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Does serum R-Spondin-1 play a role in pathophysiology of polycystic ovary syndrome?
(Selçuk Üniversitesi, 2022) Başpınar, Osman; Şimşek, Yasin; Koçer, Derya; Dizdar, Oğuzhan Sıtkı; Topaloğlu, Hatice Kayış
Objective: It has been thought that many novel metabolic and inflammatory markers are involved in the etiology of Polycystic ovary syndrome (PCOS). R-spondin-1 (Rspo1) is a member of the roof plate-specific spondin protein family. Rspo1 levels have been associated to obesity and insulin resistance. In this study, it was aimed to investigate whether the Rspo1 plays role in the PCOS pathophysiology. Materials and methods: This cross-sectional study included newly diagnosed, treatment-naïve PCOS patients and healthy controls. The Rspo1 levels were compared between PCOS patientsand healthy controls. In addition, the Rspo1 levels were compared within PCOSS group according to body mass index (BMI) and Ferriman Gallwey (FG) score. Results: verall, 83 subjects (47 patients with PCOS and 36 healthy controls) were included in the study. TheO PCOS and control groups were comparable regarding age and BMI. However, FG score, homeostasis model assessment of insulin resistance score, Rspo1 and total testosterone levels were significantly higher in patients with PCOS when compared to controls (p<0.001, p=0.01, p=0.02, p=0.001 respectively). In the PCOS group, there was no significant difference in the Rspo1 levels among BMI and FG scores subgroups It was also found that the Rspo1 had a significant positive correlation with total testosterone and dehydroepiandrosterone sulfate levels (p=0.03, r=0.23; p=0.08, r=0.30, respectively). Conclusion: The Rspo-1 may be associated with PCOS pathophysiology through total testosterone and dehydroepiandrosterone sulfate. Further molecular and genetic studies are needed to support this hypothesis.
Konya‘da nadir görülen zoonotik infeksiyon; babesiozis olgu sunumu
(Selçuk Üniversitesi, 2021) Kurt, Esma Kepenek; Kandemir, Bahar; Handemir, Erol; Bitirgen, Mehmet
Babesyoz, Babesia adlı bir mikroorganizmanın etken olduğu eritrosit içi kene kaynaklı zoonotik bir infeksiyondur. Ülkemizde sporadik olarak görülmekle birlikte insan babesyozisi konusunda yayınlanmış çok fazla olgu bulunmamaktadır. Bu olguda ateş ve pansitopeni nedeniyle araştırılan, kene teması olmadığı halde periferik kan yaymasında eritrosit içi parazite ait yapılar görülerek, Babesyoz tanısı ile kinin ve klindamisin ile tedavi edilmiş ve tedavinin ikinci gününde ateşi düşüp tam kan sayımı düzelen bir olgu sunulmaktadır.
Radyological comparison of lumbar nerve root thickness in patients with lumbar disc herniation
(Selçuk Üniversitesi, 2022) Paksoy, Kemal; Şentürk, Salim; Akyoldaş, Göktuğ; Bozkurt, İsmail; Yaman, Mesut Emre; Apaydın, Aydın Sinan; Sezgin, Yılmaz
Introduction: the aim of this study was to compare radiologically the effect of the disc on Root thicknesses in patients with acute disc herniation. Methods: It was performed by measuring the same level of Root thickness in lumbar MRI images of patients presenting with acute disc herniation symptoms. Findings: Lumbar MRI images of 95 patients were compared radiologically. It was statistically determined that the thickness of the nerve root on the side exposed to the compression of acute disc herniation increased compared to the other nerve root thickness at the same level. Results: This study found statistically significant increase in the diameter of the affected nerve root in acute lumbar disc herniation. Especially in multi-level disc herniations, it may be useful to measure the nerve root thickness in determining the level that causes the actual clinic.
Cerrahi hemşirelerin basınç yaralanması, risk faktörleri ve önlenmeye ilişkin bilgilerin incelenmesi
(Selçuk Üniversitesi, 2021) Ünlü, Akile Aydoğmuş; Andsoy, Işıl Işık
Amaç: Çalışma cerrahi hemşirelerinin basınç yaralanması, risk faktörleri ve önlemeye ilişkin bilgilerinin değerlendirilmesi amacıyla tanımlayıcı olarak yapıldı. Gereç ve Yöntem: Çalışmanın evrenini Karabük ilindeki üniversite, devlet ve özel hastanelerin ameliyathane, cerrahi klinikler ve cerrahi yoğun bakımında çalışan 400 hemşire oluşturdu. Tam sayım örnekleme yöntemi ile çalışmanın yapılacağı tarih aralığında izinli veya raporlu olmayan, katılıma istekli ve onam veren 245 cerrahi hemşiresi çalışma kapsamına alındı. Veriler, kişisel bilgi formu ve ‘Modifiye Pieper Basınç Yarası Bilgi Testi’ ile toplandı. Verilerin değerlendirilmesinde ortalama, standart sapma, Minumum Maksimum, Ortanca ve IQR değerleri, arşılaştırmalarda Mann Whitney U testi, Kruskal Wallis Varyans analizi kullanıldı. Bulgular: Çalışmada cerrahi hemşirelerin en yüksek oranda doğru yanıt verdikleri konuların sırasıyla yara tanımı, evrelendirilmesi, önleme ve risk olduğu belirlendi. Yoğun bakımda çalışan hemşirelerin önleme ve risk, yara tanımına yönelik aldıkları puanların cerrahi kliniklerde çalışan hemşirelere göre anlamlı düzeyde yüksek (p=0.007), basınç yaralanması ile sık karşılaşma, ölçek kullanma, hizmetiçi eğitim alma, basınç yaralanmasına yönelik makale okuma ve internetten araştırma yapma ile hemşirelerin doğru yanıt puan ortalamaları arasında istatistiksel olarak anlamlı fark olduğu görüldü (p<0.001). Sonuç: Bu sonuçlar doğrultusunda; cerrahi klinikler ile ameliyathanelerde çalışan hemşirelere basınç yarası, önleme ve risk değerlendirmeye yönelik hizmet içi eğitim planlama, bilimsel toplantıya katılma ve araştırma yapmaya teşvik etme önerilebilir.
Investigation of morphometric parameters of processus coronoideus and mandible in human dry mandibles between sides
(Selçuk Üniversitesi, 2022) Keselik, Gonca Ay; Malas, Mehmet Ali
Aim: In our study, we aimed to determine of the relationship between mandible coronoid process and other mandible morphometric parameters in dry bones and compare these datas between the sides. Materials and Methods: Twenty-two human mandible from our anatomy laboratory bone collection were photographed in three different ways, from 2 lateral (right and left side) and 1 posterior. Measurements were analyzied on digital images using Image J software. Morphometric parameters of coronoid process and morphometric parameters that belongs to mandibles ramus and body were compaired between both sides. Coronoid process types were hook, triangular, round and square. The parameters were compared between the two sides and correlation analysis was performed. Results: There was no significant difference between sides in all parameters. There was a strong correlation between area of coronoid process and height of coronoid process on both sides (p<0.001). Correlation the values of the coronoid process the parameters on the right side were higher than the left side. Conclusion: In our study, the correlation values of the parameters of the right coronoid process with each other were higher than those of the left side. However, there was no statistically significant difference between both sides. For the differences in morphometric parameter values between the coronoid process between both sides, further studies should be conducted in the developmental process up to childhood, adolescence, adult and geriatric development. Furthermore, further studies are needed to evaluate the effects of chewing side preference on coronoid process and to evaluate the differences in side/gender.
Elektif sezaryen ameliyatı geçiren primipar ve multipar hastaların anestezi tekniği tercihlerinin karşılaştırılması
(Selçuk Üniversitesi, 2021) Tör, İbrahim Hakkı; Aksoy, Ayşe Nur; Özkan, Hava
Amaç: Bu çalışmanın amacı, iki aşamalı anket formu kullanarak, elektif sezaryen operasyonu planlanan primipar ve multipar hastaların anestezi yöntemi tercihlerinin karşılaştırılmasıdır. Ayrıca, hastaların anestezi yöntemi tercihini etkileyen faktörlerin tespit edilmesi planlandı. Gereç ve Yöntem: Miad gebeliği olan, elektif sezaryen operasyonu planlanan 100 primipar ve 100 multipar hasta olmak üzere 200 hasta çalışmaya dahil edildi. Hastalardan iki aşamalı anket formununu doldurmaları istendi. Anket formu doldurulduktan sonra bir anestezi uzmanı tarafından anestezi yöntemleri hakkında sözel olarak bilgilendirme yapıldı. Sözel bilgilendirme sonrası hastalara tercih ettikleri anestezi yöntemini değiştirmek isteyip istemedikleri soruldu. Hastaların demografik-obstetrik bilgileri ile anket sorularına verdikleri cevaplar kaydedildi ve veriler uygun istatistiksel testler kullanılarak analiz edildi. Bulgular: Multipar hastalarının 98’i (%98) ve primipar hastalarının 65’i (%65) anestezi tekniği hakkında bilgili sahibiydi (p <0.001). Bilgi sahibi olan katılımcıların çoğunluğu (n=59,% 36.19) en fazla bilgiyi anestezi doktorlarından aldıklarını ifade etti. Primipar hastaların 21’i (%21), multipar hastaların 9’u (%9) başlangıçta bölgesel anesteziyi reddetti. Anestezi uzmanı tarafından yapılan sözel bilgilendirme sonrası bölgesel anesteziyi reddeden pimipar hastalardan 9’u (%42.8) tercihini bölgesel anestezi yöntemi olarak değiştirdi. Sonuç: Multipar hastalar bölgesel anestezi yöntemini primipar hastalara göre daha yüksek oranda tercih etmektedir. Anestezi doktoru tarafından anestezi tekniği ile ilgili ayrıntılı sözel bilgilendirme yapılması hastaların bölgesel anestezi tercihini artırabilir.
Evaluation of the demographical, clinical, laboratory findings and treatments of pediatric patients with brucellosis diagnosis in the pediatrics Department of the Faculty of Medicine at Sivas Cumhuriyet University between 2009 and 2019
(Selçuk Üniversitesi, Tıp Fakültesi, 2022) Şimşek, Cemile Ece Çağlar; Ekici, Mahmut
Amaç: Bu araştırmada Sivas Cumhuriyet Üniversitesi Araştırma ve Uygulama Hastahanesi Çocuk Sağlığı ve Hastalıkları Kliniğinde izlenen Brusellozis tanısı almış çocuk hastaların demografik ve klinik özellikleri, laboratuvar bulguları, hastanın tüm belirtileri, aldığı tedaviler, yatış süresi, komplikasyonları, tedavi sonrası prognozunun değerlendirilmesi amaçlanmıştır. Gereç ve Yöntemler: Bu çalışmaya Sivas Cumhuriyet Üniversitesi Araştırma ve Uygulama Hastahanesi Çocuk Sağlığı ve Hastalıkları Kliniği’ne 01.01.2009-31.12.2019 tarihleri arasında başvuran 0-18 yaş grubu, Brusellozis tanısı alan 51 hasta alındı. Hastaların dosyaları geriye dönük olarak incelendi. Tüm olgularda tanı; öykü, klinik belirti ve bulguların varlığında Standart Tüp Aglütinasyon Testi (STA)’nin pozitif (≥1/160) olması ve/veya kan kültüründe Brusella türlerinin saptanmasına göre konulmuştur. Araştırmaya alınan hastaların hastahaneye başvuru tarihleri, yaşları, cinsiyetleri, yaşadıkları yer, çiğ süt ve süt ürünü kullanımı, çiftlik hayvanları ile temas öyküsü, tanıya kadar geçen süre, ailede diğer bireylerde Brusella öyküsü, yaşanılan konutun özellikleri, evde yaşayan kişi sayısı, sosyal güvence, fizik muayene bulguları, laboratuvar bulguları, hastanın tüm belirtileri, aldığı tedaviler, yatış süresi, komplikasyonları, tedavi sonrası prognozu incelenip kaydedildi. Bulgular: Hastaların 41 ‘i (%80,4) erkek, 10’ u (%19,6) kızdı. Hastaların yaşları 2-17 yaş arasındaydı ve yaş ortalaması 10,9±4,10’du. Hastaların yakınmalarının başlaması ile Bruselloz tanısı almaları arasındaki süre 1 gün ile 30 gün arasında değişiyordu ve ortalama 10 gündü. En sık şikayet 39 (%76,5) hastada görülen ateş idi. İkinci sık olarak görülen şikayet 34 (%66,7) hastada olan eklem ağrısıydı. 15 (%29,4) hastanın başvuru anındaki fizik muayenesinde ateşi mevcuttu. 12 (%23,5) hastanın eklem şişliği vardı. Tedavi öncesi ve tedavi sonrası Eritrosit Sedimentasyon Hızı (ESH), C-Reaktif Protein (CRP) değerleri istatistiksel olarak anlamlı fark saptandı (p=0,001, p=0,002). Tedavi öncesi Trombosit (PLT),Aspartat Aminotransferaz (AST) ve Alanin Aminotransferaz (ALT) değerleri anlamlı derecede yüksek idi (p=0,010, p=0,000, p=0,000). Sonuç: Türkiye’nin Bruselloz açısından endemik bölge olmasından dolayı uzun süren ateş, terleme, eklem ağrısı şikayetleri olan her çocukta Bruselloz da düşünülmelidir. Bruselloz tanısı alan hastanın aile üyelerinin hem klinik hem serolojik olarak değerlendirilmesi gerekebilir. Bu durum olası olguların da erken tanı ve tedavilerinin yapılmasına olanak sağlayacaktır. Hastalığın erken dönemde tanınması ve tedavi edilmesi, hayvancılığın yaygın olduğu yerlerde, özellikle kırsal kesimde; halkın çiğ süt ve/veya süt ürünlerinin kullanılmaması konusunda bilinçlendirilmesi, Bruselloz’un bulaşma yolları ve korunma yöntemleri açısından halkın ve sağlık personelinin eğitimi, Bruselloz’dan korunmada önlem olacak ve komplikasyon gelişiminde azalma sağlayacaktır.
Movement Releated Cortical Potentials Obtained by Saccadic Eye Movements In Multiple Sclerosis
(Selçuk Üniversitesi, 2022) Gündüz, Zahide Betül; Eğercioğlu, Tomris Uğur; Tokgöz, Osman Serhat; Akpınar, Zehra
Introduction Movement Related Cortical Potentials (MRCP) are a non-widespread electrophysiological study of clinical use.It demostrates brain mechanisms that appear in cortex during planning and preparing movement by electrophysiologic findings.We aimed to evaluate MRCP that occur due to saccadic eye movement in Multiple Sclerosis (MS). Material and methods: Twenty-five patients in 18-55 age group and with well cognitive functions who were diagnosed as multiple sclerosis according to Mc Donalds criteria with 0-5 Expanded Disability Status Scala (EDSS) and 20 healthy volunteers in a similar age range were included. Results: We could not distinguish clearly all the previously reported components of the MRCP in the records.However,it was observed that the latency of the BP group(Bereitshaftpotential, preparation potential) of both groups was longer in the patient group when the latency values were consistent with the values reported in the literature.The amplitude of the PP(peak-pit),which can be regarded as a component of NS(negative slope) and MP(motor potential),is higher in the patient group and may indicate that the target is more difficult in the patient group. Conclusions: Studies on cognitive impairment in multiple sclerosis have generally been conducted through neuropsychological tests.However,the small number of patients was one of the biggest factors that limited us.The mean EDSS score in our patient group was also low.Although we could not obtain a record that corresponds to the typical MRCP pattern in the literature,we believe that we can make a small contribution by adding new question marks to the MRCP studies with the results we obtained.
The Relationship Between Social Anxiety and Anxiety Sensitivity in Young Adults with Methamphetamine Use Disorder
(Selçuk Üniversitesi, 2023 Ekim) Turan, Çetin; Önen, Sinay; Bakırcı, Güssüm; Sayın Yerli, Merve; Ünal, Süheyla
Objective: Recently, it has been observed that the prevalence of substance use in young adulthood has increased. Comorbidity of anxiety disorders is high in individuals with substance use disorder (SUD). In this study, it was aimed to investigate the relationship between anxiety sensitivity and social anxiety in young adults using methamphetamine. Material and Methods: 101 patients diagnosed with methamphetamine use disorder were included in the study. Participants were evaluated with sociodemographic data form, Addiction Profile Index (BAPI), Symptom Check List (SCL-90-R), Liebowitz Social Anxiety Inventory (LSAI) and Anxiety Sensitivity Index-3 (ASI-3). Results: It was determined that 70.3% of the subjects with SUD were diagnosed as social anxiety disorder (SAD). ASI-3, SCL-90-R and BAPI scores were statistically significantly higher in the SAD group than in the non-SAD group (p<0.05). A statistically significant positive correlation was found in the SAD group between the LSAI-fear/anxiety subscale scores and ADI-3 total (r=0.26, p<0.05), ADI-3 cognitive (r=0.34, p<0.05) and SCL-90-R total scores (r=0.28, p<0.05). No correlation was found between LSAI scores and ADI-3 total and subscale scores in the non-SAD group (p>0.05). Conclusion: It can be suggested that anxiety sensitivity is a common risk factor for both methamphetamine use disorder and social anxiety. Social anxiety symptoms should be questioned in individuals with methamphetamine use disorder and substance addiction treatment should be carried out together with social anxiety disorder treatment.
Comparison of Post Biopsy Pathology and Post Radical Prostatectomy Pathology in Patients with Prostate Cancer Detected After Fusion Biopsy
(Selçuk Üniversitesi, 2023 Ekim) Altıntaş, Emre; Kaynar, Mehmet; Kılıç, Özcan; Batur, Ali Furkan; Gül, Murat; Özer, Halil; Çelik, Murat; Göktaş, Serdar
Aims: To compare the post-radical prostatectomy (RP) final pathologies and post-biopsy pathologies of the patients diagnosed with prostate cancer (PCa) after fusion biopsy according to the International Society of Urological Pathology (ISUP) grading system. Material and Methods: In this retrospective study, data of 182 patients who underwent fusion biopsy and concomitant systematic biopsy between January 2020 and August 2022 was reviewed. All these patients were biopsy naive with PIRADS-3 lesions according to the multiparametric MRI (mpMRI) imaging. A total of 89 patients with PCa detected by biopsy were included in the study. Age, PSA, PSA density, and lesion grades according to PI-RADS were analyzed. The post-biopsy (fusion and systematic biopsy) pathology results of 60 patients who underwent RP were compared with the final pathology results after RP. Results: Pathological results after fusion biopsy and RP were compared. The individual agreement between RP and fusion biopsy for each ISUP grade was moderate to almost excellent (0.558 to 0.848). When the overall agreement between RP and fusion biopsy was evaluated, the weighted kappa was calculated as 0.721 (95% CI: 0.577 to 0.865), which was determined as substantial significant agreement. On the other hand, the overall agreement between systematic biopsy and pathology results after RP was calculated as weighted kappa 0.544 (95% CI: 0.405 to 0.683) and this agreement was determined as moderate agreement. Conclusion: Our study showed that the concordance between the pathology result after fusion biopsy and the final pathology after RP was higher than the standard TRUS prostate biopsy. We think this compliance is crucial in the regulation and follow-up of the treatment of the patients.
A Comparative Analysis of Regional and Local Anesthesia in Arteriovenous Fistula Surgery: A Single-Center Study
(Selçuk Üniversitesi, 2023 Ekim) Çiçek, Mustafa Cüneyt
Background: This retrospective study aimed to compare the outcomes of regional anesthesia and local anesthesia techniques in arteriovenous fistula operations, focusing on patency rates, operation time, and postoperative pain. Methods: A total of 77 arteriovenous fistula and arteriovenous graft operations performed between April 2020 and April 2023 on adult patients with chronic renal failure were analyzed. The patients were divided into two groups based on the anesthesia technique: local (n = 49) and regional anesthesia (n = 28) groups. Results: The majority of operations in the local anesthesia group involved radio-cephalic arteriovenous fistula, while brachio-cephalic, brachio-basilic arteriovenous fistula, and arteriovenous grafts were predominantly performed in the regional anesthesia group. There was no significant difference in operation time between the two groups. However, the regional anesthesia group had a significantly lower need for pain relief within the first 24 hours postoperatively. There were no significant differences in early postoperative fistula failure, bleeding or hematoma between the groups. One case of local wound infection was observed in each group during post-discharge follow-up. Conclusion: This retrospective analysis suggests that regional anesthesia provides superior pain control in the first 24 hours following arteriovenous fistula surgery compared to local anesthesia. Regional anesthesia is a safe and effective technique and can be preferred for more sophisticated arteriovenous fistula procedures.
Investigation of the Adequacy of 100 IU/Kg Unfractionated Heparin Loading Dose by Activated Clotting Time in Children with Congenital Heart Disease During Cardiac Catheterization
(Selçuk Üniversitesi, 2023 Ekim) Gokdemir, Mahmut; Cındık, Nimet
Purpose: This study investigated whether an activated clotting time (ACT) between 200 and 300 sec could be achieved with a100 IU/kg unfractionated heparin (UHF) loading dose in patients with congenital heart disease (CHD) during pediatric cardiac catheterization. Materials and Methods: We included 264 patients aged 0-18 years with CHD undergoing cardiac catheterization between January 2022-March 2023. Data on patient characteristics, UHF doses, and ACT values were retrospectively obtained. The patients were intravenously administered 100 IU/kg UFH after sheath placement. We aimed to obtain a value between 200 and 300 sec according to the ACT measured at the 5th minute. If the measured ACT value at the 5th min was < 200 sec, additional heparin doses between 20 and 50 IU/kg were administered such that the total heparin loading dose did not exceed 150 IU/kg. Patients were divided into two groups based on whether the ACT value was below or above 200 sec. Results: Median age, weight, and ACT value at procedure were 6.41(IQR:2.01–32.21) months, 6.13(IQR:3.79-11.9) kg, and 212(IQR:190-240) sec, respectively. The ACT value of 170(64.4%) of the 264 patients was between 200-300 sec, which was considered the target value. The ACT value of 86(32.6%) of the 264 patients was below the target value and that of eight (3%) patients was above the target value. Hematoma occurred at the access site in four patients (1.5%). We did not detect retroperitoneal hematoma, other bleedings at location, or thromboembolism in any of the patients. No significant differences were observed in comparisons between age subgroups and ACT distribution, or between age subgroups and ACT subgroups (p>0.05) Conclusion: This study revealed that a 100 IU/kg UFH loading dose produced the target ACT value in 64.4% of the patients and that the UFH loading dose should be individualized according to the ACT value in the remaining patients.
Different Approach on our Cells and the Use of CRISPR/Cas 9 Technology: Super Gene’ethic
(Selçuk Üniversitesi, 2023 Ekim) Köksoy, Hale; Karakaya, Serap; Bacak, Pelin; Koçer, Şengül; Kav, Emine; Demir, Sümeyra; Demirel, Ece; Akkaya, Himmet; Akmeşe, Ayşe Nur; Taşkaya, Ayşenur; Yüksel, Elif Senanur; Ameen Al Qadri, Mohammed Saleh
Aims: CRISPR/Cas9, a revolutionary genome editing tool derived from a bacterial system, has transformed molecular biology research, enabling precise and versatile modifications to the genome. This study surveyed 300 participants, including instructors, second-grade medical students, and patient relatives from Selcuk University Faculty of Medicine, to assess their knowledge, attitudes, and ethical perspectives on gene editing. Methods: A comprehensive survey was conducted, and the participants’ demographics were correlated with their responses. Statistical analysis was performed using SPSS 22.0. Results: The survey revealed significant differences (p<0.05) in attitudes based on gender, age, and participation groups. The age group of 18-29 exhibited the highest participation rate (57.3%), while the age group of 60-65 had the lowest (1%). Approximately 50.3% of participants reported no prior knowledge of CRISPR/Cas9 although 64.3% were university graduates. Obtaining approval from ethics committees was considered crucial by 151 respondents for commencing CRISPR/Cas9 research. Interestingly, 63.3% showed eagerness for genetically modified plants and animals, while only 9% expressed interest in studies related to eternal youth. Additionally, 88% found gene editing studies conflicting with their beliefs. Conclusions: CRISPR/Cas9 holds great promise for biomedicine and healthcare but necessitates enhanced public awareness and informed decision-making. The study highlights the importance of promoting informed discussions on the ethical implications of CRISPR/Cas9 to address the concerns and perceptions of various demographics. These valuable insights contribute to the ongoing discourse on the impact of CRISPR/Cas9 on society.
Does the Usage of Drains Create a Risk of Surgical Site Infection During Breast Surgery?
(Selçuk Üniversitesi, 2023 Ekim) Gün Koplay, Tuğba; Güzelant, Asuman
Aim: Drains are used to avoid hematoma, seroma and infection in breast surgery. A topic of debate in breast surgery research is the probability of surgical sites becoming infected through retrograde contamination. In this study, we aimed to determine whether drains cause surgical site infections by using drain tip cultures. Material and Methods: This study included 99 patients 162 breasts of whom had undergone breast surgeries, including augmentation, reduction, reconstruction and gynecomastia, by the same surgeon. Data on the patients’ demographic characteristics, clinical findings, antibiotherapies, types of surgeries and drain features such as type, duration of use, output volume and tip cultures were collected. Results: The study included 99 patients—3 male, 96 female—with a mean age of 37.84. The mean body mass index was 24.5. Seven breast augmentations, three gynecomastia surgeries, 37 breast reconstructions with implants, three breast reconstructions with latissimus dorsi flaps and 49 reduction mammoplasties were performed. We did not observe infectious symptoms such as fever, hyperemia, abscess or hematoma in any of the patients. Fifty-six Jackson–Pratt® drains and 106 Hemovac drain tip cultures were evaluated. The mean follow-up duration was 7.16 days, and the mean output volume was 224.66 cc. The drain tip cultures of all the patients were negative. Conclusions: According to our analysis, drains did not cause retrograde contamination or surgical site infection.
Evaluation of Neutrophil/Lymphocyte Ratio and Platelet/Lymphocyte Ratio in Covid-19 Patients Treated for Cytokine Storm
(Selçuk Üniversitesi, 2023 Ekim) Duksal, Faysal; Burnik, Cengiz; Yavuz, Serkan; Mermer, Mehmet
Background/Aims: There is a significant increase in proinflammatory cytokine levels in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) patients entering cytokine storm. Neutrophilto-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR), also increase in inflammatory diseases. The aim was to evaluate the NLR and PLR of coronavirus disease 2019 (COVID-19) patients receiving tocilizumab (TCZ) due to cytokine storm. Materials and Methods: In this retrospective, cross-sectional study conducted between March and December 2020, adult patients with laboratory-confirmed COVID-19 were analyzed Results; The mean age of 519 patients included in the study was 61.6 ± 17.0 years, with male predominance (64.7%). 70.7% of patients had at least one type of comorbidity and the most common comorbid conditions were chronic obstructive pulmonary disease (45.9%) and asthma (28.7%). 399 patients who were given TCZ (group 1) and 120 patients who were not given TCZ (group 2) were evaluated. Compared with group 2, group 1 had more male predominance and they were older (p<0.001). The mortality rate, which was found as 48.6% in group 1, was approximately twice as high in the intensive care unit (ICU). NLR and PLR were significantly higher and lymphopenia was more prominent in group 1, especially in ICU patients than group 2 (p<0.001). Conclusion: High NLR, PLR and lymphopenia was more common in critically ill Covid-19 patients. Therefore, they may be used as a marker to predict poor prognosis. It can be suggested to treat these patients more aggressively in the initial period.
Assessing the Diagnostic Value of the Red Blood Cell Distribution-to-Platelet Ratio in Acute Leg Embolism Requiring Emergent Surgical Intervention
(Selçuk Üniversitesi, 2023 Ekim) Çiçek, Ömer Faruk; Atalay, Ataberk; Çelik, Recep; Özdil, Mehmet; Boncuk, Fatih; Ünlü, Adeviye; Babadağ, Nisa Nur; Ayyıldız, Şükran Aybike; Salehi, Farid; Coşkuner, Emre; Yıldırım, Elif; Ceylan, Zülal
Background: The objective of this study was to evaluate the significance of the red blood cell distribution-to-platelet ratio (RPR) as a diagnostic indicator, derived from the initial hemogram measurements of patients who underwent emergent surgical treatment for acute leg embolism, by comparing it to a control group of healthy individuals. Methods: The study included 48 patients who underwent femoral embolectomy for acute lower limb ischemia, while an additional 49 individuals were enrolled as a control group. Demographic, clinical, and laboratory data were compared between the two groups. Using the receiver operating characteristic curve to determine the RPR cutoff value, the area under the curve, sensitivity, and specificity were calculated. Results: The age and gender distribution of both groups were comparable. The admission RPR values of patients who underwent surgery for acute embolism were statistically higher compared to healthy individuals (0.0677 (IQR: 0.0547-0.0803) vs. 0.0504 (IQR: 0.0441-0.0572), p<0.001). The area under the curve for acute extremity embolism was determined as 0.832, and the RPR cut-off value of 0.566 was found to predict acute extremity embolism with a sensitivity of 72.9% and a specificity of 73.5% (p<0.001). Conclusion: Our findings provide preliminary evidence that RPR can be used as a novel diagnostic indicator for acute leg embolism. Rather than being used diagnostically alone, it is thought that a comprehensive evaluation of this ratio, when combined with the patient’s medical history and other clinical findings, has the potential to expedite the diagnostic process, particularly in healthcare settings with limited access to imaging resources.
Clinical Outcomes and Midterm Mortality After Carotid Endarterectomy: A Single Center Study
(Selçuk Üniversitesi, 2023 Ekim) Yaşar, Emre; Bayram, Muhammed
Objective: This single-centre study aimed to investigate the clinical outcomes and midterm mortality in patients who underwent carotid endarterectomy (CEA) for various indications. Methods: The study included 109 patients who underwent CEA at our institution. Demographic characteristics, indications for surgery, operative techniques, and early postoperative complications were recorded. Follow-up data were obtained for a mean period of 23.3 ± 17.2 months, and mortality causes, and neurological outcomes were analysed. Results: The mean age of the patients (73 men and 36 women) was 66.53 ± 8.00 years. Indications for CEA included transient ischemic attack (TIA) in 21.1% and a history of ischemic stroke in 26.6% of patients. Overall, 86.2% had unilateral carotid stenosis of 70% or more. Most patients (89.9%) were operated under general anaesthesia, and the conventional carotid endarterectomy technique was employed most (78.0%). The most frequent reconstruction method for the longitudinal carotid arteriotomy was Dacron patch plasty (56.0%). Early follow-up revealed low hospital mortality (0.9%) and limited postoperative complications (3.7% TIA, 1.8% major neurological complications, and 1.8% minor neurological complications). During the follow-up period, absolute survival was 87.0%. Conclusion: Our study demonstrates favourable early outcomes and acceptable long-term mortality rates following CEA. However, larger and multicentre studies are warranted to further confirm these results and enhance our understanding of CEA’s long-term benefits.
Morphometric Evaluation of Thoracic Vertebrae Using Multidetector Computed Tomography in Patients with Scoliosis
(Selçuk Üniversitesi, 2023 Ekim) Tatar, Mehmet Cengiz; Karabulut, Ahmet Kağan; Öztürk, Mehmet; Güleç, Ali; Fazlıoğulları, Zeliha; Ünver Doğan, Nadire
Aim: Many people have congenital and acquired deformities associated with the vertebral column. Vertebral surgery is practiced in cases like scoliosis, traffic accidents, falling down from height, cancer, and disc hernia. We aimed to reduce morbidity and mortality by creating alternative predictions for surgery and treatment with the findings and results we obtained in our study in patients with scoliosis. Methods: Patients with scoliosis (eight male, eight female) who underwent thoracic vertebrae imaging by multidetector computed tomography at Selcuk University Faculty of Medicine between 2013 and 2017 and who were not operated and those without scoliosis (eight male and nine female) who underwent imaging for other reasons were retrospectively evaluated. The group aged >15 years was created in a similar way. Similarly, groups with thoracic X-ray and tomography were created; Cobb angles and the width, height, and distance between the dorsal tips of the transverse process were measured in 12 thoracic vertebrae. Lateral distances from the midline junction of the right lamina of vertebra to the lateral of the right transverse process and pedicle of vertebra junction were measured; measurements were repeated for the left side and recorded. Measurements were made in 780 thoracic vertebrae. Results: Mean Cobb angle of 8 in 10–14-year-old male patients with thoracic scoliosis was 30.9° and mean age was 13 years. Mean Cobb angle of 8 in 10–14-year-old female patients with thoracic scoliosis was 32.72° and the mean age was 12.75 years. Conclusion: Our findings will help for manufacturers create personalized screws and plates, and help surgeons make operational choices.
A Comparative Evaluation of Suture Techniques in Mitral Valve Replacement: Impact on Clinical Outcomes
(Selçuk Üniversitesi, 2023 Ekim) Mola, Serkan; Yıldırım, Alp; Hasanzade, Sabir; Deniz, Gökay; Kasapoğlu, Burak
Objective: This study aimed to compare the outcomes of mitral valve replacement (MVR) using the intermittent simple suture technique versus the horizontal matrix suture technique with pledgeted in terms of paravalvular leakage and infective endocarditis. Materials and Method: A retrospective analysis was conducted on 422 patients who underwent MVR between 2019 and 2023. Patients were divided into two groups based on the suture technique used: group B (simple suture technique) and group P (horizontal matrix suture technique with pledgeted). Propensity score matching was performed to balance the groups, resulting in 62 case pairs for comparative analysis. Results: There were no intraoperative mortalities, and the duration of cardiopulmonary bypass and cross-clamp time did not significantly differ between the two groups. No significant differences were observed in terms of total hospitalization time, early mortality, cerebrovascular events and arrhythmias. Postoperative echocardiography revealed minimal paravalvular leakage in both groups with non-serious leakage observed in four patients in group B and two patients in group P. The incidence of infective endocarditis was one in group B and two in group P. Hemolysis indicators showed higher mean values in the simple suture technique group although not statistically significant. Conclusion: The study findings suggest that there is no significant difference in the incidence of paravalvular leak and infective endocarditis between the intermittent simple suture technique and the horizontal matrix suture technique with pledgeted. Both techniques can be safely employed in MVR.
The Relationship Between the Internet Usage Features, Internet Use Under Parental Supervision, and Depressive Symptoms in Children
(Selçuk Üniversitesi, 2023 Ekim) Orhan Kılıç, Betül; Gül Ateş, Eylem
Aims: Internet usage has become popular among children in the last decade. Little is known about how children should use the digital world. The present study aimed to investigate the relationship between Internet use, frequency of Internet use under parental supervision, and depressive symptoms in children. Material and Methods: The prospective cross-sectional study was conducted on 79 children aged 7-18 years old and their families who applied to the pediatric clinics between March 2021 and June 2021. The participants completed an online questionnaire, including sociodemographic data, children’s Internet use, and the Children’s Depression Inventory (CDI). Children’s Internet use was asked with a questionnaire created by ourselves for this study. Results: The present study found no significant relationship between Internet usage time and depressive symptoms in children. Nevertheless, we showed that children who used the Internet more frequently under parental supervision and used the Internet for study purposes had lower depressive symptoms (p=0.026, p<0.001). Conclusion: Internet use under parental supervision might protect children against the harmful effects of the digital world.

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