2021 - Cilt 5 - Sayı 1
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Öğe Diagnosis of covid-19 in children and nursing approach: A systematic review(2021) Sarman, Abdullah; Tuncay, Suat; Sarman, EmineAim: This study was carried out to summarize the systematic literature review on current information about Serious acute respiratory syndrome 2 (SARS-CoV-2 or Covid-19 in children and to determine nursing approach. Methods: Regarding the research, 156 publications were examined between 21 January and 15 November 2020. The review was conducted with the key words of “SARSCoV-2”, “coronavirus”, “Covid-19”, “child”, “nursing”, which are openly accessible on databases such as PubMed, Science Direct and the WHO. Results: Covid-19 infection may be asymptomatic or characterized by fever and fatigue in children; they can be potential carriers of the disease. Several upper respiratory symptoms have been seen, such as nasal congestion and a runny nose. In some patients, abdominal pain, nausea, vomiting and diarrhea occurs. Fever and cough were evident in pediatric patients. As the condition progresses, dyspnea, cyanosis and other signs may arise after typically one week of the disease, along with systemic toxic signs, including restlessness or malaise, decreased appetite, poor feeding and reduced activity. Children’s condition might progress quickly and turn to respiratory failure, which cannot be improved by conventional oxygen within 1-3 days. Metabolic acidosis, septic shock, irreversible bleeding and coagulation dysfunction can take place in such severe cases. However, Covid-19 may cause an inflammatory reaction in some children. Those starting with gastrointestinal symptoms may progress to severe conditions and newborns whose mothers are infected with Covid-19 could have severe complications. Conclusion: This systematic review has shown that children generally develop mild Covid-19 disease and these infections are often acquired through community sources. Diagnosis of the disease is difficult in children and there is limited data on children with Covid-19. The disease mainly causes fever, respiratory symptoms and other flu-like manifestations in children. The signs and symptoms of the disease should be carefully monitored. Nurses should know the course and symptoms of the disease well in children and take precautions.Öğe A rare anatomical variation detected incidentally on computed tomography of the thorax: the azygos lobe(2021) Gürün, Enes; Akdulum, İsmailAim: An azygos lobe is an unusual anatomical variation of the upper lobe of the right lung. During the formation of the lungs, the right azygos lobe develops as the precursor of the azygos vein, moving along the pleural surface rather than arcing forward above the origin of the lung to reach the upper vena cava, enters the apex of the right lung in the upper thoracic region. The purpose of this study was to assess the prevalence of the right azygos lobe in a sample of the Turkish population. Methods: This study was conducted from February to October 2020. Each computed tomography (CT) scan was checked for the presence of a right azygos lobe and a fissure on the axial plane. The azygos lobe was described as the convex line in the paramediastinal portion of the upper right lung on the CT scan. Our exclusion criteria were previous thoracic surgery in the right lung or parenchymal distortion on CT examinations. Results: One thousand nine hundred and sixty-five thorax CT scans were evalu¬ated retrospectively. Nine hundred and forty-five of them were from men and the remainder were from women. A total of 15 right azygos lobe variations were detected (six females, nine males). The mean age of the patients was 52.87 ± 14.604 years (30–77). The azygos lobe frequency was 0.76%. Conclusion: The azygos lobe is typically an uncommon variation of the right lung and is not really a distinct lobe. It is a very important variation that should be known about as it can mimic pathological conditions such as cysts, abscesses, or lung le¬sions. Since the azygos lobe is usually an incidental finding, radiologists and sur¬geons should be aware of this this potential anomaly during the imaging and inter¬ventional procedures.Öğe 16. comparison of volumetric and cosmetic scoring changes after treatment of benign thyroid nodules using microwave ablation and ethanol ablation therapy(2021) Karatay, Emrah; Javadov, MirkhaligAim: This study retrospectively evaluated the effects of treatment of benign mixed-type and spongy-type thyroid nodules with microwave ablation (MWA) and ethanol ablation (EA) therapies. The changes in volume obtained by ultrasonography and cosmetic scores were examined. The efficiency of both treatment methods was also compared by statistical analyses. Methods: Between July 2015 and July 2020, archive scanning was performed for patients who underwent MWA and EA in the radiology clinic. As a result, 57 MWA and 55 EA patients were included in the study. Nodule volumes from before the treatment, 3 months, and 6 months after ablation treatment were noted for each case. Cosmetic scores for all patients were also examined. Results: A statistically significant difference was found in the mean nodule volume at 6 months between MWA and EA, with MWA being more successful (p<0.05). The MWA technique also resulted in significantly higher mean cosmetic score reduction (p<0.05). Conclusion: Minimally invasive approaches are increasingly adopted in the treat¬ment of benign thyroid nodules, and both MWA and EA are effective and safe treat¬ments techniques. The results show that MWA treatment leads to better cosmetic scores and nodule volume changes in patients with benign mixed-type and spongy-type thyroid nodules.Öğe Comparison of psychopathologies of children of Parents with Chronic Psychiatric Disease(2021) Yıldırım, Fatma; Toros, Fevziye; Karpuz, DeryaAim: In this study, children whose parents were diagnosed with schizophrenia and bipolar I disorder (BID), were compared with each other, and compared with those who did not have any mental disorders in their parents in terms of presence and types of psychopathology. Methods: This study was carried out on a group of children aged 6 to 17 years. The parents of 11 children were diagnosed with schizophrenia, the parents of 36 children were diagnosed with bipolar disorder and 47 children whose parents did not have any mental disorders, were included in the control group. All children and adolescents filled in the State-Trait Anxiety Inventory for Children (STAI-CH); the parents completed a socio-demographic data form, Conners’ Parent Rating Scale-Short form (CPRSSF), DSM IV-based Screening and Assessment Scale for Behavioural Disorders in Children and Adolescents (T-DSM-IV) and Children’s Sleep Habits Questionnaire (CSHQ)-Abbreviated Form. Results: As a result of the assessments, Oppositional defiant disorder (ODD) symptoms were found to be higher in children who had parents diagnosed with the BID (BID-c) when compared with both children who had parents diagnosed with schizophrenia (SZ-c) and the control group (p=0,08). Learning problems were found to be higher in the SZ-c group when compared with both the (BID-c) and the control group (p=0,08). State anxiety was found to be higher in the SZ-c group when compared with the control group (p=0,020). No difference was found between the groups in terms of conduct disorder (CD), attention deficit (AD), hyperactivity, psychosomatic complaint, sleep disorder and trait anxiety (respectively; p=0,112, p=0,590, p=0,098, p= 0,776, p=0,741, p=0, 924). Conclusion: The results of the study suggested that the symptoms of ODD may be more common in the BID-c group, and the learning problem might be more common in the SZ-c group. Care should be taken in terms of ODD in children of parents diagnosed with bipolar I disorder, and in terms of learning problems in children of parents diagnosed with schizophrenia.Öğe Relationship between whole blood viscosity and lower extremity peripheral artery disease severity(2021) Yenerçağ, Mustafa; Arslan, Uğur; Çoksevim, Metin; Dereli, Seçkin; Doğduş, Mustafa; Erdoğan, GüneyAim: Increased blood viscosity (BV) has good correlaton with lower extremity peripheral artery disease (LEAD). However, the relationship between BV and peripheral arterial disease (PAD) anatomical complexity and symptom severity have not been studied adequately so far. The aim of the present study was to assess the relationship between whole blood viscosity (WBV) and LEAD anatomical complexity and symptom severity. Methods: The study included 240 consecutive patients with suspected PAD who had lower extremity peripheral angiography between March 2016 and March 2020. A Transatlantic İntersociety Consensus II (TASC II) A-B lesion was defined as anatomical simple LEAD, and a TASC II C-D lesion was defined as anatomical complex LEAD. Symptom severity of all patients were categorized from 0 to 6 according to Rutherford classification. WBV was assessed using a validated calculation formula derived from hematocrit and total plasma protein levels, both at low (LSR) and high (HSR) shear rate. Results: TASC II C-D group presented significantly higher WBV values both at LSR (40.2 ± 9.5 vs. 46.5 ± 13.2; p < 0.001) and HSR (15.9 ± 0.5 vs. 16.5 ± 0,7; p < 0.001). In ROC analysis, a cut-off value of 16.1 WBV at HSR had 74.5% sensitivity and 68% specificity for predicting TASC II C-D (AUC: 76.2%, p < 0.001) and a cut-off value of 42.9 WBV at LSR had 73.4% sensitivity and 66.6% specificity for predicting TASC II C-D (AUC: 74.2%, p < 0.001). In multivariate analysis, both high WBV at LSR (OR: 2.121, 95% CI: 1.079 – 3.164, p < 0.001) and high WBV at HSR (OR: 2.737, 95% CI: 1.671 – 4.483, p < 0.001) were independent predictors for TASC II C-D. There was a significant positive correlation between WBV at LSR and Rutherford symptom category (0-6) (r = 0.412, p <0.001) and WBV at HSR and Rutherford symptom category (0-6) (r = 0.402, p <0.001). Conclusion: Our data suggests that; increased WBV values may be associated with TASC II C-D lesions, which indicated more anatomically complex LEAD. Also WBV values positively correlated with Rutherford symptom severityÖğe The diagnostic value of parathormone washout in Tc-99m MIBI negative primary hyperparathyroidism cases(2021) Korkmaz, HakanAim: To determine the sensitivity and positive predictive value (PPV) of the measurement of parathormone (PTH) in fine needle aspiration (FNA) washout fluid, in the preoperative localization of hyperfunctional parathyroid lesions. Methods: Medical records of patients diagnosed with primary hyperparathyroidism (PHPT) in our clinic between 2016-2020 were retrospectively evaluated. Thirty-six patients with PHPT who underwent preoperative FNA-PTH washout procedure were included in the study. FNA-PTH washout was only performed in patients with negative technetium-99m methoxy isobutyl isonitrile / single photon emission computed tomography (Tc-99m MIBI/SPECT) imaging. It was accepted to be higher than plasma PTH level as positive cut-off value for PTH washout in determining parathyroid lesions. Sensitivity, PPV, false positive, false negative and diagnostic accuracy values of PTH washout were calculated. Results: PTH washout was false positive in 2 cases, false negative in 1 case and true positive in 33 cases. In the discrimination of true parathyroid lesions, the sensitivity of PTH washout was calculated as 97.05%, PPV 94.29% and diagnostic accuracy 91.67%. PTH washout levels correlated positively with plasma PTH and parathyroid lesion volüme (respectively, r=0.347, p=0.041 ve r=0.356, p=0.036). All patients tolerated the FNA-PTH flushing procedure well and no complications developed afterwards. Conclusion: The FNA-PTH washout is a safe and useful method to localise parathyroid lesions in PHPT patients with negative Tc-99m MIBI/SPECT imaging.Öğe The effect of retrograde intrarenal surgery on kidney function in renal stone treatment(2021) Selmi, Volkan; Sarı, Sercan; Öztekin, Ünal; Caniklioğlu, Mehmet; Işıkay, LeventAim: In this study, we aimed to evaluate the alteration in renal function by analyzing the estimated glomerular filtration rate after Retrograde Intrarenal Surgery, and present the factors which have an impact on alteration. Methods: We analyzed 88 patients who underwent RIRS for renal stones between May 2018 and February 2019, prospectively. Estimated glomerular filtration rate was calculated by modification of diet in renal disease (MDRD) formula preoperatively, on the first postoperative day, on the first postoperative month and the third postoperative month. All data was recorded on the follow-up form. All procedures were performed under general anesthesia. Results: The stone-free rate of the study was 79.5%. Preoperative eGFR was 99.86 mL/min/1.73m2 for the study group. The eGFR was calculated 101.80 mL/min/1.73m2 on the first postoperative day and 111.66 mL/min/1.73m2 on the third-month follow-up. The change in eGFR was 1.94 mL/min/1.73m2 in the early period and 11.8 mL/min/1.73m2 in the long-term follow-up period. There was a statistically significant improvement in eGFR in the long-term follow-up period than the early period when compared to preoperative renal function. Conclusion: On the contrary of former stone removal modalities, RIRS can stabilize postoperative kidney function. It may even help improve postoperative kidney function in patients with preoperative renal dysfunction. Urologists may keep in mind the RIRS option in patients with this conditionÖğe Increased cesarean-section birth rates and affecting related factors(2021) Deniz, AlparslanAim: The present study aims to evaluate the opinions of physicians on increased C-section delivery rates and their coping ways working at different institutions. Method: This descriptive, cross-sectional study included a total of 200 obstetricians and gynecologists with an experience of at least 20 years chosen through simple random sampling among registered in the Republic of Turkey, Ministry of Health da-tabase. In the questionnaire, their opinions about test exams and their opinions about solutions to decrease C-section rates were investigated. Results: The majority of the participants (89.0%) responded “Strongly Agree” to the following item: “Factors other than medical causes may affect the decision for C-sec-tion”. Similarly, the majority of the physicians responded “Strongly Agree” to the item on the increase in C-section rates along with malpractices and social pressure put by the patient and her relatives(89.0% and 89.5%, respectively). For the majority of the participants (84.0% and 85.0%, respectively), the main suggestions to overcome the increased C-section delivery rates was to lower; social pressure put against the physicians by the patient and her relatives, and removal of malpractice penalties re-latedfor possible adverse outcomes during normal delivery. In this study, the majority of the physicians responded “Strongly Disagree” to the items related to the imposing penalties and granting bonuses (56.0% and 56.5%, respectively). Similarly, 81.0% of the physicians responded “Strongly Disagree” to the item stating that healthcare planners correctly interfere with the main cause of increased C-section rates. Conclusions: The most important reasons for the high cesarean rates are seen as the fear of malpractice and social pressure of physicians working in both public and private sectorsÖğe The relationship between obesity, depressive symptoms and sleep duration in children and adolescents(2021) Çelebi, Fahri; Özcabı, Bahar; Güven, AylaAim: In this study, we aimed to investigate the relationship between symptoms of depression and sleep duration with anthropometric measurements in obese children and adolescents. Methods: Forty children and adolescents (25 girls) diagnosed with obesity were included. Sociodemographic and clinical data were obtained using the sociodemographic and clinical data form. Age, gender, height and weight values were recorded; body mass index (BMI), percentile and standard deviations (SDS) were calculated. Children’s Depression Inventory (CDI) was used to assess depression. The degree of obesity was classified according to the BMI values of the cases, the cases in class 1 and 2 were grouped as “subgroup 1”, and the cases in class 3 as “subgroup 2”. Groups were compared in terms of sociodemographic features, depression and sleep duration. Results: Mean age of the group was 12.8±2.6 years. There was a significant difference in patients with depression in terms of body weight, BMI, BMI-SDS and sleep duration compared to those without depression. CDI scores in subgroup 2 were significantly higher than subgroup 1. CDI scores were positively correlated with body weight, BMI and BMI-SDS and negatively correlated with sleep duration. Sleep duration was negatively correlated with body weight and BMI. Conclusion: Depressive symptoms and sleep duration may be associated with the severity of obesity in children. We consider that the assessment of depression and sleep disorders by a pediatric psychiatrist is important and useful in children with obesity.Öğe Seasonal variation of immune hemolytic anemia(2021) Özbalcı, Demircan; Alanoğlu, Emine Güçhan; Sak, RüveydaAim: Immune hemolytic anemia is an autoimmune disease that is related to autoantibodies against erythrocytes. Such antibodies appear for a variety of reasons such as hematologic and oncologic malignancies, infections, and connective tissue diseases but in many cases, a true etiologic agent has not been discovered. Many hematologic as well as rheumatologic disorders have seasonal variations but there have not been many studies evaluating the possibility of seasonal variation of immune hemolytic anemia. Methods: It was investigated whether the patients with immune hemolytic anemia who were diagnosed and followed in the hematology outpatient and inpatient clinic of Suleyman Demirel University from 2002 to 2018 had a significant seasonality. We also evaluated whether there was any seasonality relationship between gender and beginning of the hemolytic attacks. Results: There was no significant difference when seasons were grouped as spring, summer, autumn and winter, according to gender (p = 0,122). The evaluation of seasons in two groups as autumn-winter and spring-Summer revealed that male patients tended to suffer immune hemolytic anemia in autumn-winter, whereas females, significantly, tend to contract the disease in spring-Summer (p=0,046). Conclusion: Immune hemolytic anemia had significant seasonality pattern depending on gender. More prospective studies are needed to support these findings in this studyÖğe The relationship between procalcitonin, D-dimer, ferritin, troponin and lactate levels with COVID-19(2021) Şahin, Levent; Gür, AliAim: Coronavirus disease-2019 patients may experience an increase in inflammation or clotting disorders. It is believed that some biomarkers can be decisive in decision to hospitalize. Our aim in this study was to investigate the relationship between serum procalcitonin, troponin, D-dimer, ferritin and lactate levels, and Coronavirus disease-2019. Methods: Patients suspected of suffering from the Coronavirus disease-2019 and whose serum biochemistry and blood gas tests were performed, were included in the study. The relationships between the blood parameters of the patients with negative or positive Polymerase Chain Reaction test results, and those who were hospitalized or non-hospitalized, were examined. Results: Out of a total of 452 patients, 244 (54%) were male and 208 (46%) were female. There was a statistically significant difference between polymerase chain reaction test positive and test negative groups in terms of procalcitonin, D-dimer, lactate and troponin levels (p?0.005). There was no statistically significant difference between hospitalized and non hospitalized patient in terms of ferritin (p=0.224). However, there was a significant difference in terms of procalcitonin, D-dimer and troponin levels (p?0.005). Conclusion: Our results revealed that high serum procalcitonin, D-dimer, lactate and troponin levels are associated with the decision to hospitalize Coronavirus disease-2019 patients, whereas ferritin levels played no such role.Öğe Results of conjunctival autograft transplantation combined with amniotic membrane transplantation surgery in recurrent pterygium cases(2021) Tanrıverdi, Cafer; Balcı, ÖzlemAim: To evaluate the results of conjunctival autograft transplantation (CAT) combined with amniotic membrane transplantation (AMT) surgery in recurrent pterygium cases. Methods: This is a retrospective interventional case series involving patients admitted to our clinic with recurrent pterygium. Patients' examination and postoperative findings were taken through standard slit-lamp microscope examinations. Fourteen eyes of 14 patients were included in the study. All cases were treated with excision, followed by CAT combined with AMT. Corneal recurrence was evaluated as the main result. Fibrovascular proliferation greater than 1 mm on the cornea was accepted as recurrence after surgery. Results: The mean age of patients was 56.4 ± 7.5 (range: 40 – 65) years. During the mean follow-up period of 24.9 ± 10.7 (range: 12 – 50) months, pterygium and symblepharon recurred in only one eye (7.1%) after 4 months. Conclusion: In this study, it was seen that acceptable results were obtain and low recurrence rates could be achieved with the combination of CAT and AMT for the treatment of recurrent pterygium.Öğe Is enoxaparin sodium exactly safe for subcutaneous fibroblast?: A cell culture study(2021) Kubat, Emre; Gürpınar, Aylin; Ertuğrul, Gökşen; Işık, Hakan; Karasoy, Duru; Onur, Mehmet AliAim: Despite relatively low amount in the subcutaneous tissue, fibroblasts play a critical role in the continuity of intercellular connections, maintenance of tissue integrity, and forming a balanced fascial network. Enoxaparin sodium is widely used in the prophylaxis and treatment of deep vein thrombosis. In the present study, we aimed to examine the cytotoxic and apoptotic effects of enoxaparin sodium on fibroblast cells in an in vitro model. Material and Methods: In a mouse model, L929 fibroblast cells were treated with enoxaparin sodium 4000 IU, 2000 IU, 1000 IU, 500 IU, and 250 IU. At 48 hours, cell morphology was evaluated; cell viability was analyzed through methylthiazole tetrazolium assay and apoptosis was assessed by propidium iodide/ acridine orange staining. Results: The test results showed that high doses (4000 IU, 2000 IU) exerted cytotoxic effects and induced apoptotic morphology. Compared to the control group, there was no significant difference in the cell viability in Dilutions III, IV, and V. Conclusion: Based on our results, despite prophylactic dose in the in vitro setting, high-dose enoxaparin showed cytotoxic and apoptotic effects. Long-term high-dose enoxaparin sodium may affect the number of subcutaneous fibroblasts, impairing the skin integrity and subcutaneous tissue healingÖğe The Investigation of Endomyocardial Biopsy Results, Plasma pro-BNP Levels and Non-invasive Parameters for Diagnosing of Acute Rejection in Patients Who Undergo Cardiac Transplantation(2021) Akkaya, ÖzgürAim: Heart failure is a disease with high mortality and morbidity, reducing the patient's quality of life. Each year 10% of heart failure patients progress to end-stage heart failure. Cardiac transplantation is the gold standard treatment method in these patients, however acute rejection is the most important factor affecting the success of this treatment. In this study, it was aimed to evaluate endomyocardial biopsy results, serum pro-BNP and non-invasive parameters in patients with acute rejection following cardiac transplantation. Patients and Methods: Twenty patients who underwent cardiac transplantation in our center were included in the study. The patients were divided into two groups, namely acute rejection (n: 10) and without rejection (n: 10). Echocardiography, electrocardiography (ECG), endomyocardial biopsy results, serum reactive proteins (CRP), sedimentation rate and serum pro-BNP levels, were evaluated among the patients and compared between the groups. Results: Endomyocardial biopsies obtained from patients with acute rejection revealed grade 1 rejection in 6 (60%) patients, grade 2 in 3 (30%) patients and grade 3 rejection in 1 (10%) patients. CRP and sedimentation rate were found to be similar between the groups (p> 0.05). High pro-BNP levels were found in patients with rejection (4843.20 ± 6690.10 pg / ml) when compared to the control group (496.30 ± 216.20 pg / ml) (p: 0.001). In addition, higher pro-BNP levels were detected with progressing of rejection grade (p: 0.03). The highest pro-BNP level was found in a patient with Grade-3 rejection (15211 pg / ml, p: 0.000). Conclusion: Our results show that serum pro-BNP levels are associated with acute rejection. In addition, higher pro-BNP levels were found to be associated with advanced rejection levels.Öğe Determination of effects of chemical agencies on liver fibrosis models frequently used in different dose and time periots(2021) Kaan, Dilek; Toprak, Güler; Yay, Arzu; Başkol, Gülden; Ertekin, Tolga; Ülger, HarunAim: In this study, it was aimed to reveal a more effective model depending on the dose and time by evaluating histopathological properties and biochemical parameters, such as alanine aminotransferase (ALT), aspartate aminotransferase (AST), albumin, triglyceride, cholesterol in carbon tetrachloride and thioacetamide (CCl4 and TAA) models. Method: Rats were divided into three groups for each model and intraperitoneally (i.p.) injected with CCl4 (0.5 ml/kg, 1.0 ml/kg, 2.0 ml/kg) and TAA (100 mg/kg, 200 mg/ kg, 300 mg/kg) for 4, 6 and 8 weeks, three times weekly, respectively. Results: In the biochemical investigation, ALT and AST values in the only 0,5 ml CCL4 of groups for 6 and 8 weeks and were found to have significant differences compared to the control groups (p <0.05), while the other biochemicals parameters values did not reveal significant difference in the groups (p >0.05). According to the results of the histopathology in the liver tissues, both the control groups showed a normal histological feature. The hepatofibrotic alterations were remarkable in the CCl4 and TAA models fibrosis depending on the increasing dose and time in all of the groups. Conclusion: Our results showed that the dose and time were reached up to until the cirrhosis for eighth week. These results would be a helpful reference for hepatofibrotic studies.Öğe What is neuroplasticity? Why it is important?: Types and its basic mechanisms(2021) Yuluğ, Burak; Aslan AhmetThe human brain is interconnected in a plastic manner to form functional brain networks. This dynamic and flexible neuronal reorganization process is essential for an efficient regeneration process in the central nervous system, especially when it comes to memory, learning, and posttraumatic conditions. Here, we tried to define basic principles and the mechanisms underlying neuroplasticity process in the brain which serve as an important template for future studies on neurorehabilitation in neurodegenerative diseases, such as stroke, Alzheimer’s Disease and traumatic brain injury
