Objectives: Primary dysmenorrhea is the most common gynecological complaint in adolescent girls. Among many factors, oxidative stress (OS) is thought to be a potential factor in the etiology of primary dysmenorrhea. In this study, it is thought that the use of IMA, thiol, and disulfide levels as a diagnostic marker in primary dysmenorrhea and antioxidant interventions may play a role in the treatment of primary dysmenorrhea and may benefit the pathophysiological and treatment process of the disease. Methods: Thirty adolescent girls (study group) with grade 2.3 primary dysmenorrhea who applied to outpatient clinic and 30 healthy young girls (control group) of similar age group were included in the study. Primary dysmenorrhea grade was analyzed with the help of the visual analog scale (VAS) and verbal multidimensional scoring system (VMS). Patient`s basal hormone levels in the early follicular phase, serum albumin, IMA, total thiol, native thiol, disulfide, C-reactive protein (CRP), and cancer antigen-125 (CA-125) were recorded as main parameters. Results: Oxidative stress markers were compared between the primary dysmenorrhea and control groups. Although albumin, IMA, and disulfide levels were higher on average in the group with dysmenorrhea, the difference was not statistically significant. Disulfide level was found to be significantly higher in the group with CA125 ≥ 35. Conclusions: In our study, we examined serum albumin, IMA, total thiol, native thiol and disulfide levels in two groups resuts were not statistically significant. In this study, we concluded that as the CA125 level increased, the disulfide level increased in parallel.
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Objectives: Prevention of hepatitis B virus (HBV) infection is necessary for patients with human immunodeficiency virus (HIV), since co-infection is associated with increased in mortality. The aim of this study was to investigate response to double-dose HBV vaccine in patients with HIV. Methods: A total of 149 patients with HIV were retrospectively evaluated. Sixty-eight patients who were HBV seronegative and administered double-dose HBV vaccine were included in the study. According to anti HBs levels, patients were evaluated in three groups: < 10 mIU/mL, 10-100 mIU/mL and ≥ 100 mIU/mL. Age, sex, transmission route, smoking, alcohol-substance abuse, comorbidities, CD4+ T cells counts and HIV viral load were compared in three groups. Results: The rate of response to HBV vaccination (anti HBs ≥ 10 mIU/mL) was 69.1%. Age was statistically significantly higher in the anti HBs < 100 mIU/mL group than in the anti HBs >100 mIU/mL group. The level of anti HBs was statistically significantly lower in patients with a CD4+ T cell count < 200 cells/μL (< 100 mIU/mL). Conclusions: The use of high-dose vaccine is a necessity as well as revaccination to improve vaccine immunogenicity in patients with HIV. In our study, low CD4+ T lymphocyte count and older age were found to have a negative effect on vaccine response.
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Objectives: In recent years, the rate of readmission (RA) within the first thirty days of discharge has been an important parameter for cost and quality standards. It is therefore extremely important for each center to analyze its own results and determine the factors affecting the RA rates in order to organize the measures to be taken. Another important issue, especially for centers focusing on specific areas of expertise, is unplanned revisit (RV) after discharge. Determination of these rates and reasons is of importance for every hospital and/or clinic to decrease these rates, thus increasing patient satisfaction and reducing costs. The aim of this study was to analyze RA and RV patients operated in the general surgery clinic of our hospital for a period of two years as well as factors affecting these rates. Methods: The study included patients who were operated in the general surgery clinic of Bursa Private Medicabil Hospital between 1 January 2018 and 31 December 2019 and who revisited and were readmitted within the first thirty days of discharge. The reasons for RA/RV and time to RA/RV, and patients’ treatments were investigated by comparing RA/RV patients with those who were not readmitted (NA) for demographic results at initial admission to determine the differences between these patient groups. Univariate and multivariate analyses were carried out using the SPSS software. The level of significance was set at p < 0.05. Results: Of the 890 patients who were operated in our clinic throughout the study period and met the study inclusion criteria, 52 (5.8%) were included in the unplanned RA group and 107 (12%) in the unplanned RV group. The mean time to RA was 10.5 ± 7.0 days for the RV group and 8.8 ± 6.7 days for the RA group (p = 0.17). Thirty-two (61.5%) of the RA patients and 41 (38.3%) of the RV patients were readmitted within the first 7 days of discharge (p = 0.003). The multivariate analysis revealed that prolonged length of hospital stay, emergency surgery, abnormal WBC, electrolyte imbalance, and abnormal hemoglobin level were significant risk factors for RV, while the development of complications, prolonged length of hospital stay, and advanced age were significant risk factors for RA. Conclusions: This study analyzing the RA and RV patients operated in the general surgery clinic of a private hospital demonstrated that the most important reasons for RA were nonspecific and preventable. Patients who developed complications, had prolonged length of hospital stay, and were at an advanced age had a higher rate of RA, while patients who had prolonged length of hospital stay, underwent emergency surgery, and had biochemical problems at initial admission had a higher rate of RV. Focusing on these patients during and after discharge and increasing home care facilities can solve the problems of many patients without admitting them to the hospital. This will be a factor that would improve patient satisfaction while reducing costs.
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Objectives: Technology unfortunately even though making our life easier, causes a lot of psychological problems when it is not used reasonably. One of them is the inability to live without a smartphone: nomophobia. This meta-analysis study considered nomophobia in Turkey in terms of gender. Methods: Using “nomophobia”, “Nomophobia Scale “, “Nomophobia Questionnaire (NMP-Q)”, “NMP-Q”and “smartphone” keywords, 9 electronic bibliographic databases, reference lists of relevant studies, and searches of the internet were performed to identify articles related to the nomophobia scale. The inclusion criteria were studies that the nomophobia questionnaire (NMP-Q) utilized to Turkish people, published in English or Turkish, and report the questionnaire score by mean/standard deviation according to gender. The mean age and sample size ratio, which were thought to have an effect on heterogeneity, are analyzed by meta-regression. Results: A total of 3370 studies were located, with 10 meeting the inclusion criteria. It revealed that females are found to be more nomofobic than males according to Nomophobia Questionnaire (NMP-Q). Conclusions: Most of the studies discussed in this study were applied to student groups. Applying nomophobia studies to different sample groups is important in determining the prevalence of nomophobia in the population and taking precautions.
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Primary Adrenal Lymphoma (PAL) is extremely rare and usually occurs in men in the 6th-7th decade as bilateral, diffuse large B-cell lymphoma (DLBCL). Here, an 80-year-old patient admitted to the urology outpatient clinic with flank pain and bilateral adrenal mass detected on ultrasound is presented. Positron Emission Tomography-Computed Tomography (PET-CT) was planned for the patient who was referred to the endocrine outpatient clinic. The PET-CT scan revealed lobulated-contoured masses containing necrotic areas with a size of 7.4×5.5×9.8 cm, 19 Hounsfield Unit (HU), and SUVmax value of 23.9 the right adrenal, and with the size of 8.4×8.7×10.8 cm, 28 HU, SUVmax value of 27.3 in the left adrenal. These masses were reported to be not compatible with metastasis and suggested a tumor of the adrenal origin or bilateral adrenocortical carcinoma. In laboratory tests, since Adrenocorticotropic hormone level 291-592 pg/mL (high) and Cortisol level was 7.5-9.5 mcg/dL (low), bilateral adrenalectomy was performed considering adrenocortical cancer primarily. Diffuse large B cell lymphoma was determined as the result of the pathology. Postoperative hydrocortisone and fludrocortisone treatment was initiated for the patient immediately. The patient was transferred to the hematology inpatient clinic to receive Rituximab, Cyclophosphamide, Doxorubicin, Vincristine, and Prednisolone chemotherapy. In this case report, we aimed to emphasize that the differential diagnosis should be made well in massive bilateral adrenal masses. Although the diagnosis is challenging, clinicians should be alert in diagnosing lymphoma in bilateral, massive adrenal masses with adrenal insufficiency. Since this disease's prognosis is poor and aggressive, a histopathological diagnosis should be obtained, and treatment should be initiated as soon as possible.
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Objectives: The aim of the study was to investigate the relationship between pain, depression, anxiety, somatic amplification and alexithymia in patients with fibromyalgia syndrome (FMS), and on quality of life and disability. As a secondary goal, the predictors of disability were evaluated. Methods: Participants were 112 female patients aged 18 and over, applied to the outpatient clinic of University of Health Sciences Bursa Yüksek İhtisas Training and Research Hospital Medical Ecology and Hydroclimatology department and diagnosed with FMS according to ACR 2016 Revised Fibromyalgia Diagnosis Criteria. The Sociodemographic Data Form, Visual Analog Scale (VAS), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Toronto Alexithymia Scale (TAS-20), Somatosensory Amplification Scale (SSAS), Fibromyalgia Impact Questionnaire (FIQ) and Health Survey Questionnaire Short Form (SF-36) were applied to each participant. All data were analyzed with correlation and linear regression. Results: Increased pain intensity, depression, anxiety, somatic amplification, "difficulty identifying feeling" and "difficulty describing feelings" dimensions of alexithymia were found related to lower quality of life and increased disability. Depression, somatic amplification, and pain severity were defined as the predictors of disability in FMS. Conclusions: Psychiatric examination of FMS patients especially in terms of depression, anxiety, alexithymia and somatic amplification as well as their physical complaints can be beneficial to minimize disability and increase the quality of life. To our best knowledge, this is the first study to show somatic amplification as a predictor of disability in FMS patients. Further studies will be helpful to understand this relationship.
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Objectives: Synovial plicae syndrome (SPS) are encountered as a mesenchymal tissue remnant during the process of embryological development, and divide the knee joint into three separate compartments. Of these, the suprapatellar plica may be affected by a syndrome that manifests with anterior knee pain, a clicking sound, snagging and a feeling of skipping after a patellofemoral overload. The present study evaluates 14 patients with suprapatellar complete plica syndrome who were treated between 2013 and 2019, and discusses the medical and surgical medium-term results of the condition. Methods: Included in the study were 225 cases who underwent knee arthroscopy between 2013 and 2019, the data of which were analyzed retrospectively. The exclusion criteria were accompanying meniscal tear, anterior and posterior cruciate ligament tears, chronic inflammatory arthritis, varus > 3˚ and valgus > 5˚ malalignments. The cases were followed-up using the Tegner Lysholm knee scoring method, during the preoperative period, in the postoperative period, and in postoperative week 12 and month 6. The statistical analysis was performed using the IBM SPSS Statistics (Windows Version 25.0. Armonk, NY: IBM Corp.) software package. Results: A retrospective analysis revealed a BMI of 28.7 ± 5.6 kg/m2 in the 14 cases. The mean age was 34.57 ± 8.53 years. Intraarticular cortisone injections and intraarticular viscosupplementations were performed at the outpatient follow-up in eight and three cases, respectively. Furthermore, eight cases had undergone previous physical therapy and rehabilitation. The mean duration of symptoms was 1.4 ± 0.8 months. The Tegner Lysholm knee scores were 69.53 ± 6.15, 88.23 ± 3.00, and 93.76 ± 3.83 in the preoperative period, week 12 and month 6, respectively. Conclusions: In conclusion, arthroscopy can be considered an efficacious and diagnostic method in knee plica syndrome. Patient satisfaction is high in the medium-term.
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In most adult cardiac surgery operations, the heart must be completely immobile and isolated from the blood. Therefore, the heart is stopped in diastole and a still operative site is obtained. Cardiac arrest results in ischemia-reperfusion injury. For these reasons, myocardial protection and the prevention of damages are required. Various cardioplegia solutions are used for this purpose. It can be said that cardioplegia is the gold standard method of myocardial protection in cardiac arrest. Nowadays, "Single-dose cardioplegia" applications are increasingly used, especially in minimally invasive cardiac surgery and basic coronary bypass procedures due to the advantages they provide, which include reduction of aortic cross-clamp time, prevention of frequent interruption of the procedure due to cardioplegia, and reduced postoperative myocardial dysfunction incidence. The two main solutions used in single dose cardioplegia applications are the Bretschneider solution and the del Nido extracellular cardioplegia solution. The del Nido cardioplegia solution (dNCS), which was originally developed for use in pediatric cardiac surgery, has recently increased its use in adult cardiac surgery due to straightforward application and long-term effectiveness. The del Nido cardioplegia reduces the aortic cross clamp duration, cardiopulmonary bypass time and required cardioplegia solution volume, and is a safer and superior cardioplegia solution and technique in terms of myocardial protection with regards to many organs and cardiac-biochemical parameters.
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Objectives: It is aimed to investigate the effect of tourniquet and tranexamic acid (TXA) on the amount of perioperative bleeding in patients undergoing total knee arthroplasty. Methods: One hundred and ninety-three patients included in the study. The patients included in the study were divided into 4 groups. Group 1 (n = 78) was determined as the patient group with long-term tourniquet application, but without additional application and was accepted as the control group. Group 2 (n = 40) was the long-term tourniquet and intravenous (IV) TXA applied group, Group 3 (n = 40) was the long-term tourniquet and intra-articular TXA applied group, and Group 4 (n = 35) was the short-term tourniquet (only in the cementing phase) and IV TXA applied group. The difference between groups according to use of a tourniquet during the operation, the method and dose of TXA, the amount of postoperative blood transfusion, the amount of drained blood, the length of hospital stay, and complications were investigated. Results: The largest Hemoglobin (Hb) and Hematocrit (Hct) decreases were found in Group 1 (3.39 ± 0.92 g/dl and 10.8%, respectively). Also the highest drainage (median 350 ml), transfusion (16.7%), length of hospital stay (mean 4.51 ± 1.07 days) and estimated blood loss (median 1559.8 ml) were in Group 1 (p < 0.05). The lowest Hb decrease (mean 2.95 ± 0.68 g/dl) and lowest drainage (median 150 ml) was seen in group 3 and the lowest length of hospital stay (mean 3.89 ± 0.8 days) in group 4 (p < 0.05). Conclusions: The use of TXA was shown to lead to a reduction in Hb and Hct, the amount of blood drained after surgery, and the length of hospital stay. The use of TXA may be a good option for bleeding control in patients undergoing total knee arthroplasty.
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Objectives: Hypertension is a cardiovascular disease which is a very common hemodynamic syndrome, and it has different prevalence in different regions as it is common all over the world. In recent studies, it is known that microRNAs (miRNAs) play an important role in hypertension disease and that miRNA expressions are regulated by epigenetic mechanisms. There are also studies proving that microRNAs are new therapeutic targets for pulmonary arterial hypertension, and miRNAs can participate in the pathophysiology of hypertension in many ways and it can be used as a biomarker for hypertension disease. It is thought that miRNAs can be effective in the diagnosis and treatment of hypertension and further studies are needed. Recently, the relationship between miRNAs and hypoxia has also been focused on and has been taken into account in studies. In this review, we aimed to present the effects of miRNAs on hypertensive disease and current approaches. Finally, with gene targeting studies, we think that miRNAs, which can be biomarkers and molecular agents, will hold promise in preventing the progression of hypertension in the future, and we hope that they can create ideas for future studies.
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