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Öğe Evaluation of the Sheffield score, clinical characteristics, and the therapeutic approach in children with upper gastrointestinal system bleeding(Verduci Publisher, 2022) Yucel, A.OBJECTIVE: Unlike adults, there is no valid and reliable scoring system for upper gastrointestinal system bleeding (UGB) in children. The Sheffield scoring system, which is awaiting confirmation, is the single scoring system which can be predictive for children who require high-risk, endoscopic therapeutic intervention. The aim of this study was to evaluate the efficacy of the Sheffield scoring system, the clinical characteristics of patients, and the treatments applied. PATIENTS AND METHODS: Evaluation was made of a total of 86 children with UGB who underwent esophagogastroduodenoscopy and for whom the Sheffield score was calculated. The decision for therapeutic intervention was made according to the clinical status independently of the score. The demographic data of the patients, clinical symptoms and findings, risk factors, and treatments were examined retrospectively. RESULTS: The Sheffield score was calculated as >8 in 67.4% of the patients and > 8 in 32.6%. Endoscopic hemostatic intervention was applied to 15.1% of the patients. The rate of therapeutic endoscopy was significantly high in the high-score group. In 11 patients with Sheffield score >8, the bleeding was brought under control with octreotide treatment administered before endoscopy and no invasive intervention was applied. The sensitivity and specificity of the Sheffield score were determined to be at a good level in the prediction of the requirement for therapeutic endoscopy and octreotide treatment. CONCLUSIONS: The Sheffield score can reliably predict the need for endoscopic treatment with high sensitivity and specificity. In children with a high score, the need for an invasive intervention can be reduced with the administration of vasoactive treatment before esophagogastroduodenoscopy. The Sheffield score can thus be of guidance in the determination of the need for vasoactive treatment.Öğe Effect of whitening mouthrinses on color change, whiteness change, surface roughness, and hardness of stained resin composites(Mosher & Linder, Inc, 2023) Fidan, Muhammet; Tuncdemir, Makbule TugbaPurpose: To evaluate the effect of whitening mouthrinses on the color change, whiteness change, surface roughness, and hardness of stained resin composites after different immersion times. Methods: Three different resin composites (Estelite Sigma Quick, G-Aenial Anterior, Omnichroma) were used to prepare a total of 90 samples (30 samples from each resin composite). The samples were kept in coffee for 12 days, then divided into three subgroups (Control, Crest 3D White, and Listerine Advanced White; n=10 each). Color change (Delta E-00) and whiteness change (Delta WID) were evaluated at time intervals of 0-24 hours (TO-T1), 0-72 hours (TO-T2), and 24-72 hours (T1-T2). Surface roughness and hardness values were evaluated at TO, T1, and T2 after immersion in mouthrinses. Two-way ANOVA (for color and whiteness changes) and generalized linear model (for surface roughness and hardness) were used for data analyses (P< 0.05). Results: Omnichroma had the highest value for color change with Crest 3D White during TO-T1 and TO-T2. Crest 3D White showed better color changes than Listerine Advanced White. In all composites and mouthrinse groups, the highest and lowest values of Delta WID were at TO-T2 and T1-T2, respectively, with the highest value for Omnichroma with Crest 3D White at TO-T2 and the lowest for G-Aenial Anterior with control groups at T1-T2. The highest roughness values were found with the Omnichroma at T2. Whitening mouthrinses significantly increased roughness and decreased hardness compared to baseline.Öğe The correlation between electrocardiographic parameters and mortality in non-cardiac ICU patients(Verduci Publisher, 2023) Erdem, K.; Duman, I.; Erguen, R.; Erguen, D.- OBJECTIVE: This study aimed to determine the correlation between selected electrocardiogram (ECG) parameters (recorded at admission) and mortality in non-cardiac, non-COVID-19 intensive care unit (ICU) patients, and to determine the sensitivity and specÖğe The role of decoy receptor 3 in inflammation and atherosclerosis in patients with chronic kidney disease and renal transplant patients(Soc Espanola Nefrologia Dr Rafael Matesanz, 2023) Uysal, Saliha; Toker, Aysun; Turkmen, Kultigin; Keskin, SuatIntroduction: The cardiovascular risk has been increased in chronic kidney disease associated with chronic inflammation and atherosclerosis. Decoy receptor 3, is a member of the TNF receptor superfamily and associated with inflammation and atherosclerosis. The aim of our study is to determine the relationship, between serum DcR3 levels and inflammatory markers in patients with renal transplantation, those receiving dialysis treatment and cases with chronic renal failure that did not receive replacement therapy, and to evaluate their correlation with USG findings. Material and methods: A total of 150 patients aged between 22-86 years, consisting of 4 groups, namely renal transplantation, dialysis, predialysis chronic kidney disease and control groups, were included in the study. Serum decoy receptor 3, VCAM-1, ICAM-1 and IL-8 measured with ELISA method. Carotid intima-media thickness and presence of carotis arter plaque performed by ultrasound probe, non-invasively. Results: All serum markers were higher in dialysis and pre-dialysis chronic kidney disease groups compared to renal transplant and control groups (p < 0.05). Serum decoy receptor 3 level (median(min-max)) of renal transplant group (0.49 ng/mL (0.19-1.65)) was higher than control group (0.35 ng/mL (0.19-2.22)). There was no difference between patients receiving dialysis (0.89 ng/mL (0.41-4.98)) and patients with pre-dialysis chronic kidney disease (0.71 ng/mL (0.29-1.68)). There was no difference between patient groups in terms of the presence of plaque. Conclusion: Although renal transplantation provides a significant improvement in the inflammatory process, not return completely. Inflammatory process associated with uremic milieu may predispose to atherosclerosis in patients with pre-dialysis chronic kidney disease and hemodialysis patients. (c) 2022 Sociedad Espanola de Nefrologia. Published by Elsevier Espana, S.L.U. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).Öğe Evaluating the effect of tumor size and sidedness on prognosis in stage 2 colon cancer: a retrospective population study(Verduci Publisher, 2022) Demir, H.; Caglayan, D.; Kaman, O.; Inanc, M.; Urvay, S.; Beypinar, I; Demirci, A.OBJECTIVE: In this study. we aimed to evaluate the effect of tumor size and tumor sidedness on prognosis in patients with stage 2 colon cancer. PATIENTS AND METHODS: Data of 501 patients diagnosed with stage 2 colon cancer were evaluated retrospectively. It was evaluated whether the patients' age, gender, tumor differentiation, tumor node metastasis (TNM) stage, overall survival rate, and disease-free survival rate had any correlation with horizontal tumor diameter and tumor sidedness. In the ROC analysis performed to determine the cut-off value for the tumor diameter, which we think will predict survival, no significant results were obtained with maximum sensitivity and specificity. Therefore, the median value of the tumor diameter, which is 5 cm, was accepted as the cut-off value. Kaplan-Meier method and Cox regression analysis were used for survival analysis and determination of prognostic factors. RESULTS: When the patients were evaluated in terms of tumor localization, 189 (37.7%) patients had right colon tumors and 312 (62.3%) patients had left colon tumors. There was no statistically significant difference in terms of disease-free survival and overall survival according to tumor localization. When the patients were analyzed by dividing them into two groups according to the horizontal tumor size (<5 cm and >= 5 cm), no statistically significant difference was found between the groups in terms of disease-free survival (DFS) and overall survival (OS) p=0.085, p=0.699, respectively. CONCLUSIONS: Our results suggest that the management of patients with stage 2 colon cancer requires a better understanding of tumor biology rather than features such as tumor size and localization.Öğe Multidisciplinary treatment and functional outcome evaluation of combined injuries of nerves, vessels, and flexor tendons: spaghetti wrist(Verduci Publisher, 2022) Atilgan, N.; Duman, N.; Colak, T. S.; Korucu, I. H.; Demiryurek, M.OBJECTIVE: In this study, we aimed to evaluate the effectiveness of the modified Kessler technique in managing spaghetti wrist lacerations by multidisciplinary treatment. PATIENTS AND METHODS: Patients who were operated and followed up with the diagnosis of spaghetti wrist tears in our clinic between January 2012 and December 2020 were included in the study. In the postoperative follow-ups, the parameters evaluating the functionality of the patients were examined. RESULTS: Patients were 105 male (86.7%) and 16 women (13.2%), with a mean age of 36.83 & PLUSMN; 16.38 years. At the final follow-up, functional outcomes were assessed. The most common injury mechanism was glass-related injuries (35.5%). The mean starting surgery time of the patients was 4.64 & PLUSMN;2.98 hours. The most frequently involved structures were the palmaris longus with a rate of 51% and the flexor digitorum superficialis with a rate of 45%. There were significant differences regarding intrinsic function and grip strength between male and female patients (p = 0.04, p = 0.21, respectively). There were significant differences regarding sensation and grip strength between smoker and nonsmoker patients (p = 0.03, p = 0.01, respectively). The number of the damaged structures was negatively correlated with postsurgical functional outcomes of four tests, including tendon function, opposition, intrinsic function, and grip strength. The physical therapy period was correlated to hand function tests (r = 0.756, p < 0.05). Nerve damage was negatively correlated with sensation (p = 0.011, r =-0.932). CONCLUSIONS: The modified Kessler technique is reliable with functional outcomes for spaghetti wrist injuries involving tendons, nerves, and arteries. Meticulous and early surgical treatment within the first 8 hours of spaghetti wrist injury and early initiation and long-term physical therapy are vital in patients' functional outcomes.Öğe Central Nervous System Fungal Infections in Children With Leukemia and Undergoing Hematopoietic Stem Cell Transplantation: A Retrospective Multicenter Study(Lippincott Williams & Wilkins, 2022) Karaman, Serap; Kebudi, Rejin; Kizilocak, Hande; Karakas, Zeynep; Demirag, Bengu; Evim, Melike S.; Yarali, NeseBackground: Central nervous system fungal infections (CNSFI) are seen in patients with hematologic malignancies and have high morbidity and mortality. Because of their rarity, there is limited data on CNSFI in children with no established treatment protocols or guidelines. Materials and Methods: In this multicenter retrospective study. 51 pediatric patients with leukemia. 6 of whom had undergone bone marrow transplantation, with proven or probable CNSFI were evaluated. Fungal infections were defined as proven or probable based on European Organisation for Research and Treatment of Cancer criteria. Proven CNSFI was diagnosed by appropriate central nervous system (CNS) imaging or tissue sample findings in combi-nation with positive microbiological results of cerebrospinal fluid. A positive culture, microscopic evidence of hyphae, a positive result of the galactomannan assays are defined as positive microbiological evidence. Probable CNSFI was defined as appropriate CNS imaging findings together with proven or probable invasive fungal infections at another focus without CNS when there is no other explanatory condition. Data was collected by using the questionnaire form (Supplemental Digital Content 1, http://links lww.com/JPHO/A541). Results: Seventeen patients had proven, 34 patients had probable CNSFI. Headaches and seizures were the most common clinical findings. The median time between the onset of fever and diagnosis was 5 days. The most common fungal agent identified was Aspergillus. Sixteen patients received single-agent. 35 received combination antifungal therapy. Surgery was performed in 23 patients. Twenty-two patients (43%) died. 29 of the CNSFI episodes recovered with a 20% neurological sequelae. Conclusion: CNSFIs should be considered in the differential diagnosis in patients with leukemia and refractory/recurrent fever, headache, neurologicalocular symptoms, and a radiologic-serological evaluation should be performed immediately. Early diagnosis and prompt management, both medical and surgical, are essential for improving clinical outcomes.Öğe Comparison of the results of percutaneous and open screw fixation in the treatment of scaphoid nonunion fractures(Verduci Publisher, 2022) Atilgan, N.; Duman, N.; Colak, T. S.; Korucu, I. H.; Demiryurek, M.; Yilmaz, M.OBJECTIVE: Our study aims to compare the clinical results of percutaneous screw fixation and non-vascularized bone graft-ing with open screw fixation in patients who did not achieve union due to failure in diagnosis and treatment after a scaphoid fracture. PATIENTS AND METHODS: Forty-three pa-tients with scaphoid nonunion fractures cor-responding to the first three Slade and Dodds classification were divided into two groups. Non-vascularized bone grafting with open re-duction and internal fixation (ORIF) was applied to 24 patients in the first group, and 19 patients in the second group were treated with a closed reduction and internal fixation (CRIF) (percu-taneous screw fixation). The patients were fol-lowed up for preoperative and postoperative functional scores and time to union.RESULTS: Our study found that the scaphoid was most commonly fractured in the waist of the scaphoid. In our study, we found that distal scaphoid fractures had the highest union rate (100%), followed by the waist fractures (93.2%) and the weakest union (50%) in the proximal pole fractures. We observed that the fastest union had occurred in the fractures of the waist. We also ob-served that the union was completed earlier in patients who operated with ORIF than those with CRIF. We found union in 87.5% of patients who underwent ORIF, in 84.2% of patients who under-went CRIF. CRIF operation duration was short-er than expected from ORIF operation duration.CONCLUSIONS: We found that similar union rates could be achieved in the patient groups who underwent percutaneous and open screw fixation by selecting the appropriate patient in scaphoid nonunion fractures. Union was faster and functional results were more satisfactory in the ORIF group. The operation time was shorter in the CRIF group.Öğe Evaluation of personalized methylprednisolone therapy in critically ill COVID-19 patients: an observational comparative study using real-life data(Verduci Publisher, 2022) Duman, I; Celik, J. B.; Iyisoy, M. S.; Degirmencioglu, S.; Korkmaz, A.; Duman, A.OBJECTIVE: Methylprednisolone is commonly used to attenuate the cytokine storm and prevent mortality in COVID-19 pneumonia. However, the optimal methylprednisolone dose and duration are unclear. Additional data are required on the effectiveness of methylprednisolone in reducing mortality in COVID-19. This real-life retrospective study aimed to analyze the data of a COVID-19 dedicated ICU and compare the mortality rates of standard care, low-dose, and pulse-dose met hylprednisolone in patients requiring mechanical ventilatory support. PATIENTS AND METHODS: Methylprednisolone's indication. dose. and duration were determined according to the severity of COVID-19 pneumonia based on the patient's demographic parameters, comorbidities. laboratory data. radiology, and arterial blood gas analysis results. 867 patients were grouped as: no methylprednisolone (standard care), low-dose (0.5-1 mg/kg/day) methylprednisolone or pulse-dose (250-1,000 mg/day) met hylprednisolone. RESULTS: The overall mortality rate was 63.78%. Adjusting the dose of methylprednisolone according to the severity of the disease resulted in statistically similar mortality rates despite the increase in disease severity. Mortality was 62.71% in standard treatment. 65.76% in low-dose, and 62.10% in pulse-dose methylprednisolone groups (p = 0.633). Invasive mechanical ventilation at admission was associated with increased mortality (HR: 1.826 [95% CI: 1.542-2.161]; p < 0.001). Hematologic disorders and malignancies, arterial blood pH and HCO3, neutrophil count, and NLR at admission were also associated with mortality. CONCLUSIONS: Personalizing the dose and duration of methylprednisolone according to the patient's disease severity assessed with demographic, clinical, and laboratory results may benefit mortality in severe COVID-19 patients receiving ventilatory support in the ICU. Hematologic disorders and malignancies, arterial blood pH and HCO3, neutrophil count, and NLR at admission were associated with mortality in our patient cohort.Öğe Re: Response To: The effect of platelet-rich fibrin (PRF) on maxillary incisor retraction rate. Kuter Karakasli, Emire Aybuke Erdur. Angle Orthod. 2021; 91:213-219(E H Angle Education Research Foundation, Inc, 2022) Erdur, Emire Aybuke[Abstract Not Availabe]Öğe A novel rapid and accurate method for detecting Helicobacter Pylori: the modified antigen test(Verduci Publisher, 2022) Keskin, M.; Yavuz, A.OBJECTIVE: We aim to assess the diagnostic accuracy of the gastric biopsy Helicobacter pylori (H. pylori) antigen stool test as a novel method for detecting H. pylori, comparing this test with the histopathological evaluation of H. pylori and H. pylori antigen stool test as the reference standards. PATIENTS AND METHODS: The study involves patients who are scheduled for an upper gastrointestinal endoscopy. Gastric biopsies were endoscopically obtained from all patients, and H. pylori antigen stool tests were performed for all patients. Results from the gastric biopsies that were studied using the H. pylori antigen stool test in terms of the novel method were obtained and recorded. The inter-rater agreement between the H. pylori tests in determining positive and negative results was investigated using Fleiss' and Cohen's kappa tests. The capacity of applied tests in predicting the presence of H. pylori was analyzed using a receiver operating characteristic (ROC) curve analysis. RESULTS: A total of 55 patients were studied (32 females and 23 males). The strongest coherence was obtained between the gastric biopsy test and histopathological evaluation with a kappa value of 0.664 in Cohen's kappa analysis of overall coherence between tests. The most accurate sensitivity and specificity values were obtained for the gastric biopsy test and histopathological evaluation cross-tabulation for both overall comparisons at 90.5% sensitivity and 79.4% specificity. CONCLUSIONS: With this new, rapid, and easy-to-apply method, patients' endoscopies and gastric biopsies looking for the presence of H. pylori would be determined with more sensitive and more specific accuracy rates than current antigen stool tests, and H. pylori can be eradicated immediately without waiting for the histopathological evaluation period.Öğe Re: Response To: Effect of injectable platelet-rich fibrin (i-PRF) on the rate of tooth movement: A randomized clinical trial; Emire Aybuke Erdur; Kuter Karakasli; Elif Oncu; Bahadir Ozturk; Sema Hakki, Angle Orthod. 2021;91:285-292(E H Angle Education Research Foundation, Inc, 2022) Erdur, Emire Aybuke[Abstract Not Availabe]Öğe Disease characteristics of psoriatic arthritis patients may differ according to age at psoriasis onset: cross-sectional data from the Psoriatic Arthritis-International Database(Clinical & Exper Rheumatology, 2021) Bilgin, E.; Aydin, S. Z.; Tinazzi, I.; Bayindir, O.; Kimyon, G.; Ozisler, C.; Dogru, A.Objective To explore the impact of early versus late-onset psoriasis (PsO) on the disease characteristics of psoriatic arthritis (PsA) in a large-multicentre cohort. Methods The data from a multicentre psoriatic arthritis database was analysed. Patients were grouped according to age at psoriasis onset (early onset; 40 years of age, late-onset; 40 years of age) and disease characteristics of the groups were compared by adjusting for BMI and PsA duration, where necessary. Results At the time of analyses, 1634 patients were recruited [62.8% females; early onset 1108 (67.8%); late-onset, 526 (32.2%)]. The late-onset group was more over-weight [66.8% vs. 86.8%, p<0.001; adjusted for age -aOR 1.55 (1.11-2.20; 95% CI)]. The early onset group had more scalp psoriasis at onset (56.7% vs. 43.0%, p<0.001), whereas extremity lesions were more common in the late-onset group (63.8% vs. 74.2%, p<0.001). Axial disease in males and psoriatic disease family history in females were significantly higher in the early onset group [38.0% vs. 25.4%; p=0.005; adjusted for PsA duration -aOR 1.76 (1.19-2.62; 95% CI) / 39.5% vs. 30.1%; p=0.003; OR 1.51 (1.15-1.99; 95% CI), respectively]. Psoriatic disease activity parameters, patient-physician reported outcomes and HAQ-DI scores were similar in both groups. Conclusion Clinical features of PsA may be affected by the age at onset of PsO. Different genetic backgrounds in early and late-onset PsO may be driving the differences in psoriasis and PsA phenotypes.Öğe Part of the Covid 19 puzzle: Acute parkinsonism(W B Saunders Co-Elsevier Inc, 2021) Akilli, Nazire Belgin; Yosunkaya, AlperParkinsonism developed owing to viruses is one of the important causes of secondary parkinsonism. After the Spanish flu pandemic, the increase in the number of parkinsonian cases in the long term has drawn attention on the relationship between viruses and parkinsonism. For this reason, the relationship between influenza and parkinsonism has been studied most. Nowadays in which we are experiencing the COVID-19 pandemic, scientists, based on the experiences gained from the Spanish flu pandemic, have drawn attention to the fact that the third wave of the pandemic might be parkinsonism. However, as we have reviewed in the literature, acute parkinsonism due to COVID-19 was not reported during this pandemic. Here, we present a case in which signs of acute parkinsonism developed on the 3rd day of the illness and neurological symptoms regressed with convalescent plasma treatment. (C) 2021 Elsevier Inc. All rights reserved.Öğe Assessment of Outcomes After Limberg Flap Reconstruction for Scrotal Defects in Patients With Fournier's Gangrene(H M P Communications, 2021) Dadaci, Mehmet; Yildirim, Mehmet Emin Cem; Yarar, Serhat; Ince, BilsevBackground. Fournier's gangrene (FG) is a rarely encountered necrotizing fasciitis principally affecting skin and subcutaneous tissues of the genital region, perineum, and abdominal wall. The overall incidence of FG is 1.6 cases per 100 000 per year; the incidence in males is higher. Management techniques described in the literature have both advantages and disadvantages, and there is no gold standard treatment technique. Objective. This study evaluated whether the Limberg flap can be used reliably in scrotal defects with fewer complications than are seen with traditional techniques. The results of unilateral or bilateral Limberg flaps for scrotal reconstruction after FG were assessed. Materials and Methods. This retrospective, single-center study analyzed records from 29 male patients with scrotal defects after multiple debridements who were treated from January 2013 to January 2018. Twenty-one patients (72.4%) with hemiscrotal defects and 8 patients (27.6%) with defects involving greater than 50% of the scrotal surface were included in this study. Demographic data that were analyzed included smoking history, comorbid conditions, time of surgery, and time of follow-up. Flap dimensions were measured. Patients were evaluated in terms of flap viability and postoperative complications. Results. Mean age was 64 years (range, 47-80 years). The mean follow-up period was 16 months (range, 12-26 months). Dehiscence with seroma were detected in 4 patients (13.7%) on postoperative days 4 and 5. The average size of the flaps was 11 cm x 15 cm. Seroma and dehiscence were encountered in 4 patients (13.7%) during postoperative follow-ups. No postoperative infection was observed in any patient, and no partial or total flap loss was reported. Conclusions. These results suggest that use of the Limberg flap technique for scrotal reconstruction following FG has the important benefits of being easily harvested while providing tension-free repair and acceptable cosmetic results.Öğe The role of melatonin in preventing radiation-induced intestinal injury(Imprimatur Publications, 2021) Sezen, Orhan; Erdemci, Burak; Calik, Muhammet; Koc, MehmetPurpose: Despite the therapeutic effects of radiotherapy on tumor cells, it has potential severe adverse effects on the sur- rounding normal tissues. Acute or chronic intestinal adverse effects that are likely to occur in patients undergoing radio- therapy for pelvic and abdominal cancers lead to increased morbidity, significant impairment of the quality of life, and economic losses. Various biological, chemical and pharma- cological agents are being tested to protect from and to treat radiation enteritis. This experimental study aimed to inves- tigate the protective effects of melatonin against radiation induced intestinal injury when administered before radiation exposure in rats. Methods: In the present study, villus height and the number of villi in the ileum and jejunum of rats receiving two dif- ferent doses of intraperitoneal melatonin (5 and 10 mg/kg) prior to a single fraction of radiation given at a dose of 8 Gy to the abdominal region, was evaluated by histopathological examination 3 and 7 days after radiation exposure. Results: At a dose of 5 mg/kg, melatonin was found to be effective in preventing radiation-induced injury to villus height in the jejunum and the number of villi in the ileum and jejunum, and at a dose of 10 mg/kg it was also effective in preventing radiation-induced injury to villus height in the ileum. Conclusions: Melatonin is effective for the prevention of radiation-induced intestinal injury. This outcome can be considered an evidence to test melatonin in clinical trials.Öğe Repentance at the Moment of Death: An Important Subject Affecting People's Spiritual Health(Lippincott Williams & Wilkins, 2021) Caksen, Huseyin[Abstract Not Availabe]Öğe THE IMPORTANCE OF SPIRITUAL CARE IN PATIENTS WITH NEUROLOGICAL DISORDERS(Medicinska Naklada, 2021) Caksen, Huseyin[Abstract Not Availabe]Öğe THE IMPORTANCE OF SUPPLICATION AS A COMPONENT OF RELIGIOUS COPING WITH COVID-19 PANDEMIC(Medicinska Naklada, 2021) Caksen, Huseyin[Abstract Not Availabe]Öğe Religious Coping in Children With Grief After a Sibling Death Because of Cancer(Lippincott Williams & Wilkins, 2021) Caksen, Huseyin[Abstract Not Availabe]
