INTRODUCTION: It is recommended that patients with low back and back pain not responding to conservative treatment, or who have accompanied by findings defined as 'red flag' (fever, night pain, weight loss, accompanying malignancy, etc.) should be evaluated radiologically. Transpedicular vertebral biopsy and vertebroplasty are spinal surgical procedures that have been performed for many years in patients with signs of bone collapse or infiltrative involvement, both for pathological diagnosis and treatment.
METHODS: CT and MRI images, clinical and pathology records of 31 cases who underwent transpedicular vertebral biopsy and vertebroplasty in our clinic between 2018-2020 were reviewed retrospectively. The procedure, procedure level and pathological diagnoses for each patient were recorded.
RESULTS: In 7 (23%) of our cases, biopsy was performed by transpedicular intervention only for the diagnosis of spondylodiscitis and for the determination of the causative agent. 24 (77%) of them had vertebral compression fractures and both diagnostic transpedicular biopsy and vertebroplasty were performed in the same session. The causative agent was detected in 3 (43%) of the patients with discitis findings (2 cases of staphylococcus aureus, 1 case of tuberculosis); in 4 (57%) the pathology and culture results were negative. While malignancy was detected in the histopathological examination of only 2 (8%) of our patients with compression fractures who underwent vertebroplasty (1 case GIS malignancy, 1 case multiple myeloma), osteoporotic compression fractures were found in the other 22 (92%) cases. In only one of the cases who underwent vertebroplasty, operation was performed at 2 levels (L1 and L2). Other levels were L1 (10 cases), L3 (5 cases), T11 (3 cases), L2 (2 cases), T9 (1 case), T12 (1 case) and L5 (1 case), respectively.
DISCUSSION AND CONCLUSION: Transpedicular vertebral biopsy can be safely performed in the detection of causative agent and pathological diagnosis of vertebral corpus lesions and infections. Vertebroplasty is an effective and reliable method for both pain control and increasing the stability of the vertebra in patients with pain due to osteoporotic bone collapse or metastatic vertebral involvement.

INTRODUCTION: Vitamin D is significantly effective in bone and mineral metabolism. Low levels of vitamin D has been associated with rickets, susceptibility to infections, obesity, diabetes mellitus, muscle weakness, depression, and development of autoimmune diseases in children. On the other hand, elevated levels may cause hypercalcemia, polyuria, hypertension, nephrolithiasis, and renal failure. In this study, we aimed to examine serum 25-hydroxyvitamin D3 [25(OH)D] levels of children in the risk group for low vitamin D levels.
METHODS: A total of 1259 patients who applied to our pediatric outpatient clinic for routine examination between January and December 2015 were evaluated retrospectively; age, gender, [25(OH)D] levels were grouped according to seasons.
RESULTS: Our study included 711 (56.4%) girls and 548(43.6%) boys between the ages of 0 and 18. The mean vitamin D levels of the patients were found as 21.69±11.23 ng/mL. The vitamin D level of 50% of the children was below 20 ng/ml and at the level of deficiency and insufficiency. A statistically significant difference was found between age groups according to vitamin D levels (p<0.05). While the number of children with vitamin D level above 20 ng/ml was significantly higher in the 0-2 age group, the number of children with vitamin D level below 20 ng/ml in the 12-18 age group was higher. In our study, vitamin D levels of girls were significantly lower than boys (p<0.05). In addition, the rate of the season being spring was 28.2%, while the rate of being winter was 25.2% in children with a vitamin D level below 12 ng/mL.
DISCUSSION AND CONCLUSION: When vitamin D levels were evaluated according to age, gender and season, the levels were found to be significantly lower in the 12-18 age range, in girls, and in the spring/winter seasons, compared to other groups.

INTRODUCTION: Cyst in the canal of nuck (CCN) is a result of a closure defect during the processus vaginalis in girls. The symptom and mass findings in the inguinal region can mimic an irreducible inguinal hernia. The aim of this study was to investigate the differential diagnosis and surgical findings of girls who were operated on for an irreducible inguinal hernia and the frequency of consideration of a CCN.
METHODS: The data of 868 female patients aged 0–16 years who were referred to surgery with the preliminary diagnosis of an inguinal hernia between 2004 and 2019 were analyzed retrospectively.
RESULTS: A total of 138 patients (15.89%) were sent to emergency surgery for an inguinal hernia that could not be reduced. In 15 (10.8%) of these patients, the hernia spontaneously reduced after the application of general anesthesia. In the remaining patients, in order of decreasing frequency, the findings were ovarian sliding hernia (n=93; 67.3%), CCN (n=17; 12.3%), herniated small intestine (n=12; 8.6%), and lymphadenitis (n=1; 0.07%). The mean age of the patients diagnosed with CCN (52.13 months) was significantly higher than the mean age of patients with an incarcerated inguinal hernia (7.23 months).
DISCUSSION AND CONCLUSION: CCN is seen more frequently than expected. Especially, the differential diagnosis should be made with irreductable inguinal hernia in older than 2 years.

INTRODUCTION: In surgical applications requiring vascular anastomosis, the success of the operation depends on the anastomosis stay open. In this case, the surgical technique that can be applied is of great importance. The fact that too many surgical techniques have been described in microvascular anastomoses shows that the search continues in this area. Our aim in this study was to examine the effectiveness of existing methods.
METHODS: In this study, known methods of microvascular anastomosis were reviewed in chronological order.
RESULTS: In our study, microvascular suture techniques used in end-to-end and end-to-side anastomoses since 1978 were examined and compared with conventional suture technique combined with interrupted eversion suture. Although the important point is that the surgeon knows which technique and applies that technique well, conventional suture combined with interrupted eversion suture was superior to other available techniques in our practice.
DISCUSSION AND CONCLUSION: Many microvascular suture techniques have been described and applied for microsurgical anastomoses, including both end-to-end and end-to-side anastomoses. Research has shown that regardless of the method, techniques which work in order and can provide anastomoses with good long-term results, are successful.

INTRODUCTION: We aimed to measure the level of knowledge about fever by reaching 300 mothers. If the level of information is found to be inadequate in accordance with the results, by alerting the authorities about the results and ensuring that they reach the public; We thought that it might be useful for many applications to hospitals, unnecessary antibiotic use, antibiotic resistance, reducing the panic level of families and relieving the state budget. As a matter of fact, we thought that the Ministry of Health is a valuable study to help the studies to be done today in order to shed light on how effective these advertisements are due to the fact that they were made before the public awareness activities and we published the information obtained today.
METHODS: Study was conducted with 300 mothers who applied to Pediatric Clinics between 2009-2010 under the permission of the ethics committee. Aim of correcting existing mistakes and statisticing the information we should provide to mothers.
RESULTS: 82% of the mothers who participated in our study had low socioeconomic level. Fever consciousness was low in 57% of our mothers. The rate of antibiotic use was 53%.According to the data of our study, 58% of mothers do not measure fever correctly. There is no fever measuring device in 45%.
DISCUSSION AND CONCLUSION: We found that mothers' awareness of fever, their behaviors about febrile convulsions, and their awareness of antibiotic use were insufficient. We determined that the mother being a housewife, the mother's education level being low, socioeconomic level score was low, her husband's occupation, her husband's education was low, and fever awareness and antibiotic use were negatively affected. When we consider the results, we anticipate that mothers should be informed about fever, that they will make unnecessary applications to the child and that they will prevent delayed and inadequate intervention.

INTRODUCTION: Rapid and early diagnosis in neonatal sepsis is of great importance in reducing morbidity and mortality. An increase in acute phase reactants before the causative agent is shown in the hemoculture supports the diagnosis. Monitoring of C-reactive protein (CRP) levels is used for this purpose in clinical applications. In recent years, the use of procalcitonin (PCT) in neonatal sepsis has come to the fore. PCT increase occurs earlier than CRP. In this study, we aimed to compare CRP and PCT levels in the diagnosis and follow-up of neonatal sepsis.
METHODS: The study was carried out with 40 patients hospitalized in the neonatal intensive care unit (NICU) with the diagnosis of sepsis and 40 control subjects.
RESULTS: Pre-treatment PCT and CRP values of the study group were significantly higher than the control group (p<0.05). When the pre-treatment CRP and PCT values were compared with the CRP and PCT values after the 72nd hour of the treatment, a statistically significant decrease was found (p<0.05).
DISCUSSION AND CONCLUSION: As a result, PCT has been found to be as useful as CRP, which is routinely used in the early diagnosis of sepsis and in monitoring the response to treatment.

INTRODUCTION: Chronic obstructive pulmonary disease (COPD) is a common, preventable, and treatable disease characterized by chronic inflammatory response in the airways and lungs, usually characterized by progressive, persistent airflow limitation. Apelin is a newly discovered peptide with inotropic and vasodilatory properties and is an endogenous ligand of the APJ receptor. The aim of this study is to examine the possible association of variations in the apelin gene (APLN) with COPD in the Turkish population.
METHODS: This study was a case-control study, and a total of 341 people aged 40-80 years were included in the study (224 COPD and 117 healthy controls). Genotyping of 2 single nucleotide polymorphisms (SNPs) (rs3115758 and rs3115759) in the APLN was performed by real-time polymerase chain reaction (PCR) method. Genotype and allele frequencies between COPD patients and healthy individuals were compared with Student's t test.
RESULTS: The TT and AA risk genotypes of the rs3115758 and rs3115759 variants in the APLN were found to be associated with a significantly increased risk of COPD at the same rate. Heterozygous and homozygous mutant genotypes (GT, TT, GA, and AA, respectively) of rs3115758 and rs3115759 variations of the APLN were detected at a significantly higher rate, in the same proportion of patients. In the multiple regression analysis, it was determined that the TT genotype of rs3115758 increased the development of COPD by 0.59 times, independent of other COPD risk factors.
DISCUSSION AND CONCLUSION: As the first study in the literature examining the relationship between polymorphisms in the APLN and COPD in the Turkish population, various variations in the APLN were found to be associated with COPD in the Turkish population.

INTRODUCTION: Post-operative complications contribute high mortality rates. Pre-operative evaluation is performed to determine the risk of complications and mortality. Hence, we aimed to evaluated American Society of Anesthesiology Classification 3, 4 and 5 patients and their post operative prognosis.
METHODS: The patients, admitted to intensive care unit (ICU) in a tertiary hospital in Turkey in a year, were evaluated retrospectively.
RESULTS: Among 590 patients, the mean age was 62.7±17.5. Postoperatively, 94.4% of the patients were discharged. However, 5.6% the patients died and all of them had an emergency surgery.
DISCUSSION AND CONCLUSION: Pre-operative evaluation supplies a valuable estimation of patient prognosis. We recommend that the patients, who will undergo an emergency surgery, should be carefully followed during both under anesthesia and in ICU.

INTRODUCTION: Erectile dysfunction (ED) is considered as a risk factor for cardiovascular diseases (CVD), which stands among the most important causes of death worldwide. For this reason, the evaluation of ED with a multidisciplinary approach is crucial. This study aims to assess the awareness of urologists in Turkey about the relation between ED and CVD.
METHODS: An online questionnaire consisting of 13 questions was sent by email to urology specialists and urology assistants registered to the Turkish Association of Urology (TAU) communication network. The questionnaire consisted of the first six questions including personal questions about working conditions and work experience, and the last seven questions about the awareness of the relation between ED and CVD.
RESULTS: 154 people participated in the questionnaire sent to urologist via the communication network of the TAU. 59.8% of the participants stated that they always questioned the presence of CVD in patients presenting with ED complaints, and 11.7% always asked for a cardiology consultation. The rate of requesting a cardiology consultation in ED patients was similar (p>0.05) among the participants when grouped based on the professional title, their interest in andrology, institution they worked, and frequency of seeing ED patients. However, in the 40 years of age and under group the rate of requesting cardiology consultation was significantly higher compared to over 40 years of age group (p=0.01).
DISCUSSION AND CONCLUSION: It was found that age and professional experience were decisive in the overall approach and generally, the urologists had high level of awareness about the relation between ED and CVD.

INTRODUCTION: Our aim in this study was to compare the results of accelerated collagen cross-linking (CXL) treatments on visual acuity and topographic parameters in cases with progressive keratoconus.
METHODS: The cases with the diagnosis of progressive keratoconus between January 2015 and January 2018, who underwent accelerated CXL, were analyzed retrospectively. Subjects who received 9 mW/cm² ultraviolet A (UV-A) treatment for 10 min and were treated with 18 mW/cm2 UV-A for 5 min were included in the study. Uncorrected visual acuity (UCVA), Uncorrected visual acuity (BCVA), refractive value changes (spherical, cylindrical values), and corneal topography values obtained using the Sirius device at preoperative and postoperative 1st, 3rd, 6th and 12th months (K1, K2, Kmaximum, anterior elevation, posterior elevation) were compared statistically.
RESULTS: A total of 80 eyes of 80 cases; 40 eyes treated with UV-A for 10 min and 40 eyes treated with UV-A for 5 min were included in the study. There was no difference between the two groups in terms of age and gender. There was a statistically significant increase in UCVA and BCVA (logMAR) values for both groups at the 6th and 12th months post-operatively when we compared the values before surgery (p<0.05) There was no significant difference between the two groups in terms of refractive changes and topographic changes (K1, K2, K maximum, anterior elevation, posterior elevation) after surgery compared with before surgery (p>0.05).
DISCUSSION AND CONCLUSION: In cases of progressive keratoconus, 10-min 9 mW/cm² and 5-min 18 mW/cm² accelerated CXL methods showed similar results at the end of 1-year follow-up in terms of visual acuity improvement and topographic changes. Both methods seem to be effective in preventing keratoconus progression.

INTRODUCTION: Perioperative hypothermia (POH) emerges as an important problem in increasing the morbidity and mortality rates of geriatric patients. The purpose of this study was to determine the incidence of POH in geriatric patients undergoing elective surgery. In addition, to determine the risk factors associated with POH in geriatric patients, to contribute to the improvement of temperature monitoring awareness and body temperatures.
METHODS: Patients over 65 years of age who would undergo elective surgery under sedoanalgesia, general and regional anesthesia were included in the study. Demographic and operative data of the patients, body temperatures at the time of entering the waiting room and exiting the waiting room in the pre-operative period, at the 0th min (min), 60th min, 120th min, 180th min, and 240th min in the intraoperative period and in the post-operative period, and body temperatures at the time of entry and exit from the recovery unit were measured from the tympanic membrane and recorded. Body temperatures below 36°C were accepted as hypothermia.
RESULTS: A total of 178 patients, including 75 females (42.1%) and 103 males (57.8%), were included in the study. The mean age of the patients was 73±7.44 years. While the pre-operative mean body temperature of the patients was 36.8±0.46°C, the mean body temperature at the entrance and exit of the postoperative recovery unit was 35.61±0.89°C and 36.11±0.63°C, respectively. In the intraoperative period, the mean value of body temperature at the 0th min was found to be higher than the 60th, 120th, and 180th min, which was statistically significant (p<0.01). A statistically significant difference was found in all time frame comparisons of prolonged operation time and decrease in body temperature (p<0.01).
DISCUSSION AND CONCLUSION: In our study, POH emerges as an important problem in geriatric patients. We suggest that routine monitoring of body temperature and warming of patients are necessary to prevent hypothermia in geriatric patients. Especially in operations that are planned to take a long time; improvements should be implemented quickly to avoid hypothermia.

INTRODUCTION: The number of patients who apply to cardiology outpatient clinics to get a medical certificate in order to participate in sports is increasing day by day. This study was carried out to evaluate the characteristics and cardiological examination results of the cases who applied to the pediatric cardiology outpatient clinic in a period of one year.

METHODS: Demographic characteristics, personal and family history, blood pressure (BP), electrocardiogram (ECG) and echocardiogram (echo) results of children who applied to our center for participation in sports between 01.01.2019 and 31.12.2019 from the pediatric cardiology outpatient clinic records and whose ICD code was entered into the system accordingly, were retrospectively analyzed.
RESULTS: The study group consisted of 468 children and adolescents. Of the cases, 312 (67%) were male and 156 (33%) were female. Their mean age was 11.33 (min: 3, max: 17, n=468). Their mean body weight was 47.35 kg (min: 18, max: 93, n=147) and their mean height was 152.62 cm (min: 112, max: 188, n=147). While 104 (22%) of the cases had a history that could affect sports activity, 364 (78%) did not. While there was a family history that might affect their ability to do sports in 123 (26%) cases, there was no cause in 345 (74%) cases. The mean systolic BP values of the cases were 110 mmHg (min: 82, max: 171), and the mean diastolic BP values were 68 mmHg (min: 40, max: 90). On ECG examinations, 1 case had extrasystole and 1 had Wolf-Parkinson-White syndrome. The mean QTc interval values were 414.88 ms (min: 350, max: 467). In addition to the examination, exercise stress test, ambulatory BP monitoring or BP monitoring, Holter monitoring were requested in 78 of the cases (17%). Echo evaluation revealed pathology in 26 cases (5.5%). Twenty-five of these pathologies were insignificant pathologies, and 1 of them was a cardiac pathology that would affect performing sports acitivities. Nine of the children (1.9%) were not given a medical certificate to do sports. Four of them were referred to the arrhythmia outpatient clinic.
DISCUSSION AND CONCLUSION: When the cardiology examination findings in the study were evaluated, it was determined that the rate of cardiac pathology that would affect doing sports was very low. Most of the cases were cases that could be evaluated in primary and secondary health care institutions with a good anamnesis, physical examination, ECG and BP monitoring. Standardizing such preparticipation examinations according to a guideline will be beneficial both for obtaining objective results and for ensuring the physician's safety and convenience.

INTRODUCTION: Gastrointestinal perforations (GIPs) are problems with high mortality in the neonatal period. In the present study, the purpose was to share our experiences on GIPs in the neonatal period.
METHODS: A total of 28 patients who were followed up and treated in the Neonatal Intensive Care Unit between 2005 and 2020 were evaluated retrospectively with risk factors, characteristics, clinical and laboratory findings, and mortality rates.
RESULTS: There were a total of 16 male (57.1%) and 12 female (42.9%) patients 15 of whom were (53.6%) preterm, 13 (46.4%) were term. The mean birth weight was 2162±855 g. The most common cause of perforation was necrotizing enterocolitis with 16 cases. Perforation sides were jejunoileal in 17 cases, colon in eight cases, duodenum in two cases, and stomach in one case. A total of 12 of the cases (42.8%) were lost due to perforation. Statistically significant relations were detected between birth weight and gestational age and mortality.
DISCUSSION AND CONCLUSION: GIPs appear as an important reason for mortality during the neonatal period. It is important to be careful because of perforation-related mortality in infants with low birth weight and low gestational age.

INTRODUCTION: Postoperative wound site infection is an important source of morbidity in surgeries. This leads to financial burden in patients and healthcare systems. There is a need for simple and inexpensive methods in order to reduce surgical site infection (SSI). In this study, we aimed to retrospectively investigate the effect of saline irrigation on the reduction of surgical wound site infections following cesarean section.
METHODS: A total of 2,220 patients who underwent cesarean section in the obstetrics and gynecology clinic of our hospital between January 2017 and December 2020 were included in the study. A total of 1,090 cesarean sections with skin irrigation were compared with 1,130 cesarean sections performed without irrigation. Variable factors that could affect infection such as cesarean technique, patient population’s characteristics, and operating room conditions were completely same for both groups.

RESULTS: SSI was detected in 22 (1%) of the 2,220 patients. Nine (0.8%) patients in Group 1 and 13 (1.1%) patients in Group 2 were infected. The difference between both groups was statistically insignificant (p>0.05). Patients’ age, body mass index (BMI), gestational week, length of stay, pre-cesarean hemoglobin, the rates of urgent cesarean sections, smokers, and diabetes mellitus (DM) were similar between both groups (p>0.05). The rates of DM (p=0.056) and BMI (p=0.022) were statistically higher compared to general patients.
DISCUSSION AND CONCLUSION: Our results indicated that saline irrigation was not effective in surgical wound site infections.

INTRODUCTION: While shock wave lithotripsy (SWL) was recommended as the first-line treatment method for proximal ureteral stones, today both SWL and ureterorenoscopy (URS) are the first-line treatment methods for proximal ureteral stones smaller than 10 mm in the European Urology Association’s Urolithiasis guidelines. recommended. In the present study, we aimed to compare the effect of URS and SWL in proximal ureteral stones smaller than 10 mm.
METHODS: We performed a retrospective analysis of 87 patients with proximal ureteral Stones <10 cm in our institution. Forty-three patients underwent SWL were labeled as Group I, and 44 patients underwent URS by semirigide ureteroscop were labeled as Group II. Success and complications of the two procedures were compared. All statistical analyses were performed using SPSS, version 21. While “t-test” was used for comparison the independent groups, paired t-test was used in the matched groups. Statistical significance was considered at p<0.05. Chi-square analysis was used for the countable variables. Mann-Whitney U test was used for comparing two independent groups.
RESULTS: Mean age of the patients were 44.6±12.5 years and 44.3±15.1 years in group I and group II, respectively (p>0.05). Male/female ratio was about 4 and 2 in Groups I and II, respectively (p>0.05). The mean stone size of the patients was 7.8±1.3 mm and 6.8±1.5 mm in groups I and II, respectively (p<0.05). Any major complicatian and mortality were not experienced in both groups. The stone-free rates were 67.5% (n=29) and 81.8% (n=36) in group I and group II, respectively (p>0.05) (Table 1)
DISCUSSION AND CONCLUSION: According to our results, although the success rate of URS was higher in patients with proximal ureteral stones <10 mm compared to SWL, the difference was not statistically significant.

INTRODUCTION: Down syndrome (DS) is the most common genetic disorder. Congenital cardiac anomalies are common and are a major cause of mortality and morbidity in cases with DS. The aim of this study was to determine congenital cardiac anomalies in children with DS and to identify the severity of these pathologies.
METHODS: Genetically and clinically diagnosed DS cases with congenital cardiac anomalies, whose examination and follow-ups were done in our pediatric cardiology outward clinic between February 1, 2018 and February 1, 2021, were retrospectively reviewed from medical records.
RESULTS: This study consisted of 131 cases with DS, including 72 (54.9%) boys and 59 (45.1%) girls. There were no anomalies in the echocardiographic findings of 54 (41.2%) of the cases. Congenital cardiac anomaly was identified in 77 (58.8%) cases. Of these cases, 10.7% had atrioventricular septal defect, 14.5% had ventricular septal defect, 9.7% had atrial septal defect, 5.3% had patent ductus arteriosus, and 2.3% had tetralogy of fallot and the rest had other pathologies. Surgical treatment was administered to 31 (23.2%) cases. Three cases had pulmonary hypertension. Two cases were administered pacemaker implantation in the postoperative period. Wolf-Parkinson-White syndrome was observed in the electrocardiography of 3 (2.3%) cases. When the cases’ other system pathologies were examined, it was observed that 30 cases (22.9%) had hypothyroid, the most common pathology.
DISCUSSION AND CONCLUSION: Half of the patients with DS in the study group had congenital cardiac anomalies. About half of these cases required surgical or invasive intervention. This indicates that cardiac examination and follow-up of patients with DS is important and necessary.

INTRODUCTION: The objective of the study is to investigate Toxoplasma gondii antibody seroprevalence in pregnancies who applied for prenatal care to the tertiary center in Trakya (Thrace) Region of Turkey between January 01, 2014, and December 31, 2018, retrospectively.
METHODS: This study retrospectively analyzes seroprevalence of T. gondii IgM and IgG antibodies of 2.317 pregnant patients in their first trimester attended to the Obstetrics and Gynecology Antenatal Care Unit in Trakya University, Faculty of Medicine between January 01, 2014, and December 31, 2018. For this purpose, IgM, IgG and if necessary, IgG avidity results were evaluated.
RESULTS: In our study period 2.317 pregnant women were analyzed. 1.630 pregnant women (70.3%) were IgG and IgM seronegative, 607 (26.1%) were IgG seropositive, 61 (2.6%) were both IgG and IgM seropositive and 19 (0.9%) were only IgM positive. 30 of 61 patients with both IgG and IgM seropositivity showed low avidity. After 2 weeks for seroconversion control, in 16 of the patients with just IgM positivity, only 3 18.7%) showed seroconversion. We excluded patients who did not participate our routine follow-ups.
DISCUSSION AND CONCLUSION: Even toxoplasma exposure rate in the pregnant women from the Trakya Region of Turkey is high (26.1%) before pregnancy, about 70% of first-trimester pregnant patients were found seronegative. Screening during the first trimester would be appropriate and prenatal education should be given to the patients.

INTRODUCTION: Acute ischemic stroke is one of the important causes of mortality and morbidity. It is responsible for approximately 5% of in-hospital mortality. Early recognition of risk factors for mortality in acute ischemic stroke cases is important in terms of disease management and appropriate family information. In this study, we aimed to investigate the relationship between Cardiac Troponin I (cTnI) and Mean Platelet Volume (MPV) and mortality in patients with acute ischemic stroke.
METHODS: Patients who applied to the Emergency Medicine Clinic between 01.01.2016 and 01.01.2018, whose diagnosis code was entered as cerebrovascular disease (CVD) and whose magnetic resonance diffusion imaging tests were reported as acute infarct by the radiology clinic were screened, and the patients' age, gender, current comorbid diseases, mean platelet volume (MPV) and troponin values were recorded. Mortality status of the patients were screened through the Turkish Republic Ministry of Health Death Notification System, and their first and third month mortality were recorded. Patients with elevated troponin and suspected acute coronary syndrome by a cardiology or emergency medicine specialist were excluded.
RESULTS: A total of 357 patients were included in our study. The median age of the patients was 72 (IQR: 62-81). While 43 (12%) of 357 patients died within the first month, 66 (18.5%) of them died within the first three months. When the relationship between the first month and third month mortality of the patients and their comorbid diseases was examined, it was found that only the presence of dementia had a significant relationship with the third month mortality (Chi-square, p=0.021). When the relationship between MPV and troponin values of the patients and their first and third month mortality was examined, a significant relationship was found between first month mortality and troponin (Mann-Whitney U, p<0.001) and third month mortality and troponin (Mann-Whitney U, p<0.001).
DISCUSSION AND CONCLUSION: It was concluded that troponin elevation in patients with acute ischemic stroke is a parameter that may be useful in estimating the risk of mortality.

INTRODUCTION: Although the diagnosis and treatment of testicular torsion has been standardized today, its etiology is still controversial. There are various opinions regarding the challenges and risk factors of testicular torsion. Of these views, the seasons and climates are controversial on testicular torsion. In our study, we have aimed to understand whether climatic factors such as air temperature, relative humidity and atmospheric pressure change during the development of testicular torsion in our study.

METHODS: Patients aged 0–18 years who were diagnosed with testicular torsion who were operated on between January 1, 2010 and December 31, 2019 in Ümraniye Training and Research Hospital were included in the study. While evaluating the study data, the conformity of the parameters to the normal distribution was evaluated with the Shapiro–Wilks test, and the comparison of the quantitative data showing normal distribution as well as descriptive statistical methods was evaluated with the Paired Samples t-test.
RESULTS: A total of 200 children were operated for testicular torsion. 27% of the children were diagnosed with testicular torsion in spring, 20.5% in summer, 27% in autumn, and 25.5% in winter. There is no statistically significant difference between the air temperature, relative humidity and atmospheric pressure values on the day of admission to the hospital and the values of the 3 days and monthly average before the admission.
DISCUSSION AND CONCLUSION: Although there are contradictory publications on the development of testicular torsion on climatic factors and seasons, it is thought that the change in meteorological data is not a risk factor for the development of testicular torsion.

Hyperbaric oxygen therapy is a treatment method that involves breathing 100% oxygen in a specially manufactured pressure chamber under a certain pressure and for a certain period of time.
In this article, we present two patients, one with Buerger's disease and the other with osteomyelitis, who were treated with hyperbaric oxygen therapy.
Hyperbaric oxygen therapy is an important adjunct therapy that is generally applied in chronic wounds that do not heal despite surgical procedures and other medical treatments. With this method, in addition to the transported amount with hemoglobin, the oxygen transported in the liquid phase also reaches the problematic tissues. At the same time, due to the antiedema effect of hyperbaric oxygen therapy, it provides an additional contribution to the oxygenation of the tissues. We have obtained successful results by using hyperbaric oxygen therapy in 2 different patients: patient chronic osteomyelitis and with Burger's disease

Neonatal abstinence syndrome (NAS) is a clinical condition in which infants born to mothers with substance addictions (heroin, cannabis, opiates, etc.) exhibit withdrawal symptoms and physical addiction as they have been exposed to the substances prenatally and are lacking the substance postnatally. Most often emerges with the central nervous system and autonomous nervous system findings in NAS. Seizures have been reported rarely and require emergency treatment. We report the patient who born to a mother addicted to heroin who suffered NAS and was successfully treated with fentanyl infusion as far as we know, is the first in the literature.