 0.001). The mean hospital stay was 7.1±2.0 days in the first group, while it was 9.3±3.3 days in the control group. This difference was statistically significant (p=0.014). In both groups, there was a 1 (5%) patient who developed a need for thoracotomy. Thoracoscopy with sedo-analgesia in early period is a safe method for patients who have undergone tube thoracostomy due to trauma. This method reduces the duration of chest tube removal and hospital stay of patients. The need for thoracotomy after follow-up was similar in both groups..Öğe The role of serum HDL, LDL, and uric acid levels in predicting the prognosis of community-acquired pneumonia(Eylem Değirmenci, 2022) Hoşgün, Derya; Akpınar, Evrim Eylem; Günay, Ersin; Ateş, Can; Ogan, Nalan; Afşar Karatepe, BerçemCommunity-acquired pneumonia (CAP) leads to inflammation and oxidative stress as a result in infection. In the present study, we aimed to investigate the relationship between initial serum high-density lipoprotein (HDL), low-density lipoprotein (HDL), and uric acid levels on short-term (30-day) changes in the course of CAP.Materials and methods: The retrospective study included 113 patients with CAP that received inpatient care between 2012 and 2018.The HDL, LDL and uric acid values in the blood received in hospital admission were examined for their relationship with short-term mortality and correlation with hospitalization.Results: The 113 patients comprised 71 (62.8%) men and 42 (37.2%) women with a mean age of 74±11 years. Of the 113 patients, 30-day mortality occurred in 12 (10.6%) patients. Of the 113 patients, 17 (16.5%) patients were hospitalized in ICU. All cases detected as mortality were followed in ICU. Normal ranges of HDL, LDL, and uric acid concentrations were accepted as 40-70 mg/dL, 60-130 mg/dL, and 1.8-8 mg/dL, respectively. The mean serum LDL, HDL, and uric acid levels were 97.95±42.11 (range, 26-271) mg/dL, 40.94±13.70 (range, 5.10-83.20) mg/dL, and 5.99±2.18 (range, 1.40-13.20) mg/dL, respectively. HDL and LDL levels were found to be insignificant predictors of 30-day mortality (p=0.482 and p=0.725, respectively). Similarly, serum HDL, LDL, and uric acid levels were found to be insignificant predictors of the duration of hospitalization and ICU requirement. On the other hand, multivariate logistic regression analysis indicated that uric acid concentration was a protective factor for 30-day mortality (OR, 0.694; 95% Cl, 0.478-0.989, p=0.048), whereby increased uric acid concentration was found to decrease the risk of mortality and reduced uric acid concentration was found to increase the risk of mortality by 1.44 times (1/0.694).Conclusion: We suggest that monitoring uric acid levels with serial measurements in patients with CAP may be useful for predicting the short term prognosis. Further prospective multicentric studies with larger patient series are needed to investigate the correlation between serum uric acid levels and clinical risk scores.Öğe Clinical characteristics and outcomes of pregnant women admitted to the emergency department(İnönü Üniversitesi, 2022) Sanalp Menekşe, Tuğba; Soykan Sert, Zekiye; Sert, Ekrem TahaTo evaluate the demographic and obstetric characteristics, complaints, and outcomes of pregnant patients who presented to the emergency department (ED). Materials and Methods: Pregnant women aged 18 years and over who presented to the ED of our hospital between September 30, 2020, and September 30, 2021, were retrospectively included in the study. The clinical data of the patients were obtained from the hospital’s electronic database. The patients’ age, gestational week, complaints at the time of presentation to ED, distribution of diagnoses, and outcomes (admission and discharge) were recorded. Results: A total of 561 pregnant patients were included in the study. The mean age of the patients was 27.6±5.7 years, and 42.6% were in the third trimester. We found that 59.8% of the cases presented to ED for obstetric reasons and 40.2% for non-obstetric reasons. While 55.5% of the patients with obstetric presentations underwent emergency delivery, 51.3% of the those with non-obstetric presentations had respiratory tract infections. In addition, 90.7% of the patients with obstetric presentations were hospitalized. The hospitalization rate of those with obstetric presentations was statistically significantly higher than the non-obstetric presentation group (p<0.001). Conclusion: We found that the ED visits of pregnant women mostly occurred during the third trimester and for obstetric reasons. The early detection of life-threatening complications in pregnant women is critical for the health of both the mother and fetus. It is important to increase the awareness of clinicians concerning obstetric emergencies due to the special nature of this patient population and frequency of emergency surgical interventions.Öğe Editöre mektup: kaptoprile bağlı gelişen akut pankreatit: olgu sunumu(Ahi Evran Üniversitesi Tıp Fakültesi, 2021) Özdemir, Serdar; Kokulu, KamilKaplan ve arkadaşları tarafından hazırlanan “Kaptoprile bağlı gelişen akut pankreatit: Olgu sunumu” başlıklı olgu sunumunu büyük bir ilgi ile okuduk.1 Yazarlara sık kullanılan antihipertansif ajanlardan biri olan ve daha çok öksürük, anjiyoödem ve böbrek yetmezliği yan etkileri bilinen kaptoprilin akut pankreatit gibi nadir görülen yan etkisini vurgulayan bu yazıdan dolayı teşekkür ederiz. Bununla birlikte olgunun tartışmasına katkı sunabilecek birkaç noktaya değinmek isteriz.Öğe Evaluation of kidney functions after nephrectomy: single center experience(Necmettin Erbakan Üniversitesi, Meram Tıp Fakültesi, 2021) Sarıtaş, Hazen; Ok, Fesih; Erdoğan, ÖmerIn this study, it was aimed to investigate the kidney function, hypertension development and proteinuria in individuals with only one kidney . Patients and Methods: The study included 96 patients who had previously undergone nephrectomy with the causes of nephrolithiasis and chronic pyelonephritis-induced nonfunctional kidney, RCC (Renal Cell carcinoma), trauma, and donor nephrectomy among 17800 patients who applied to the Siirt State Hospital Nephrology and Urology outpatient clinics between January 2016 and December 2019. The data of the patients were obtained from patient files database retrospectiv ely. Results: A total of 96 patients, 45 female and 51 male, were included in the study. 23 (24%) of the patients had donor nephrectomy (DN), and 73 (76%) had nephrectomy (DE) due to nephrolithiasis, chronic pyelonephritis, trauma, and renal cell cancer (RCC). The patients were divided into two groups as those who underwent DN and DE due to other etiologies. Between DN and DE group, there was no statistically significant difference in terms of mean age, distribution of gender, presence of HT before nephrectomy, DM, presence of hematuria and new onset proteinuria (P> 0.05). Compared to the DN group, the frequency of new onset in CKD and HT development was significantly higher DE group. Conclusion: Nephrectomy is a risk factor for the development of CKD, proteinuria and hypertension. Therefore, preventive measures should be taken in a timely manner to reduce the prevalence of nephrectomies due to benign diseases.Öğe Retroaortik sol renal ven basit renal kist oluşumunda predispozan bir faktör mü(Kafkas Üniversitesi Tıp Fakültesi, 2021) Erdoğan, HasanRetroaortik sol renal ven (RSRV) abdominal aorta ile vertebra arasından geçerek vena cava inferiora drene olur. Bu durum, sol renal venin abdominal aorta ile vertebra arasında basıya uğramasına ve sol renal vende basınç artışına neden olur. Biz bu çalışmada, abdomen bilgisayarlı tomografi (BT)’de RSRV olan olgularda sol renal vendeki basınç artışının basit renal kistler ile ilişkili olup olmadığını değerlendirmeyi amaçladık. Materyal ve Metot: Bu çalışma retrospektif olarak, 2015–2019 yılları arasındaki abdomen BT görüntüleri taranarak yapıldı. RSRV saptanan toplam 198 hasta çalışmaya dâhil edildi. Bu hastalarda sağ ve sol böbrek arasında kist sayısı ve boyutu açısından anlamlı fark olup olmadığı istatistiksel olarak değerlendirildi. Bulgular: Hastaların yaş ortalaması 52,6±16,5 (19–90) olarak saptandı. Kist sayıları açısından her iki böbrek arasında anlamlı bir fark saptanmadı (P=0,737). Kist boyutu açısından ise her iki böbrek arasında anlamlı bir fark mevcuttu (P=0,012). RSRV’yi olan sol böbrekteki kistlerin boyutları anlamlı düzeyde daha büyüktü. Sonuç: Çalışmamızda her iki böbrek arasında kist sayıları açısından anlamlı bir fark bulamazken, RSRV’ye sahip olan sol böbrekteki kistlerin boyutunun anlamlı olarak daha büyük olduğunu saptadık. Bu durum RSRV’nin renal kist oluşumunda etkisinin olmayabileceğini, fakat oluşan kistlerin boyutuna etki edebileceğini düşündürmektedir.Öğe Determinants of outcomes in older adult patients admitted to the ıntensive care unit from the emergency department(Muğla Sıtkı Koçman Üniversitesi, 2021) Kokulu, Kamil; Sert, Ekrem Taha; Mutlu, Hüseyin; Sarıtaş, AyhanThere is no consensus among clinicians on the criteria for admission of older adult patients to the intensive care unit (ICU). In this study, we aimed to determine the impact of risk factors assessed during admission to the emergency department (ED) in older adult patients admitted to the ICU from the ED on ICU mortality. Patients aged 65 years or older, who were admitted to the ICU between January 1, 2019, and December 31, 2019, were retrospectively evaluated. Patients were divided into two groups according to their age: 65–74 years old and 75 years and older. Clinical and demographic data were evaluated and patients were analyzed according to the age groups. The association of risk factors on ICU mortality was determined using logistic regression analysis. Of the 839 patients included in the study, 66.3% were in the 65–74 age group and 33.7% were in the ≥75 age group. A proportion of 24.7% of the patients (n=207) died. The risk factors associated with ICU mortality were low mean arterial pressure (OR=0.98, 95% CI:0.97-0.99), low Glasgow Coma Scale score (OR=0.73, 95% CI:0.66-0.80), intubation requirement (OR=12.58, 95% CI:6.02–26.30), underlying cancer diagnosis (OR=7.23, 95% CI: 2.60-20.16), and long stay in the ED (OR=1.65, 95% CI:1.46–1.87).Age alone was not associated with ICU mortality (p=0.122). Admission to the ICU from the ED should consider the risk factors associated with ICU mortality.Öğe The importance of anterior segment examination in resistant macular edema(Gazi Göz Vakfı, 2021) Yaşar, Erdoğan; Gürlevik, Uğur; Yıldırım, Nilgün; Özer, Ahmet; Bilgeç, Mustafa DeğerA 28-year old male patient underwent cataract surgery and secondary IOL implantation in the sulcus at an external centre for a diagnosis of traumatic cataract to the right eye. The patient then had reduced vision and was diagnosed with CMO. Despite a total of 15 antiVEGF applications at the external centre, the edema did not improve. In our examination, it was seen that the IOL had been placed in the sulcus and one leg was suspended on the iridotomy. IOP was 26mmHg. On FFA, there was seen to be leakage in the optic disc, peripheral retina and macula. It was thought that the CMO was secondary to infl ammation caused by contact of the IOL on the iris. Surgery was performed by suturing the haptics to the sclera using the patient’s own IOL. Then no CMO was observed throughout 2 years. The elevated IOP continued and the causes of this were thought to be steroid use, infl ammation and damage at the micro level in the angular structure associated with the trauma.
