Introduction: Pregnancy is considered a low-grade inflammatory state presented with increased levels of pro-inflammatory markers.
Despite the well-recognized association between inflammation and kidney injury, there is still a lack of available data concerning
the role of thyroid hormone alterations in inflammation and acute kidney injury (AKI). We examined the relationship of kidney
injury molecule-1 (KIM-1) and interleukin-1 beta (IL-1β) with renal and hepatic injury in hypothyroid, normothyroid (euthyroid), or
hyperthyroid pregnant women.
Methods: A total of 77 pregnant women with no additional health problems were enrolled in the study. Serum KIM-1 and IL-1β levels
were analyzed by ELISA.
Results: There were significant differences between normothyroid, hyperthyroid, and hypothyroid pregnants regarding creatinine,
aspartate aminotransferase (AST), free T4, anti-thyroglobulin (anti-TG), anti-thyroperoxidase (anti-TPO), and plateletcrit (PCT) levels
(p=0.018, p=0.032, p=0.011, p=0.001, p=0.003, and p=0.016, respectively). The mean creatinine levels of the hypothyroid group
were significantly higher than those of the hyperthyroid group (p=0.015). The mean AST and PCT levels of the hypothyroid group
were considerably higher than those of the normothyroid group (p=0.024 and p=0.014, respectively). In the correlation analysis,
age was the single parameter that was significantly correlated with KIM-1 and IL-1β in all pregnant women (p=-0.024 and p=-0.018,
respectively). In the hypothyroid pregnant women group, KIM-1 was correlated with creatinine levels and age (p=0.037 and p=0.022,
respectively).
Conclusion: KIM-1 level in pregnant women with hypothyroidism can serve as a useful biomarker to show AKI.
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Introduction: Polycystic ovary syndrome (PCOS) is one of the most common endocrine abnormalities of reproductive age and has
a highly heterogeneous nature regarding its multisystemic symptoms. To elicit pathophysiological roots, metabolic mapping and
between-correlations among key parameters are of vital importance. We generated a platform including cardinal hormones, lipids,
homeostasis model assessment of insulin resistance (HOMA-IR) and oxidative markers [total-oxidant status (TOS), total antioxidant
status (TAS), oxidative stress index (OSI), copper (Cu)] related to pathophysiology.
Methods: This prospective case-control study included 46 patients with PCOS and 44 non-PCOS healthy women. Samples were
obtained from the Obstetrics and Gynecology Clinic of University of Health Sciences Turkey, İstanbul Training and Research Hospital.
TAS, TOS, and Cu levels were measured by automated methods.
Results: Anti-Mullerian hormone, total testosterone (TT), dehydroepiandrosterone sulfate, low-density lipoprotein, high-density
lipoprotein (HDL), total cholesterol, TOS, OSI were increased in patients with PCOS with no significant differences in the mean values
of other parameters. ROC analysis revealed that TOS and OSI had an acceptable predictive value for PCOS diagnosis. Plasma HOMA-IR,
triglyceride, HDL, TT, and sex-hormone-binding globulin levels were correlated with OS markers.
Conclusion: Redox status was found to be sensitive to hormonal alterations. Metabolites were then were compared with the oxidative
markers to reveal any relationship that may explain the causal link between metabolic and redox changes Ultimately, evaluating
broad-based metabolic profiling of patients, the current study contributes to the literature, which has controversial data and
correlation findings poses new questions requiring further research to elicit underlying mechanisms and so to set new targets for
both prevention and treatment.
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Introduction: In our study, patients who applied for abdominal wall mass and pain after cesarean section and were examined and
treated and diagnosed endometriosis were evaluated in terms of age, body mass index (BMI), number of cesareans, clinical signs, size
of endometriosis and surgical characteristics, as well as therapy and results.
Methods: January 2001-December 2021 in our clinic after cesarean section, surgery due to a painful mass in the abdominal wall
and pathologically diagnosed endometriosis cases were retrospectively investigated. Age, number of cesareans, clinical signs, size of
endometriosis and surgical characteristics and therapy results were recorded. Four patients were diagnosed with endometriosis with
a tru-cut biopsy. All patients underwent primary mass excision.
Results: A total of 14 patients were identified. The average age of the patients was 35.9 and the average BMI was 26.81. All patients
were admitted with a painful mass at the cesarean site. Only four patients had multiple cesarean sections. Ultrasonography and
abdominal computed tomography were evaluated. Desmoid tumor, foreign body reaction, granuloma, abscess and endometriosis
were identified in their preliminary diagnosis. Endometriosis was established by tru-cut biopsy in four patients. Primary mass excision
was performed for all the patients. In one patient, prolene mesh repair was performed, while in other patients primary repair was
performed. In all patients, pathological diagnosis was reported as endometriosis ekstarna.
Conclusion: The diagnosis of endometriosis should be kept in mind when diagnosing patients with pain and/or mass complaints at
the site of surgery after cesarean section.
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Introduction: In recent, a new classification system for intraoperative adverse events (iAEs) was proposed, called “the Classification
of Intraoperative Complications (CLASSIC).” Our aim was to evaluate the relationship between CLASSIC and the grade of postoperative
complications (PostC) in gastrointestinal oncological surgery.
Methods: Demographics, preoperative laboratory parameters, grades of iAEs, grades of PostC, and intraoperative pH and lactate
levels were evaluated in patients who underwent gastric and colorectal surgery.
Results: A total of 95 patients were included in this study. Mean age was 60±14, 57 male vs 38 females. There was no significant
relationship between the grade of iAEs and PostC in terms of demographics and the presence of intraoperative acidosis. Preoperative
albumin level was inversely proportional to the grade of iAEs. There was no relationship between the grade of iAEs and the grade
of PostC (p=0.563). The actual rates of high-grade PostC in patients with low-grade iAEs and high-grade iAEs were 10% and 18%,
respectively. Additionally, the length of stay was higher in patients with high-grade iAEs (p=0.018).
Conclusion: CLASSIC may be a predictive of the grade of PostC in patients who undergo gastrointestinal surgery. High-grade iAEs is a
valuable predictor of increased hospital stay.
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Introduction: This study aims to determine the experiences and opinions of physicians on informed consent practices, to research
their awareness of their legal responsibilities, and to provide solutions to the problems encountered in practice.
Methods: This research is a descriptive field study. One hundred and eighty-four physicians working in a state hospital in İstanbul
participated in this study between January 15 and February 15, 2018. The questionnaire form was used as a data collection tool. After
the participants were informed about the purpose and method of the research, their consent was obtained, and they were asked
to fill in the questionnaire forms. The analysis of the data was performed using the SPSS 18.00 program. The significance level was
accepted as p<0.05.
Results: One hundred and eighty-four physicians working in a state hospital in İstanbul participated in this study. 69% (n=127) of
the physicians participating in the study were male and 31% (n=57) were female. 35.3% (n=65) of the participants were from the 30-
39 years old age group. 96.7% (n=178) of the physicians in the study stated that they personally informed their patients before the
surgical interventions. 83.7% (n=154) of the physicians think that the lawsuits filed against the physicians due to medical malpractice
affect the health services provided by the physicians to their patients.61.4% of the participants (n=113) think that they have not
received enough education in their medical education processes regarding the rights and obligations of the physicians.
Conclusion: Considering the current situation in Turkey, the informed consent process is not yet at the level it should be. Since
human rights are in the process of development in the world, informed consent and many more patient rights will gain importance
with studies on this subject. Therefore, training, and studies should be increased to inform physicians and patients about informed
consent and to make them a behavioral model physicians
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Introduction: Vertebral artery hypoplasia (VAH) is a common variation; however, its role in posterior circulation stroke (PCS) has
not been fully elucidated. Thus, this study aimed to evaluate the relationship between VAH and PCS with clinical and laboratory
parameters.
Methods: Between January 2016 and June 2020, 178 patients with PCS who were hospitalized in the neurology department were
included. The demographic characteristics, vascular risk factors, stroke patterns, and the National Institutes of Health Stroke Scale
(NIHSS) and modified Rankin Scale (mRS) scores of patients were recorded. Patients with VA diameter of ≤2.0 mm or 1:1.7 ratio
difference in computed tomography angiography were included in the VAH group.
Results: This study included 115 females and 63 males. The mean age of patients was 65.8±12 years. VAH was determined in 74
(41.6%) patients, whereas none in 104 patients (58.4%). No significant difference was determined in terms of gender and age in
patients with and without VAH (p=0.310 and p=0.676, respectively). No statistically significant difference was found between the two
groups in terms of vascular risk factors (p>0.05). Lacunar stroke pattern was less frequently found in patients with VAH (p=0.045).
Other stroke patterns were similar in both groups (p>0.05). The NIHSS (p=0.01) and mRS (p=0.018) scores were significantly higher
in patients with VAH than those without.
Conclusion: The presence of VAH in PCS may adversely affect the clinical severity.
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Introduction: At present, sedation and analgesia have become an integral part of gastrointestinal endoscopy. This study aimed to
provide data on the attitudes and behaviors of gastroenterology specialists toward sedation practices in endoscopy units in Turkey.
Methods: This cross-sectional and descriptive study included a total of 744 gastroenterology specialists, who are members of the
Turkish Gastroenterology Association. They were invited by e-mail to participate in the study. The questionnaire consisted of 18 items
on sedation practices implemented during procedures in the endoscopy unit. Questionnaire responses were statistically analyzed.
Results: All patients who underwent endoscopic procedures, such as endoscopic ultrasound, endoscopic retrograde
cholangiopancreatography, and endoscopic submucosal dissection, received sedation. The sedation rates were 97.9% (n=138) in
colonoscopy and 72.3% (n=102) in gastroscopy. With regard to the frequency of sedation, 33 (23.4%) used sedation for all patients, 55
(39%) used it frequently, and 15 (10.6%) used it rarely. The current anesthesia team in endoscopy units consisted of anesthesiologists
(53.2%) and anesthesia technicians (60.3%).
Conclusion: It is necessary to prepare guidelines on sedation use in endoscopy units to assist care providers and health managers in
providing quality service.
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Introduction: Vaginitis is one of the most common complaints of women who present to health institutions. This study aimed
to evaluate the results of vaginal culture obtained from patients who were admitted to the outpatient clinic because of recurrent
vaginitis.
Methods: Patient records including vaginal culture results of patients aged 18-49 years who were admitted to the gynecology
outpatient clinics of the University of Health Sciences Turkey, İstanbul Training and Research Hospital between January 2018 and
June 2020 with the complaint of recurrent vaginitis were analyzed retrospectively.
Results: The mean age of the 206 patients included in the study was 34.4±12.2 years. Of the 206 vaginal cultures, 124 (60,1%) were
negative and 82 (39.8%) were culture positive. Thirty-four patients (16,5%) had mixt microorganisms, 22 had Candida species (10,6%)
and 11 had Gardnerella vaginalis (5,3%). Various bacteria were isolated in 15 patients.
Conclusion: The rate of vaginitis recurrence and type of microorganism detected can be affected by various factors such as
sociocultural structure, race, education level, and contraception method. Only a few studies examined vaginal culture results in
patients with recurrent and persistent vaginitis in general and in Turkey. In this study, the contribution of vaginal culture to patient
management was limited in this patient group; moreover, the incidence of recurrent vaginitis was lower in women who were using
the barrier method.
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Introduction: This study aimed to evaluate the effects of depression severity on stress coping methods of mothers with mentally
disabled children.
Methods: This study included 50 mothers of children with intellectual disabilities who were admitted to the psychiatric outpatient
clinic of our hospital. Sociodemographic data form, Beck Depression scale, and Stress Coping scale were applied to all participants.
Results: The mean Beck Depression score of participants was 17.42±6.32. A One-Way relationship was found between the Beck
Depression score and Stress Coping scale-desperate and submissive subscales. The Stress Coping Scale-desperate approach score is
higher in those with severe depression than those with mild depression, whereas the Stress Coping scale-self-confidence subscale is
higher in those with severe depression. The Stress Coping scale-submissive approach score is higher in participants with moderate
depression than those with mild depression (p<0.005).
Conclusion: Depression negatively affects the stress coping methods of mothers with children with intellectual disabilities, and
psychosocial support is recommended to be provided to mothers who prefer desperate and submissive approaches to stress
management methods.
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Introduction: The admission blood glucose (ABG) level is associated with increased mortality in non-diabetics patients with Coronavirus
disease-2019 (COVID-19) in short-term follow-up studies. However, post-discharge mortality has also increased in COVID-19. Thus, this
study aimed to examine the relationship between ABG and 90-day mortality including the post-discharge period.
Methods: Non-diabetic patients who are hospitalized due to COVID-19 in 2020 were evaluated. Patients were divided into groups
according to the ABG level. Groups 1, 2, and 3 have ABG level of <100 mg/dL, 100-139 mg/dL, and 140-199 mg/dL, respectively.
Intensive care unit admission, in-hospital mortality, and 30- and 90-day mortality rates were evaluated as outcomes. COX regression
analyzes were used to assess mortality risk factors.
Results: A total of 1207 non-diabetic patients, of whom 49.2% were females, with a mean age of 65.2±13.4 years, were included in
the study. The patients were followed up for a median of 153 (inter quartile range: 107.5-251, maximum: 369) days. The in-hospital
and 30-day mortality of group 2 was higher than group 1 in the univariate analysis but without statistical significance in multivariate
analysis. Group 3 had worse outcomes than group 1 in both univariate and multivariate analysis at all endpoints. Group 3 had 2.533
adjusted hazard ratios (95% confidence interval: 1.628-3.941, p<0.001) 90-day mortality compared with group 1.
Conclusion: Non-diabetic patients with COVID-19 with an admission glucose level of ≥140 mg/dl had 2.5-fold increased all-cause
mortality at 90 days. Therefore, being more careful in treating and following non-diabetic patients with COVID-19, especially those
with hyperglycemia at admission, was recommended.
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