2022 - Cilt 6 - Sayı 1
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Öğe Anesthesia Management in Bart's syndrome: A Case Report(2022) Çiçekci, FarukBart's syndrome is a genetic disorder that is also associated with epidermolysis bullosa (EB), which is characterized by congenital focal absence of the skin, mechanical bullous, and nail dystrophy. We present the anesthesia management of a male neonate with congenital localized skin absence, nail dystrophy, and ear atrophy who underwent surgery due to congenital pyloric atrophy. Palliative measures were perforemed paying attention to skin lesions in areas of rich-red peeling on the hands and feet of the patient, and standard general inhalation anesthesia was administered. As far as I could research in the English literature, this case report may be the first case report to present the management of anesthesia in a patient with Bart syndromeÖğe Effects of LDD and CAPE Administration on Total Antioxidant and Total Oxidant Levels in Experimental Periodontitis Model of Rat Brain(2022) Yiğit, Umut; Kırzıoğlu, Fatma Yeşim; Özmen, Özlem; Uğuz, AbdülhadiAim: Observing the effects of caffeic acid phenethyl ester (CAPE) and/or low dose doxycycline (LDD) on total antioxidant and oxidant status of brain in experimental periodontitis is the purpose of the study. Methods: 48 male Wistar albino rats were designed as the following: control group (C, n=8), periodontitis + CAPE group (PC, n=10), periodontitis + LDD (PD, n=10), periodontitis + LDD + CAPE group (PCD, n=10), and periodontitis group (P, n=10). The time period for the experiment was 14 days. 10 µmol/kg/day of CAPE was administered using an intraperitoneal injection (IP). 10 mg/kg/day of LDD was administered using an oral gavage method. Histopathological changes were evaluated. Results: Beneficial results were seen in all of the groups after LDD and/or CAPE administration on decreasing the alveolar bone loss level and oxidative stress. All of the experimental groups showed signs of periodontitis with alveolar bone loss. The P group leads with the most alveolar bone loss compared to the other periodontitis groups and the lowest group was the PC group in the periodontitis groups. The evolution of alveolar bone loss from high to low was that group P, group PD, group PCD, group PC, and group C (P < 0.05). However, there is no statistical difference between brain total antioxidant status and brain total oxidant status average values according to brain groups (p > 0.05). Conclusion: The combination of LDD and CAPE are not significantly different when applied alone or together on oxidative status. But both of the agents have beneficial effects on reducing the oxidative stress and tissue damages.Öğe Clinical And Radiological Results Of Ludloff Medial Open Reduction Technique In Patients Wıth Developmental Hip Dysplasia(2022) Demir, Sedat; Çetin, Baki Volkan; Kaptan, Ahmet Yiğit; Vatansever, Emrah; Ok, Mehmet; Altay, Mehmet AkifAim: The aim of this study was to evaluate the clinical and radiological results of Ludloff medial open reduction surgery in patients with the developmental of hip dysplasia, younger than 18 months old. Methods: The radiological and clinical results of 35 patients (49 hips), younger than 18 months of age treated with Ludloff medial approach due to DDH between the years 2013 and 2020 were retrospectively evaluated. Preoperative, final control acetabular index angles and medial apertures were measured according to the McCay criteria, Tönnis classification, Kalamchi-MacEwen classification, IHDI classification and Severin classification were analysed. Results: At the last control, the youngest age was 27 months, the oldest was 88 months and the mean age was 43.90 ± 14.17 months. The follow-up period was performed at a minimum age of 12 months, a maximum age of 72 months, and the mean follow-up period was 24.81 ± 17.17 months. According to the Tönnis classification, 40 hips were Tönnis classification type 1 (81.63%), 4 hips were Type 2 (8.16%), 3 hips were Type 3 (6.12%) and 2 hips were Type 4 (4.08%) in the follow-up visit. According to McCay clinical evaluation criteria, 38 hips (79.59%) were grade 1 which equates to excellent results. Grade 0 (no necrosis) was detected in 38 (77.55%) of 49 hips according to the Kalamchi and MacEwen AVN clinical evaluation criteria. According to the Severin classification, type 1 results were observed in 32 (65.31%) of 49 hips, type 2 in 9 hips (18.37%), type 3 in 1 hip (2.04%) and type 4 in 7 hips (14.29%). The mean CE angle was found to be 18.56 ± 9.93. Additional surgical intervention was required in 8 hips of 6 patients. Conclusion: Clinically and radiologically satisfactory results were obtained in DDH patients with Ludloff medial open reduction technique, below the age of 18 months.Öğe NTNG2 Mutation: A Candidate Gene for a New Brain-Skin Disorder with Early Neuropsychiatric Manifestation? An Analysis Based on 3000 Patients(2022) Ayaz, Akif; Yuluğ, BurakAim: In this study, the relationship between genetic analysis and exome sequencing and clinical and neuroimaging findings of four patients from the same family was investigated by analyzing a clinical and genetic (WES) database containing more than 3000 patients. Methods: We analyzed the WES data of approximately 3000 patients performed in our center in terms of NTNG2 biallelic mutations. In addition, MR imaging findings were investigated. Results: We found four patients with the same mutation in the NTNG2 gene, presenting with similar clinical and neuroimaging findings. As a result of filtering, the c242G>A variant was determined in the NTNG2 gene. In addition, mild to severe brain parenchymal volume loss and frontal and temporal lobe atrophy were seen in cases 1, 2, and 4 on axial T2-weighted MRI. Conclusion: The current study has similar phenotypic and genotypic features and is a very rare report showing NTNG2 mutation in this context. Existing clinical data are important in choosing NTNG2 gene-related neuropsychiatric disorders as a future treatment target.Öğe Diagnosis and Treatment of Acute Pulmonary Embolism: A Single Center Experience(2022) Ertekin, Ayşe; Balcı, Aydın; Bozkurt, Erhan; Atay, Emre; Aktaş, Ramazan SamiAim: Pulmonary embolism is a potentially life-threatening cardiovascular disease frequently encountered in emergency departments. The computed tomography pulmonary angiography is the imaging modality of choice in the diagnosis of pulmonary embolism. This study aimed to examine the effects of clinical findings and treatment methods on prognosis and mortality by examining patients diagnosed with acute pulmonary embolism in the emergency department. Methods: In this retrospective cohort study, records of patients with acute pulmonary embolism were accessed from the archive. Patients' age, gender, medical complaints, co-morbidities, the treatment method applied to the patients, and the clinical outcomes of the patients were analyzed. The statistical distribution of the patients' demographic and clinical information was calculated. Results: The most common complaint of 206 patients with acute pulmonary embolism was dyspnea. 25.7% patients had massive pulmonary embolism. The blood d-dimer, lactate and troponin T levels of patients with massive pulmonary embolism were found to be higher than patients with sub-massive pulmonary embolism. Thrombolytic therapy was administered to 6.8% of acute pulmonary embolism patients and it was found to be a method that had a statistically positive effect on survival. D-dimer, white blood cell, neutrophil, blood urea nitrogen, lactate and troponin T values were found to be higher in mortal patients. It was determined that 13.1% of the patients died. Conclusion: The sooner the early diagnosis of acute pulmonary embolism, which can be mortal in the emergency department, is made and the treatment is started, the mortality rate will decrease significantly.Öğe The Protective Effects Of Beta Glucan Against Experimental Renal Ischemia Reperfusion Injury(2022) Mavi Bulut, Ayşegül; Şirinyıldız, Ferhat; Cesur, GökhanAim: This study aimed to investigate the possible protective effects of beta-glucan against oxidative stress caused by ischemia and reperfusion injury in kidney tissue. Materials and methods: In the study, 30 male Wistar albino rats weighing 300-350g were used (n=10). Rats were randomly grouped into three groups of Sham control, ischemia reperfusion group (IR), ischemia reperfusion + beta glucan group (IR + BG). Sham group had left nephrectomy, the right kidney taken for histopathologic and biochemical examination. After left nephrectomy in IR group, ischemia procedure was applied for 45 minutes via nontraumatic microvascular clamp, then reperfusion was applied for 60 minutes in the right kidney. In the IR+BG group, rats were administered 100 mg/kg beta glucan via gastric gavage for 10 days. Reperfusion was applied for 60 minutes after 45 minutes of ischemia to the right kidney under anesthesia. Results: As a result of biochemical examination MDA values showed a significant increase in IR group compared to Sham group (p<0,05). In IR+BG group, there was a significant decrease compared to IR group (p<0,05). Tissue MPO values in IR group showed a significant increase compared to Sham group, whereas in the IR+BG group there was not a significant decrease. Also, there was not a significant difference in tissue catalase levels. Tissue GSH values showed a significant decrease in IR group compared to Sham group (p<0,05). In the IR+BG group a significant increase was found compared to IR group (p<0,05). Less damage has been revealed in the IR+BG group compared to IR group in histopathologic examination. Conclusion: All these data show that beta glucan may have an antioxidant effect on renal ischemia reperfusion injuryÖğe Validation and Efficiency of a Scoring System Used in the Differentiation of Uncomplicated Appendicitis(2022) Kubat, Mehmet; Şahin, SerdarObjective: Various parameters are used to differentiate between complicated and uncomplicated appendicitis cases, and scoring systems are even created where these parameters are used together. The aim of this study was to evaluate the effectiveness of one of these scoring systems by external validation. Methodology: Retrospective evaluation was performed on the clinical, radiological and laboratory findings of patients who underwent an appendectomy between January 2018 and January 2021. Scoring was performed using the previously described scoring systems for each patient considered to have acute appendicitis as a result of imaging. They were divided into complicated appendicitis and uncomplicated appendicitis groups, according to clinical and pathological evaluation results. Results: While evaluating 425 patients, ultrasonography was used in 48% and tomography in 52% of the patients. Significant effectiveness of the score of ?6 was observed in the group using tomography (p<0.001, AUC: 0.838, Sensitivity 83.3%, positive predictive value 50.8%, specificity 84.3%, negative predictive value 96.3%). Significant effectiveness of the score of ?5 was observed in the ultrasonography group (p<0.001, AUC: 0.790, Sensitivity 85.7%, positive predictive value 39.0%, specificity 72.2%, negative predictive value 96.1%). Conclusion: The scoring system created for the selection of uncomplicated appendicitis cases has been shown to be effective and has been externally validated. Since each of the parameters used in the scoring system has higher efficiency than its independent effectiveness, scoring systems that evaluate clinical, radiological and laboratory variables together, give better results in clinical practice.Öğe Detection of Intestinal Parasites by Different Methods in Our Type 2 Diabetic Patients(2022) Özsan Yılmaz, MügeAim: Long term persistently high blood glucose levels result in various complications and conditions in diabetic patients. One of them is gastrointestinal disorders and the other is increased risk of infectious diseases like parasitosis. The aim of the study is to demonstrate of intestinal parasites with various techniques in diabetic patients and confirm of the frequency of the parasites. Methods: A total of 65 patients with type 2 Diabetes Mellitus were included in the study. Laboratory tests were done and gastrointestinal symptoms were recorded. Fecal specimens were evaluated with direct microscopy, Kinyoun acid-fast staining method, trichrome staining method and antigen screening test. Results: Of the patients included in the study 31 were male and 34 were female. While 53.8% of the patients had no chronic complications of diabetes, 33.8% had multiple complications. Thirty (46.2%) patients had gastrointestinal complaints. Examination of stool samples revealed G. intestinalis in two patients (3.07%) , C. parvum in three patients (4.6%), and G. intestinalis + E. histolytica in six patients (9.2%) by RAT. No association was found between the existence of parasite determined by RAT and any of the patient characteristics of age, sex, duration of diabetes, and dyspeptic complaints (p-values are 0.27; 0.14; 0.90; 0.68, respectively). Conclusion: This is the first study to explore the prevalence rate of parasitosis detected by RAT in patients with diabetes. In this study, we also compared different parasite detection methods in this patient population and showed that RAT is a more sensitive method.Öğe Predictive Value of Carbohydrate Antigen-125 in Determining the Left Ventricular Diastolic Dysfunction(2022) Kankılıç, NazımAim: Carbohydrate antigen-125 (CA-125) is a well-known marker for mesenchymal cell activation. It is being investigated as a predictive marker for cardiac pathologies due to pericardial or pleural mesenchymal cell activation. In this study, the relationship between left ventricular diastolic diameter (LVDd) and ejection fraction (EF) and serum CA-125 levels was investigated. Material and Method: Thirty-eight patients who underwent coronary artery bypass graft operation were included in the study. LVDd and EF values were calculated. Routine blood parameters and serum CA-125 levels were obtained from blood samples. Patients were divided into groups according to LVDd (LVDd <50mm vs. ?50mm) and EF (EF <50% vs. EF?50%). Results: Among the low (<50%) and high (?50%) EF groups, serum neutrophil, mean platelet volume (MPV), lactate dehydrogenase (LDH), aspartate aminotransferase (AST), troponin-I, triglyceride, and very low-density lipoprotein (VLDL) levels were statistically different (p<0.05). However, no statistical difference was observed between the low (<50mm) and high (?50mm) LVDd groups in other blood parameters except for serum CA-125 levels (p>0.05). Higher serum CA-125 levels were obtained in patients with a high left ventricular diastolic diameter (?50mm) (p<0.05). In addition, CA-125 was found to be an important predictor of left ventricular diastolic diameter with an optimal cut-off value of 0.644 kU/L (60% sensitivity and 78.3% specificity). Conclusion: According to our results, increased serum CA-125 level is an independent predictor of higher LVDd and may be a good indicator of left ventricular functions.Öğe The Effects Of Tumor Localization On Small Cell Lung Cancer And Its Association With Prognosis(Acta Medica Alanya, 2022) Bulut, Sertan; Çelik, DenizAim: Lung cancer is classified as non-small cell lung cancer (NSCLC) and small-cell lung cancer (SCLC) as pathological subtypes. SCLC is associated with a significantly short life expectancy, and it constitutes 10-15% of all lung cancers. Previous studies showed that lung cancer is mostly dominated by the upper lobe and is more common in the right lung than in the left. The main aim of this study is to analyze the localization of the tumor in the right and left lung in aggressive and malignant SCLC patients by comparing it with determinants such as anatomical features, demographic features, laboratory features, including the association with peripheral-central localizations, especially overall survival. Methods: There were four hundred forty-six lung cancer patients diagnosed in a chest diseases clinic in a tertiary training and research hospital between 31.03.2014 and 31.03.2020. Of these, twenty percent (n=90) were diagnosed as SCLC. Among ninety patients, six were excluded from the study due to incomplete medical SCLC records, and finally, eighty-four patients with SCLC were included in the study. Results: We classified eighty-four patients into two groups as right and left lung localized SCLC and analyzed all the data. We found that the left lung tumor group had the more extensive-stage disease and had significantly high CRP levels (p=0.027, p=0.045, respectively). When we analyzed the data such as demographic characteristics, diagnostic methods, overall survival, treatment characteristics, stage characteristics, anatomical features of the right and left tumor groups, we found that there were no significant differences.We use univariate and then multivariate analysis for survival. We found that being sixty-five years old and over (p=0.014), high CRP levels (p=0.016), having centrally localized tumors (p=0.01), having poor performance status (p<0.0001), and having no treatment for primary cancer (p=0.001) were associated with worse survival. Conclusion: Primary treatment of SCLC patients should start promptly. We found that the central location of the tumor as anatomical localization may be associated with worse survival. Also, we found that the left lung tumor group had the more extensive-stage disease and had significantly high CRP levels. Being sixty-five years old and over, high CRP levels, having poor performance status, and having no treatment for primary cancer were significantly associated with worse survival.Öğe Assessment Of Tp-E Interval, Tp-E/Qt, Tp-E/Qtc Ratıos In Thalassemıa Major Patıents(2022) Erkal, ZehraAim: Thalassemia major (TM) is a genetic hemoglobinopathy that causes chronic hemolytic anemia. Repeated blood transfusions are needed for treatment. Iron accumulation is used to predict the risk of ventricular arrhythmia. We designed this study to compare the Tp-e interval, Tp-e/QT ratio and Tp-e/QTc ratio, which are the novel and reliable predictors that show ventricular repolarization, between the TM patients and healthy control group. Method: We included 97 TM patients who presented to our outpatient clinic for routine cardiac check-up from March 2019 to June 2020 and 90 healthy volunteers. In addition to the demographic and echocardiographic findings, patients’ electrocardiograms (ECG) were retrospectively analyzed. Their serum ferritin, C reactive protein (CRP) levels and neutrophil to lymphocyte ratios were recorded and compared. Result: The Tp-e interval was 80 msn (60.0-80.0) in the group of thalassemia major patients whereas it was 60 msn (50.0-70.0) (p<0.001) in the control group. The Tp-e/ QT ratio was 0.200 (0.160-0.225) in the TM group while it was 0.175(0.150-0.210) in the control group (p=0.014). The Tp-e/QTc ratio was 0.180 (0.130-0.190) in the TM group while it was 0.150 (0.130-0.180) in the control group (p=0.035). No correlation was found between their serum ferritin levels and ECG parameters. Conclusion: Prolonged Tp-e interval, Tp-e/QT ve Tp-e/QTc ratios on the ECG in TM patients are associated with impaired ventricular repolarization due to excessive cardiac iron deposition and ventricular arrhythmias. These simple but reliable parameters can be used to predict the risk of arrhythmiaÖğe Effectiveness Of Clinical Parameters And Laboratory Values In Predicting The Clinical Course of Sarcoidosis(2022) Çelik, Deniz; Bulut, SertanAim: The natural course of sarcoidosis is heterogeneous. There is no clear marker that can predict the course of this disease and its characteristics over months/ years. We aimed to analyze our patients' data to identify a prediction parameter at admission. Methods: The patients with sarcoidosis and followed-up between 2015-01-01 and 2020-12-31 comprised the study group. The patients were staged by a Scadding staging system. Improvement or deterioration in at least two of the clinical-laboratoryradiological parameters indicates regression, stable disease, progression, or relapse of sarcoidosis. Results: The study group comprised four cases (6.9%) defined as stage 0; fifteen cases (25.86%) as stage 1; 39 cases (67.24%) were defined as stage 2. The mean age at diagnosis was 40.84±13.56 in stage 0 + stage 1 group, while it was 48.05±13.36 in the stage 2 group (p=0.06). 74.1% of the cases were women. The female/male ratio was found at 2.86. 57 out of 58 cases had a pathological diagnosis (EBUS TBNA). While PFTs values and DLCO were significantly lower at advanced stages but the same statistical significance was not identified between these values and the clinical course of the disease. As a result of the multivariate analysis, it was observed that only the presence of chest pain at admission affected the progression of the disease in the follow-up period. Conclusion: Sarcoidosis is a multi-systemic disease and there is no clear finding for predicting the poor prognosis of the disease. We conclude that chest pain symptom at admission is valuable predictive finding and can be used as a clue for the progression at follow-upÖğe The Effect of Self Glucose Monitoring on Glycemic Control of Patients with Diabetes Mellitus Fasting During Ramadan(2022) Aladağ, Nazire; Akın, Seydahmet; Özgür, Yasemin; Böyük, Banu; Keskin, ÖzcanBackground: It is known that a significant number of patients with diabetes insist on fasting in the month of Ramadan, despite the advice of their physicians and reliable authorities. In order to provide the best possible care and support to these patients, the International Diabetes Federation (IDF) and the Diabetes and Ramadan (DAR) International Alliance created practical guidelines. The aim of this study was to investigate the effect of consulting a physician and glucose self-monitoring on diabetes management during Ramadan in patients with fasting diabetes. Methods: With this retrospective observational study, patients over 18 years of age who were diagnosed with diabetes, who came to the diabetes outpatient clinic for control after Ramadan and who made their follow-up from our outpatient clinic before Ramadan, were included. Participants intending to fast (previous or not) were asked about previous fasting experiences, questions about whether they consulted the doctor before Ramadan, and for those who fasted, how they spent this Ramadan. The biochemical data of fasting patients before and after Ramadan were analyzed. Results: A total of 394 patients with diabetes participated in the questionnaire and 98 of them (24.9 %) who were fasted were included in the study. The mean age of the fasting patients with diabetes was 59.7 ± 12.3 years and39.2 %were female. It was detected that 86.7% of the fasting people were fasting for more than 15 days. Fasting rates were higher in males than females (32.4% to 20.8%). It was found that 25.9% of patients with type 2 DM and 10.3% of patients with type 1 DM were fasting. It was determined that 62.8% of the patients intending to fast were consulted to the physician about this subject, 55.3% of them were determined risk by physician and 70% of them followed up with self monitoring blood glucose (SMBG).It was determined that 23.4% (23/98) of fasting patients had a reduction in the number or dose of diabetes medications used; 5.1% (5/98) experienced a complication that would disrupt fasting; 16.3% gained weight (2.8 ± 2.4 kg) and 23.5% lost weight (2.7 ± 1.9 kg). A significant increase in HbA1c and a significant decrease in UACR were detected. It has been determined that A1c control of those who follow with SMBG is better protected than those who do not. Conclusion: In our study, it was seen that a quarter of patients with diabetes fasted. The most valuable result of this study is that the diabetic patients have achieved a more successful diabetes control by providing auto control mechanisms with SMBG, regardless of whether or not they have received medical advice by physician consultation during the Ramadan period.Öğe Functional and radiological results of the surgical treatment of pediatric femoral neck fractures(Acta Medica Alanya, 2022) Toprak, Duran; Özdemir, Mustafa Abdullah; Doğar, Fatih; Bilal, ÖkkeşObjective: Our aim in this study was to evaluate the demographic data on femoral neck fractures, postoperative complications, and functional and radiological results following its surgical treatment in the pediatric age group. Pediatric femoral neck fractures often occur after high-energy trauma and seen rarely. Material and Methods: Twenty-six patients who underwent surgery after the diagnosis of femoral neck fracture in our clinic between 2012 and 2019 were examined. Demographic data, trauma mechanism, accompanying injuries, and postoperative complications of the patients were recorded from our registry system. Functional radiological evaluation was performed using Ratliff criteria. Results: The mean age of the participants in the study was 11.11 (3–16) year, and the mean follow-up time was 29.34 (12-60) months. According to Ratliff criteria, 18 patients (69.2%) achieved good, 6 patients achieved (23.1%) moderate, and 2 patients achieved (7.7%) poor results after surgery. Avascular necrosis was observed in 5 patients (19.2%) in total. Avascular necrosis did not occur in 10 patients who underwent surgery within first 6 hours. Avascular necrosis occurred in 5 (31.25%) out of 11 patients who underwent surgery after 6 hours. This result was statistically significant (p = 0.049). Of the 5 patients with avascular necrosis, 3 were female and 2 were male. The clinical and radiological results were evaluated according to the Ratliff criteria, and the results were found to be worse in females than in men. There was a statistically significant difference between the genders (p=0.029). Conclusion: Although femoral neck fractures are rare injuries in the pediatric age group, they are important due to the high risk of complications. The most important complication is avascular necrosis. Results are better males than in females. The results of surgical treatments aimed at anatomical reduction in the shortest possible time are satisfactoryÖğe Evaluation of Congenital Mediastinal Vascular Anomaly Types And Frequencies Among 2000 Cases(2022) Dadalı, Yeliz; Özkaçmaz, Sercan; Demir, Mustafa; Bursalı, İlkeAim: In this study, it was aimed to examine the incidence of congenital thoracic vascular anomalies in our region. Methods: The features of the patients with non-specific complaints who underwent a thorax Computed Tomography over a two years period were retrospectively reviewed on the hospital database, and demographical data (Gender and age) were recorded. All the Computed Tomography images were interpreted regarding thoracic vascular anomalies, including persistent left superior vena cava, azygos lobe, aberrant right subclavian artery, dilated left superior intercostal vein, right-sided aortic arch, situs inversus, and partial anomalous pulmonary venous return. The incidences of these thoracic vascular anomalies were calculated and compared with previous studies. Results: Mediastinal vascular anomaly was detected in 62 (3.1%) patients. A mediastinal vascular anomaly was observed in 27 (3.5%) female patients and 35 (2.6%) male patients. The most common mediastinal vascular anomaly in this study was the right aberrant subclavian artery (n:17, 0.9%) and the rarest was partial anomalous pulmonary venous return (n:1, 0.1%). Persistent left superior vena cava incidence was 0.3% (n:6), azygos lobe 0.7% (n:14), right-sided aortic arch 0.3% (n:5), situs inversus totalis 0.2% (n:3), and dilated left superior intercostal vein 0.8% (n:16). Conclusion: Mediastinal vascular anomalies are rare and usually asymptomatic. But the imaging findings of these conditions must be well-known to accurately planning the interventions and also to prevent iatrogenic injuries.Öğe CT Angiography and Doppler Ultrasound Evaluation of Congenital Portosystemic Shunts(2022) Akdulum, İsmail; Akyüz, Melih; Gürün, Enes; Öztürk, Mehmet; Sığırcı, AhmetAim: The aim of the study was to describe the Doppler ultrasonography and computed tomography findings that should be considered in the diagnosis and treatment of congenital portosystemic shunts. Methods: Archive retrospectively scanned. In consideration of shunts: communication type and aneurysm were defined. Additional imaging modalities were utilized. Results: 11 patients were included in the study. The ages ranged from 0 to 158 months. There were two patients with shunt connecting segment-4 portal vein - middle hepatic vein, two patients with segment-3 portal vein - left hepatic vein, two patients with left portal vein – middle hepatic vein, two patients with portal vein - left renal vein, two patients with portal vein -inferior vena cava, and one patient with portal vein - perirectal venous plexus. Conclusion: Some classifications used in congenital portosystemic shunts are insufficient in guiding treatment. Elaborate definition of the imaging findings including the involved vessels, type of communication, and presence of aneurysm or dilated vessels is of the prime importance for tailoring clinical management of the patients.Öğe Diagnostic accuracy of kidney shear wave elastography at the diagnosis of ureteral stones(2022) Yıldırım, Utku Mahir; Şahin, Erkan; Solak, Aynur; Örs, Bumin; Serter, SelimAim: To determine the efficacy of kidney shear wave elastography (SWE) in patients diagnosed with ureteral stones Method: Both kidneys of 30 patients were evaluated prospectively with SWE. The ureteral stone size and the degree of hydronephrosis were determined by sonographic examination. The contralateral kidney was accepted as the control parameter. Stone size, grade of hydronephrosis and kidney shear wave speed changes were noted and their relations were examined for statistical significance. Results: Affected kidney group had significantly increased SWE values than the control group. (3.87+-1.22 vs 2.06+-0.72 m/sec) (p=0.01). Neither the stone size nor the kidney SWE values showed a correlation with the gender. There was a positive correlation between the grade of hydronephrosis and the stone size (p=0.047, r=0,36). Kidneys with grade 2 hydronephrosis had significantly higher SWE values than those with grade 1 hydronephrosis. Conclusion: SWE is a promising tool to observe the parenchymal elasticity changes in patients with hydronephrosis secondary to ureteral stones. Further studies are necessary to confirm the research resultsÖğe Osteoporosis and Fragilty Fractures: An Overview.(2021) Aslan, AhmetOsteoporosis (OP); It is a metabolic bone disease characterized by decreased bone mineral density (BMD) and bone strength, increased bone fragility and fracture risk, and deterioration in the microarchitecture of bone tissue. The most important cause of morbidity and mortality in OP are fragility fractures such as osteoporotic hip fractures. Prevention and treatment of osteoporosis can prevent hip fractures and comorbidities. In this paper, the available information about Osteoporosis and Osteoporotic fractures is briefly reviewed.
