Pages I - IX (6 accesses)
|2.||Radiotherapy in Oligometastatic and Oligoprogressive Disease|
Mihriban Erdoğan, Gönül Demir, Zeliha Güzelöz, Ferhat Eyiler, Cüneyt Ebruli, Olçun Ümit Ünal, Murat Keser, Mustafa Emiroğlu
doi: 10.4274/terh.galenos.2021.70487 Pages 1 - 6 (9 accesses)
Oligometastasis is an intermediate group in the biological spectrum between localized disease and metastatic diseases. In terms of prognosis, it may present with a different course than common stage cases. There are many studies have showing the benefit of aggressive local therapy in these cases. In these studies, local treatment of all metastatic foci was shown to prolong survival in oligometastatic disease with primary control. In this review, the role of radiotherapy in oligometastatic disease is discussed considering studies.
|3.||Radiotherapy in Adjuvant Therapy in High-intermediate Risk and High Risk Endometrial Cancer: A Review Article|
Mihriban Erdoğan, Zeliha Güzelöz, Gönül Demir, Cüneyt Ebruli, Ferhat Eyiler, Murat Keser, Olçun Ümit Ünal, Mustafa Emiroğlu
doi: 10.4274/terh.galenos.2021.24650 Pages 7 - 11 (7 accesses)
Uterus kanserlerinde, grad (G), myometriyal invazyon derinliği, lenf nodu (LN) tutulumu dışında, histoloji, lenfovasküler invazyon (LVI) varlığı, tümör çapı, yaş ve evre diğer iyi tanımlanan klinikopatolojik prognostik faktörler arasındadır. Bu faktörlerin varlığına göre hastalar düşük-orta ve yüksek riskli grup olarak sınıflandırılmıştır. Uterus kanserinin %80-85i erken evre olup, hastaların %15-20si ise ileri evre yüksek riskli grubu oluşturur. Adjuvan tedavilerde, progresyonsuz sağkalımı artırmak ve toksisite oluşturmak arasındaki seçimi yapabilmek için belki de nüks etme potansiyeli daha yüksek stage III-IV hastaları belirlemek ve onlara kombine tedaviler yapmak bir seçenek olabilir. Pozitif paraaortik/pelvik LN metastazı, cerrahi sonrası gross rezidü varlığı, birden fazla ekstrauterin yayılım olması, yüksek G, LVI varlığı, peritoneal yayılım, papiller/clear cell histoloji ve ileri yaş gibi kötü risk faktörleri daha agresiv tedavi kararını verirken bize yardımcı olabilecek parametreler olabilir.
In uterine cancers, except grade (G), depth of myometrial invasion, lymph node (LN) involvement; histology, presence of lymphovascular invasion (LVI), tumor size, age, and stage are among other well-defined clinico pathological prognostic factors. According to the presence of these factors, the patients were classified as low-intermediate and high-risk groups. 80-85% of uterine cancer is an early stage, and 15-20% of patients constitute the advanced high-risk group. In adjuvant therapies, to be able to choose between increasing progression-free survival and inducing toxicity, perhaps identifying stage III-IV patients with higher relapse potential and giving them combined therapies may be an option. Poor risk factors such as positive paraaortic/pelvic LN metastasis, postoperative gross residue, multiple extrauterine spread, high G, lymphovascular invasion, peritoneal spread, papillary/clear cell histology, and advanced age can help us in making more aggressive treatment decisions.
|4.||Evaluation of the Frequency of Epilepsy in Pediatric Palliative Care Service|
Nilgün Harputluoğlu, Ünsal Yılmaz, Tanju Çelik
doi: 10.4274/terh.galenos.2021.69379 Pages 12 - 18 (9 accesses)
Objective: Epilepsy is a disorder characterized by sudden, repetitive, non-triggered seizures caused by abnormal and excessive electrical discharge in cortical neurons. There are no data regarding the palliative care needs of patients with epilepsy in Turkey. This study evaluates the frequency, etiology, clinical characteristics, and needs of children with epilepsy hospitalized in pediatric palliative care (PPC) services.
Methods: Following the approval of the local ethics committee, patients who received PPC services were retrospectively analyzed. Demographic data, primary diagnosis, device and technology used, duration and frequency of hospitalization, seizure type, electroencephalography, and magnetic resonance imaging findings of patients diagnosed with epilepsy were evaluated.
Results: Fifty-two (52%) of 100 patients included in the study had a diagnosis of epilepsy. The mean age of the patients with epilepsy was 4.8±0.8 years, and 53.6% (n=48) were male. It was found that 63.5% (n=33) of the patients diagnosed with epilepsy had cerebral palsy, and 26.9% (n=14) had inborn errors in metabolism. The most commonly used drug was levetiracetam, with 46.2%. Additionally, it was observed that patients with epilepsy had a statistically significantly more prolonged hospital stay than those without epilepsy and those with focal seizures than those with generalized seizures (p=0.004, p=0.023).
Conclusion: More than half of the patients needing palliative care had a diagnosis of epilepsy, and the presence of epilepsy prolonged hospital stay. The study may also be of interest to both pediatricians and pediatric neurologists in the field of PPC, which requires a multidisciplinary approach.
|5.||Maternal and Neonatal Outcomes of Patients who Delivered with Kiwi Omnicup Vacuum System: Experience of A Tertiary Care Hospital|
İsmail Alay, Şükrü Yıldız
doi: 10.4274/terh.galenos.2021.58751 Pages 19 - 25 (7 accesses)
Amaç: Vakum yardımıyla doğum en çok tercih edilen müdahaleli vajinal doğum yöntemidir ve Kiwi Omnicup, plastik kap, esnek çekiş kablosu ve el tipi vakum pompasına sahip vakum destekli doğum için yakın zamanda tasarlanmış bir sistemdir. Bu çalışmanın amacı, üçüncü basamak bir hastanede Kiwi Omnicup sisteminin uygulanma oranlarını değerlendirmek ve Kiwi Omnicup yardımıyla yapılan doğumların erken neonatal ve maternal sonuçlarını değerlendirmektir.
Yöntem: Bu çalışmada, Ocak 2016 ile Aralık 2019 tarihleri arasında üçüncü basamak bir hastanede 37 haftalık gebelik haftasından sonra Kiwi Omnicup Vakum sistemi ile olan doğumlar incelendi. Hastaların sosyo-demografik özellikleri, obstetrik verileri, doğum sonrası erken neonatal ve maternal sonuçları kaydedildi. Uzamış doğumun ikinci evresi, anne yorgunluğu veya tükenmişliği, ve fetal kötülük hali gibi vakum yardımlı doğum endikasyonları kaydedildi. Üçüncü veya dördüncü derece perine yaralanmaları, erken postpartum kanama, omuz distosisi, fetal ölüm, fetal skalp yaralanması, ve yenidoğan yoğun bakım ünitesi ihtiyacını içeren maternal ve neonatal komplikasyonlar kaydedildi.
Bulgular: Çalışma süresi boyunca 4525 vajinal doğumun 58i (%1,28) Kiwi Omnicup sistemi yardımıyla olmuştur. Hastaların yaş ortalaması 25,3±5,3 idi. Hastaların ortalama vücut kitle indeksi 28,4±3,2 kg/m2 idi ve hastaların %86,2 si aşırı kilolu ve obez idi. Uzun süren doğum eylemi (%48,3), Kiwi yardımıyla doğum için en fazla kaydedilen endikasyondu. Beş yenidoğanda (%8,6) kaput succedaneum görülmüştür. Sekiz yenidoğan pediatri bölümünde yakın gözlemde kalmıştır. İki bebek yenidoğan yoğun bakım ünitesine transfer edildi. Başka herhangi bir maternal ve neonatal komplikasyon gözlenmemiştir.
Sonuç: Kivi Omnicup Vakum sistemi müdahaleli doğum için kullanımı kolay ve düşük maternal ve neonatal kötü sonuç oranlarına sahiptir. Bu sistemin uygulanabilirliği çeşitli çalışmalarla doğrulanmış olmasına rağmen, klinisyenler tarafından kullanım oranları düşüktür. Doğumda klinisyenlerin Kiwi Omnicup Vakum sistemini kullanmaktan kaçınma nedenleri değerlendirilmelidir.
Objective: Vacuum-assisted delivery is the most preferred operative vaginal delivery method and Kiwi Omnicup is a recently designed system for vacuum-assisted delivery with has a plastic cup, flexible traction wire, and a handheld vacuum pump. The aim of this study was to assess the Kiwi Omnicup application rates in a tertiary care hospital and evaluate the early neonatal and maternal outcomes of Kiwi-assisted deliveries.
Methods: The Kiwi Omnicup Vacuum-assisted deliveries after 37 weeks of gestation between January 2016 and December 2019 at a tertiary care hospital were reviewed in this study. The sociodemographic characteristics of the patients, obstetric data, early postpartum neonatal, and maternal outcomes of the patients were obtained. The vacuum-assisted delivery indications, including the prolonged second stage of labor, maternal exhaustion, and fetal compromise were recorded. Maternal and neonatal complications including, third or fourth-degree perineal lacerations, early postpartum hemorrhagic, shoulder dystocia, fetal death, fetal scalp laceration, and neonatal intensive care unit necessity of newborns were recorded.
Results: During the study period, 58 (1.28%) of the 4525 vaginal deliveries were performed with the Kiwi Omnicup system. The mean age of the patients was 25.3±5.3 years. The mean body mass index of the patients was 28.4±3.2 kg/m2 and 86.2% of the patients were overweight and obese. The prolonged second stage of labor was the most recorded (48.3%) indication for Kiwi-assisted delivery. Caput succedaneum occurred in 5 neonates (8.6%). Eight newborn babies were observed closely in the Pediatric department. Two newborns were transferred to the intensive care unit. Any other maternal and neonatal complications were observed.
Conclusion: The Kiwi Omnicup Vacuum system is easy to use and has low maternal and neonatal adverse outcomes. Although the feasibility of this system was confirmed by several studies, it has low usage rates. The reasons for avoidance from Kiwi omnicup vacuum usage at delivery should be evaluated.
|6.||Sensory and Sensorimotor Gating in Children with Subclinical Hypothyroidism|
Sibel Kocaaslan Atlı, Nihal Olgaç Dündar, Uğraş Erdoğan, Nur Evirgen Esin, Turan Onur Bayazıt, Mehmet Cemal Kahya, Gönül Çatlı, Pınar Gençpınar, Bumin Nuri Dündar
doi: 10.4274/terh.galenos.2021.68815 Pages 26 - 32 (8 accesses)
Objective: Attention and learning problems have been reported in children diagnosed with subclinic hypothyroidism (SH). Sensory gating is an automatic phenomenon that is related to attentional processes. It is known that an impairment in sensory/sensorimotor gating negatively affects the signal processing mechanism and hence attention and learning processes. The aim of the present study was to evaluate the effect of SH on sensory gating processes via P50 suppression and prepulse inhibition (PPI) in children.
Methods: Fifteen children aged 8-16 years, diagnosed with SH, and 15 healthy children were included in the study. Auditory P50 suppression and PPI paradigms were applied during the recordings. P50 suppression was examined via auditory brain potentials recorded by electroencephalography. PPI was evaluated via electromyography, in which the blink reflex was recorded by oculomotor muscle activity.
Results: No statistical difference was found in P50 suppression and PPI processes between children in the SH and control groups. These findings indicate that the sensory gating processes children with SH are not affected.
Conclusion: The findings of this study show that the sensory gating processes of SH children are not affected. However, considering that brain maturation continues until the age of 20s, it may be more useful to scrutinize these processes with a wider age range and a larger number of participants to reveal more clearly how sensory gating is affected by SH.
|7.||The Relationship Between Suprapatellar Fat Pad Edema/Mass Effect and Sagittal Alignment of the Patellofemoral Joint|
Elif Günaydın, Semra Duran
doi: 10.4274/terh.galenos.2021.60476 Pages 33 - 38 (11 accesses)
Objective: This study aimed to compare the measurements of the sagittal alignment of the patellofemoral joint on magnetic resonance (MR) images between patients with suprapatellar fat pad edema/mass effect and a gender and age-matched control group of patients without suprapatellar fat pad edema.
Methods: A total of 55 patients with suprapatellar fat pad edema/mass effect was compared with the control group with anterior knee pain. Suprapatellar fat pad edema/mass effect and sagittal alignment of the patellofemoral joint were evaluated from the sagittal MR images. Sagittal alignment was evaluated using the Insall-Salvati (IS) ratio, patella-patellar tendon (P-PT) angle, and quadriceps tendon-P (QT-P) angle. The measurements were also compared between the two groups.
Results: The mean IS ratio, and P-PT angle did not significantly differ between the two groups (p>0.05). The mean QT-P angle was significantly higher in patients with suprapatellar fat pad edema/mass effect than in the control group (p=0.01).
Conclusion: The suprapatellar fat pad edema/mass effect is not associated with the sagittal alignment of the patellofemoral joint. The QT-P angle was higher in patients with a mass effect on the suprapatellar fat pad.
|8.||Door-related Fingertip Injury in Preschool Children: A Simple Treatment Method in the Emergency Department|
Tamer Coşkun, Hasan Onur Arık
doi: 10.4274/terh.galenos.2021.02223 Pages 39 - 44 (9 accesses)
Objective: To present a feasible treatment method of pediatric nail and nail bed laceration, which could be performed in the emergency room.
Methods: Twenty-one pediatric patients who presented to the emergency department of our institute with a fingertip injury were analyzed retrospectively. The detached flap at the fingertip was reduced and fixed with 25-g needle tip. Four-zero prolene, PDS, silk, or monocryl were used. The wound was sutured at the bilateral edges of the paronychial region while holding the distal interphalangeal joint. An additional second suture was added from the proximal nail to the eponychium. If the nail was completely separated from the matrix, a 4th suture was added to the hyponychial region at the distal nail. Six-month patency of the fingertips following repair was the primary outcome measure of this study.
Results: During a mean follow-up of 6.4 months, no fingertip necrosis developed and revision surgery was not required in any patient. No nail deformity requiring further treatment was found at the last follow-up.
Conclusion: This study demonstrates that fingertip injuries developing because of door pinching in preschool children can be treated under local anesthesia in the emergency room without repair of the nail bed. This approach seems to be a valid and safe alternative to surgical repair under general anesthesia.
|9.||The Investigation Frequency of JAK2 Gene Mutation in Glomerulonephritis|
Tuba Demirci Yıldırım, Utku Erdem Soyaltın, Altuğ Koç, Serkan Yıldız, Mehmet Tanrısev, Yaşar Bekir Kutbay, Ferhat Ekinci, Süleyman Yıldırım, Harun Akar, Cengiz Ceylan
doi: 10.4274/terh.galenos.2021.55899 Pages 45 - 49 (15 accesses)
Objective: Glomerulonephritis (GN) a heterogeneous group disease and the pathophysiology of GN is not understood yet. The aim of the study, the investigation frequency of Janus kinase (JAK)2 gene mutation in GN.
Methods: The study was conducted in University of Health Sciences Turkey, İzmir Tepecik Education and Research Hospital, Nephrology Clinic, and Dokuz Eylül University Faculty of Medicine Nephrology Clinic, between May 2015 and October 2015. Sixty-seven patients with GN and 100 healthy participants as a control group were included in the study. JAK2 gene mutation was investigated on peripheral venous blood.
Results: Thirty-three (49%) of the participants in the GN group were male and the mean age was 45.8±12.4 years. Thirty-seven (37%) of the participants in the control group were male and the mean age was 40.1±14.7 years. There were no JAK2 V617F mutations in both the study and control groups.
Conclusion: In our study, no direct relationship was found between the JAK2 mutation and GN. To evaluate the relationship between the JAK-signal transducers and activators of transcription (STAT) pathway and GN, further studies are needed, especially at the tissue level.
|10.||Collaboration with Medical Education: Board Exams of Medical Specialist Associations|
Aysel Başer, Funda İfakat Tengiz, Hale Sezer, Hatice Demir, Egemen Şen, Hatice Şahin
doi: 10.4274/terh.galenos.2021.08683 Pages 50 - 58 (9 accesses)
Objective: In Turkey, the boards were established in the last twenty years. Collaboration between boards and medical education discipline will lead board exams to be valid, reliable, acceptable, and fair. In this study, it is aimed to reveal the areas where boards can collaborate with the medical education discipline.
Methods: A workshop was held within the scope of a congress held in İzmir in February 2020. In the workshop, it was aimed to raise awareness about the stages of board examination from planning to implementation and the knowledge and skills that board members should have. At the beginning of the workshop, participants were taken to the 5-station Objective Structured Clinical Examination (OSCE). OSCE stations evaluated participants characteristics, proficiency exam planning, question preparation, question evaluation, and problem-solving. A discussion session was conducted based on the basis of participant performances. The workshop was completed with a presentation on deciding the pass-fail score of an exam.
Results: It was determined that the participants did not have information about board exams and were not involved in planning. It was determined that the participants could not write multiple-choice questions in accordance with the criteria and could not technically evaluate the prepared multiple-choice questions. At the problem-solving OSCE station where performance was evaluated, some participants could not use the time effectively and did not consider the rules. A session was held to decide the passing score of the OSCE that participants were included in. The Angoff technique was used and the scores determined by the participants were visualized, and the importance of reconciliation for the passing score was discussed.
Conclusion: The workshop showed that there are areas that can be collaborated with the medical education discipline in planning and implementing board exams.
|11.||Examining the Effects of COVID-19 Pandemic on ST Segment-elevation Myocardial Infarction Treatment Strategies with the Impact of Event Scale|
Nazile Bilgin Doğan, Barış Kılıçaslan
doi: 10.4274/terh.galenos.2022.44365 Pages 59 - 67 (8 accesses)
Objective: Primary percutaneous coronary intervention (PPCI) is the first-line recommended therapy for acute ST-segment-elevation myocardial infarction (STEMI). While some papers have suggested to continue performing PPCI for patients with STEMI, some papers highlighted using lytic therapy during the earlier pandemic period. The points underestimated in these publications were the psychological impact of the coronavirus disease-2019 (COVID-19) pandemic on cardiologists and their STEMI treatment strategies. Based on this idea, we searched an answer to this question. This document evaluated STEMI treatment strategies using the Impact of Event Scale (IES) during the early stages of the COVID-19 pandemic.
Methods: An online, questionnaire study conducted randomly to 1000 cardiologists via e-mail or WhatsApp message to evaluate cardiologists STEMI treatment strategies with five psychological factors [daily moods (F1), willingness and ability to work (F2), anxiety about infection (F3), lack of medical information (F4), and feeling of being protected (F5)] which were filled between 01-15 May 2020 by 136 volunteers in Turkey.
Results: Turkish invasive cardiologists major treatment choice for patients with STEMI were PPCI during the early pandemic period, even they felt worse all in all, less willingness to work, and higher anxiety about infection, which means higher total IES, F1, F2, and F3 scores in the study. Different psychological impacts of COVID-19 pneumonia had different effects on cardiologists treatment strategies. The F3 score was the major determinant psychological factor for the STEMI treatment strategy. The participants with the highest F3 scores [10.0 (9.0-11.0)] preferred thrombolytic therapy.
Conclusion: This unique study evaluating cardiologists real-life STEMI treatment strategies using the IES during the COVID-19 pandemic showed that lytic therapy came to the fore again for the cardiologists with the highest anxiety level about COVID-19 pneumonia in real-life.
|12.||Comparison Breastfeeding Motivation and Perceived Social Support Levels of Primiparous and Multiparous Women in the Postpartum Period|
Emine Gök, Sümeyye Bakır, Gül Ertem
doi: 10.4274/terh.galenos.2022.65391 Pages 68 - 75 (13 accesses)
Objective: In this study, it was aimed to compare the breastfeeding motivation and social support levels in primiparous and multiparous women in the fourth week postnatally.
Methods: This descriptive, cross-sectional study was conducted in a training and research hospital in western Turkey between May-October 2019. The study sample comprised 160 mothers (primiparous=80, multiparous=80) who agreed to participate in the study. The study data were collected through telephone interviews, using the Breastfeeding Motivation Scale and the Multidimensional Scale of Perceived Social Support. Descriptive statistics, independent samples t-test, chi-square analysis were used in the analysis of the data.
Results: While the primiparous mothers performed their breastfeeding behavior in a controlled manner, the breastfeeding behavior of the multiparous was more motivated by autonomous motivation (p<0.05). The perceived social support level was 62.01±18.25 for the primiparous and 54.48±17.59 for the multiparous. The perceived social support level of the primiparous was statistically significantly higher than multiparous (p<0.05).
Conclusion: Evaluation of the individual motivation characteristics and social support levels of mothers from the perspective of parity in breastfeeding interventions performed to obtain positive results is of importance.
|13.||Long-term Follow-up Liver Stiffness Results of Chronic Hepatitis C Patients Treated with Direct-acting Antivirals|
Gözde Derviş Hakim, Ayşe Gökçen Tufan
doi: 10.4274/terh.galenos.2022.68736 Pages 76 - 84 (8 accesses)
Objective: Non-invasive assessments, i.e., transient elastography (Fibroscan®), FIB-4 (Fibrosis-4) and [AST (aspartate aminotransferase) to platelet ratio index] APRI scores are used to measure liver stiffness during the long term follow up of patients diagnosed with Chronic hepatitis C (CHC). To evaluate the liver stiffness measurements detected by non-invasive methods in CHC patients treated with direct acting antivirals (DAAs) in the long term.
Methods: Liver stiffness measurements carried out with transient elastography, FIB-4, APRI scores, and biochemical data before and after the treatment and during the long-term follow-up of 26 patients with CHC treated with DAAs were reviewed retrospectively. Patients receiving Paritaprevir + Ritonavir/Ombitasvir + Dasabuvir were included in group 1 (n=13), and patients receiving Sofosbuvir + Ledipasvir ± Ribavirin in group 2 (n=13).
Results: Mean liver stiffness measurement of the patients was 15.50±2.13 kPa (min-max: 5.20-45.00 kPa) before treatment, 12.15±1.84 kPa (min-max: 4.30-42.00 kPa) at the end of treatment and 9.73±1.57kPa (min-max: 3.0-42.2 kPa) at 28 months after the treatment. Significant regressions were also seen in the APRI and FIB-4 scores of patients during the long term follow up treatment compared to baseline (APRI at the onset of treatment: 0.79±0.62, APRI during the long term follow-up: 0.25±0.13, p<0.01; FIB-4 at the onset of treatment: 2.65±1.82, FIB-4 during the long term follow up: 1.66±1.23, p<0.01).
Conclusion: Significant improvements were seen in the stage of fibrosis in the long-term follow-up of the treatment with current antiviral therapies.
|14.||Extensive Peritoneal Lavage (EIPL) with Saline After Curative D2 Gastric Resection For Treatment of Locally Advanced Gastric Cancer Patients|
Ali Alemdar, Mehmet Güray Duman, Selma Şengiz Erhan, Ali Güner, İsmayil Yılmaz
doi: 10.4274/terh.galenos.2022.82997 Pages 85 - 93 (7 accesses)
Objective: This study evaluated extensive intraoperative peritoneal lavage (EIPL) on overall survival (OS), adverse events, and recurrence type in gastric cancer patients who underwent curative D2 lymph node dissection.
Methods: Medical records of 235 patients undergoing D2 curative gastrectomy for clinically locally advanced gastric cancer without peritoneal carcinomatosis between January 2011 and October 2021 were reviewed retrospectively. Patients were grouped according to surgery plus EIPL and non-EIPL. Clinicopathological features and recurrence type, prognostic factors on OS, and incidence of adverse events were evaluated.
Results: The mean age of patients included in this study was 63 years in the EIPL group and 61 in the non-EIPL group. The OS rate of patients with EIPL was 63%, and the non-EIPL group was 61.6%. All postoperative complications were less in the EIPL group (p=0.008). Peritoneal metastases were less in the EIPL group (p=0.003).
Conclusion: Free cancer cells in the abdominal cavity may be detected due of tumor manipulation and lymphovascular dissection during surgery. Using EIPL can reduce peritoneal recurrence. Postoperative complications due to exudate, debris, and possible intestinal content caused by perioperative dissection can be prevented with EIPL.
|15.||Incidental Gynecological Findings in Lumbar Spine MRI: The Prevalence of These Findings and Their Importance For Patient Management|
Ebru Hasbay, Muzaffer Sancı
doi: 10.4274/terh.galenos.2023.01643 Pages 94 - 99 (8 accesses)
Objective: To assess the prevalence of incidental gynecological findings in lumbar magnetic resonance imaging (MRI).
Methods: We evaluated 299 patients who underwent lumber MRI in consideration of lumbar discopathy. Lumbar MRI was reported by an experienced radiologist. Ovarian cysts, endometrioma, uterine leiomyoma, adenomyosis, endometrial thickening, and nabothian cysts were included, in addition to gynecological malignancies.
Results: Of the 299 patients scanned, 43 had incidental extraspinal gynecological findings, and in four of these 43 patients, the findings had malignant potential.
Conclusion: It is recommended that radiologists give more attention to extraspinal gynecological findings in lumbar spine MRI, as the detected pathology can provide explanations for pain or can signal potentially life-threatening conditions.
|16.||Comparative Transcriptome Analysis Identifies Target Genes for Treatment of IDH Wild-type Lower-grade Gliomas|
Fadime Öztoprak, Zerrin Işık, Yavuz Oktay
doi: 10.4274/terh.galenos.2023.60024 Pages 100 - 119 (14 accesses)
Objective: Isocitrate dehydrogenase 1/2 (IDH 1/2) mutations define a group of low-grade gliomas (LGGs) that display more favorable prognosis compared with LGGs without them. Although IDH wild-type (IDHwt) LGGs are classified as low-grade, they almost invariably progress to higher grades and rarely respond to aggressive treatment regimes. Here, we employed a comparative transcriptomic approach to identify key genes that could significantly contribute to the aggressive progression of IDHwt LGGs.
Methods: Using The Cancer Genome Atlas LGG cohort data and weighted gene coexpression network analysis methodology, we identified modules that correlated significantly with clinical features. We focused on modules that correlated with telomerase reverse transcriptase (TERT) promoter mutation status, as TERT promoter mutations are shared between glioblastomas and oligodendrogliomas, however, with two opposite prognostic outcomes. We selected module pathways shared between IDH mutant (IDHmt) and IDHwt LGGs and identified genes that were differentially expressed between the two groups.
Results: Several synaptic proteins are down-regulated in IDHwt compared with IDHmt, while GNG12 and VIPR2 are up-regulated. Finally, we identified known drugs that could target many of those genes and therefore could be tested against IDHwt LGGs.
Conclusion: Targeting of multiple candidate genes identified in this study could provide novel approaches toward the treatment of IDHwt LGGs.
|17.||Clinical Characteristics and Outcomes of Vaccinated and Unvaccinated Pregnant Women Hospitalized With COVID-19: An Observational Study by Vaccination Status|
Özge Özdemir, Gökhan Bolluk, Ulaş Çoban
doi: 10.4274/terh.galenos.2023.88965 Pages 120 - 127 (8 accesses)
Objective: To evaluate maternal and obstetric characteristics, presenting symptoms, and pregnancy outcomes in vaccinated versus unvaccinated groups of pregnant women hospitalized with a diagnosis of coronavirus disease-2019 (COVID-19).
Methods: A total of 190 pregnancies hospitalized with a diagnosis of COVID-19 were included in this observational study and divided into two groups: vaccinated (n=82) and unvaccinated (n=108). Data on maternal and obstetric characteristics, presenting symptoms, radiological involvement, laboratory findings, need for oxygen or stay in the intensive care unit, and length of hospital stay were recorded. Pregnancy outcomes were evaluated using gestational week at diagnosis, gestational week at delivery, delivery due to COVID-19, fetal birthweight, and Apgar score.
Results: When compared with the vaccinated group, unvaccinated pregnant women COVID-19 were younger and had significantly lower rates of use of assisted reproductive technology, hypertensive disease, diabetes, coronary artery disease, and asthma. Unvaccinated women were more likely to present with dyspnea, fever, and chest pain, as well as radiological involvement and need for the intensive care unit. Gestational week at delivery, fetal birthweight, and Apgar scores were significantly lower, length of hospital stay was significantly longer, and the rate of delivery due to COVID-19 was significantly higher in the unvaccinated group versus the vaccinated group.
Conclusion: Our findings indicate a milder course of disease and a lower risk of adverse pregnancy outcomes in vaccinated versus unvaccinated pregnant women diagnosed with COVID-19. Hence, our findings suggest that pregnant women should be counseled to receive the COVID-19 vaccine to prevent maternal and fetal risks related to severe acute respiratory syndrome coronavirus 2 infection.
|18.||Comparison of the Effect of Prophylactic Ephedrin, Ringers Lactate, and Colloid Applied During Spinal Anaesthesia on Hemodynamic Parameters in Geriatric Patients|
Pelin Uzun Sarıtaş, Birgül Yelken
doi: 10.4274/terh.galenos.2023.48039 Pages 128 - 135 (8 accesses)
Objective: Spinal anesthesia, especially in the elderly population, may cause a range of problems from hypotension, cerebral ischemia and myocardial infarcts, to acute renal failure and cardiac arrest. In our study, we researched the effect of ephedrine, ringer lactate, and colloid solutions administered prophylactically on hemodynamic parameters in geriatric patients administered spinal anesthesia.
Methods: This prospective, randomized, double-blind study included 75 patients aged 65 years and older in the American Society of Anesthesiologists I-II risk group undergoing urogenital system surgery. Patients were randomly divided into 3 groups called R, C and E. Group R was administered 1000 mL ringer lactate + 2 mL 0.9% NaCl, group C were administered 500 mL hydroxyethyl starch solution, and group E were administered 1000 mL ringer lactate + 10 mg ephedrine (with 2 mL volume). All patients had 5 mL/kg/hr ringer lactate administered for maintenance. The patients systolic (SBP), diastolic (DBP) and mean blood pressure (MBP), heart rate (HR), and SpO2 data were recorded. The values before administering fluids were taken as control values and a 30% fall in systolic blood pressure or systolic blood pressure <90 mmHg was accepted as hypotension, and 5 mg IV ephedrine was administered.
Results: In all groups, the SBP, DBP, and MBP were identified to have statistically significant increases at prepuncture (PP) and intraoperative 5th minute (I5) times. In group C, the hemodynamic changes after the increase at PP and I5 were less for SBP, DBP and MBP compared to groups R and E. In terms of HR, only group R had a statistically significant fall. One case in group R had bradycardia was identified.
Conclusion: All three methods can be used safely in the geriatric population; however, we concluded that patients with colloid infusion had more stable hemodynamic parameters.
|19.||Comparison of the Results of Indirect Immunofluorescence and Immunoblot in the Detection of Anti-Nuclear Antibodies|
Alper Togay, Nisel Yılmaz
doi: 10.4274/terh.galenos.2023.74317 Pages 136 - 141 (10 accesses)
Objective: The indirect immunofluorescence (IIF) antibody method using HEp-2 cells for anti-nuclear antibodies (ANA) screening is the gold standard. Some antigens have been purified and termed as extractable anti-nuclear antibodies (ENA) to detect the autoantibodies. These autoantibodies are usually detected by the immunoblot (IB) method. In this study, we compared the ANA patterns detected by the IIF method with the ENA detected by IB to predict which confirmatory test should be selected for which ANA patterns.
Methods: 2894 serum samples sent from different clinics to both ANA and IB between January 2019 and March 2022 were analyzed in the Medical Microbiology Laboratory of University of Health Sciences Turkey İzmir Tepecik Education and Research Hospital.
Results: The ENA positivity rates of samples with positive ANA patterns were centromere 91%, Topo I-like 83%, speckled 66%, homogeneous with other ANA patterns 53%, speckled with other ANA patterns 53%, homogeneous 45%, nucleolar 30%, nuclear dots 28%, nuclear envelope 15%, and dense fine speckled-70 (DFS70) 10%, respectively. In the study, 100 (12.9%) of the clinical specimens with ANA positivity were sent from male patients and 674 (87.1%) from female patients, and the mean age was 43±19.17 years (age range: 0-88).
Conclusion: Our data are highly consistent with the centromere, Topo I-like, and granular patterns in IIF between specific antibody positivity detected in IB for antibodies associated with the pathogenesis of systemic autoimmune rheumatic diseases. We believe that the tests can be used more efficiently with rational laboratory use and can provide more accurate guidance to the clinic.
|20.||Severe COVID-19 Pneumonia and Critical Congenital Heart Disease in a Newborn|
Osman Güvenç, Serdar Başgöze, Serdar Beken, Metehan Özen, Ender Ödemiş
doi: 10.4274/terh.galenos.2021.93653 Pages 142 - 145 (8 accesses)
The new coronavirus infection, which has resulted in a pandemic, may lead to pneumonia, severe respiratory insufficiency, multi-organ failure, and death in adults and elderly as well as people with chronic diseases. As the number of people affected by this globall pandemic, patients in all age groups are being identified with more reported neonatal and pediatric patients. It has been reported that neonates and infants with a congenital cardiac disease constitute the most commonly affected group. Favipiravir may be administered in case of coronavirus disease-2019 (COVID-19) pneumonia that starts in the neonatal period. Here, we report a newborn with an interrupted aortic arch and severe COVID-19 pneumonia. The patient, who had severe COVID pneumonia, was successfully operated after being treated.
|21.||Rare Lesion of the Bladder, Inflammatory Myofibroblastic Pseudotumor|
Mehmet Yoldaş, Hakan Üçok, Yusuf Özlem İlbey
doi: 10.4274/terh.galenos.2021.75508 Pages 146 - 149 (7 accesses)
An inflammatory myofibroblastic pseudotumor is a rare lesion that can occur in many localizations, the most common being the lung. Although there are no large series of studies, it is more common in men. Diagnosed by histopathological examination of the excised tissue. There is no pathognomic radiological, clinical, and laboratory diagnostic method. Initially, intermittent fever may cause symptoms such as weight loss, fatigue, as well as suprapubic or abdominal pain due to the compression effect of the mass depending on the area where it is located. Its metastasis is very rare, but local invasion is common. Local excision is applied in the treatment.
|22.||Two Cases Detected with Pulmonary Embolism After COVID-19 Acute Period|
Melike Yüksel Yavuz, Aysu Ayrancı, İbrahim Onur Alıcı, Ahmet Emin Erbaycu
doi: 10.4274/terh.galenos.2021.81084 Pages 150 - 154 (8 accesses)
While the coronavirus disease-2019 (COVID-19) pandemic is in full swing, its long-term effects are also noticeable over time. While the incidence of pulmonary embolism (PE) in hospitalized patients was approximately 2.6-8.9%, it was observed in one-third of patients hospitalized in the intensive care unit despite standard prophylactic anticoagulation. Although the thrombotic effects are known in the acute period and prophylactic and treatment approaches are used for this, we still need studies on how long and in whom the effects of the thrombotic process will continue. Cases of PE seen months after COVID-19 have been reported as case series in the literature. We also planned to present two patients who had PE after a diagnosis of COVID-19, one after sixteen days and the other three months later, and who had no additional risk factors, by discussing the literature.