INTRODUCTION: We aimed to present the results of posttransplant follow-up in patients who had renal transplantation in different centers in Turkey and abroad and who were not followed up in their centers due to socioeconomic and transportation reasons.
METHODS: 167 patients who had been followed up in our clinic for at least one year and who had kidney transplantation from live donors were included in the study. Since the first 3-month follow-up of the patients was performed in the centers where they were transplanted, the data of the patients after 3 months were evaluated. Clinical and laboratory data of patients with renal transplantation were compared in Turkey and abroad.
RESULTS: 51 patients were female and 116 were male.Follow-up period after transplantation was 46.9±51.5(3-268) months. The preeemptive kidney transplant was administered to 43 (26%) patients. 128 of the patients had undergone kidney transplantation in Turkey and 39 in the abroad. The mean frequency of referral to their centers in the preemptive and nonpreemptive groups was 1.5 ± 1.9 and 1.02 ± 1.7 per year, respectively. The mean serum creatinine levels in the preemptive and nonpreemptive group was 1.4 ± 0.7 mg / dl and 1.3 ± 0.5 mg / dl, respectively. Graft survival was 100% in the first year and 97% in the 5th year, patient survival was 100% in the first year and 100% in the 5th year.
DISCUSSION AND CONCLUSION: The graft and patient survival of the patients with kidney transplantation followed in our clinic were found similar to the centers performing active kidney transplantation

INTRODUCTION: The aim of this study was to compare the results of patients who underwent robot-assisted radical prostatectomy (RARP) over 70 years old and those who underwent RARP under 70 years old.
METHODS: A total of 1019 cases performed by 4 surgeons between February 2009 and December 2018 were reviewed retrospectively. First 50 cases of each surgeon were not included to exclude the learning curve effect. All patients (n = 819) were divided into two groups according patient age, Group 1 = ≥70 years old (n = 151), Group 2 = <70 years old (n = 668).
RESULTS: : Mean patient age was 72.6± 2.5 versus 60.9±5.4 years p=0.00; mean console time was 148.2±53.3 versus 148.7±45.1 minutes, p=0.94; bladder neck reconstruction was 21.2% versus 12.4%, p=0.005; transurethral catheter removal time was 9.4±3.4 versus 9.0±3.9 days, p=0.170; for groups 1 and 2, respectively. Positive surgical margin rates were 27.2% versus 24.1%, p=0.432; erectile function (IIEF≥21) rates on postoperative 12th-month were 26.3% versus 50.2%, p=0.005 for groups 1 and 2, respectively. 12th-month continence rates were 89.5% versus 96.6%, p=0.002 for groups 1 and group 2, respectively.
DISCUSSION AND CONCLUSION: RARP in patients over 70 years old is worse in terms of functional outcomes than patients under 70 years old. RARP surgery in patients over 70 years old is a safe surgical procedure with similar oncologic and operative outcomes.

INTRODUCTION: Toxic hepatitis is a dose-dependent or idiosyncratic liver disease accompanied by acute or chronic liver injury that induced by the ingestion of drugs or other substances. It even could be mortal, sometimes. Toxic hepatitis is common due to Heliz grass which is consumed frequently in Eastern and Southeastern Anatolia of our country. We aim to present toxic hepatitis due to Heliz consumption for the first time in the literature, in this study.
METHODS: The data of 30 patient, hospitalized and followed-up and treated in gastroenterology department of our hospital, and who had a history of Heliz grass consumption in the last 1 day between 2014-2018 were compiled and analyzed.
RESULTS: Liver function tests of the patients were elevated. Hepatitis markers were negative in viral serology except one patient. Examinations for autoimmune liver disease, brucellosis and celiac examinations were normal. Ten patients were referred to the transplant center because of the need for transplantation. None of these patients required transplantation at follow-up. All were discharged with healing.
DISCUSSION AND CONCLUSION: Heliz, well known in Turkey's eastern and southeastern Anatolia, is a plant used in various dishes, making cheese with herbs and making pickles. Although it is thought that this plant has various benefits among the public, its hepatotoxicity-producing effect has not yet entered the literature. We believe that Heliz hepatotoxicity will be included in the differential diagnosis in patients with toxic hepatitis.

INTRODUCTION: Surgical experience and tumor characteristics are extremely important in laparocopic partial nephrectomy surgery (LPN). Most of the studies examining the relation of R.E.N.A.L.nephrometry score to surgical success have examined the results of experienced surgeons. In this study, we investigated the effectiveness of R.E.N.A.L. nephrometry score (RNS) in predicting complications and success for urologists who are at the beginning of the learning curve for laparoscopic partial nephrectomy.
METHODS: The first 30 cases of LPN performed by a single surgeon were evaluated, retrospectively. The patients were grouped according to the RNS as low-risk and medium-high risk. Operation time, warm ischemia time and were recorded. Postoperative blood transfusion rate, hospital stay, hemogram levels and pathology results (surgical margin and tumor type) were evaluated. The comparison of perioperative values of the two groups was done by Mann-Whitney U test.
RESULTS: There was no statistically significant difference between operation time, warm ischemia time, hospital stay time, and intra-operative bleeding amount (p> 0.05) between the low risk group and medium-high risk group patients. The total complication rate was 33.3%. The compliction rate for the low risk group was 27% (n = 5) (major complication 5.5% (n = 1)) and 41.6% (n = 5) for the medium-high group (major complication 8.3% (n = 1)). In comparing the two groups for complications, no significant difference was found (p = 0.46).


DISCUSSION AND CONCLUSION: The R.E.N.A.L.nephrometry score does not affect the success and complication rates of urologists at the beginning of the learning curve in LPN surgery.

INTRODUCTION: The aim of this study is to evaluate the color stability of high-viscosity universal bulk-fill composite resin, which is continuously exposed to cola, orange juice and distilled water for 1 day and 1 week.
METHODS: For our study, 36 disc-shaped samples with a diameter of 5 mm and a thickness of 2 mm were prepared using a stainless steel mold from a high-viscosity universal bulk-fill composite. The prepared samples were randomly divided into 3 groups according to the drinks used (n = 12). Initial color measurements were made before each sample was exposed to the drink. All samples were then stored in the respective beverage in an incubator at 37 ° C. This process was continued for 1 week, and color measurements were repeated at day 1 and at the end of week 1. The data were analyzed with SPSS V23 program. Comparisons between groups were analyzed by one-way analysis of variance.
RESULTS: The effects of the tested beverage groups on ∆E1, ∆E2, ∆L1, ∆L2, ∆a1, ∆a2, ∆b1 and ∆b2 values were statistically analyzed. It was determined that drinks and immersion time had statistically significant effects on all parameters (p <0.05).
DISCUSSION AND CONCLUSION: Exposure of high viscosity bulk-fill composites to acidic beverages causes color change in direct proportion to the immersion time.

INTRODUCTION: Candida species may cause severe clinical conditions with high mortality. The use of broad-spectrum antibiotics, immunosuppression, invasive medical procedures, and prolonged hospitalization in intensive care units (ICUs) have led to an increase in the incidence of Candida infections in recent years. In this study, we aimed to determine the frequency and distribution of Candida infections and to contribute to the local epidemiological data and guide for empiric antifungal therapy.
METHODS: In this study, Candida species isolated from blood cultures between 2017-2019 were examined retrospectively. BacT/ALERT 3D (BioMérieux, France) and Render BC128 (Shandong Huifa Electronics Technology Co., Ltd., China) automated blood culture systems were used. Candida isolates identified by conventional methods were determined to the species level by using Phoenix TM 100 automated identification system (BD Phoenix System, Beckton Dickinson, USA).
RESULTS: Candida species were isolated from 192 samples (0.74%) in 25808 bloodcultures. The most commonly isolated Candida species was C. albicans (50.0%), followed by C. parapsilosis (37%), C. tropicalis (5.7%) and C. glabrata (5.2%), respectively. The majority of Candida isolates (89.6%) were isolated from patients in intensive care units (ICUs).
DISCUSSION AND CONCLUSION: The results of our study are consistent with many studies reported in our country. This study provides information about the epidemiology of invasive candidiasis. Determining the frequency and distribution of Candida species and updating local epidemiological data periodically is extremely important in guiding the empirical antifungal therapy.

INTRODUCTION: Fluorine‐18‐fluorodeoxyglucose (18F‐FDG) positron emission tomography (PET)/computed tomography (CT) is a trusted method for the evaluation of cancer patients. In this study, we aimed to calculate the SUVmax values for semi-quantitative evaluation in patients with pulmonary lesions undergoing diagnostic PET / CT study and to investigate serum YKL-40 and ischemia modified albumin (IMA) levels.
METHODS: We performed a prospective case-control during July 2012-July 2013. Patients referred to the nuclear medicine clinics with suspected pulmonary lesions were enrolled in the study prospectively. In this study we analyzed 85 patients who underwent ‎routine PET/CT imaging for suspicious lung masses. Of the included patients, 20 (23.5%) had BLD, while ‎‎65 (76.5%) had lung cancer (LC) in the pathological examination of the lesions. Additionally, 35 participants from the patient relatives ‎were enrolled as healthy controls. SUVmax were calculated in patients who underwent PET / CT study, and serum samples of YKL 40, IMA, carcinoembryonic antigen (CEA) and lactate dehydrogenase (LDH) values were measured.
RESULTS: Patients with LC had higher mean SUVmax values compared to the BLD group (‎9.49±2.27 vs. 3.13±1.15) (p<0.001). Serum YKL-40 (71,42±7,65ng/L and102.03±12.22 ng/L vs. 31,79±7,52 ng/L), IMA (0,90±0,16 and 0,84±0.09 vs. 0,70±0,08), LDH (268,00±63,30 U/L and 261.03±65,02 U/L vs. 165,08,00±52,62 U/L), and CEA (4,60±1,10 ng/mL and 2,47±0.81 ng/mL vs. 1,9±0,41 ng/mL) measurements remained greater in patients having LC and BLD than the healthy participants (p<0.001).
DISCUSSION AND CONCLUSION: In this study we concluded that SUVmax and serum YKL‐40 levels were increased in LC cases. SUVmax may be an efficient variable to distinguish LC from BLD.

INTRODUCTION: Multiple myeloma (MM) is a malignant hematological disease characterized by malignant proliferation of a single plasma cell clone leading to monoclonal protein in plasma or urine. Presence of monoallelic loss of chromosome 13 (del13) or loss of long arm (del13q) indicates poor prognostic outcome in patients treated with standard chemotherapy. Del13/del13q is detected by FISH method in approximately half of newly diagnosed MM patients.
METHODS: 42 patients diagnosed with MM according to the criteria of the International myeloma working group and treated at research and education hospital, were included in this study. Clinical, laboratory, pathological data were analyzed retrospectively and genetic data obtained by FISH method.
RESULTS: 26 patients were female (61.9%) and 16 were male (38.1%). The mean age was 62. Del13 results were obtained in 30 of 42 patients, while positive in 6 patients (20%) negative in 24 patients (80%). Among the 30 patients with chromosome 13 results, 4 had IgA, 19 had IgG type monoclonal protein. All of the 6 patients with del13 were IgG myeloma (2 kappa, 3 lambda).

DISCUSSION AND CONCLUSION: Compared to the recent studies, del13 is lower in our study. In many studies, del13 has been found in rates ranging from 30-50%. Although the rate of 20% we found is lower than the data in the literature, it is valuable in terms of reflecting the frequency of del13 in myeloma patients. Therefore, we strongly recommend that conventional karyotyping and FISH analysis of common chromosomal abnormalities be performed in newly diagnosed MM patients.

INTRODUCTION: This study aimed to evaluate the relationship between necrotizing enterocolitis (NEC), risk factors, and feeding intolerance in very low birth weight premature newborns.
METHODS: The cases who were born under 30 weeks of gestational age and developed feeding intolerance were evaluated retrospectively for NEC.
RESULTS: Necrotizing enterocolitis was detected in 17(31.5%) of 54 patients with feeding intolerance. Besides, stage 3 NEC was detected in 2 patients without any signs of feeding intolerance. The mean birth weight of the patients was 970 ± 300 g and gestational age was 27 ± 5 weeks. When the risk factors were examined, preeclampsia, clean residues, biliary residues, more than 50% residues, abdominal distension and delayed stool exit were found statistically significant differences in the NEC group. Abdominal distention and the presence of more than 50% residues were the highest sensitivity among the two groups. The highest specificity was found in the presence of clean residues, the highest negative predictive value was abdominal distension, the highest positive predictive value was the presence of abdominal distention, and biliary residues.
DISCUSSION AND CONCLUSION: Although it is not recommended as a standard in larger premature and term infants, residual follow-up in very low birth weight premature babies may provide important clues in the diagnosis of necrotizing enterocolitis.

INTRODUCTION: This study; It was performed to determine the anxiety levels of patients who received hyperbaric oxygen therapy for the first time.
METHODS: Research; It was performed in the Hyperbaric Oxygen Therapy unit of a city hospital between May 2018 and February 2020. The sample of the descriptive study consisted of 76 patients who underwent hyperbaric oxygen therapy for the first time. In order to evaluate the subjective parameters of the patients in hyperbaric oxygen treatment process; Visual Comparison Scale and Status-Trait Anxiety Inventory were used. Objective measurements evaluated during the hyperbaric oxygen treatment were recorded in the form of physiological parameters. Study data were evaluated using SPSS 22.0 statistical package program.
RESULTS: In the study; When the patients came to the clinic, the state anxiety levels and the Visual Comparison Scale means scores were found to be high and decreased immediately after the treatment. Mean anxiety levels of the patients were determined as 77.22 ± 7.8. In repeated measurement, the mean oxygen saturation levels of the patients increased and their respiratory averages decreases ( p<0.05).
DISCUSSION AND CONCLUSION: In this study, subjective (Status-Trait Anxiety and Visual Comparison Scale) and objective (respiration rate) measurement results; reveals that patients with hyperbaric oxygen therapy for the first time showed higher anxiety levels when they arrived at the clinic after treatment. Coclusions; in patients undegoing hyperbaric oxygen therapy, it justifies taking measures for anxiety.

INTRODUCTION: Aminoglycosides are used in gram-negative bacterial infection and are frequently used against Enterobacteriaceae and nonfermentative bacteria.
Recently, increased resistance to aminoglycosides has been observed. In this study, we aimed to see aminoglycoside resistance in Enterobacteriacea and nonfermentative bacteria and the effectiveness of aminoglycosides in carbapenem resistant Enterobacteriacea isolates.

METHODS: Aminoglycoside resistance rates of 4076 Enterobacteriaceae and 1252 nonfermentative bacteria isolated from various clinical samples sent to microbiology laboratory between November 2015 and September 2016 were investigated. The identification of bacteria was made at the species level with the Vitek MS automated system.
RESULTS: The total resistance rate in enterobacteriaceae isolates was found to be 2.72% for amikacin and 17.44% for gentamicin. In Enterobacteriaceae group, resistance to 1.13% gentamicin was found against Escherichia coli (E.coli) (56%) and 16.08% against amikacin. For Klebsiella (25.7%) isolates, amikacin was 5.91% and gentamic was 26.04%. Among nonfermentatives, amicacin was determined as 46%, gentamicin 76%, netilmicin 55% and tobramycin 40.8% in Acinetobacter species. In Pseudomonas strains, amikacin was 4.97%, gentamicin was 14.3%, netilmicin was 27.3%, and tobramycin resistance rate was 7.74%.
DISCUSSION AND CONCLUSION: Amikacin was found to be more sensitive than gentamicin in Enterobacteriaceae isolates. In nonfermantative bacteria, it was found that the most sensitive aminoglycoside in the Acinetobacter isolates was tobramycin, and the most sensitive aminoglycoside in the Pseudomonas isolates was amikacin. In carbapenem resistant Enterobacteriaceae strains, amikacin was found to be more sensitive than gentamicin.

INTRODUCTION: We aimed to evaluate effect of foreign language problem and substance/alcohol usage on rate of non-therapeutic laparotomy in penetrating abdominal stab injuries (PASI).
METHODS: Data of 89 patients with PASI treated between January 2015 and December 2017 were evaluated retrospectively. Age, gender, injury site, surgery requirement, surgery type, patients' language problems (not knowing Turkish and English) and substance/alcohol usage were recorded. Patients were divided into two groups according to language problem: 51 patients without problem were defined as Group 1, and 38 patients with problem were Group 2; also divided into two groups according to substance/alcohol usage: nonuser 69 patients were Group 3, user 20 patients were Group 4.
RESULTS: Female/male ratio was 5/84 and mean age was 28.5±8.9. Most common injury site was epigastric region (27%), and most frequently injured organ with lumen was small intestine (40.7%). Rate of surgery (52.6% and 80%) and of non-therapeutic laparotomy (18.4% and 30%) in group 2 and 4 were higher than group 1 and 3 (p<0.05 and p<0.01). Frequency of blood transfusion (28.9% and 35%) and amount of erythrocyte suspension (1.2±2.2 and 1.3±2.3) in group 2 and 4 was higher than others (p<0.05). Ratio of hematocrit in patients undergone therapeutic laparotomy (n=27) was lower (p<0.05), and neutrophil and platelet counts were higher compared to non-therapeutic group (p<0.05).
DISCUSSION AND CONCLUSION: We concluded that surgical decision in PASI was affected by insufficient anamnesis and examination due to language problem or substance/alcohol usage, resulting in unnecessary laparotomy and increase rates of non-therapeutic laparotomies.

INTRODUCTION: By increasing elderly population in the world and in Turkey, the number of elderly patients admission to emergency services is also increasing. In this study, it was aimed to determine the complaints during admission, common observed diseases, hospitalization rates and hospitalized services of the elderly patients over 65 years old who applied to the emergency service.
METHODS: The patients aged 65 years and over who applied to Medical Faculty Hospital emergency department between 01.01.2015 and 31.12.2015 were retrospectively evaluated. The patients' gender, age, date and time of admission to the hospital, complaints about admission to the hospital, discharge of the patient after the medical treatment, referral to the hospital or intensive care unit, hospitalized departments and preliminary diagnosis were evaluated.
RESULTS: 12,998 (10,1%) of the emergency department admissions were 65 years of age or older. 6571 of the patients were male (50,6%) and 6427 (49,4%) were female. The mean age was 73,72 ± 6,6 (65-111). The patients most frequently admitted to the hospital with headache (25,1%) and chest pain complaints (15,9%). 84,2% of the patients were treated as outpatient and discharged from the emergency service while, 15,4% of the patients were admitted to the hospital, 22 patients (0,2%) were referred to other centers for various reasons and 18 patients (0,1%) were exitus. 13 of the patients (0,1%) were left the hospital without accepting treatment.
DISCUSSION AND CONCLUSION: In our study, the most common necessity of emergent interventions of geriatric patients who admitted to emergency service were, cardiac problems, respiratory system diseases and gastrointestinal diseases.

INTRODUCTION: In this retrospective study, we aimed to analyze the effect of choice of platinum chemotherapy (carboplatin vs. cisplatin) on survival in patients with small cell lung cancer(SCLC) and to identify the factors affecting survival.
METHODS: A total of 87 metastatic SCLC patients with available data, who were equal to or greater than 18 years and were treated with platinum-based chemotherapy at first-line setting, were included. Patients were grouped according to type of platinum treatment as ‘cisplatin + etoposide(PE)’ or ‘carboplatin + etoposide(CE)’.
RESULTS: Of the 87 patients included in the study, 16 (%18,4) were female. The median age was 58 years. The numbers of patients treated with PE and CE were 65 and 22, respectively. The median progression-free survivals of patients treated with PE vs. CE were 6 months and 5 months, respectively (p=0.171), with corresponding overall survival (OS) durations of 9 months and 8 months (p=0.173). Performance status, administering thoracic radiotherapy and response to first-line chemotherapy were found to be the independent factors affecting OS.
DISCUSSION AND CONCLUSION: In our study, first-line treatment with CE vs. PE did not affect survival in the patients with metastatic SCLC. However, the survival of patients with poor performance status was observed to be lower than those with better performance status. In addition, administering thoracic radiotherapy and a better response to first-line chemotherapy improved survival.

INTRODUCTION: The prejudice of healthcare personnel may be reflected as an important problem in patient follow-up. This study aimed to evaluate knowledge and prejudice regarding HIV/AIDS among physicians and nurses working in a university hospital.
METHODS: The sample size of this cross-sectional study was calculated as 191 by taking distance from confidence limit(s) to mean 1 and standard deviation 7 in two-sided 95% confidence interval. In Dicle University Hospitals, 6 nurses, 4 assistant physicians and 1 specialist physician/lecturer/teaching staff were invited by random sampling method from each of the 23 clinics. Total of 218 physicians and nurses were included. A questionnaire including demographic variables and 30 statements about HIV/AIDS was applied. The data obtained were analyzed using R-3.5.1 program.
RESULTS: 33.5% of the participants stated that they were involved in the follow-up of a HIV-infected patient. The mean HIV knowledge score was 76.3±13.7; higher in men(78.9±13.5) and doctors(83.2±11.1). The mean HIV prejudice score was 39.0±21.2; higher in nurses(42.0±22.3) and lower in participants with HIV-infected relatives/friends(23,6±14,3). There was a weak negative correlation between HIV knowledge and prejudice scores. 40.6% of the participants stated that HIV/AIDS is not a curable disease. 52.5 percent stated that they would not prefer to follow HIV/AIDS patients.
DISCUSSION AND CONCLUSION: Considering that the healthcare professionals working in Turkey, which is located in a high endemic area in terms of HIV/AIDS, will encounter this disease more, the results are worrying. Health personnel should be considered as a special group in all studies that will be done to reduce HIV/AIDS stigma.

INTRODUCTION: Suicide attempts and suicide acts are a severe cause of morbidity and mortality for individuals. In the study, It is aimed to retrospectively examine the patients over 18 years of age who applied for suicidal attempts due to excessive drug intake and to describe the characteristics of the patients, causes and consequences of the suicide attempts.
METHODS: In this study, 615 patients with suicide attempts due to excessive drug intake over the age of 18 who applied to the emergency service of Kayseri City Hospital by an ambulance or outpatient within one year were included. While analyzing the data; descriptive statistics were presented with frequency and percentage values. p <0.05 was considered statistically significant.
RESULTS: Mean age was 30.93±11.41(min: 18-max: 85). Of the cases, 63.3% were female, 62.9% were married. Of the cases, 82.9% had not previously attempted suicide and 33% had received psychiatric treatment in the past six months. The rates of attempted suicide were higher among women in the study(p= 0.01, p<0.05). In the last six months, the suicide attempt rates of those receiving psychiatric treatment were higher(p= 0.01, p<0.05). 42.1% of cases found to have attempted suicide by taking multiple drugs.
DISCUSSION AND CONCLUSION: The rate of repeat suicide attempts is high for patients who refuse to be treated or hospitalized in emergency departments and hospitals. For this reason, we recommend that the patients with suicide attempts who applied to emergency departments be consulted to the psychiatrist before discharging from emergency services and, if possible, they should be hospitalized.

INTRODUCTION: Treatment of diabetic wounds is a difficult and costly condition that reduces the patient's quality of life. In this area, cell therapies have taken their place in clinical use. In this study, it was aimed to investigate the effect of Peripheral Blood Mononuclear Cell (PBMC) application on healing in diabetic graft wound model.
METHODS: Isolation and proliferation of PBMC was achieved from rats. After creating diabetes model with streptozotocin, full-thickness skin grafts, 1x1 cm in size, were made in the back region of the rats. The rats were divided into 3 groups as control, sham and PBMC. PBMCs were applied to each wound as 1x106 cells per day. Skin biopsy was taken in the early period (3th day) and examined. Hematoxylin-eosin (H-E), masson trichrome (MT) and immunohistochemical (IHC) staining were performed. In immunohistochemical staining, anti-eNOS, anti-iNOS and anti-IL1β immunoreactivities were evaluated. Statistical analysis was performed with the H-score.
RESULTS: In H-E and MT staining, significant histopathological improvements were seen in the group treated with PBMC. Immunohistochemical staining also showed a significant decrease in the immunoreactivity of eNOS, iNOS and IL-1β in the group treated with PBMC. The changes observed were found to be statistically significant.
DISCUSSION AND CONCLUSION: PBMC administration has been shown to contribute to supportive therapy for the inflammatory process of diabetic wound healing. This study, which will contribute to the use of PBMCs in chronic wound treatment, is thought to reduce treatment costs and improve the patients’ life quality by shortening the wound healing process.

INTRODUCTION: To determine head CT scan necessity in pediatric head trauma patients and to compare the decisions of Emergency medicine physicians (EMP) and PECARN scale suggestions on head CT scan necessity.
METHODS: Our study was conducted retrospectively in our third stage hospital between January 2014 and December 2014. Patients under the age of 13 with head injury because of fall were included. Registry of all patients was analyzed and PECARN scale was applied to each patient’s data retrospectively. Suggestions of PECARN scale were noted. Head CT scans were reported by radiologist. EMP’s decision and PECARN scale suggestions were compared. Patients whom should had CT scan by PECARN scale suggestions but had no imaging were contacted and questioned about any other reasons to seek medical care.
RESULTS: PECARN suggestion and EMP’s decisions of CT necessity compared. Concordance analysis of two results are determined as 76.6% (Kappa coefficient: 0.766). EMP’s decisions had 88.76% sensitivity, 91.09% specificity, 78.22% positive predictive value, 95.74% negative predictive value and 90.48% accuracy.
DISCUSSION AND CONCLUSION: In assessment of children with minor head injury EMP decision and PECARN scale were found coherent and sufficient. Instead of early decision of CT scan, observation of patient can reduce radiation exposure, but cost effectivity of this approach should be evaluated by further studies.

INTRODUCTION: The motor symptoms of Parkinson's Disease (PD) are explained by the pathology of the dopaminergic system. However, both dopaminergic and non-dopaminergic neurotransmitters are responsible in non-motor symptoms. In this study, we described the complexity of sexual problems and factors associated with PD, and sexual dysfunction of patients and their partners.
METHODS: The data of this study were obtained from consecutive Parkinson's patients who applied to the Yüzüncü Yıl University Neurology outpatient clinic between September 2019 and March 2020. A total of 70 patients were included in the study (30 were women and 40 were men). Erectile function in men was evaluated with the International Erectile Function Assessment form-5 (IIEF-5).
RESULTS: It was observed that men were more affected than women in terms of sexual activity due to general sexual dissatisfaction and especially erectile dysfunction. (65% vs 46.6%). The distribution of erectile dysfunction scale (IIEF); 16 patients with very severe erectile dysfunction; 2 of them were found to be mild (12.5%), 3 of them medium (18.75%) and 11 of them as severe (68.75%). According to the erectile dysfunction scale, the rate of severe ones was found to be statistically different and significant from the others. (P <0.05)
DISCUSSION AND CONCLUSION: The relationship between dissatisfaction with sexual experiences, age, disease duration and advanced stage disease in men with PD was found similar to the literature. Managing sexual problems in PD is a challenge for doctors and healthcare professionals working with their PD and their caregivers. Future studies should focus on elucidating the pathophysiology of these syndromes.

INTRODUCTION: The aim of this study was to evaluate the effectiveness of rituximab in autoimmune bullous diseases.
METHODS: In this study, the data of patients who received rituximab treatment for autoimmune bullous disease in our clinic between 2012 and 2019 were retrospectively reviewed. The patients age, sex, diagnosis, presence of cutaneous/mucosal involvement before infusion, number of infusions, anti-desmoglein 1, anti-desmoglein 3 and indirect immunofluorescence data before and after treatment, treatment responses and side effects were recorded.
RESULTS: In our study, we found a significant decrease in anti-desmoglein 1 and anti-desmoglein 3 levels and accumulations in indirect immunofluorescence after rituximab treatment. (P <0.001 for both)
DISCUSSION AND CONCLUSION: The results from our study showed that rituximab is an effective agent that can be used with systemic steroid treatment.

INTRODUCTION: We aimed to investigate the effect of certain maternal and fetal features on fetal prenasal thickness, considering the correlation between prenasal thickness and subsequent birth weight.
METHODS: This was a prospective longitudinal study. Uncomplicated pregnancies between 16-23 weeks of gestation seen at a perinatology outpatient clinic for fetal ultrasound examination between September 2019 - January 2020 were included. Demographic data and fetal prenasal thickness measurements were recorded. Pregnant women were followed until delivery. Data were evaluated with Pearson correlation analysis and linear regression.
RESULTS: A total of 74 pregnant women were evaluated. The mean maternal age and fetal prenasal thickness was 29.5 ± 5.3 years and 3.2 ± 0.97 mm, respectively. In univariate analysis, maternal body mass index, age, fetal gender and parity were not significantly related with prenasal thickness. Pearson correlation analysis revealed a positive correlation between gestational age and prenasal thickness (r = 0.484, p <0.001). There was no correlation between prenasal thickness and birth weight (r = 0.133, p = 0.258).
DISCUSSION AND CONCLUSION: Prenasal thickness on second trimester ultrasound is positively correlated with gestational age, and this effect seems independent of parity, maternal body mass index, age, and fetal gender

INTRODUCTION: One of the most important complications of diabetes mellitus is diabetic foot caused by peripheral circulatory disorder. Charcot neuropathic arthropathy (CN), which occurs in the advanced stage of the diabetic foot, is a chronic, progressive and difficult to treat disease
METHODS: In this study, our aim is to evaluate the changes in the foot bone and foot joints of patients with CN according to the Sanders and Frykberg classification.Based on the data obtained from the automation records of our hospital, the patients' age, gender, diabetes diagnosis time and involved extremities, as well as foot radiographs were examined according to Sanders and Frykberg classification.
RESULTS: The average age of 20 patients included in the study was 66.7 years, 12 males and 8 females. Type 2 with up to 5 (25%) patients according to the Sanders and Frykberg anatomical classification
DISCUSSION AND CONCLUSION: The incidence of diabetes mellitus is increasing all over the world and complications due to this disease should be well known. In our study, early diagnosis of CN, is extremely important and we believe that foot amputations can be prevented with early interventions.

INTRODUCTION: One-year erythrocyte suspension transfusions were examined in our intensive care unit. It was aimed to reveal transfusion application decisions and the criteria behind these decisions.
METHODS: 188 patients in the intensive care unit of the Anesthesiology and Reanimation clinic between 2017 -2018 January and underwent transfusion of erythrocyte suspension for any reason were included in the study. Patients were divided into those who underwent erythrocyte suspension replacement due to active bleeding (Group K) and those who had a replacement without active bleeding (Group NK). Demographic data of the patients, hospitalization diagnoses, APACHE values in the first 24 hours of intensive care admission, comorbid diseases, available hemoglobin (Hb) value and length of stay in the intensive care unit were noted.
RESULTS: The ages of the patients in Group K were significantly lower (p <0.05) Tthe rate of comorbidity in Group K was significantly lower (p <0.05).APACHE values measured during intensive care admission were significantly lower (p <0.05) in Group K. Group K Hb values were found to be significantly higher (p <0.05) in the comparison made in terms of Hb values when the replacement decision was made. Group NK was significantly ahead (p <0.05) during the ICU stay.
DISCUSSION AND CONCLUSION: Tthe main determinant was the Hb value and other factors were also effective. In patients without active bleeding, evidence suggests a more conservative approach with blood transfusions. We believe that more research is needed to personalize transfusion strategies in intensive care patients and to measure the common effects of different combinations of factors.

INTRODUCTION: Bone repair is a multifactorial mechanism involving a large number of cells, molecules and growth factors. In this healing period, muscle tissue has an important role. The aim of the study was to evaluate the effect of single dose and locally administered teriparatide on mandibular bone healing and masseter muscle thickness.
METHODS: In this study, 24 Sprague-Dawley male rats were used and the experimental animals were divided into 3 groups. Groups were defined in the following way: Group-1 had empty defect, Group-2 received 20 μg of TP, and Group-3 received 40 μg of TP. Before surgery and postoperative 4th week, masseter muscle thickness was measured with the same ultrasound imaging system. This was followed by histomorphometric evaluation that was performed for the measurement of mandibular bone healing
RESULTS: A statistically significant difference had been found in terms of the amount of bone ossification area between Group-1 and Group-2 and between Group-1 and Group-3 (p<0.01), but there was no statistically significant difference between Group-2 and Group-3 (p>0.01). Increase in the masseter muscle thickness in the postoperative period was statistically significant in all groups (p<0.05). On the other hand, increase in the masseter muscles thickness was higher in Group-2 and Group-3 than Group-1 but not statistically different (p>0.05).
DISCUSSION AND CONCLUSION: As a result of this study, locally and single dose administered TP improved bone healing postoperative 4th week. On the other hand, TP did not have a significant effect on the increase of masseter muscle thickness.

Mutations of the SHOX gene are cause of various genetic growth disorders, ranging from isolated short stature to Leri-Weill Syndrome characterized by short stature, mesomelia and Madelung deformity. We describe a family with a SHOX deletion originally located on the father’s Y chromosome but transmitted to daughter’s X chromosome by crossover during meiosis. The female index patient presented with disproportionate short stature and mesomelia. Her father, sister and paternal aunt showed disproportionate short stature and mesomelic shortenings of the limbs but her brother was normal stature. Their chromosome analyses were normal but metaphase fluorescence in situ hybridization (FISH) analysis showed a deletion of the SHOX gene on the X chromosome of the index patient, her sister and her paternal aunt but on the Y chromosome of index patient’s father. Interestingly, the index patient’s brother FISH analysis was normal. This family is presented as clinical evidence of crossover in the SHOX gene.

One of the basic principles of Enhanced Recovery After Surgery (ERAS) protocols is to prevent prolonged fasting of patients with preoperative oral carbohydrate intake without increasing complication rates. The aim of this review is to investigate the effects of preoperative oral carbohydrate intake on postoperative patient outcomes. This review examines full-text meta-analyses, systematic reviews, randomized controlled studies, clinical studies and guidelines in Turkish and English languages published between 2000 and 2019 that are retrieved from databases using the keywords “ERAS protocols”, “oral carbohydrate intake”, “morbidity”, “mortality” and “complication”. The published guidelines suggest that clear liquid foods can be taken 2-3 hours before anesthesia (Level of Evidence A), and 400 ml of oral carbohydrate solution may be given. According to the results of a randomized controlled trial, preoperative oral carbohydrate intake reduces the length of hospital stay after surgical intervention and helps patients’ bowel function return to normal in a shorter time period. Similar studies report that oral carbohydrate reduces nausea-vomiting and insulin resistance, keeps blood glucose below 180 mg/dl, and increases patient comfort. However, the current literature also presents studies reporting that preoperative oral carbohydrate intake does not have a significant effect on complication rates and patient comfort, and that there is a need for new evidence-based research. It is essential to ensure that nurses, who have an active role in all stages of the perioperative process, have access to up-to-date information on preoperative oral carbohydrate intake as a part of ERAS protocols and its effects.

It is not prepared because it is a letter to the editor.