2022 - Cilt 6 - Sayı 2
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Öğe Has the Covid-19 Pandemic Affected the Practice of Orthopedics and Traumatology?(2022) Aksoy, Ahmet; Sargın, Serdar; Atik, Aziz; Gülcü, AnılAbout the impact of the Covid-19 pandemic on the practice of Orthopedics and TraumatologyÖğe The Relationship of Learning and Memory Disfunction with NEURL1 and RGS14 Genes in Patients with Autism Spectrum Disorders(2022) Akın, Sümeyye; Gültekin, Fatih; Güler, Eray MetinAttention deficit hyperactivity disorder (ADHD) is a childhood-onset disorder that affects 5% to 12% of children worldwide. Etiological factors, including nutrition, contribute to this disease, which is characterized by inattention, impulsivity and hyperactivity symptoms. Fats, which form an important part of the daily diet, can have effects on ADHD and its symptoms. In the literature, it is stated that omega-3 fatty acids are low in children with ADHD, and supplementation studies may be effective in improving symptoms. In addition, high omega-6/omega-3 fatty acids ratio in the diet and diets rich in saturated and trans fatty acids are associated with ADHD. In this review, the relationship between ADHD and dietary fatty acids was evaluated.Öğe The Relationship of Learning and Memory Disfunction with NEURL1 and RGS14 Genes in Patients with Autism Spectrum Disorders(2022) Eciroğlu, Hamiyet; Şener, Elif Funda; Öztop, Didem Behice; Özmen, Sevgi; Kaan, Dilek; Yusuf, ÖzkulAim: We aimed to evaluate the relationship between learning-memory difficulties and NEURL1 and RGS14 genes in patients with autism spectrum disorders (ASD). Method: Forty children with ASD (20 ASD, 20 high functioning autism (HFA)) and 20 healthy controls were enrolled in this study. NEURL1 and RGS14 gene expressions in blood samples of volunteers were assessed by quantitative Real-Time PCR (qRTPCR). The clinical and demographical findings in patients were determined and examined in relation to the gene expressions. Results: According to our findings, NEURL1 gene expression was decreased in both patient groups compared to the control (p<0.05). No significant difference between the groups in terms of the RGS14 gene (p>0.05). A statistically significant correlation was found between learning and memory difficulties and RGS14 gene expression in HFA patients (p=0.045). A positive correlation was observed between NEURL1 and RGS14 gene expressions of ASD patients (p=0.032, r=0,59). Conclusion: In this study, we showed that the NEURL1 gene may affect learning and memory difficulties in ASD patients. Nonetheless, we recommend that both genes be studied with more patients and preferably with brain tissues. These genes were evaluated for the first time in a clinical study on autism, and we believe that they will contribute to the literature in this respect.Öğe The Relationship Between Frontal QRS-T Angle and Premature Ventricular Contraction Burden in Ambulatory 24-Hour Holter(2022) Kuş, Görkem; Çağırcı, GökselAim: Frequent premature ventricular contractions (PVCs) can cause impaired ventricular function or dilatation of ventricular cavities. The frontal plane QRS-T [f(QRS-T)] angle is an indicator of instability in the electrophysiological properties of the myocardium and is associated with arrhythmias. The present study aimed to investigate whether f(QRS-T) angle, as a marker of ventricular repolarization heterogeneity, predicts premature ventricular contraction burden in ambulatory 24- hour Holter. Methods: The study included 100 patients. The patients were divided into two groups as ‘frequent PVC’ and ‘seldom PVC’ according to their PVC burden in 24-hour Holter monitoring. Laboratory and some ambulatory electrocardiography parameters, including frontal plane QRS-T angle, were compared between the two groups. Results: Frontal QRS-T angle (63.34±37.86° vs 23.46±14.29° p<0.001) was found to be wider in the Frequent PVC group. F(QRS-T) angle of ? 34° had a sensitivity of 82.2% and a specificity of 80% in indicating PVC load (AUC: 0.887 (0.824-0.950). In addition, a positive correlation was found between PVC burden and f(QRS-T) angle (r:0.429 p<0.001). Conclusion: The widening of f(QRS-T) angle could perhaps be considered as a surrogate marker of increased PVC burden in 24-hour Holter monitoring. Measuring f(QRS-T) angle in 12-lead ECG in patients with PVC may be a warning sign for increased PVC burden.Öğe The effect of social network diversity and social support on the thriving of healthcare workers(2022) Kılıç, Özge; Yalçınay İnan, Merve; Bilir, Esra; Pasin, Özge; Kuşçu, KemalAim: The well-being of healthcare workers is a critical indicator in the provision of high-quality care. Although researchers have stressed the importance of social interactions and social support, scarce data exist about their effects on healthcare workers’ well-being. In this study, we aim to advance the research on the relationships between social network diversity (SND), social support, and thriving. Methods: In a cross-sectional design, an anonymous online link was shared among healthcare workers in a university hospital. The survey included questions on demographics, medical diseases, items from the social network index, the multidimensional perceived social support scale, and the brief and comprehensive inventories of thriving scales. Results: A total of 103 individuals participated in the study (median age, min-max=33 (18-57); male/female = 33/70). Men and women did not differ in SND, perceived social support, or thriving scores. The brief inventory of thriving demonstrated healthcare workers older than 38 years exhibited higher scores in thriving compared to those younger than 27 years (p=0.001). According to comprehensive inventory of thriving, belonging (p=0.032), skills (p=0.006), self-worth (p=0.048), meaning and purpose (p<0.001), optimism (p=0.009), life-satisfaction (p=0.012), and positive emotions (p=0.042) differed by age groups. SND (r=.56, p<0.001) and perceived social support (r=.53, p<0.001) were positively correlated with thriving. After adjusting for potential confounders, SND, perceived social support, and age accounted for 46% of the total effects on thriving. Conclusion: This study expands on the literature and provides evidence that by increasing the diversity of social networks and improving the quality and functionality of social support, a significant and positive impact on HCWs’ well-being may be achievedÖğe Pediatric Scorpionism in Southwest Turkey: The Experience of a Training and Research Hospital(2022) Çalışkan, Duygu; Akkaya Kuybulu, Ayça EsraAim: The aim of this study was to evaluate the clinical and laboratory features and prognosis of scorpion stings in children. Methods: This was a retrospective study of children with scorpion stings, who were admitted to the pediatric emergency department in Alanya Alaaddin Keykubat University (ALKU) Training and Research Hospital between the 1st of January 2019 and the 31st of December 2020. Demographic data, admission date, time periods from sting to admission to hospital and geographical location in which the sting occurred were recorded. Recordings were also made of the affected body sites, local and systemic signs and symptoms of envenomation, results of hematological and biochemical laboratory tests, management, length of hospital stay and outcome. Results: In total, medical records of 111 children were reviewed. Patients were separated according to the clinical findings into three groups, seventy patients (63.1%) with mild symptoms and thirty-four patients (30.6%) with moderate symptoms, seven patients (6.3%) with severe symptoms. There was one exitus due to scorpion stings in the study period. Forty-one (37%) patients were hospitalised, and seven patients (6.3%) were hospitalised in the pediatric intensive care unit. Five patients (4%) received doxazosin and nineteen (17%) patients had antivenom therapy. Hospitalization in the intensive care unit was necessary for seven cases. No patient exhibited sequelae at the hospital discharge. Conclusions: Scorpion stings in our region mostly result in mild envenomation. Doxazosin, an analog of prazosin more readily available in our country, can be considered as a treatment option in serious scorpion envenomations with significant sympathetic symptoms.Öğe The Dose-Dependent Antiangiogenic Potential of Apixaban: An Experimental Outlook(2022) Akkaya, Özgür; Aydoğan, EyüpAim: Direct oral anticoagulants (DOACs) are good alternatives to conventional medical regimens for the treatment and prevention of thromboembolism. Apixaban is one of the more popular variations of these newly developed drugs. Aside from its anticoagulant potential, possible cellular effects remain a topic for future studies. The object of this study was to investigate the possible antiangiogenic effects of apixaban in the chorioallantoic membrane (CAM) model. Method: Drug pellets were prepared at 10-4, 10-5, and 10-6 M concentrations of apixaban and were placed in the chorioallantoic membrane on the fourth day of egg incubation. On the eighth day, all vascular densities of the membranes were compared with a 10-6 M concentration of bevacizumab, which is a known monoclonal, humanized, vascular endothelial growth-factor inhibitor. Results: We find that a 10-4 M concentration of apixaban has strong antiangiogenic potential similar to that of bevacizumab. However, there was moderate antiangiogenic potential at a lower dose of apixaban (10-5 M, 10-6 M). A comparison of the higher doses of antiangiogenic potential (10-4 M concentration) with lower doses of apixaban (10-5 M, 10-6 M) revealed significant statistical differences (p < 0.05). Conclusion: Our results indicate that a high dose of apixaban has strong antiangiogenic potential. The exact mechanism of this effect remains unknown. These pilot results should be confirmed with further studies to obtain an updated look at DOACs.Öğe Prevalence of perioperative hypothermia and predisposing factors in a children's hospital(2022) Şahin, Kübra Evren; Sözbilen, Murat CelalSTRACT Aim: Perioperative hypothermia is more common in pediatric patients than in adult patients due to increased body surface area/weight ratio and limited subcutaneous fat deposits. Therefore, active and passive warming techniques are used more frequently in the surgeries applied to pediatric patients. This study presents the prevalence of perioperative hypothermia and the predisposing conditions for perioperative hypothermia in pediatric orthopedic surgeries in which active and passive warming techniques are applied. Methods: This cross-sectional, descriptive, and observational study included 102 children admitted to the pediatric orthopedic clinic of a children’s hospital. Temperature measurements were made with a calibrated infrared tympanic thermometer in all cases while they were waiting in the service room, when they entered the operation theater, when they left the operation theater and when they left the postoperative care unit. Their demographic data, hemogram and thyroid hormone parameters, preoperative fasting times related to the procedure and temperature were recorded. Also, the humidity and temperature values of the operating theater, the operation type performed, the duration of the operation, the time spent in the operating theater and the recovery time from anesthesia, were all recorded in their follow-up forms. Data analysis was done using the SPSS V21.0 and was conducted at a 95% confidence interval. Results: Hypothermia was observed in 20.58% of 102 patients included in the study. Predisposing factors for perioperative hypothermia included the fact that the patient had a diagnosis of concomitant cerebral palsy, the patient's body temperature was low in the service area, low temperature and humidity values in the operating theatre and staying in the operating theatre for a prolonged period of time. Conclusion: Although active and passive warming techniques are applied during the operation, perioperative hypothermia was observed in 20.58% of pediatric patients who underwent the orthopedic operation. Consideration of predisposing factors together with active and passive warming techniques may reduce the incidence of perioperative hypothermia.Öğe Investigation of the Antiepileptics on Levels of Vitamin D and Calcium(2022) Yuluğ, Burak; Özşimşek, AhmetAim: We investigated the connection between D vitamin and factors such as the type of antiepileptic agent, patient age and gender. Methods: This retrospective case-control study enrolled a total of 301 participants, including 141 epilepsy patients with (n= 120) without drug (n=21) regimens followed up in Alanya Alaaddin Keykubat University neurology outpatient clinic and 160 healthy individuals who applied to the neurology outpatient clinic for different reasons from January 2018 to January 2021. Demographics, detailed history, use of medications, duration of antiepileptic use, plasma 25-hydroxy Vitamin D and calcium levels were determined. Results: The mean level of Vitamin D was 15.46 in the epilepsy group and 16.95 in the control group. Level of D Vitamine did not differ significantly by groups (p>0.05). There were no significant relationship regarding age and vitamin D levels in both groups while decreased Vitamin D levels were detected epileptic women. Vitamin D level was below 20 in 69.6% of healthy control group, 78.9% of carbamazepine users, 62.5% of lacosamide users, all lamotrigine users, 66.7% of levatiracetam users, and 72.4% of sodium valproate users. No significant connection were detected between levels of Vitamin D and the drug used (p>0.05) while a significant association was confirmed only between calcium levels and carbamazepine (p<0.05). Conclusion: Vitamin D and calcium levels can be found to be low in antiepileptic users; however, except for the calcium levels in the carbamazepine group, this decrease does not constitute a significant difference.Öğe Identification of the Hemodynamic Correlates of Basic Emotional States with a Mobile Functional Near Infrared Spectroscopy System(2022) Erdoğan, Sinem BurcuAim: The aim of this study was to evaluate the feasibility of a functional near infrared spectroscopy (fNIRS) system, for quantification of the similarities and differences in the spatial localization of cerebral hemodynamic activation, induced by visual presentation of neutral, negative and positive valence emotional stimuli. Method: Thirteen healthy subjects viewed neutral, pleasant and unpleasant pictures from the International Affective Picture System (IAPS) database in a block design experiment while the prefrontal cortical hemodynamic changes induced by emotional stimuli were continuously recorded with a 20 channel fNIRS system that covered the forehead region. Results: Negative valence pictures induced higher hemodynamic activity in right lateralized regions involving dorsolateral and orbitofrontal cortex, when compared to neutral and positive valence stimuli (pFDR<0.05). Each stimulus condition induced a distinct cortical activation pattern that could be identified with fNIRS. Conclusion: Our findings support the notion that different basic emotions have distinct localization and separable hemodynamic correlates in the prefrontal cortex region, which can be detected with a mobile fNIRS system. The distinct cortical hemodynamic activity patterns associated with each emotional state show the potential of fNIRS technology for decoding and differentiating basic emotions objectively and real time for future clinical and daily life applications.Öğe Clinical Outcomes of Uniportal Versus Multiportal Endoscopic Thoracic Sympathectomy in Patients With Severe Palmar and Axillary Hyperhidrosis(2022) Aslaner, OktayAim: Palmar and axillary hyperhidrosis is caused by overstimulation of the sympathetic nervous system that control the sweat glands. This study compares the clinical consequences of uniportal and multiportal thoracic endoscopic thoracic sympathectomy (ETS), in cases of severe palmar and axillary hyperhidrosis. Methods: In this retrospective study, forty-one patients who were diagnosed as severe palmar and axillary primary hyperhidrosis were analyzed. These underwent multiportal ETS between 2015 and 2020 at our thoracic surgery clinic. They were divided into two groups, 24 as uniportal (58.5%) and 17 as multiportal (41.5%). They were compared in terms of the length of hospital stay, the initial complications and possible recurrences after three months. Descriptive statistics were used to evaluate stratified and continuous variables. Results: There was no significant difference in moderate pain between the two groups. There was a significant difference between the two groups in terms of 3 days or more hospitalization. There were no significant difference related to the rate of complications such as ptosis, Horner syndrome, increased duration of surgery and recurrence rate of hyperhidrosis 3 months after surgery. Some mild to moderate side effects disappeared spontaneously at 6-month follow-up. Conclusion: The results showed that uniportal and multiportal endoscopic thoracoscopic sympathectomy (EST) are very effective, safe and minimally invasive methods for the treatment of palmar and axillary hyperhidrosis. Compared to the multiportal approach, uniportal EST causes less postoperative pain and less surgical duration.Öğe Is there a relationship between NR-2 antibody peptide level and diagnosis, prognosis and coma scores in acute ischemic stroke?(2022) Tuncar, Alpay; Cander, Başar; Küçükceran, Kadir; Yerlikaya, Fatma HümeyraAim: This study aimed to demonstrate the diagnostic and prognostic value of NR-2 peptides as a biomarker in acute ischemic stroke and to evaluate their correlation with the Glasgow Coma Scale (GCS) and the National Institutes of Health Stroke Scale (NIHSS). Materials and Methods: The importance of NR-2 peptide level in diagnosis and prognosis in acute stroke was investigated cross-sectional and prospectively. The study included 101 patients, who presented to a tertiary healthcare facility and were diagnosed with acute stroke, and 57 healthy controls. In the whole study population, serum NR-2 peptide levels were measured using the ELISA method. Results: The NR-2 peptide level was 6.32 ± 8.30 in the patient group and 3.91 ± 1.64 in the study group. The NR-2 peptide level was significantly higher in the patient group (p = 0.006). No correlation was detected between NR-2 peptide levels and scores in the GCS or NIHSS. The results indicated that NR-2 was a potential biomarker elevated in the early phase of acute stroke, but had no correlation with the prognosis of acute stroke. Conclusion: Although our data shed light on the use of the NR-2 peptide level as a biomarker in the acute phase in patients with stroke, data are insufficient to predict prognosis. We think that larger, multicenter studies with longer follow-up periods are needed.Öğe Our Experiences of Laparoscopy in the Non-palpable Testes(2022) Kocaman, Osman Hakan; Günendi, TanselAim: To demonstrate the superiority of laparoscopic undescended testicular surgery for non-palpable testicles in children in diagnosis and treatment. Methods: The files of patients between the age of 6 months and 18 years who underwent laparoscopic undescended testis investigation due to non-palpable testis in our clinic, between January 2010 and September 2021, were reviewed retrospectively. Patients with palpable testicles and patients with disorders of sex development in the examination performed under general anaesthesia were excluded from the study. Results: Fifty-three patients were included in the study. The mean age of the patients is 3.2 years (min: 8 months-max 17 years). Laparoscopic intervention was performed for a total of 59 non-palpable testicles which were left-sided in 54.7% (n=29) of the patients, right-sided in 34% (n=18), and bilateral in 11.3% (n=6). Throughout these 59 testicles, cords and vessels of 31 testicles were visualized entering the inguinal canal, atrophic testes in the abdomen were detected in 7 patients, the cord and vessels had an intraabdominal blind ending (vanishing testis) in 7 patients, and 14 testicles were in the abdomen with normal aspect. Conclusion: Simultaneous laparoscopic orchiectomy is performed in case of atrophic testis in laparoscopic exploration for non-palpable testicles. It allows the ligation of vessels of testes farther than 2 cm away from the inguinal canal, and for testes that are closer than 2 cm it grants the vessels to be released under a more precise vision thereby protecting from the complications of conventional surgeryÖğe The Relationship Between Serum 25-hydroxyvitamin D and Calcium Levels and Idiopathic Benign Paroxysmal Positional Vertigo(2022) Özşimşek, Ahmet; Karaçay, ErtanAim: We aimed to compare 25-hydroxy vitamin D (25-OH vitamin D) and Ca2+ levels of patients admitted to our clinic with the complaint of dizziness and diagnosed with idiopathic benign paroxysmal positional vertigo (BPPV) with those of healthy control group without dizziness and investigate the role of Ca2+ and 25-OH vitamin D in the development of BPPV. Material and methods: This study is a retrospective case-control study. The study sample consisted of 409 patients admitted to Alanya Training and Research Hospital Neurology outpatient clinic and diagnosed with idiopathic BPPV between 01.01.2018 and 01.08.2021, and of 338 control patients without any physician consultation due to vertigo, dizziness or imbalance in the last 1 year before admission to our clinic and whose serum vitamin D levels were measured, the Chi-square and T-test were utilized for statistical analysis. Results: Mean blood 25-OH vitamin D levels were 15.74 ng/mL and 17.91 ng/ mL in BPPV and control groups, respectively. Serum 25-OH vitamin D levels were significantly lower in BPPV group than control group (p=0.01, p<0.05). Mean serum Ca2+ levels did not exhibit any difference in BPPV and control groups. Conclusion: Decreased serum levels of 25-OH vitamin D have been associated with the occurrence of BPPV independently of other key markers.Öğe Does Adipose Tissue Thickness Affect the Duration of Rotator Cuff Operations?(2022) Aktı, Sefa; Aktı, Serdar; Doğruyol, Dağhan; Haver, Selin; Zeybek, Selin; Çankaya, DenizObjective: Accurate estimation of operation time will reduce operating room costs and increase patient satisfaction. In recent studies, authors have found that thicker adipose tissue at the operation site is associated with a higher rate of complications. However, there is no study in the literature investigating the effect on operation time of an increase in adipose tissue thickness. This present study hypothesized that thicker adipose tissue in shoulder surgeries would prolong the operation time, therefore the study was planned accordingly. Material and Methods: Preoperative magnetic resonance images of patients applied with rotator cuff repair between 2015 and 2020 were independently evaluated by two observers. The acromial fat thickness was measured as the fat thickness of the operation area, and the scapular fat tissue thickness as the fat thickness of the region relatively far from the operation area. The data obtained were evaluated using multivariate analysis and a binary logistic regression model. Results: Evaluation was made of a total of 106 patients. The mean total operation time was 89±33 mins. The mean acromial fat thickness was 12.2±4.89 mm and the mean scapular fat thickness was 27.9±12.5mm. The increase in acromial fat thickness was determined to have extended the operation time (OR=5.75, 29.21, p<0.05). Conclusion: The thickness of fat tissue in the surgical area is one of the factors affecting operating time. Patients can be informed about the risk of prolonged surgery time and associated complications before surgery and costs can be reduced by optimizing operating room planning. In addition, it should be considered that tendinous pathologies may be more common in individuals with increased adipose tissue thickness and thus contribute to prolonging the operation time.Öğe The Effect of Regularly Performed Oderate-Intensity Exercise Program on Thiol/Disulfide Homeostasis, and Ischemia-Modified Albumin(2022) Pala, Mukaddes; Altan, Mehmet; Hanikoğlu, Ferahat; Neşelioğlu, Salim; Erel, Özcan; Metin, GökhanAim: Thiol/disulfide homeostasis is an indicator of oxidative stress and antioxidant capacity. Ischemia-modified albumin (IMA) is an important marker for both oxidative stress and ischemia. We aimed to evaluate the possible effects of regularly performed moderate-intensity exercise on thiol/disulfide homeostasis, and IMA levels. Methods: Sprague Dawley rats were used. The study was composed of an Exercise group (EG, n=9) and Control group (CG, n=6). A 10-weeks swimming exercise was performed. Thiol/disulfide homeostasis measurement method was used in this study. IMA levels were measured by a cobalt-albumin binding method. Results: In the EG, total thiol levels were significantly higher compared to the CG (p<0.01). The disulfide/total thiol ratio was lower in the EG compared to the CG (p<0.01). We observed that there was a slight increase in IMA levels in EG (p=0.18). This increase was not statistically significant. Conclusion: Regularly performed moderate-intensity exercise has increased native and total thiol levels. Increase of thiol levels can prevent oxidative stress. Regularly performed moderate-intensity exercise programs appear to provide favourable effects on oxidative stress.Öğe Hip Fracture in The Elderly: An Overvıew(2022) Aslan, AhmetIn this paper, the available information about hıp fracture ın the elderly is briefly reviewed. Intracapsular and extracapsular hip fractures, which usually occur due to low energy trauma in elderly patients, are one of the most important causes of functional disability, morbidity and mortality. Treatment of hip fractures; it requires the management of a broad spectrum from prevention to surgery and post-operative care. It is important to mobilize elderly patients with hip fractures as soon as possible by treating them with the appropriate method and to avoid systemic complications that may occur due to immobility.
