GÝRÝÞ ve AMAÇ: Araþtýrmanýn amacý büro elemanlarýnýn uzun süre oturmasý ve oturma þeklinin bel aðrýsýný arttýran bir risk faktörü olup olmadýðýný anlamak ve deðerlendirmektir. Araþtýrma bu konu hakkýnda bilgi saðlamak ve literatüre katký yapmayý hedeflemektedir.
YÖNTEM ve GEREÇLER: Bel aðrýsý olan ofis çalýþanlarýna kiþisel bilgiler, mesleki bilgiler, oturma þekli ve süresi ve bel aðrýsý ile ilgili olmak üzere 3 ana kýsýmdan oluþan toplamda 18 soru içeren bir anket hazýrlandý. Bu anket bel aðrýsý þikayeti olan, 18-65 yaþ aralýðýndaki ofis çalýþaný olan 131 kiþiye uygulandý.
BULGULAR: Olgularýn yaþ ortalamasý 35±9,3 ve BKI ortalamasý 25±3,83kg/m2’ dü. Uzun süreli oturur pozisyonda çalýþan ofis çalýþanlarýnýn ayakta durma ve yürüme yüzdesi daha az, aðrýlarýnýn þiddeti ise daha fazlaydý. Aðrýnýn süresi ile oturma, ayakta durma ve yürüme yüzdesi arasýnda korelasyon vardý. Aðrýnýn þiddeti ile oturma yüzdesi arasýnda da korelasyon vardý.
TARTIÞMA ve SONUÇ: Bel aðrýsý öyküsü bulunma, yüksek BKÝ’ye sahip olma ve uzun süre oturur pozisyonda çalýþma,ofis çalýþanlarýnda bel aðrýsýnýn etkenleri olabilir

INTRODUCTION: The aim of this study was to understand and evaluate whether long sitting durations and sitting position are risk factors for lumbar pain among office workers and to contribute to the existing literature on this subject.
METHODS: A questionnaire comprising 18 items and 3 main sections about personal information, professional information, sitting position and duration, and lumbar pain was developed for office workers with lumbar pain. The questionnaire was distributed among 131 office workers aged between 18 and 65 years (mean age: 35±9.3 years; mean Body Mass Index (BMI): 25±3.83 kg/m2) who had complaints of lumbar pain.
RESULTS: Among the office workers with long sitting durations, the percentages of standing and walking were lower and the severity of pain was higher. There was a correlation between the duration of pain and percentages of sitting, standing, and walking and between the severity of pain and percentage of sitting.
DISCUSSION AND CONCLUSION: A history of lumbar pain, high BMI, and long sitting duration at work may be the risks factors for lumbar pain among office workers.

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GÝRÝÞ ve AMAÇ: Çalýþmamýzda ulusal aþý programýnda yer almayan meningokok aþýsý hakkýnda annelerin bilgi, tutumlarýnýn belirlenmesi ve bu aþýnýn uygulanmama nedenlerinin saptanmasý amaçlandý.
YÖNTEM ve GEREÇLER: Kesitsel ileriye dönük olan bu araþtýrma 01 Aðustos- 30 Ekim 2018 tarihleri arasýnda yapýldý. Hastanemiz Çocuk Polikliniðine baþvuran, 3-59 ay arasý çocuðu olan anneler çalýþmaya alýndý. Annelere araþtýrmayla ilgili bilgi verildi, onam verenlerle çalýþma formu dolduruldu. Katýlýmcýlara sosyodemografik özellikleri, meningokok aþýsýyla ilgili bilgi ve tutumlarýný içeren on üç soru soruldu.
BULGULAR: Çalýþmaya 426 anne katýldý. Annelerin yaþ ortalamasý 31,4±5,5 (19-48) yýl, çocuklarýn ise 18,5±13,4 (3-59) aydý. Annelerin %59,4’ü menenjit aþýsýnýn beyin zarý iltihabýndan koruduðunu biliyordu. Çocuklarýn 232’sine (%54,5) meningokok aþýsý yapýlmasý önerilmiþti. Meningokok aþýsý yapýlma oraný %24,9 (n: 106) saptandý. Anne eðitim düzeyinin (p<0,001), aile gelir durumunun (p<0,001) ve diðer aþýlarýn yapýldýðý saðlýk kurumunun (p<0,001) aþýnýn yapýlmasýný etkileyen faktörler olduðu belirlendi. Meningokok aþýsýnýn yaptýrýlmama nedenleri; %50,3 bilgi eksikliði, %16 maddi yetersizlik, %12,8 aþý uygulanma zamanýnýn gelmediðinin düþünülmesi, %5,7 aþýnýn gerekli olmadýðýný düþünmek ve çeþitli gerekçeler belirtildi. Meningokok aþýsýnýn ulusal aþý programýna alýnmasýný katýlýmcýlarýn %85’i istediðini, %1,6’sý istemediðini, %13,4’ü kararsýz olduðunu bildirdi.
TARTIÞMA ve SONUÇ: Annelerin meningokok aþýsý hakkýnda bilgilerinin yeterli düzeyde olmadýðý belirlendi. Ailelere ve saðlýk çalýþanlarýna meningokok aþýsý hakkýnda eðitim verilmesinin aþýlanma oranýný arttýracaðýný düþünmekteyiz.

INTRODUCTION: The present study aimed to investigate mothers' knowledge and attitudes about the meningococcal vaccine and to determine the reasons for not applying this vaccine.
METHODS: This cross-sectional prospective study was conducted between 01 August and 30 October 2018. Mothers who had children between 3-59 months were included in this study. Thirteen questions were asked about the sociodemographic characteristics of participants, their knowledge and attitudes about the meningococcal vaccine.
RESULTS: This study included 426 mothers. The mean age of mothers was 31.4±5.5 (19-48) years and children were 18.5±13.4 (3-59) months. 59.4% of mothers knew that the meningitis vaccine protects brain membrane from inflammation. 232 (54.5%) of the children were recommended meningococcal vaccination. The rate of meningococcal vaccine application was 24.9% (n: 106). The findings obtained in this study showed that maternal education level (p<0.001), family income (p<0.001) and where other vaccines were applied (p<0.001) were the factors affecting vaccination. Causes of non-application meningococcal vaccine; 50.3% lack of the information, 16% the financial insufficiency, 12% not considering the time of vaccination, 5.7% to think that the vaccine is not necessary and various reasons were stated.
DISCUSSION AND CONCLUSION: The findings showed that mothers do not have enough information about the meningococcal vaccine. We think that providing education to parents and health workers about the meningococcal vaccine would increase the rate of vaccination.

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GÝRÝÞ ve AMAÇ: Ultrasonografi (USG) tetkiki tiroid görüntülemesinde sýklýkla kullanýlmaktadýr. Bu nedenle, insidental saptanan nodül ve ince iðne aspirasyon biyopsisi (ÝÝAB) sayýsý giderek artmaktadýr. Gereksiz ÝÝAB veya yakýn dönem takip sayýsýný azaltabilmek ve hastaya uygun yaklaþýma karar verebilmek için, tiroid nodüllerinde her Bethesda kategorisine özel bazý sonografik bulgular saptamayý amaçladýk.
YÖNTEM ve GEREÇLER: Çalýþmamýzda, tiroid nodülü için USG eþliðinde ÝÝAB yapýlmýþ, yaþ ortalamasý 49 yaþ olan, toplam 1488 hasta [1260 kadýn (%85) ve 228 erkek (%15)] yer aldý. USG ve ÝÝAB sonuçlarý retrospektif olarak tekrar incelendi. USG özellikleri (en büyük çap, kontur, ekojenite, sayýsý, solid/kistik içeriði, halo varlýðý, kalsifikasyon, lenfadenopati, tiroidit bulgularý) kaydedildi. Her Bethesda kategorisi için USG özellikleri ve Bethesda kategorileri arasýndaki korelasyon istatistiksel olarak incelendi.
BULGULAR: Çalýþmamýzda toplam 1488 hasta yer aldý. Bethesda kategori 2 nodüllerinde, izo-/hiper-ekojenite, düzgün kontur, solid ve kistik içerik birlikteliði, ince halo ve çok sayýda olma oraný daha yüksekti (p<0,05). Kalýn halo (7/75, %9,5) ve lenfadenopati varlýðý (4/75, %5,5) sadece Bethesda kategori 6 nodüllerinde izlendi. Silik/düzensiz kontur, çoðunlukla Bethesda kategori 5 (5/7, %71) ve kategori 6 (34/75, %45) nodüllerinde saptandý (her ikisi için p<0,05). Solid içerik ve tek nodül, daha çok Bethesda kategori 6 nodüllerinde saptandý. Bethesda kategorileri arasýnda mikrokalsifikasyon veya tiroidit bulgularý varlýðý açýsýndan anlamlý istatistiksel fark saptanmadý (p>0,05).
TARTIÞMA ve SONUÇ: Özellikli sonografik bulgular yardýmýyla tiroid nodüllerinde, sitopatoloji öncesi bazý Bethesda kategorilerinin tahmini yapýlabilir. Böylece, gereksiz ÝÝAB iþlemlerinin ve takiplerin sayýsý azaltýlabilir.

INTRODUCTION: Ultrasound (US) is frequently performed for imaging of thyroid. So, the number of incidentally detected thyroid nodule and fine needle aspiration biopsy (FNAB) is increasing gradually. We aimed to depict specific sonographic characteristics of thyroid nodule in each cytological Bethesda category for planning patient management and reducing the number of unnecessary FNAB or short-term follow-up.
METHODS: A total of 1488 patients [1260 women (85%) and 228 men (15%) with a mean age of 49 years] who had undergone US guided FNAB were included in the study. US and FNAB findings were reviewed retrospectively. US features (size, contour, echogenicity, multiplicity, solid/cystic nature, the existence of halo, calcifications, lymphadenopathy and thyroiditis) were recorded. The correlation of sonographic and cytological findings was investigated in each Bethesda category.
RESULTS: A total of 1488 patients were enrolled in our study. Among Bethesda category 2 nodules, iso-/hyper-echogenicity, well-defined contour, solid plus cystic component, thin halo and multiplicity were more prevalent (p<0.05). Thick halo (7/75, 9.5%) and lymphadenopathy (4/75, 5.5%) were only observed in Bethesda category 6 nodules. Ill-defined/irregular contour was mostly seen in Bethesda category 5 (5/7, 71%) and category 6 (34/75, 45%) nodules (p<0.05). There was no statistically significant difference in microcalcification and thyroiditis between Bethesda categories (p>0.05).
DISCUSSION AND CONCLUSION: The prediction of Bethesda category of nodule with sonographic findings is possible in some Bethesda categories. The number of unnecessary FNABs and follow-up can be reduced.

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GÝRÝÞ ve AMAÇ: Yaþlý hastalarda optimal glisemik kontrolün komplikasyon sýklýðý ve mortaliteyi azalttýðý bilinmektedir. Bu çalýþmada son kýlavuzlarýn ýþýðýnda tedavi altýndaki yaþlý diyabetik hastalarda glisemik kontrol ve hipoglisemi sýklýðýnýn belirlenmesi amaçlanmýþtýr.
YÖNTEM ve GEREÇLER: Bu tek merkezli kesitsel çalýþma, endokrinoloji ve metabolizma hastalýklarý polikliniðine baþvuran 65 yaþ üstü, demansý ve son dönem hastalýðý olmayan tip 2 diyabetik hastalarda (n=103) yapýlmýþtýr. Hastalarýn kognitif ve fonksiyonel durumlarý, komorbiditeleri, kullanmakta olduklarý anti-diyabetik ilaçlarý sorgulanarak 2019 Endokrin Cemiyeti kýlavuzuna göre hastalarýn genel saðlýk durumlarý (iyi, orta, ya da kötü olarak) belirlenmiþtir. Hastalar tedavi altýndaki HbA1c düzeylerine göre 3 gruba ayrýlmýþlardýr; fazla tedavi alanlar (HbA1c hedef deðerin altýnda, n=14), optimal kontrol (HbA1c hedeflerini saðlayanlar, n=36), yetersiz tedavi alanlar (HbA1c hedef deðerlerin üzerinde, n=53) gruplarýna ayrýlmýþtýr. Gruplar arasýnda demografik özellikler, hipoglisemi sýklýðý, kullanmakta olduklarý antiglisemik tedaviler, komplikasyonlar karþýlaþtýrýlmýþtýr.
BULGULAR: Glisemik hedeflere göre hastalarýn %13.6’sýnýn tedavisi fazla, %35’inin tedavisi yeterli, %51.4’ünde ise tedavi yetersiz kalmaktaydý. Fazla tedavi gören hasta grubunda diyabetik retinopati daha fazla ve glomerüler filtrasyon hýzý daha düþüktü (p<0.05). Hastalarýn %39.8’inin son 4 hafta içerisinde hipoglisemik olay geçirdiði gösterilmiþtir. Diyabetik retinopatisi olan hastalarda hipoglisemi daha sýk görülmüþtür (p<0.01). Ýstatistiksel olarak anlamlýlýða ulaþamasada, hipoglisemi geçiren hastalarýn yarýsýnýn yetersiz tedavi alan grupta olduðu saptanmýþtýr.
TARTIÞMA ve SONUÇ: Yaþlý popülasyonda diyabet tedavisinin yönetimi sadece HbA1c düzeyi deðil, hastalarýn genel saðlýk durumu, komorbiditeleri ve kognitif fonksiyonlarýnýn da göz önüne alýnarak yapýlmasý ve hem hipoglisemi, hem de hipergliseminin önlenmesi amaçlanmalýdýr.

INTRODUCTION: Optimal glycemic control is known to reduce the frequency of complications and mortality rates in elderly patients. The aim of this study is to evaluate the glycemic control and hypoglycemia frequency in elderly patients with type 2 diabetes mellitus (T2DM).
METHODS: This single-center cross-sectional study was conducted in the endocrinology and metabolic diseases outpatient clinic. A total of 103 patients with T2DM older than 65 years without psychiatric disorders, end-stage renal disease, cancer and dementia were included in the study. The cognitive and functional status of the patients, their comorbidities and the anti-diabetic drugs they were using were evaluated, and the general health status of the patients (categorized simply as good, moderate, or poor) was determined according to the 2019 Endocrine Society guidelines. The patients were divided into 3 groups according to the HbA1c levels as; overtreated (HbA1c below target value, n=14), optimally controlled (those achieving HbA1c goals, n=36), and undertreated (HbA1c above target values, n=53). Demographic characteristics, frequency of hypoglycemia, antihyperglycemic therapies they used and complications were compared between the groups.
RESULTS: According to glycemic targets, 13.6% of the patients were overtreated, 35% were optimally treated, and 51.4% were undertreated. Diabetic retinopathy was higher and glomerular filtration rate was lower in the overtreated patient group (p<0.05). It has been shown that 39.8% of the patients had a hypoglycemic event in the last 4 weeks. Hypoglycemia was more common in patients with diabetic retinopathy (p<0.01). Although it was not statistically significant, half of the patients who had hypoglycemia were in the undertreatment group.
DISCUSSION AND CONCLUSION: Treatment should be tailored in each visit according to comorbidities, complications, life expectancy, and neurocognitive status of the patients in order to minimize both hypoglycemia and hyperglycemia.

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GÝRÝÞ ve AMAÇ: Amacýmýz Propofol, Midazolam ve Tiyopental'in (intravenöz (iv) anestezikler), indometazinle indüklenen gastrik hasara karþý koruyucu etkisinin olup olmadýðýný araþtýrmak.
YÖNTEM ve GEREÇLER: Ratlar rastgele 6 gruba ayrýldý (n = 7). Grup 1'deki (n = 7) ratlara gavaj yoluyla 8 ml / kg salin verildi. Grup 2'deki (n = 7) ratlara, gavaj yoluyla 25 mg / kg indometasin uygulandý. Grup 3'teki (n = 7) ratlara 20 mg / kg intraperitoneal famotidin verildi. Grup 4'teki (n = 7) ratlara 40 mg / kg intraperitoneal propofol verildi. Grup 5'teki (n = 7) ratlara 40 mg / kg intraperitoneal tiyopental uygulandý.Grup 6'daki (n = 7) ratlara, intraperitoneal midazolam 10 mg / kg uygulandý. Grup 1 dýþýndaki tüm gruplarda deney ilacý verildikten 5 dakika sonra 25 mg / kg indometasin, gavaj yoluyla uygulandý. Tüm gruplara, oral indometasin uygulanmasýndan 6 saat sonra ratlar sakrifiye edildi ve gastrektomi yapýldý. Tüm numuneler fotoðraflandý. Makroskopik fotoðraflar bir bilgisayara yüklendi. Bir patolog, her mide eksizyon örneðinin fotoðrafýndaki ülser alanlarýnýn boyutunu “piksel” cinsinden ölçmek için “Olympus Stream Start” görüntü analiz yöntemini kullandý. Her bir sýçan için toplam ülser sayýsý ve toplam ülser alaný hesaplandý. Diðer gastrik doku parçalarý histopatolojik inceleme ile deðerlendirildi.
BULGULAR: Ýndometazin grubunun gastrik mukozasýnda net ülserasyon gözlendi. Araþtýrmada kullanýlan propofol, midazolam ve tiyopental iv anestezik ilaçlar, anti-ülser etkinliðine sahip olmadýðý belirlendi.
TARTIÞMA ve SONUÇ: Propofol, midazolam ve tiyopentalin, ratlarda indometazinle indüklenen gastrik hasara karþý koruyucu etkisinin olmadýðý tespit edildi.

INTRODUCTION: The peresent study was conducted to research whether the intravenous (iv) anesthetics of propofol, midazolam and thiopental have a protective effect against gastric injury induced in rats with indomethacin.
METHODS: Rats were randomly divided into 6 groups (n=7). Rats in Group 1 (n=7) had 8 ml/kg saline administered via gavage. Rats in Group 2 (n=7) were administered 25 mg/kg indomethacin via gavage. Rats in Group 3 (n=7) were given 20 mg/kg famotidine intraperitoneal. Rats in Group 4 (n=7) were given 40 mg/kg propofol intraperitoneal. Rats in Group 5 (n=7) were administered 40 mg/kg thiopental intraperitoneal. Rats in Group 6 (n=7) were administered 10 mg/kg midazolam intraperitoneal and then 5 minutes later 25 mg/kg indomethacin via gavage in all groups except Group 1. All groups were sacrificed 6 hours after administration of oral indomethacin and gastrectromy was performed. All samples were photographed. Macroscopic photographs were uploaded to a computer. A pathologist used the “Olympus Stream Start” image analysis method to measure the size of the ulcer areas on photographs of each stomach excision sample in “pixels”. The total number of ulcers and total ulcer area were calculated for each rat. Other pieces of gastric tissue were assessed with histopathological study.
RESULTS: Clear ulceration was observed in the gastric mucosa of the indomethacin group. The iv anesthetic medications of propofol, midazolam and thiopental used in the study did not have any antiulcer efficacy.
DISCUSSION AND CONCLUSION: It was determined that propofol, midazolam and thiopental had no protective effect against gastric injury induced in rats with indomethacin.

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GÝRÝÞ ve AMAÇ: Bronþiyolit, bebek ve küçük çocuklarda alt solunum yollarýný tutan ve küçük hava yollarýnda obstrüksiyonla sonuçlanan, yaygýn, akut, bulaþýcý bir hastalýktýr. Bu çalýþmada, RSV antijen tayininde epitelyum örneğinin alýnmasý için altýn standart olmasýna raðmen nazofarenks aspirasyonu yerine nazofarenks sürüntüsünün kullanýlabileceği düşünülmüştür. Her iki yöntemle alýnan örneklerin test sonuçlarýnýn karşýlaştýrýlarak, nazofarenksten sürüntüsünün aspirasyona alternatif olarak kullanýlabilirliğinin değerlendirilmesi amaçlanmýştýr.
YÖNTEM ve GEREÇLER: Hastanemiz çocuk acil birimine akut bronþiyolit, bronkopnömoni ve üst solunum yolu enfeksiyonu tablosuyla başvuran, uzun süreli yatarak tedavi gereksinimi olmadan acilden taburcu edilen veya süt çocuğu servisine yatýrýlan 1-24 ay arasýndaki 298 bebek çalýşmaya alýnmýştýr. Çalýşmaya alýnan hastalarýn her birinden hem nazofarengeal aspirasyon hem de sürüntü örnekleri alýndý. Alýnan örnekler acil laboratuvarýnda ilk 15-30 dakikada immunokromatografik yöntemle çalýşýldý. Sonuçlarýn istatistiksel değerlendirmesi Fisher’s Exact test, ki-kare testi ve Mc Nemar testleri kullanýlmýştýr. Elde edilen p değeri eğer 0.05’den küçükse sonuç anlamlý, büyükse sonuç anlamsýz olarak kabul edilmiştir.
BULGULAR: RSV sýklýğý %54 (161 olgu) olarak saptandý. En fazla RSV saptanan yaş grubu ilk 6 ay içindeki bebeklerdi. Test sonuçlarý semptomlarýn başlama zamanýna göre değerlendirildi ve hastalýğýn 2-8. günlerinde iken pozitif bulunan olgu sayýsýnýn daha fazla olduğu görüldü. Solunum yollarýndan örnekleme yöntemleri arasýnda RSV tanýsýnda altýn standart olan nazofarengeal aspirasyonun, nazofarengeal sürüntüye göre duyarlýlýğýnýn yüksek ve yalancý negatifliğinin daha düşük olduğu görüldü. Nazofaringeal aspirasyon yöntemiyle RSV olgularýnýn %45.6’sý tespit edilirken, nazofaringeal sürüntü yöntemiyle %39.6’sý tespit edildi, aralarýndaki fark anlamlýydý (p<0.05). Olgular yaş grubu ve fizik muayene bulgularýna göre değerlendirildiğinde ise, ilk 6 ay içinde olup, farenks hiperemisi mevcut olanlardan alýnan sürüntü örneklerinin duyarlýlýğýnýn daha yüksek, yalancý negatifliğinin daha düşük olduğu görüldü.
TARTIÞMA ve SONUÇ: Nazofarengeal aspirasyonla alýnan örneklerin sürüntüyle alýnan örneklere göre daha iyi sonuç verdiği çalýşmamýzda da ortaya konulmuştur. Ancak bazý özel şartlar ve klinik semptomlar varlýğýnda, nazofarenksten eküvyonla sürüntü alýnmasý yönteminin, daha travmatik bir yöntem olan aspirasyona tercih edilebileceği gösterilmiştir. Tüm yaş gruplarýnda olmasa da, özellikle farenks hiperemisi olan ilk 6 ay içindeki çocuklarda nazofarenksten eküvyonla sürüntü yöntemi nazofaringeal aspirasyon yöntemine göre üstün saptanarak uygulanabileceği kanýsýna varýlmýştýr.

INTRODUCTION: Bronchiolitis is a common, acute, contagious disease in infants and young children, which is associated with lower airway obstruction. Respiratory syncytial virus (RSV) is the main cause of viral lower respiratory tract infections in infants and children worldwide. RSV infections constitute 45-83% of all viral infections. One of the easiest and quickest methods to detect RSV is immunochromatography. Determination of the RSV antigen is frequently used in the samples taken from epithelial cells of the nose, nasopharynx or oropharynx where the virus is placed. In this study, although the aspiration of nasopharynx for the removal of the epithelium sample in RSV antigen determination is the gold standard, it was thought that nasopharyngeal swab could be used instead of nasopharyngeal aspiration to take an epithelial sample. By comparing the test results of the samples taken from both methods, we aimed to evaluate the usability of the nasopharyngeal swab as an alternative to aspiration.
METHODS: In this study, 298 infants aged between 1-24 months who were admitted to the hospital presented with acute bronchiolitis, bronchopneumonia and upper respiratory tract infection were included. Both nasopharyngeal aspiration and swab samples were taken from each patient. Immunochromatographic methods were used in the first 15-30 minutes in the emergency laboratory. Statistical analysis of the results was performed using SPSS for Windows 10.0 statistical package program. Fisher's exact test, chi-square test and Mc Nemar tests were used in the comparisons. If the obtained p-value was less than 0.05, the result is significant; if the p-value was greater than 0.05, the result is considered meaningless.
RESULTS: The frequency of RSV was 54% (161 cases). The maximum number of RSV detected was in the first six months of age. The test results were evaluated according to the time of onset of symptoms and 2-8 days were more RSV positive cases. Nasopharyngeal aspiration, which is the gold standard in the diagnosis of RSV, had a higher sensitivity and also lower false negativity than the nasopharyngeal swab. While 45.6% of RSV cases were determined by nasopharyngeal aspiration method, 39.6% of them were detected by nasopharyngeal swabs, and the difference between them was significant (p<0.05). When the cases were evaluated according to the age group and physical examination findings, within the first six months, the sensitivity of the swab samples taken from those who had pharynx hyperemia were higher, and the false negativity was lower.
DISCUSSION AND CONCLUSION: In our study, the findings suggest that the samples taken with nasopharyngeal aspiration yielded better results than the samples taken with the swab. However, in some special conditions and clinical symptoms, nasopharyngeal swabs have been shown to be preferable to aspiration which is a more traumatic method. It has been concluded that nasopharyngeal swabs can be applied superiorly to nasopharyngeal aspiration in children in the first six months of age, especially with pharynx hyperemia. Similar studies need to be performed with a higher number of cases because there is not enough study in the literature. The results obtained in our study will contribute to future studies.

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GÝRÝÞ ve AMAÇ: Bu çalýþma, annelerin, infantil kolik hakkýnda bilgi kaynaklarýný, kolik ataklarýný etkileyebilen faktörler ve davranýþsal yatýþtýrma yöntemleri hakkýndaki algýlarýný, bebeðe verilen tamamlayýcý ve alternatif bitkisel destekler hakkýndaki yaklaþýmlarýný ve ilaç tedavilerini deðerlendirmek için yapýldý.
YÖNTEM ve GEREÇLER: Bu prospektif, tanýmlayýcý kesitsel çalýþma, Yenidoðan Polikliniði’nden takip edilen 0-6 ay arasý bebeklerin anneleri ile yapýldý. Çalýþmaya gönüllü 150 anne alýndý. Çalýþmanýn 26 soruluk anket formu araþtýrmacýlar tarafýndan oluþturuldu. Anketteki sorular, katýlýmcýlara, yüz yüze soruldu.
BULGULAR: Çalýþmaya katýlan annelerin 106’sýnda (%70.7) infantil kolikli bir bebek öyküsü vardý. Annelerin, %45’i saðlýk çalýþanlarýndan, %18’i internet ve sosyal medyadan ve %13’ü aile büyüklerinden bilgi almýþtý. Kolik ataklarýný, en sýk annenin yediði yiyeceklerin, annenin kendini sýcak tutmamasýnýn, formula ile beslenmenin arttýracaðýný düþünüyorlardý. Kolik ataklarýný azaltmada en sýk baþvurulan davranýþsal yatýþtýrma yöntemleri; bebeðe masaj yapmak, banyo yaptýrmak ve karnýna ýlýtýlmýþ havlu koymak idi. Çalýþmada, annelerin 54’ü (%36) bebeklere bitki çayý verilebileceðini ve rezene çayýný (%61.3) tercih edeceklerini belirttiler. Hekimler tarafýndan en sýk verilen tedaviler probiyotik damla ve ikinci sýklýkta simetikon damla idi. Bebeklere kolik tedavisinde en sýk probiyotik damla, ikinci sýklýkta ise simetikon damla verildiði görüldü. Annelerin 59’u (%39) kolik ataklarýnýn ileride bebeðe zararý olacaðýný ve 122’si (%81,3) annenin psikolojisini bozabileceðini belirtti.
TARTIÞMA ve SONUÇ: Aileler, infantil koliðin iyi seyirli ve kendini sýnýrlayan bir durum olduðu, bebeklerine zarar vermeyeceði ve tamamlayýcý-alternatif bitkisel desteklerin yan etkileri konusunda bilgilendirilmelidir. Annelerin bebek bakýmýnda diðer aile büyükleri tarafýndan desteklenmeli, saðlýk çalýþanlarý tarafýndan motive edilmeli ve gerekli durumlarda anneler psikolojik danýþmanlýk desteði almalýdýr.

INTRODUCTION: This study aims to evaluate the sources of information of mothers about infantile colic, the factors that may affect colic attacks and their perception about behavioral soothing techniques, their attitudes regarding supplementary and alternative vegetable supplements and medicine treatments.
METHODS: This prospective, descriptive cross-sectional study was conducted with the mothers of 0-6 month old babies followed in the Newborn Policlinic. One hundred fifty volunteering mothers were included in this study. The data were collected using a questionnaire. The questionnaire in this study, including 26 questions, was prepared by the researchers. In the questionnaire, the participants were asked questions face to face.
RESULTS: The findings obtained in this study showed that 106 mothers (70,7%) had a story about an infantile colic baby. 45% of the mothers received information from health professionals, 18% from the internet and social media, 13% from family elders. They were thinking that colic attacks would increase because of the food the mothers ate due to the mothers not keeping themselves warm and formula feeding. The behavioral soothing techniques most widely used were giving a massage to the baby, washing the baby and putting a warm towel on the baby’s belly. Fifty-four mothers (36%) said that the babies could be given herbal tea and (61.3%) said that they would prefer fennel tea. The most common treatments administered by physicians were probiotic drops and simethicone drops. Fifty-nine of the mothers (39%) indicated that colic attacks would do harm to the baby in the future and 122 of them (81.3%) indicated that the same could be harmful to the mothers’ psychology.
DISCUSSION AND CONCLUSION: Parents should be informed that infantile colic is a self-limiting and benign condition, will not harm their babies. They also should be conscious of the side of supplementary and alternative vegetable supplements. The mothers should be supported by other family elders in baby-care, motivated by health professionals, and mothers should receive psychological counseling support when necessary.

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GÝRÝÞ ve AMAÇ: Bu çok merkezli kesitsel çalýþma, pediatristlerin çocuklarda meydana gelen travmatik diþ avülsiyonunun (TDA) acil müdahalesi hakkýndaki bilgi ve tutumlarýný incelemeyi amaçlamaktadýr.
YÖNTEM ve GEREÇLER: Pediatristler, web üzerinden kendi kendilerine uygulanan bir anketi doldurmaya davet edildi. Anket, konuyla ilgili daha önce mevcut anketlerde kullanýlan araçlardan uyarlanmýþ 19 sorudan oluþturuldu. Sorular, kiþisel ve mesleki profilleri, TDA’na karþý pediatristlerin tutumu ve TDA'nýn acil durum yönetimine iliþkin pediatristlerin sahip olduðu bilgilerin deðerlendirildiði üç bölüme ayrýldý. 256 katýlýmcýnýn verileri SPSS 22 kullanýlarak analiz edildi.
BULGULAR: Katýlýmcýlarýn yaklaþýk% 87,9’u kariyerleri boyunca en az bir travmatik diþ avulsiyonu vakasý ile karþýlaþtýðýný ifade etti. Pediatristlerin sadece % 6,64'ü diþ yaralanmalarý konusunda eðitim almýþtý. Katýlýmcýlarýn büyük çoðunluðu (% 89,1) diþ travmasý eðitiminin önemini vurguladý. TDA vakalarýnda, çocuk doktorlarýnýn sadece % 5,5'i diþi yeniden implante edeceklerini bildirdi. Ortalama bilgi puaný 4.88±0.55 idi. Kalýcý diþlerin yeniden yerleþtirilmesi ile süt diþleri arasýndaki fark bilgisine gelince, pediatristlerin sadece% 23,1'i doðru yanýt verdi. Kamu hastanelerinde görev yapma ve on yýl ve üzerinde mesleki deneyimi sahip olmanýn bilgi puaný üzerine anlamlý etkisi olduðu görüldü (her ikisi için de p<0.001). Avülse diþlerin saklanabilmesi için en uygun ortam olarak süt cevabýný katýlýmcýlarýn sadece % 40.42’si verebildi.
TARTIÞMA ve SONUÇ: Bu çalýþmanýn bulgularýna göre, Türkiye'deki Pediatristler arasýnda TDA hakkýndaki bilgiler düþükten orta dereceye kadar deðiþmektedir. Bu, pediatristler nezdinde TDA yönetimi konusundaki bilgilerinin geliþtirilmesi ihtiyacýný vurgulamaktadýr.

INTRODUCTION: This multicenter cross-sectional study aimed to assess the level of knowledge and attitude of pediatricians in the management of traumatic tooth avulsion (TTA) in children.
METHODS: In this study, pediatricians were invited to complete a self-administered questionnaire on the web. The survey consisted of 19 questions adapted from instruments used in previously existing questionnaires on the topic. The questions were divided into three parts: g personal and professional profiles, the attitudes of pediatricians towards TTA, and actual knowledge of the emergency management of TTA. Data from 256 respondents were analyzed using SPSS 22.
RESULTS: Approximately 87.9% of the participants reported at least one case of traumatic tooth avulsion during their careers. Only 6.64% of the subjects received education on dental injuries. The vast majority of participants (89.1%) stressed the importance of dental trauma education. In cases of tooth avulsion, only 5.5% of the pediatricians reported that they would reimplant it. The mean knowledge score was 4.88±0.55. Regarding the knowledge of the difference between reimplanting permanent teeth and primary teeth, only 23.1% of pediatricians responded correctly. Working in public hospitals and having ten years or more professional experience had a significant effect on knowledge score (for both p<0.001). Only 40.42% of the participants were able to give milk response as the most suitable storage media for avulsed teeth.
DISCUSSION AND CONCLUSION: Based on the findings of this study, knowledge of avulsed teeth among Pediatricians in Turkey ranges from low to moderate, which highlights the need to improve the knowledge of the management of traumatic dental injuries among pediatricians.

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GÝRÝÞ ve AMAÇ: Bu çalýþmada direkçli fokal epilepsisi olan çocuklarda Lakozamid (LCM) tedavisinin etkinliði, tolere edilebilirliði ve yan etkilerinin araþtýrýlmasý amaçlanmýþtýr.
YÖNTEM ve GEREÇLER: Ýlaca dirençli fokal epilepsisi olan16 yaþýndan küçük çocuklar çalýþmaya dahil edildi. Üç ayda bir týbbi kayýtlar ve nöbet günlükleri incelendi. LCM’ye yanýt nöbet sýklýðýnda ≥50% azalma olarak tanýmlandý.
BULGULAR: Ýlaca dirençli fokal epilepsisi olan 25 çocuðun tedavisine LCM eklendi. Ortalama epilepsi süresi 5.2 yýl ve LCM baþlama yaþý ortalama 8 yaþtý. LCM tedavisine yanýt oraný 3., 6. ve 9. aylarda sýrasýyla %44, %64, %76 idi. Onikinci ayýn sonunda cevap oraný %84 idi ve hastalarýn %16’sýnda nöbet yoktu. Dört hastada yan etki geliþti; üç hastada LCM tedavisi sonlandýrýldý ve bir hastada doz azaltýldýðýnda yan etki düzeldi.
TARTIÞMA ve SONUÇ: LCM, dirençli fokal epilepsisi olan çocuklar için etkili bir antiepileptik ilaçtýr. Nöbet sýklýðýný zamanla azaltýr. Ýyi tolere edilir ve bu hastalarda umut verici bir seçenektir.

INTRODUCTION: This study aimed to assess the efficacy, tolerability and adverse effects of Lacosamide (LCM) in children with refractory focal epilepsy.
METHODS: Children aged younger than 16 years with drug-resistant focal epilepsy were enrolled. The medical records and seizure diaries that were evaluated every three months were reviewed. Response to LCM was defined as ≥50% reduction in seizure frequency.
RESULTS: Twenty-five children with drug-resistant focal epilepsy received LCM as add-on therapy. The mean duration of epilepsy was 5.2 years and the mean age at LCM initiation was 8 years. The rate of response to LCM treatment in the 3th, 6th and 9th months were 44%, 64%, 76%, respectively. At the end of 12 months, the response rate was 84% and 16% of the patients were seizure free. Four patients had adverse effects; three patients were discontinued LCM and one improved after decreasing the dose of the drug.
DISCUSSION AND CONCLUSION: LCM is an effective add-on antiepileptic drug for children with refractory focal epilepsy. It diminishes the frequency of seizures over time. It is well tolerated and a promising option in these patients.

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GÝRÝÞ ve AMAÇ: Ergenlik, maddeleri deneme açýsýndan en riskli dönem kabul edilir. Bu çalýþmanýn amacý Edirne il merkezindeki tüm lise öðrencilerinde psikoaktif madde kullaným oranlarýný belirlemektir.
YÖNTEM ve GEREÇLER: Bu kesitsel çalýþma, 8,483 öðrenciyle gerçekleþtirilmiþtir. Kullanýlan anket, “Avrupa Alkol ve Diðer Maddeler Okul Araþtýrma Projesi” anketlerinden derlenmiþtir. Hayat boyu madde kullanýmlarý, madde tercihlerinde cinsiyet farklýlýklarý, öðrencilerin sorunlu davranýþlarý ve bunlarýn madde kullaným oranlarýna etkileri, madde kullanma nedenleri, madde kullanýlan yerler ve temin kaynaklarý, kullanýcý arkadaþ ve akrabalarýn kullaným oranlarýna etkileri deðerlendirilmiþtir.
BULGULAR: Yaþlarý 15-19 arasý olan, %53,0’ýný kýzlarýn oluþturduðu 8402 öðrenci anketi tamamladý. Alkol en sýk kullanýlan madde (%24,6) iken, onu tütün (%21,5) ve esrar (%1) izledi. Diðer madde kullaným sýklýklarý %1’in altýnda kaldý. Tütün, alkol, esrar, ekstazi, uçucular ve kokain kullanýmý erkeklerde anlamlý olarak daha yüksek saptandý. Sorunlu davranýþlar bazý maddelerin kullaným sýklýðýnda artýþ ile iliþkiliydi. Madde kullanan arkadaþlar, hem madde kullanýmýnýn ana nedeni hem de ana madde teminatý kaynaðýydýlar. Öðrencilerin madde kullandýklarý baþlýca yer sokaklar olarak bulundu.
TARTIÞMA ve SONUÇ: Edirne’deki lise öðrencilerinin psikoaktif madde kullanýmlarý dünyadaki çoðu yerden daha az sýklýkta olsa da, öðrencilerin sorunlu davranýþlarý ve risk faktörleri benzerlik göstermektedir.

INTRODUCTION: Adolescence is considered to be the most risky period for experimenting with harmful substances. This study aims to determine the psychoactive substance consumption rates among all of the high school students in city center of Edirne, Turkey.
METHODS: This cross-sectional study was conducted with 8.483 high school students. The survey form used in the present study was compiled from questionnaires used in “The European School Survey Project on Alcohol and Other Drugs” study. Overall lifetime substance use, gender differences in substance preferences, students’ problematic behaviors and their effects on the substance use ratios, reasons for substance usage, locations where the students use the substances and sources where the substances were obtained, how the substance use ratios were affected by user friends and relatives were the covered objects.
RESULTS: A total of 8402 school students aged 15-19 years completed the questionnaire, 53.0 % of which were females. Alcohol was the most common substance used (24.6%), followed by tobacco (21.5%) and cannabis (1%). Frequency of other substances remained under 1%. Tobacco, alcohol, cannabis, ecstasy, inhalants, and cocaine usage were significantly higher in males. Having problematic behaviours were associated with the rise in substances usage. User friends were both the main reason of usage and the supplier of the substances. The main location where the students use substances were the streets.
DISCUSSION AND CONCLUSION: Although frequencies of psychoactive substance usage among high school students of Edirne were found to be lower than most of the other locations all around the world, students’ problematic behaviours and risk factors were similar.

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GÝRÝÞ ve AMAÇ: Kliniðimizde akut divertikülit nedeniyle tedavi edilen olgularýn demografik verileri, tedavi yaklaþýmlarý ve sonuçlarý irdelenmiþtir.
YÖNTEM ve GEREÇLER: Tedavi edilen 85 hastanýn verileri retrospektif olarak incelendi.
BULGULAR: : Ortalama yaþ 50,49±13,22 olup, 51 olgu kadýn ve 34 erkek idi.VKÝ ortalamasý 29,26±5,86 idi. Olgularýn tamamýnda karýn aðrýsý vardý. Olgularýn 83' ünde sol alt kadran aðrýsý, 2 ‘sinde sað alt kadran aðrýsý, 55'inde bulantý kusma þikayeti, 39’ unda da ateþ mevuttu. Ortalama CRP deðerlerine göre (128,85) deðerlendirildiðinde, CRP yüksek olgularda yatýþ günü anlamlý oranda uzundu (p=0,042).
Olgular BT bulgularýna göre 4 gruba ayrýldýlar. Evre 1A VE 1B ‘de medikal tedavi uygulanýrken, Evre 2 grubundaki olgulara radyolojik perkutan drenaj uygulandý. Evre 3 grubundaki 2 olguya cerrahi drenaj, 3 olguya da Hartman prosedürü uygulandý. Hartman prosedürü uygulanan olgulardan ikisinde yara yeri enfeksiyonu geliþti. Evre 4’ deki olguya da Hartman prosedürü uygulandý. Ortalama yatýþ süreleri, Evre 1A; 5,27±2,47, evre 1B; 8,3±2,49, Evre 2; 16±9,89, Evre 3; 9,2±3,70, Evre 4; 6 gün idi.

TARTIÞMA ve SONUÇ: Divertikülitlerin tedavisinde erken evrelerde antibiyotikler birinci tedavi seçeneði olarak önemini korurken, batýn içi lokalize abselerde radyoloji rehberliðinde drenaj ön plana çýkmaktadýr. Cerrahi uygulamalarýnda ise Hartman prosedürü hala önemli bir seçenek olarak durmaktadýr

INTRODUCTION: The present study aims to evaluate the patients treated in our clinic for acute Diverticulitis and to review the treatment options.
METHODS: In this study, demographic data, treatment approaches and results of cases treated for acute diverticulitis in our clinic were examined and the records of 85 patients were retrospectively analyzed.
RESULTS: The average age was 50.49±13.22, and 51 cases were female and 34 were male. The BMI average was 29.26±5.86. There was abdominal pain in all cases and 83 presented with left lower quadrant pain, while two had right lower quadrant pain. In 55 cases, nausea and vomiting were noted, and in 39 cases, fever was present. When evaluated according to average CRP values (128.85), in patients with high CRP, the hospital's hospitalization day was significantly longer (p=0.042). Medical treatment was applied in Stage 1A and 1B, while radiological percutaneous drainage was applied to patients in stage 2 group. Surgical drainage was performed in two patients in stage 3 group, and Hartmann’s procedure was performed on three patients. The case in Stage 4 was also performed on the Hartmann’s procedure.
DISCUSSION AND CONCLUSION: In the treatment of diverticulitis, especially in the early stages, antibiotics remain the first option, while radiology-guided drainage was preferred for localized abscesses. In surgical applications, the Hartmann’s procedure still an important procedure.

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GÝRÝÞ ve AMAÇ: Bu çalýþmadan amacýmýz, ampirik tedaviye yol gösterici olmasý için, hastanemizdeki dolaþým yolu enfeksiyonlarýndan izole edilen mikroorganizmalarýn kümülatif antibiyogram sonuçlarýný irdelemektir.
YÖNTEM ve GEREÇLER: Ocak 2017-Eylül 2018 tarihleri arasýnda, laboratuvarýmýza gönderilen kan kültürü örnekleri, BACT-ALERT 3D (Biomerieux- Fransa) sisteminde inkübe edilmiþtir. Üreyen mikroorganizmalar, konvansiyonel yöntemler ve MALDI-TOF MS ile tanýmlanmasý, ve VITEK-2 otomatik identifikasyon sistemi ile antibiyotik duyarlýlýk testleri yapýlmýþtýr. Kümülatif antibiyogram verileri Clinical Laboratory Standards Institiute (CLSI) M39- A4 önerileri doðrultusunda analiz edilmiþtir. Çalýþmamýz için gerekli olan bilgiler hastanemiz veri sisteminden alýnmýþtýr. Ampirik tedavi için kümülatif antibiyotik duyarlýlýk sýnýrý >%90 olarak kabul edilmiþtir.
BULGULAR: Toplam 969 adet mikroorganizma analiz edilmiþtir. Enterococcus izolatlarýnda vankomisin, teikoplanin, linezolid ve tigesiklin, ve Staphylococcus aureus izolatlarýnda ise bu antibiyotiklere ek olarak daptomisin etkili bulunmuþtur.
Escherichia coli izolatlarýna karþý karbapenem grubu antibiyotikler ve tigesiklin ampirik tedavi amacýyla kullanýmý uygun bulunurken, Klebsiella pneumoniae izolatlarýna karþý etkili bulunmamýþtýr. Bununla birlikte diðer Enterobacteriales üyeleri için sadece amikasin ampirik tedaviye uygun bulunurken, non-fermentatif Gram negatif çomaklardan Pseudomonas aeruginosa ve Acinetobacter baumannii enfeksiyonlarý için ampirik tedaviye uygun bir antibiyotik bulunmamýþtýr.
Candida albicans test edilen tüm antifungallere duyarlý bulunurken, C.albicans dýþý kandidalar için amfoterisin B, mikafungin ve kaspofungin ampirik tedaviye uygun bulunmuþtur.

TARTIÞMA ve SONUÇ: Ampirik tedavi için Gram negatif çomak grubu bakteriler söz konusu olduðunda seçeneðin çok sýnýrlý olduðu gözlenmiþtir. Enfeksiyon kontrol komitesi eðitim programlarý ve süreçlerin sýký takibiyle antibiyotik direnç oranlarýnýn iyileþtirilebileceði kanýsýndayýz.

INTRODUCTION: In this study, we aimed to investigate cumulative antibiogram results of microorganisms isolated from bloodstream infections of patients admitted to our hospital to provide a guideline for the empirical treatment.
METHODS: The blood culture samples sent to our laboratory between January 2017 and September 2018 were incubated in BACT-ALERT 3D (bioMerieux- France) system. The microorganisms were identified with conventional methods and MALDI-TOF MS (bioMerieux- France), and the antibiotic susceptibility test was performed with VITEK-2 (bioMerieux- France) automated systems. The cumulative antibiogram data were analyzed according to Clinical and Laboratory Standards Institute M39-A4 criteria. Data analysed for our study were retrieved from our hospital information system. The cumulative antibiotic sensitivity limit for empirical treatment was considered to be at a level >90%.
RESULTS: In this study, 969 isolates were analysed. Vancomycin, teicoplanin, linezolid, and tigecycline were effective in Enterococcus species. In addition to these antibiotics, daptomycin was evaluated to be effective against Staphylococcus aureus. Carbapenems and tigecycline were effective in Escherichia coli isolates, and they can be used as empiric antibiotics but not against Klebsiella pneumoniae isolates. Amikacin was effective against other bacteria in Enterobacteriaceae members. However, no appropriate antibiotic was detected to be effective for the empirical treatment of non-fermentative Gram-negative rods, including Pseudomonas aeruginosa and Acinetobacter baumannii infections. Candida albicans was sensitive to all antifungal agents. Amphotericin B, micafungin and caspofungin were appropriate for empirical treatment of other Candida species.
DISCUSSION AND CONCLUSION: Empirical treatment options for Gram-negative rods are highly limited and we believe that training programmes scheduled by the infection control committee and close monitoring of the associated processes will improve and decrease antibiotic resistance rates.

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GÝRÝÞ ve AMAÇ: Oral laktüloz solüsyonu ile elde edilen BT enterografinin preoperatif dönemde kolorektal kanser TNM evrelemesinde etkinliðini araþtýrmayý amaçladýk.
YÖNTEM ve GEREÇLER: Çalýþmada yaþlarý 28 ile 86 arasýnda deðiþen (ortalama 63.4) 37 erkek (%66) ve 19 kadýn (%44) olmak üzere toplam 56 kolorektal kanserli olgunun abdominal BT enterografi (BTE) incelemeleri geriye dönük olarak deðerlendirildi. BTE görüntüleri baðýmsýz 2 radyolog tarafýndan deðerlendirildi ve uyumsuzluk olan olgular konsensus ile çözümlendi. BTE bulgularý cerrahi rezeksiyon sonrasý histopatolojik verilerle kýyaslandý. TNM evrelemesine göre sensitivite, spesifisite, pozitif prediktif deðer, negatif prediktif deðer ve doðruluk oranlarý hesaplandý.
BULGULAR: Kolorektal kanserlerde BT enterografi tekniðinin genel doðruluk oraný T evrelemesi için %87.5 (49/56) olarak tespit edildi. 2 olguda olduðundan fazla, 5 olguda olduðundan düþük evreleme yapýldý. N evrelemesi için genel doðruluk oraný %76.8 (46/56) olarak tespit edildi. 5 olguda olduðundan fazla, 8 olguda olduðundan düþük evreleme yapýldý.
TARTIÞMA ve SONUÇ: Laktüloz solüsyonuyla elde edilen BT enterografi, kolorektal kanser preoperatif dönem TNM evrelemesinde yararlý bir teknik olarak kullanýlabilir.

INTRODUCTION: In this study, we aimed to investigate the efficacy of computed tomographic enterography (CTE) with oral lactulose solution for preoperative staging of colorectal cancer.
METHODS: Abdominal CTE examinations of 56 consecutive patients (37 men [66%] and 19 women [44%] with a mean age of 63.4 years and age range of 28–86 years) with colorectal carcinoma were retrospectively included in this study. The CTE images were independently evaluated by two radiologists. Disagreements were resolved by consensus. CTE findings were compared with pathologic results as the reference standard. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy rate of TNM staging were calculated.
RESULTS: The overall accuracy of CTE for the T stage was 87.5% (49 of 56 patients). Overstaging and understaging occurred in two and five of 56 patients, respectively. The overall accuracy of the assessment of lymph node involvement CTE images was 76.8% (46 of 56 patients). Over and understaging occurred in five of 56 patients and eight of 56 patients, respectively.
DISCUSSION AND CONCLUSION: CTE with oral lactulose solution can be used as a useful technique for preoperative TNM staging of colorectal cancers.

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GÝRÝÞ ve AMAÇ: Böbrek biyopsisi renal parenkim hastalýklarýnýn sebebi, yaygýnlýðý ve bazen de tedaviye cevabýnýn deðerlendirilmesinde sýklýkla baþvurulan bir yöntemdir. Bu çalýþmamýzda merkezimizde 10 yýl boyunca yapýlan böbrek biyopsi incelemelerinin klinikopatolojik özelliklerini deðerlendirdik.

YÖNTEM ve GEREÇLER: Haydarpaþa Numune Eðitim ve Araþtýrma Hastanesi' nde 2005-2014 yýllarý arasýnda eriþkin yaþ grubunda yapýlan 532 nativ böbrek biyopsisi retrospektif olarak deðerlendirildi. Bütün biyopsi örnekleri ayný patolog ve ayný laboratuarda ýþýk mikroskopisi ve immünfloresan yöntemleri ile incelendi.
BULGULAR: Olgularýn ortalama yaþý 41.3±12.8 yýl (18-65 yýl), erkek cinsiyet %52.3 (n: 278) olarak hesaplandý. Primer ve sekonder glomerülonefritler için en sýk böbrek biyopsi endikasyonu nefrotik düzeyde proteinüriydi. En sýk histopatolojik tanýlar, primer glomerülonefritlerde fokal segmental glomerüloskleroz, sekonder glomerülonefritlerden diyabetik nefropati olarak saptandý.
TARTIÞMA ve SONUÇ: Merkezimizin 10 yýllýk böbrek biyopsi serisinin deðerlendirilmesi sonucunda genelde ulusal ve uluslararasý literatürle uyumlu sonuçlar elde edilmiþtir. Hem yerel merkezlerde hem de ulusal ölçekte böbrek biyopsi veri tabanlarýnýn oluþturulmasý böbrek hastalýklarýnýn deðerlendirilmesinde yol gösterici olmaktadýr.

INTRODUCTION: Kidney biopsy is a frequent method of assessing the cause, extent and sometimes the appropriate treatment response of renal parenchymal diseases. In this study, we evaluated the clinicopathologic features of kidney biopsy examinations performed in our center for 10 years.
METHODS: A total of 532 native kidney biopsies performed in the adult age group between the years 2005-2014 in Haydarpaþa Training and Research Hospital were evaluated retrospectively. All biopsy specimens were examined by light microscopy and immunofluorescence by the same pathologist in the same laboratory.
RESULTS: The mean age of the cases was 41.3±12.8 years (18-65 years) and the percentage of males was 52.3% (n=278). The most frequent biopsy indication for primary and secondary glomerulonephritis was nephrotic-range proteinuria. The most frequent histopathologic diagnoses were focal segmental glomerulosclerosis among primary glomerulonephritis and diabetic nephropathy among secondary glomerulonephritis.
DISCUSSION AND CONCLUSION: As a result of the evaluation of 10-year kidney biopsy series at our center, results which are in general compatible with the national and international literature have been obtained. We concluded that establishment of kidney biopsy databases both at local centers and at national scales would be beneficial in the evaluation of kidney diseases.

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GÝRÝÞ ve AMAÇ: Yüksek riskli prostat kanseri tedavisinde radikal prostatektomi (RP) ile radyoterapi (RT) ve androjen deprivasyon tedavisi (ADT) sonuçlarýný karþýlaþtýrmayý amaçladýk.
YÖNTEM ve GEREÇLER: Nisan 2010-Mayýs 2018 tarihleri arasýnda yüksek riskli prostat kanseri nedeniyle RT ve ADT veya radikal prostatektomi ile tedavi edilen 83 hasta çalýþmaya dahil edilerek hastalarýn verileri retrospektif olarak analiz edildi. 40 hastaya RT ve ADT kombinasyon tedavisi uygulanýrken, 43 hastaya RP uygulandý. Gruplar tedavi öncesi genel özellikler, tedavi sonrasý biyokimyasal nüks, metastaz, hastalýksýz saðkalým ve genel saðkalým açýsýndan karþýlaþtýrýldý.
BULGULAR: Hastalarýn ortalama yaþý cerrahi grubunda 64.05 (50-74), RT grubunda 69.35 (49-79) idi. Ortalama PSA baþlangýç deðeri, cerrahi grupta 22.79 (3-93) ng / ml ve RT grubunda 40.60 (3-201) ng / ml idi.Cerrahi grubunda 15 (% 34.8) hastada ve RT grubunda 2 (% 5) hastada biyokimyasal nüks görüldü. Hastalýksýz saðkalým süresi cerrahi grubunda 31.12 (12-68) ay ve RT grubunda 41.4 (16-88) ay olarak hesaplandý.
TARTIÞMA ve SONUÇ: Çalýþma sonuçlarýmýz, RT ve ADT uygulamasýnýn, birçok çalýþmada olduðu gibi, yüksek riskli prostat kanseri tedavisinde daha avantajlý onkolojik sonuçlara sahip olduðunu göstermiþtir.

INTRODUCTION: We aimed to compare the outcomes of high risk prostate cancer treatments with radical prostatectomy (RP) or radiotherapy (RT) and androgen deprivation therapy (ADT).
METHODS: 83 patients who were treated with RT and ADT or radical prostatectomy for high risk prostate cancer between April 2010 and May 2018 and whose data were retrospectively analyzed were included in our study. While 40 patients received RT and ADT combination therapy, 43 patients received RP. The groups were compared in terms of pre-treatment general features, post-treatment biochemical recurrence, metastasis, disease-free survival and overall survival.
RESULTS: The mean age of the patients was 64.05 (50-74) years in the surgical group and 69.35 (49-79) years in the RT group. The mean prostate-specific antigen baseline value was 22.79 (3-93) ng/ml in the surgical group and 40.60 (3-201) ng/ml in the RT group. Biochemical recurrence was observed in 15 (34.8%) patients in the surgical group and 2 (5%) patients in the RT group. Disease-free survival time was 31.12 (12-68) months in the surgical group and 41.4 (16-88) months in the RT group.
DISCUSSION AND CONCLUSION: Our study results revealed that RT and ADT application has more advantageous oncological results in the treatment of high-risk prostate cancer, as in many studies.

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GÝRÝÞ ve AMAÇ: Gebelik süreci sýrasýnda artan steroid hormonlarýn etkisi ile bilier lipid metabolizmasý ile safra kesesi fonksiyonunda önemli deðiþiklikler olur ve bu da litojenik safra oluþumunu kolaylaþtýrýr.Çalýþmanýn amacý, farklý paritelerdeki ve farklý trimesterlerdeki saðlýklý gebeler ile gebe olmayan saðlýklý kontrol grubunun kese fonksiyonunu deðerlendirerek, iki grup arasýndaki farký araþtýrmak ve artan gebelik sayýsýnýn safra kesesi motilitesine etkilerini ortaya koymaktý.
YÖNTEM ve GEREÇLER: Çalýþmanýn hasta grubu, saðlýklý ve gönüllü 50 gebe kadýndan oluþturulurken, kontrol grubu 20 saðlýklý gebe olmayan kadýndan oluþturuldu. Her iki gruptaki olgularýn yaþ, gebelik haftasý, gebelik sayýsý kriterleri sorgulandý. Yöntem olarak 8 saatlik açlýk sonrasýnda sonografik olarak olgularýn safra kesesi volümleri ölçüldü ve 80 gr. çikolata yedikten sonra 45. dakikada safra kesesi tokluk volümü ölçümü yapýldý. Elde edilen açlýk volümü (AV), tokluk volümü(TV) ve kese ejeksiyon fraksiyonlarý(EF) hesaplandý. EF: (1-TV/AV) x 100.
BULGULAR: Gebe grubundan trimesterler arasýnda AV ve TV ortalamalarý açýsýndan incelendiðinde, 3. trimester ortalama deðerleri diðer iki gruptan anlamlý düzeyde farklý olduðu saptanmýþtýr( p<0,001). EF ortalama deðerleri açýsýndan 1.ve 3. trimesterler arasýndaki fark anlamlý bulunmuþtur(p<0,05). Ayný paritedeki gebe ve kontrol gruplarý arasýnda AV, TV ve EF ortalama deðerleri incelendiðinde sadece TV deðerleri açýsýndan, tek pariteli gebelerden elde edilenler ile diðer gruplar arasýnda anlamlý fark saptanmýþtýr.


TARTIÞMA ve SONUÇ: Gebelerde safra kesesi motilitesi ile ilgili yapýlan çalýþmalarda, genel olarak AV, TV ortalama deðerlerinin gebeliðin geç dönemlerinde iki katýna çýktýðýný bildirilmiþtir. Bu çalýþmada da benzer þekilde AV ortalama deðerleri 3. trimesterde 1. trimesterin yaklaþýk iki katýna, TV ortalama deðerleri üç katýna ulaþmakta, EF ortalama deðerleri ise 3.trimesterde 1.trimester ortalamasýnýn yarýsý kadar azalmaktadýr. Bu sonuç, son trimesterde safra kesesi yetersiz ekskresyonunun belirginleþtiðini desteklemektedir.
Sonuç:
Gebelikte sýklýðý artan safra kesesi patolojilerinin ortaya çýkýþýndan sorumlu tutulan kese disfonksiyonunun, son trimesterde oldukça belirginleþtiði ve ilk gebeliðin, diðerlerine göre gebeliðe baðlý geliþen hormonal deðiþimden daha fazla etkilendiði sonucuna ulaþýlmýþtýr.

INTRODUCTION: The hormonal changes that occur during the pregnancy increase the risk of developing gallstones. The impact of placental steroid hormones such as elevated estradiol (E2) and progesterone (PGN) continuously affect the biliary lipid storage and gallbladder activity in safe pregnant women. Gallbladder bile quantities of biliary cholesterol begin to increase from the first trimester to the third trimester of pregnancy, along with a steady increase in biliary sludge and gallstone occurrence. Ultrasound is a widely used method of imaging, and has the advantage of being safe for the pregnants. It is generally considered as the first line for gallbladder disease assessment. The study aimed to reveal whether there was a difference in motility marker values such as Fasting Volume (FV), Postprandial Volume (PPV), and Ejection Fraction (EF) between trimesters with the effect of changing steroid hormones. These parameters were also compared between groups of pregnant and non-pregnant people, considering gestation numbers.
METHODS: The patient group consists of 50 pregnant women who applied to the gynecology and obstetrics clinic at our hospital. 20 healthy non-pregnant women constituting the control group were also included in the present study. The age and parity of the cases were included in the study. The trimesters of the pregnancies were also recorded for the pregnant group. After the fasting on the day of the examination, gallbladder volumes of the patients were measured. After feeding for 45 minutes, gallbladder postprandial volume measurements were obtained. The gallbladder ejection fractions were calculated using these values (EF: [FV-PPV]×100/[FV]).
RESULTS: When the PPV mean values between the trimesters were observed, significant difference was not found between the 1st and 2nd trimesters (p>0.05) moreover significant difference was found between the 1st and 3rd trimesters and the 2nd and 3rd trimesters (p<0.001).
In the analysis made in terms of EF values, obtained from the pregnant group, the difference between the trimesters was found significant (p<0.05). In terms of EF mean values, any significant difference was not found between 1st and 2nd the trimesters and 2nd and 3rd trimester (p>0.05),but the difference between 1st and 3rd trimesters were found to be significant with the decrease of EF values in 3rd trimester (p<0.05). When comparing control group’s mean FV, PPV, and EF valuesto the pregnant women in the 3rd trimester consideringmean FV, TV and EF values, the difference was found to be statistically significant (p<0.001). However, a significant difference between the pregnant and control group was found when examining PPV values (p<0.05).
DISCUSSION AND CONCLUSION: Pregnancy is considered predisposing for gallbladder pathologies, because of the development of the bile stasis depending on insufficient bile excretion and changed bile content especially due to increased PGN and E2 hormone levels in the late period of pregnancy.
When the mean values obtained from the 3rd trimester pregnant women and the mean values of the control group were compared, the increase in FV and PPV and the decrease in EF were at statistically significant levels (p<0.001). These findings are expected results due to increases in PGN and E2 serum levels in the last trimester of pregnancy. In this study, there was a significant difference in PPV mean values of only nulliparous ones compared to the other groups (p<0.005), while no significant difference was found between the multiparity groups in terms of EF, FV, and PPV mean values.
When the pregnant group and control groups in the same parity were compared in terms of PPV mean values, the values of the pregnant group were significantly higher in the group with parity 1, compared to the values belonging to the control group. This result is an outcome of the negative effect of the first pregnancy forming bile stasis which is much higher than the following pregnancies.
It was concluded that the gallbladder dysfunction, which is held responsible for the emergence of gallbladder pathologies, the frequency of which increases in pregnancy, becomes more pronounced in the last trimester and in the first pregnancy the women are affected by hormonal changes more than following pregnancies.

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GÝRÝÞ ve AMAÇ: Çalýþmamýzda hastanemizde takip-tedavi edilen hastalarýn kan kültürlerinden izole edilen Pseudomonas spp. ve Acinetobacter spp.’lerin yýllar içindeki sýklýklarýnýn daðýlýmlarý ve antibiyotik direnç oranlarý ve yýllar içinde gözlenen deðiþimin artan veya azalan bir eðilim gösterip-göstermediðinin deðerlendirilmesi amaçlandý.


YÖNTEM ve GEREÇLER: 1 Ocak 2013 - 1 Kasým 2019 tarihleri arasýnda hastanemizde yatan hastalardan alýnan ve hastanemiz Mikrobiyoloji Laboratuvarý tarafýndan kabul edilen kan kültürlerinin sonuçlarý retrospektif olarak tarandý. Otomatize kan kültürü sistemi, BACTEC FX (Becton–Dickinson, USA) kullanýldý. Þuslarýn bakteri identifasyonu ve antibiyotik duyarlýlýklarý VITEK MS MALDI-TOF (bioMérieux, USA) ve VITEK® 2 Compac otomatize sistemi (Biomerieux, Fransa) kullanýlarak yapýldý.
BULGULAR: Toplam 21.367 kan kültürünün % 20,5'inde bakteri üremesi tespit edildi. Çalýþma grubu kan kültüründe üreme saptananlarýn (n=263, %5,9) Pseudomonas spp. ve (n=254, %5,7) Acinetobacter spp. idi. Yýllarý içinde, kan kültüründe Pseudomonas spp. üreme sýklýklarýnda anlamlý bir eðilim yoktu (p=0,2). Buna karþýlýk Acinetobacter spp. yýllar içinde azalan bir deðiþim gösterdi (p=0,004). Acinetobacter spp.’nin tigesikline olan direnç oranlarýnda yýllar içinde artan bir eðilim saptandý (p=0,0005). Pseudomonas suþlarý seftazidim ve amikasine karþý yýllar içinde direnç oranlarý azalan bir eðilim gözlendi (sýrasýyla p=0,01 ve p=0,04).
TARTIÞMA ve SONUÇ: Gram-negatif bakteriler arasýnda çoklu ilaç direnci giderek artan bir sorundur. Özellikle Acinetobacter ve Pseudomonas cinsi bakteri infeksiyonlarýnda olasý direnç durumunu tahmin etmek son derece zordur. Bu nedenle lokal ve ulusal ölçekte çalýþmalarýn yapýlarak empirik tedavi seçeneklerinin belirlenmesi gerektiði kanýsýndayýz.

INTRODUCTION: In this study, we aimed to investigate the changes in the frequencies and antibiotic susceptibilities of Pseudomonas spp and Acinetobacter spp isolated from blood cultures in our hospital.
METHODS: Results of blood cultures, which were obtained from inpatients of our hospital and accepted by our microbiology laboratory between January 1st, 2013 and November 1st, 2019, were retrospectively searched. Automated blood culture system BACTEC FX (Becton–Dickinson, USA) was used. Identification and susceptibility tests of the strains were made using VITEK MS MALDI-TOF (bioMérieux, USA) and VITEK® 2 Compac automated system; (Biomerieux, French).
RESULTS: Bacterial growth was detected in 20.5% of the total 21,367 blood cultures. Of the positive cultures, 263 (5.9%) were Pseudomonas spp. and 254 (5.7%) were Acinetobacter spp. The frequency of Pseudomonas spp. in the blood cultures over the years did not change (p=0.2), whereas the frequency of Acinetobacter spp decreased (p=0.004). Tigecycline resistance of Acinetobacter spp increased over the years (p=0.0005). However, ceftazidime and amikacin resistance of Pseudomonas spp decreased over the years (p=0.01 and p=0.04, respectively).
DISCUSSION AND CONCLUSION: Multidrug resistance among Gram-negative bacteria is an increasing problem. Estimating the probable resistance pattern of especially Acinetobacter and Pseudomonas infections is difficult. Thus, in our opinion, empirical treatment strategies should be defined by local and national studies.

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GÝRÝÞ ve AMAÇ: Bu çalýþmanýn amacý, medikal tedaviye yanýt vermeyen inatçý peptic ülser hastalýðýnda uyguladýðýmýz elektif bilateral trunkal vagotomi (BTV), gastrojejunostomi (GJ) ve Braun (B) anastomozu tekniðinin sonuçlarýný deðerlendirmektir.
YÖNTEM ve GEREÇLER: içerisinde elektif cerrahi (BTV+uzun urve GJ+B) uygulanan 32 hastanýn demografik verileri, cerrahi indikasyonlar (intraktabilite, stenoz, refrakter kanama), kullanýlan teþhis yöntemleri (Baryumlu grafi, üst gastrointestinal endoskopi), ülser lokalizayonu, erken ve geç dönem postoperative komplikasyonlar, hastanede kalýþ süreleri retrospektif olarak incelendi.
BULGULAR: Yaþ ortalamasý 47 (aralýk, 29-73) idi. Hastalarýn 3 ü (%9) hariç hepsi erkek (%91) ti.Ülserin en sýk görüldüðü yer duodenum ön duvar olarak tespit edildi (64.6%). Medikal tedaviye direnç, sürekli semptom veren inatçý ülser (intraktabilite, % 34.4) ve pilor stenozu (31.3%) en sýk cerrahi endikasyonlarý oluþturmakta idi. Erken dönem postoperatif komlikasyonlar; cerrahi alan infeksiyonlarý (6.6%), gecikmiþ mide boþalýmý (3.3%) ve atalektazi (3.3%) olurken tüm hastalar postoperatif 5. ve 10. günler arasýnda taburcu edildiler. Ortalama 20 ay (aralýk, 12-30) takip sürecinde midede dolgunluk hissi, epizodik diare ve Dumping sendromu (sýrasýyla, %15.3, %11.5 ve % 7.7) geç dönemde en sýk görülen komplikasyonlar arasýndaydý. Mortalite görülmedi.
TARTIÞMA ve SONUÇ: Günümüzde modern anti-ülser tedavilerin kullanma girmesiyle ülser cerrahisi oldukça az ugulanmakla birlikte, medikal tedaviye dirençli inatçý ülserlerde BTV+GJ+B prosedürü güvenle ugulanabilir.

INTRODUCTION: The present study aims to evaluate the results of bilateral truncal vagotomy (BTV), gastrojejunostomy (GJ) and Braun (B) anastomosis technique, which has been used in our patients with intractable peptic ulcer.
METHODS: Demographics, indications of surgery (intractability, stenosis, refractory bleeding), diagnostic methods used (barium X-ray, upper gastrointestinal endoscopy), localization of ulcer, early and late postoperative complications, hospitalization period and mortality parameters of 32 patients, who underwent elective surgery (BTV+GJ with long afferent and efferent loops+B) in a two-year period, were retrospectively evaluated in this study.
RESULTS: The mean age was 47 years (range, 29-73), and all of them were male (91%) except three patients (9%). The most common localization of ulcers was the first part of the duodenum at anterior wall (64.6%). Resistance to the medical treatment and persistent symptoms (intractability, 34.4%) and pyloric stenosis (31.3%) were the most common indications for surgery. Early postoperative complications were surgical site infections (6.6%), delayed gastric emptying (3.3%) and atelectasis (3.3%). All patients were discharged home between the 5th and 10th postoperative days. Gastric dullness, episodic diarrhea and Dumping syndrome (15.3%, 11.5% and 7.7%, respectively) were among the commonest late postoperative complications in a mean of 20 months follow-up period (range, 12-30). There was no mortality.
DISCUSSION AND CONCLUSION: Although ulcer surgery is rarely performed today, after introduction of modern anti-ulcer medications, we think that the BTV+GJ+B procedure can be applied safely in intractable cases.

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GÝRÝÞ ve AMAÇ: Kýrmýzý kan hücreleri daðýlým geniþliði (RDW) dolaþýmdaki eritrositlerin boyutlarýnýn çeþitliliðinin sayýsal ölçümüdür. Artmýþ RDW’nin serebrovasküler patolojiyi etkileyebileceði ve trombotik hadiselerin geliþiminde predispozan bir rolünün olabileceði bazý çalýþmalarda gösterilmiþtir. Biz bu çalýþmamýzda, 2016-2018 tarihleri arasýnda akut iskemik inme tanýsý ile kliniðimizde yatan hastalarla, saðlýklý kontrollerin ve hastalarýn RDW deðerleri ile inme þiddeti ve prognozu arasýndaki iliþkiyi incelemeyi amaçladýk.
YÖNTEM ve GEREÇLER: Erenköy Ruh ve Sinir Hastalýklarý Hastanesi Nöroloji servisine akut iskemik inme (AÝÝ) tanýsý ile interne edilmiþ hastalarýn 24 saatlik hemogram incelemeleri yapýldý. Hastalarýn nörolojik deðerlendirmeleri 1. ve 10. günde NIH stroke skalasý (NIHSS) ile, ve erken dönem prognozlarý modifiye Rankin Skalasý (mRS) ile deðerlendirildi.
BULGULAR: Çalýþmaya 271 akut iskemik inme geçirmiþ hasta ve 142 kontrol hastasý alýndý. Ortalama yaþ hasta grubunda 69.54±12.8 ve kontrol grubunda 68.35±19.38 bulundu. Cinsiyet daðýlýmý hasta grubunda M/F; %52.2/%47.8 ve kontrol grubunda M/F; %44.6/%55.4 olarak bulundu. Yaþ ve cinsiyet daðýlýmý açýsýndan iki grup arasýnda istatistiksel olarak anlamlý bir fark yoktu. Ortalama RDW deðerleri, hasta grubunda 15.39±1.4 ve kontrol grubunda 14.59±2.02 olarak bulundu. Ortalama RDW deðerleri gruplar arasýnda istatistiksel olarak anlamlý farklý bulundu (p: 0.04). Ýnme þiddeti ve erken dönem prognoz ile RDW deðerleri arasýnda korelasyon bulunmadý (p>0.05).
TARTIÞMA ve SONUÇ: Akut iskemik inme hastalarýnda RDW deðerleri kontrollere göre yüksek bulunmakla birlikte, inme þiddeti ve erken dönem prognoz ile RDW deðerleri arasýnda anlamlý iliþki tespit edilemedi.

Anahtar kelimeler: Ýskemik inme, RDW, inflamasyon

INTRODUCTION: The red cell distribution width (RDW) is a numeric estimation of the erythrocyte dimension in the circulation. Increased RDW has been shown to have a predisposing role in the development of vascular thrombosis and therefore it is an instigator of serebrovascular diseases. In this study, we aimed to investigate the relationship between RDW values with stroke severity and prognosis in patients in comparison with a healthy control group.
METHODS: The first 24 hours complete blood count examinations of the hospitalized patients with acute ischemic stroke were requested. Neurological examination was evaluated with NIHSS on Day 1 and Day 10 and early prognosis was evaluated with mRS.
RESULTS: 71 patients with acute ischemic stroke and 142 control patients were included in the study. The mean age of the patients and in the control group were 69.54±12.8 and 68.35±19.38, respectively. Male to female (M/F) ratio of patients and the control group were 52.2/47.8 and 44.6/55.4, respectively. The mean RDW values were 15.39±1.4 in the stroke group and 14.59±2.02 in the control group. Mean RDW values were significantly different between the two groups (p: 0.04). There was no correlation between stroke severity and early prognosis and RDW (p>0.05).
DISCUSSION AND CONCLUSION: RDW values were found to be high in acute ischemic stroke patients, but there was no correlation between RDW values, stroke severity and early prognosis.

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GÝRÝÞ ve AMAÇ: Bu çalýþmanýn amacý, Konvansiyonel Pap smear (CPS) ile Sývý bazlý Sitoloji (LBC) sonuçlarýný servikovajinal enfeksiyöz ajanlarýn saptanabilirliði açýsýndan karþýlaþtýrmaktýr.
YÖNTEM ve GEREÇLER: Ýstanbul'da üçüncü basamak bir merkezde 2005-2017 yýllarý arasýnda gerçekleþtirilen rahim aðzý kanseri tarama testlerinin sonuçlarý geriye dönük olarak incelendi. Çalýþmada, bakteriyel vajinozis, Trichomonas vaginalis, Candida, Actinomyces ve Herpes simpleks virüsü servikovajinal enfeksiyon ajanlarý olarak deðerlendirildi.
BULGULAR: 21-65 yaþ arasý toplam 60014 kadýnýn smear sonuçlarý incelendi. Bunlarýn 58979'unda CPS tekniði, 1035'inde LBC tekniði kullanýlmýþtýr. Enfeksiyöz ajan CPS'nin % 8.6'sýnda ve LBC'nin % 8'inde tespit edilmiþtir (P = 0.503). CPC tekniði ile 3.459 (% 5.9) kadýnda ve LBC tekniði ile 43 (% 4.1) kadýnda bakteriyel vajinoz tespit edildi (P = 0.003). CPS tekniðinde Trichomonas vaginalis, Actinomyces ve Herpes simplex sýrasýyla 249 (% 0,4), 62 (% 0,1) ve 4 (% 0,0) kadýnda saptanýrken bu ajanlar LBC ile görülmedi (P = 0,034; P = 0,627; P = NS, sýrasýyla). CPS ve LBC tekniklerinde sýrasýyla 1.342 (% 2.3) ve 40 (% 3.9) kadýnda kandida tespit edildi (P <0.001).
TARTIÞMA ve SONUÇ: Bu çalýþmanýn sonuçlarýna göre bakteriyel vajinozis, trichomonias vaginalis, actinomyces gibi enfeksiyon etkenlerinin saptanabilirliði LBC tekniði ile yapýlan smear testlerinde CPS tekniðine göre daha düþüktür. Candida enfeksiyonlarý LBC tekniði ile tespit edilebilir. Klinisyenler, CPS tekniðinin bakteriyel vajinozis, trichomonias vaginalis, actinomyces enfeksiyon ajanlarýnýn saptanmasýndaki üstünlüðünü bir avantaj olarak dikkate alabilir.

INTRODUCTION: The present study aims to compare Conventional Pap smear (CPS) and Liquid-based Cytology (LBC) results concerning detectability of cervicovaginal infectious agents.
METHODS: The results of cervical cancer screening tests performed between 2005 and 2017 in a tertiary center in Istanbul were analyzed retrospectively. For this study, bacterial vaginosis, Trichomonas vaginalis, Candida, Actinomyces and Herpes simplex virus were evaluated as infectious agents of cervicovaginal infection.
RESULTS: Smear results of 60014 women between the ages of 21-65 were examined. CPS technique was used in 58979 of these, and the LBC technique in 1035. Infectious agent was detected in 8.6% of CPS and 8% of LBC (p=0.503). Bacterial vaginosis was detected in 3.459 (5.9%) women using CPC technique and 43 (4.1%) women using LBC technique (p=0.003). While Trichomonas vaginalis, Actinomyces and Herpes simplex in CPS technique were detected in 249 (0.4%), 62 (0.1%) and four (0.0%) women, respectively, these agents were not seen with LBC (p=0.034; p=0.627; p=NS, respectively). Candida was detected in 1.342 (2.3%) and 40 (3.9%) women in CPS and LBC techniques, respectively (p<0.001).
DISCUSSION AND CONCLUSION: According to the results of this study, the detectability of infectious agents, such as bacterial vaginosis, trichomonas vaginalis, and actinomyces, is lower in smear tests performed using the LBC technique compared to the CPS technique. Candida infections can be detected with the LBC technique. Clinicians can consider the advantages of the CPS technique in detecting cervicovaginal infectious agents.

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GÝRÝÞ ve AMAÇ: Santral venöz kateterizasyonun (SVK), günümüzde kritik hastalarýn takibinde ve tedavisinde önemli bir yeri ve yaygýn bir kullaným alaný vardýr. Bu çalýþmada çocuk yoðun bakým ünitemizde santral kateter kullanýmýnýn gözden geçirilmesi ve bu kullanýmda ultrasonografi (USG) kýlavuzluðunda yapýlan venöz giriþ iþlemlerinin etkinliðinin araþtýrýlmasý amaçlanmýþtýr.
YÖNTEM ve GEREÇLER: Hastanemiz Çocuk Yoðun Bakým Ünitesi'nde (ÇYBÜ) 01.05.2017- 01.05.2018 tarihleri arasýnda yatan ve çeþitli nedenlerle SVK yerleþtirilen 51 hastanýn kayýtlarý retrospektif olarak incelendi. Çalýþmada hastalarýn yaþý, vücut aðýrlýklarý, tanýlarý, SVK uygulama yeri, endikasyonlarý, USG kullanýmý, iþlem sýrasýndaki ponksiyon sayýsý, iþlem süresi, kateter kalýþ süresi, hastalarýn prognozu ve hasta izleminde oluþan komplikasyonlar kaydedildi. Çalýþma verileri deðerlendirilirken parametrelerin normal daðýlýma uygunluðunda Shapiro Wilks testi, niceliksel verilerin karþýlaþtýrýlmasýnda normal daðýlým gösteren parametrelerin iki grup arasý karþýlaþtýrmalarýnda Student t test, normal daðýlým göstermeyen parametrelerin iki grup arasý karþýlaþtýrmalarýnda Mann Whitney U test kullanýldý. Niteliksel verilerin karþýlaþtýrýlmasýnda ise Fisher’s Exact test ve Continuity (Yates) Düzeltmesi kullanýldý.
BULGULAR: SVK takýlan 28’i (%54,90) kýz ve 23’ü (%45,10) erkek olmak üzere toplam 51 hasta çalýþma kapsamýna alýndý. USG kullanýlan ve kullanýlmayan hastalarda, yaþ, cinsiyet, vücut aðýrlýðý, PRISM (Pediatric Risk Of Mortality) skoru, yoðun bakým yatýþ gün sayýsý, mekanik ventilatör kullanýmý, kateter kullaným süresi açýsýndan istatistiksel olarak anlamlý bir farklýlýk saptanmadý (p<0,05). Ancak USG kullanýlan hastalarda, kullanýlmayanlara göre ponksiyon sayýsýnýn daha az ve kateter takma süresinin daha kýsa olduðu saptandý (p=0,000 ve p=0,049)
TARTIÞMA ve SONUÇ: Çocuk yoðun bakým ünitesindeki kritik hastalarýn izlem ve tedavilerinde gerekli olan santral venöz kateter uygulamalarýnýn ultrasonografi eþliðinde yapýlmasý güvenlidir, iþlem uygulama süresini ve ponksiyon sayýsýný belirgin olarak azaltmaktadýr.

INTRODUCTION: Central venous catheterization (CVC) is a substantial, commonly used approach in the treatment and follow-up of critically ill patients. This study aims to review the use of central catheters in pediatric intensive care unit and evaluate the efficacy of venous access procedures performed under ultrasonography (USG) guidance.
METHODS: Material and Methods:
The records of 51 patients hospitalized in the Pediatric Intensive Care Unit between 01 May 2017 and 01 May 2018 and were implanted with CVC for various reasons were retrospectively examined. In this study, the data on age, body weight, diagnosis, CVC implantation region, indication, USG use, number of punctures during the procedure, procedure duration, implantation duration, prognosis, and complications that occurred during patient monitoring were recorded. Shapiro-Wilk test was used for evaluating the agreement of the parameters with a normal distribution, and for the quantitative data comparison, the Student t-test was used for comparing two groups for parameters with a normal distribution, while the Mann-Whitney U test was used for comparing two groups for parameters without normal distribution. For qualitative data comparison, Fisher's Exact test and Continuity (Yates) Correction were used.
RESULTS: In this study, 51 patients implanted with CVC (28 (54.9%) female and 23 (45.1%) male) were included. No statistically significant difference was detected between patients for whom implantation was performed with and without USG considering age, gender, body weight, PRISM (Pediatric Risk of Mortality) score, intensive care unit hospitalization duration, mechanical ventilator use, catheter use duration (p<0.05). Nonetheless, it was noted that the number of punctures and the duration of catheter use reduced in patients implanted with CVC under USG (p=0.000 and p=0.049).
DISCUSSION AND CONCLUSION: The findings obtained in this study suggest that it is safe to perform central venous catheterization procedures required for the monitoring and treatment of patients in pediatric intensive care unit under ultrasonography and it clearly reduces the duration of the procedure and number of punctures.

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