INTRODUCTION: During the pandemic, various measures have been taken from the Ministry of Health to family health centers to minimize the effects of COVID-19 on both society and the healthcare system. It is crucial to quickly revise the hospital for such a large pandemic crisis to effectively treat patients that require hospitalization or intensive care. It is vital to act quickly, postpone the treatment of elective patients, and make room for patients affected by the pandemic. It is also important that the same diagnostic and treatment algorithms are followed all over the country to get reliable feedback. In this study, we share our experience in the successful management of the COVID-19 outbreak between March 11 and May 7, 2020, and investigate the role of the hospital organization in the success of the treatment.
METHODS: Kartal Dr. Lütfi Kýrdar Training and Research Hospital has been declared as a pandemic hospital by the Ministry of Health on March 11, 2020. To hospitalize patients diagnosed with COVID-19, 500 pandemic patient beds were arranged in 31 clinics.
RESULTS: Until this date, 37350 polyclinic examinations have been performed for COVID-19. The highest number of outpatient examinations was reached by 1656 on April 20, 2020. By the end of March, there was a noticeable increase in both the number of inpatient and outpatient clinics. Through pandemics, a total of 2536 patients was hospitalized, 163 of them were children. While 2087 (82%) of our inpatients were discharged, 255 (10%) of the patients are still being treated in our institution.
DISCUSSION AND CONCLUSION: In conclusion, we think that in the diagnosis and treatment of COVID-19, having adequate physical space and sufficient workforce, and carrying out the treatment process with a good organizational chart will help us treat patients in a shorter time and will contribute to the reduction of morbidity and mortality.

Objective: Incisional hernias that are the type of anterior abdominal wall hernia (ventral hernia) are common surgical problems after abdominal procedures. Although these types of hernias are seen after every abdominal operation, they are mostly seen after the midline and transverse incisions. However, the incidence of incisional hernia is 20%, according to the latest data, the incidence of incisional hernia is 2-11%. Only in the U.S.A., 190 000 incisional hernia operations are carried out per year. Incisional hernias that are seen after abdominal surgical procedures cause important loss of labour, morbidity and adversely affect the quality of life. Because of the high incidence and morbidity rate, it is one of the important problems of surgery. Incisional hernias originated from previous insufficient healing of abdominal closure. Factors that cause incisional hernias are obesity, tight closure of wound edges, wound infection, hematoma, seroma, type of incision, the technique of abdominal closure, steroid use, malnutrition (hypoproteinemia), smoking, COPD, diabetes and mellitus.
Methods: In this study, experimentally, we aimed to show the pathologic and biochemical effects of different closure techniques on wound healing into the cellular level of rats.
Results: In this study, we used 40 female rats that were Wistar Albino types and their mean-weight was 200–250 gr. Rats were divided into five groups. Each group included eight rats. U-shaped samples were taken from mid-line incision, previously made, for pathologic (inflammation, angiogenesis and collagen activity) and biochemical [MDA (malondialdehyde), NO (nitric oxide), caspase 3 activity, MMP 2-9 (Metalloproteinases 2 and 9), TNF alfa (tumor necrosis factor alfa), IL6 (interleukin 6)] study, and after these procedures, rats were sacrificed.
Conclusion: The findings obtained in this study show that there was no statistically significant difference between abdominal closure techniques one by one or continue suturing concerning incisional hernia if the fascia was closed optimally (not very tight, not to deteriorate the vascularity and end to end closing).

INTRODUCTION: Antibodies against the phospholipase A2 receptor (PLA2R) on podocyte membranes result in the formation of immune complexes that cause loss of function of the glomerular basement membrane in primary membranous nephropathy (PMN). It has also been demonstrated that there is a deposition of complement 4d (C4d) in the glomeruli in PMN. The present study aims to evaluate PLA2R and C4d immunoexpressions in PMN cases and search the correlation with the clinical parameters.
METHODS: In this study, clinicopathological data and paraffin-embedded specimens were collected from 51 patients. The formalin-fixed paraffin-embedded tissues were stained using routine hematoxylin-eosin, periodic acid-Schiff, and silver methenamine stains and immunostained for anti-PLA2R and C4d. Ten normal kidney tissues and 10 focal segmental glomerulosclerosis (FSGS) cases were selected as controls for PLA2R and C4d immunoexpression.
RESULTS: Of the PMN cases, 51 (100%) cases were positive for PLA2R, including 15 (29%) cases that scored 2+, and 36 (71%) cases that scored 3+. Forty of the 51 cases (78%) were positive for C4d. The percentages of cases staining positively for C4d, per scoring group, were as follows: 31 (61%) cases faintly (1+) positive and 9 (18%) cases moderately (2+) positive. No strong positivity was observed. All of the control cases (100%) were negative for PLA2R and C4d. There was no statistically significant difference between the intensity of the staining of PLA2R and the staining of C4d, proteinuria levels, creatinine levels, and complement 3 (C3) positivity. Similarly, there was no statistically significant difference between the intensity of the staining of C4d and proteinuria levels, creatinine levels, and C3 positivity.

DISCUSSION AND CONCLUSION: Immunohistochemical detection of PLA2R and C4d is a safe and easy method for the diagnosis of PMN. In cases where fresh tissue is not available for the detection of IgG and C3 using the immunofluorescence method, positivity for PLA2R and C4d with immunohistochemistry may be beneficial for the diagnosis of PMN.

INTRODUCTION: Procalcitonin (PCT) is a highly specific marker for the detection of infectious diseases. In recent years, studies on this marker have been conducted in patients with pleural fluid. Our aim in this study is to investigate the role of pleural fluid procalcitonin level in distinguishing parapneumonic pleural effusion (PPE) from other causes of exudative pleural effusion and its relationship with thorax ultrasonography (USG).
METHODS: A total of 128 exudative pleural effusion patients were included in this study. The patients were divided into two groups as PPE and non-PPE. Demographic findings, comorbidities, radiographic images in chest radiography and thorax USG, hemogram and CRP results, albumin, protein, lactate dehydrogenase (LDH) and glucose levels in pleural fluid and pleural fluid cell count were recorded. Pleural fluid PCT levels, serum PCT levels and thoracic USG images of PPE and non-PPE groups were compared statistically with each other. P-value <0.05 was considered statistically significant.
RESULTS: Of the 128 patients, 71 (55%) were diagnosed with PPE and 57 (45%) were diagnosed with non-PPE causes. There was no significant difference in the level of pleural fluid PCT and serum PCT levels between the PPE and non-PPE groups (p=0.31 and p=0.21, respectively). No statistically significant difference was found between the anechoic fluids and the complex pleural effusion without septum in the PPE and non-PPE groups (p=0.079 and p=0.147, respectively). However, complex septated fluids were higher in PPE group and this difference was statistically significant (p=0.003).
DISCUSSION AND CONCLUSION: It was found that the pleural fluid PCT and serum PCT measurements in the PPE did not have a diagnostic value. Pleural fluid PCT/serum PCT ratio were not significantly different between the two groups. In addition, there was no correlation between thoracic USG images and PCT levels.

INTRODUCTION: We aimed to review our data about the functional outcomes of the buccinator myomucosal flap used for head and neck reconstruction after oncologic ablative surgery.
METHODS: Retrospective chart analysis was performed of 15 patients between the ages 52 and 78 years (mean age 66 years) who had buccinator myomucosal flaps for oral cavity reconstruction after tumor ablation. All the resections and reconstructions were performed by the first author (BK) at two tertiary referral centers. The demographic feature of the patients, anatomical subsites of the cancer, operation type, flap raising time, total operation time, blood loss during flap harvesting, wound problems and other postoperative complications, decannulation time and postoperative oral feeding time were collected from the patients` medical charts.
RESULTS: One patient had minimal distal flap loss. There was no need for additional surgery for this patient. Two patients had partial wound dehiscence, which was resutured in the operating theatre. The donor sites were closed primarily in all cases. One of the patients had wound dehiscence in donor site which healed by secondary intention. Mean flap size was 7x3.2 cm. All flaps needed a second operation for pedicle separation due to the pedicled flap nature. All separations of pedicles were performed using sedation and adequate analgesia in operating theatre without general anesthesia. Mean separation time was 12 days after the first surgery. Three patients had tracheostomy and the mean decannulation time was three days for those. Soft diet was started in the postoperative 2nd day in all patients. However, mean postoperative oral feeding time without any nasogastric tube assistance was five (3–9 days) days. Mean flap harvesting time was 35 minutes (25–49 minutes). Mean intraoperative blood loss during flap harvesting was 25 ml (20–40 ml).
DISCUSSION AND CONCLUSION: Buccinator myomucosal flap should be in the armamentarium of every head and neck surgeon for oral cavity reconstruction.

INTRODUCTION: The rate of cardiac implantable electronic device (CIED) infections has become prevalent in recent years, and they are related to severe complications, as well as a cost burden. In the present study, we assessed the results of our single tertiary care center experience.
METHODS: All patients who underwent CIEDs implantation between 2012 and 2018 with procedural and follow-up data available were included in this study.
RESULTS: Device infection was defined in six of 512 patients aged from 29 to 78 years old. The mean follow-up period was 2.8±1.7 years. They were new implants and system, removal which included a generator, and all transvenous leads were carried out for five cases. Removal of the generator and debridement of the pocket was performed in one case with isolated pocket erosion without local signs of infection and the wound was irrigated with antibiotic solution. A 2-week oral antibiotic therapy was administered to all patients following discharge. After reimplantation, there was no infection recurrence in three patients during 13±6.1 months follow-up period. Baseline characteristics, with the exception of implanted device types, were similar between infected and non-infected patients. Hematoma or pneumothorax was not observed in patients with device infection.
DISCUSSION AND CONCLUSION: Prevalent risk factors for device infections were not relevant to our patients. Our device infection rates (1.17%) were slightly lower, and there was no serious complication due to the device infection itself or its management.

INTRODUCTION: Neonatal sepsis continues to be an important cause of morbidity and mortality in infants despite improvements in diagnosis and treatment. This study was planned to evaluate the demographic data, causative microorganisms and acute phase reactants at the time of diagnosis of blood culture positive sepsis in our neonatal intensive care unit.
METHODS: We evaluated our patients diagnosed with blood culture positive sepsis in the neonatal intensive care unit during three years retrospectively. In this study, 131 patients whose clinical and laboratory findings were consistent with sepsis were included.
RESULTS: The most common microorganism isolated from blood cultures that were taken at the time of diagnosis was S. aureus (n=36, 27.5%). Nineteen of them were methicillin-resistant S. aureus. Klebsiella species were isolated in 26 cases (19.8%) (K. pneumoniae, K. oxytoca and ESBL positive Klebsiella species in 13, 2 and 11 cases, respectively). Thrombocyte counts of our patients were statistically significantly lower on the first day of culture sampling compared to the fifth-day values (p<0.05), in contrast, CRP and mean platelet volume (MPV) values were significantly higher (p<0.05). According to our findings, on the first day of culture sampling, the CRP and mean of maximum CRP values of our patients with gram-positive sepsis were significantly lower than the values of our patients with gram-negative sepsis (p<0.05).
DISCUSSION AND CONCLUSION: In this study, the most common microorganisms which cause sepsis in our neonatal intensive care unit were determined. We detected that the clinical findings and markers of sepsis differ depending on the type of the organism, whether gram-positive or gram-negative and the type of infection, whether it is nosocomial or not.

INTRODUCTION: Preoperative pulmonary and cardiac function tests and some characteristics of the patients and surgery may predict operative outcomes after resection for lung cancer. In this study, we aimed to analyze the effects of these parameters on short-term outcomes.
METHODS: This is a retrospective study, including 117 patients who underwent surgical anatomical resection due to lung cancer and carcinoid tumor at a single center between January 2018 and September 2018. In this study, body mass index, forced expiratory volume in 1 sec (FEV1), transfer coefficient of the lung for carbon monoxide (KCO), ejection fraction, mean pulmonary artery pressure, and neoadjuvant treatment were evaluated and categorized into groups. Logistic regression and Kruskal–Wallis analysis were used to determine the predicted effects of the parameters on the duration of hospitalization and general complication rates. The patients who underwent major chest-wall reconstructions were excluded from this study.
RESULTS: The series comprised of 72 males and 45 females, with a mean age of 63.8±9.8 years. Most patients underwent a lobectomy (n=87; 61.5%). The evaluated parameters were not related to the duration of hospitalization and general complication rates. However, neoadjuvant treatment and preoperative low FEV1 were significantly related to occurring postoperative pneumonia.
DISCUSSION AND CONCLUSION: Over the limits of safety, which have been well known, preoperative pulmonary and cardiac functions did not predict the duration of hospitalization in patients who underwent resections for lung cancer. Postoperative pneumonia was related to the neoadjuvant treatment and relatively lower preoperative FEV1. The longer duration of hospital stay was the only parameter related to open surgery.

INTRODUCTION: To investigate the ability of the Action Research Arm Test (ARAT) scores to predict functional independence in the evaluation of upper extremity motor functions in stroke patients.
METHODS: A total of 59 patients with stroke with a mean age of 61.10±9.12 were included in this study. Forty-one (69.5%) of the patients were male, and 18 (30.5%) were female. After obtaining the demographic data of the patients who were followed up in the stroke outpatient clinic after the stroke, upper extremity functions were evaluated using ARAT test, and functional independence was evaluated with Performance Assessment of Self Care Skills (PASS) and Functional Independence Scale (FIM) tests. The data were retrospectively evaluated and recorded.
RESULTS: The mean stroke duration was 15.38±7.16 months. According to Spearman correlation test results, there was no correlation between ARAT and PASS (p=0.902), PASS-BADL (Basic activities of daily living) (p=0.480), PASS-IADL (Instrumental activities of daily living) (p=0.524) and between ARAT and FIM (p=0.451), FIM Motor (p=0.393), and FIM Cognitive (p=0.553). There was a weak correlation between the FIM and the PASS scores (r=0.278, p=0.033).
DISCUSSION AND CONCLUSION: ARAT scores routinely used in the evaluation of upper extremity motor functions were not correlated with functional independence. In addition to the ARAT test, functional independence scales may be appropriate for the evaluation of upper extremity motor functions.

INTRODUCTION: The present study aims to evaluate the efficacy and safety of botulinum toxin A (BONT-A) injection therapy on a group of patients with Idiopathic Parkinson’s disease (IPD)-associated sialorrhea.
METHODS: A retrospective analysis of 21 patients with sialorrhea and IPD treated with BoNT-A at our neurology outpatient clinic was conducted between June 2017- December 2018. BoNT-A was injected into the parotid glands without ultrasound guidance. Pre-treatment sialorrhea severity was quantified according to the Drooling Frequency and Severity Scale (DFSS) and Unified Parkinson’s Disease Rating Scale (UPDRS) part 2 item 6 Demographic characteristics of all the patients were recorded. Patients were summoned before the injection, one week after the injection, one month after the injection and three months after the injection and adverse effects on patients associated with the medical treatment were evaluated.
RESULTS: A significant decrease in the UPDRS and DSFS scores was observed when the 1st week, 1st month and 3rd months after the procedure are evaluated. However, the DSFS and UPDRS scores were significantly lower in the 1st month after the injection with regards to the 3rd month after the injection. No serious side effects were observed in the patients.
DISCUSSION AND CONCLUSION: In this study, it is demonstrated that BoNT-A injection is simple, safe, tolerable and effective in sialorrhea treatment of patients with IPD. However, further clinical studies involving longer-term follow-up and a larger number of patients are required to confirm and extend our results.

INTRODUCTION: Our objective was to examine the clinical properties of two anesthetic regimens, propofol-remifentanil target-controlled infusion (TCI) or desflurane-remifentanil TCI under bispectral index (BIS) guidance during lower abdominal surgery procedures.
METHODS: Sixty consenting patients who scheduled for lower abdominal surgery were prospectively studied and were included in one of the two groups: propofol-remifentanil group (Group P) or desflurane-remifentanil group (Group D). General anaesthesia was induced with 2 mg kg-1 propofol, 1 µ kg-1 remifentanil and 0.6 mg kg-1 rocuronium injection. After intubation, remifentanil was administered using the TCI device in both groups. The pharmacokinetic model of Minto was used. Group D patients received a 50%–50% oxygen-air mixture and 6% desflurane. The Schnider model was selected for the administration of propofol 1% (10 mg/mL) in Group P, and the TCI dose was adjusted to 4/mL-1. The propofol infusion and inspired fraction of desflurane were adjusted to keep BIS value between 40–60. Hemodynamic parameters, time until recovery of spontaneous respiration, eye-opening and tracheal extubation, compliance with verbal commands, duration of anesthesia and surgery and postoperative modified Aldrete scores were recorded for all patients.
RESULTS: The heart rate (p=0.006), diastolic arterial pressure (p=0.003) and mean arterial pressure (p<0.0001) for the Group P was significantly higher than Group D. The extubation time was shorter in Group P (p=0.02), but there was no significant difference between the groups concerning other recovery findings.
DISCUSSION AND CONCLUSION: BIS-guided combinations of propofol-remifentanil and desflurane-remifentanil delivered using TCI are both suitable for patients undergoing lower abdominal surgery. The low blood pressure achieved with target-controlled infusions of remifentanil and desflurane may confer important advantages.

INTRODUCTION: The present study aims to investigate the excessive daytime sleepiness in patients with hypothyroidism and in the healthy control group using the Epworth sleepiness scale.
METHODS: This study was completed with 127 people, 75 of whom were hypothyroidism and 52 were control group. Age, height, weight, body mass index, waist circumference, systolic and diastolic blood pressure of the all participants were recorded. Thyroid hormone tests and biochemical parameters were examined in the morning. Epworth Sleepiness Scale was used to measure daytime sleepiness.
RESULTS: Epworth Sleepiness Scale scores were 7.3±0.7 in the hypothyroid group and 6.4±0.4 in the control group, and there was no significant difference between the groups (p=0.703). Weight (p<0.001), body mass index (p<0.001), waist circumference (p=0.001) and triglyceride levels (p=0.001) were higher and high density lipoprotein levels were lower (p=0.001) in the hypothyroid group than the control group. Total cholesterol, low density lipoprotein level and high density lipoprotein level were lower in patients with hypothyroidism and excessive daytime sleepiness than those without hypothyroidism. High density lipoprotein levels were also lower in the group with normal thyroid function and excessive daytime sleepiness. There was no correlation between Epworth Sleepiness Scale scores and age, weight, height, body mass index, waist circumference, neck circumference, thyroid-stimulating hormone, systolic and diastolic blood pressure and blood lipid levels (p>0.05).
DISCUSSION AND CONCLUSION: Hypothyroidism and control group were similar concerning excessive daytime sleepiness. However, metabolic parameters deteriorated in daytime sleepy group compared to non-daytime sleepy group. It was concluded that similar studies with broader participation should be conducted.

INTRODUCTION: Laparoscopic adrenalectomy is the gold standard for the resection of adrenal tumors. There are some technical difficulties due to the rarity in general surgical practice and the long learning curve. The present study aims to evaluate perioperative and postoperative results of laparoscopic transperitoneal adrenalectomy in a single center.
METHODS: Between December 2008 and June 2018, 65 patients underwent laparoscopic transperitoneal adrenalectomy. Patients’ demographic data, peroperative and postoperative results were retrospectively analyzed from hospital medical records.
RESULTS: Sixty-five patients underwent laparoscopic transperitoneal adrenalectomy. In this study, there were 44 female and 21 male patients. According to the tumor types, there were forty-seven functional adrenal tumors, thirteen incidental adrenal tumors and three isolated adrenal metastasis from lung cancer. Thirty-one patients had right-sided and thirty-four patients had left-sided adrenal tumors. Conversion to open surgery was seen in five patients.
DISCUSSION AND CONCLUSION: Laparoscopic transperitoneal adrenalectomy is a feasible and safe operative technique in adrenal tumors. Patients should be mobilized early and enforced to respiratory exercise to decrease postoperative complications. In addition to them, the surgeon should be experienced in laparoscopy to decrease the rate of conversion.

INTRODUCTION: In this study, we tried to evaluate retrospectively high levels of parathyroid hormone in patients who received parathyroidectomy due to primary hyperparathyroidism in the light of the literature search.
METHODS: In this study, 121 patients who underwent surgery for primary hyperparathyroidism between September 2015 and December 2017 were retrospectively evaluated, according to gender, preoperative calcium and PTH levels, postoperative calcium and PTH levels, diagnosis, histopathological results, type of surgery, follow-up time and recurrence. We excluded patients who were unreachable.
RESULTS: Mean age was 54.83±12.56 (26–82). One hundred three patients were female (85.1%). One hundred nineteen patients were diagnosed (98.4%) as adenoma, whereas two patients were diagnosed as (1.6%) hyperplasia. According to histopathological results, 103 (85.1%) adenoma, four (3.3%) carcinoma, four (3.3%) hyperplasia and 10 (8.2%) adenoma and papillary carcinoma of the thyroid were found. Preoperative mean PTH value was 301.9±470 pg/ml (79-3674 pg/ml). Preoperative mean calcium level was 10.10 mg/dl (10.10 - 13.07 mg/dl). Postoperative mean PTH value was 77.2±11.1 pg/ml (6.0- 907 pg/ml). Postperative mean calcium level was 9.38±0.7 mg/dl (6.3- 11.4 mg/dl). Mean value was 9.38±0.7 mg/dl. Mean follow-up time was 18.75±5.4 (8–28) months. Post-operative PTH elevation persisted in 17 (14.8%) patients. Nine (7.4%) of them had chronic kidney failure, three (2.4%) patients suffered from vitamin D deficiency, and five (4.1%) cases had a recurrence.
DISCUSSION AND CONCLUSION: Primary hyperparathyroidism is a rare disease. In the absence of postoperative PTH decrease and normocalcemic PTH elevation should be considered as well as recurrence. Renal diseases, bone hunger and Vitamin D deficiency should be evaluated.

INTRODUCTION: In parallel with the increase in the elderly population in our country as in the world, the rate of the patients applied to the emergency services has shown an increase. The present study aims to investigate the application reasons of the patients aged 65 and over who were followed up in our emergency internal medicine unit, to examine their current diseases, to treat their newly-emerging acute problems, and to evaluate their follow-up processes.
METHODS: All patients aged 65 and over, who applied to the Emergency Internal Medicine Unit a tour hospital between October 2017 and December 2017, were retrospectively evaluated in this study. Gender, current disease, application reason and diagnosis (including ICD 10 codes) of the patients were recorded through their files. Applications were examined retrospectively through the hospital information system, and all data were entered into the program called SPSS 20.00 in the computer environment.
RESULTS: The mean age of 310 geriatric patients aged 65 and over who were examined in this study was 76.6.The youngest age was 65 and the oldest age was 103. Furthermore, it was found that 149 (47.9%) of the patients were men, 161 (51.8%) of them were women, 129 (41.5%) of them were between the ages of 65 and 74, 133 (42.8%) of them were between the ages of 75 and 84, 48 (15.4%) of them were in the age of >85. The most common diseases were cardiovascular system diseases, gastrointestinal system diseases and urinary system diseases.
DISCUSSION AND CONCLUSION: In our day, the rate of the elderly population applied to emergency services has increased. It has been found that the most common diseases are cardiovascular system diseases, gastrointestinal system diseases and urinary system diseases. In the first examination of the patients at hospitals, determination of the methods on diseases in accordance with their physical examination findings, anamnesis and medical treatment will be beneficial in terms of their life quality and survival.

INTRODUCTION: This study aims to investigate the effects of Turkey’s adoption of clinical trial (CT) regulations and international guidelines on CTs conducted in Turkey over the course of the 24 years.

METHODS: The ClinicalTrials.gov website and its advanced filtering were used to identify registered CTs performed in Turkey during four six-year intervals. Various characteristics of the CTs, such as design, phase distribution, participant age, and type of funding, and the percentage of surgery-related CTs, were analyzed.
RESULTS: The number of CTs conducted in Turkey increased exponentially during the 24-year study period, from 23 studies between 01/01/1994 and 01/01/2000 to 1930 studies between 01/01/2012 and 01/01/2018. Phase distribution analysis showed that there were more late-phase CTs than early-phase CTs in Turkey during the study period.
DISCUSSION AND CONCLUSION: Modernization of Turkey’s regulations for CTs facilitated the relevant growth of CTs in Turkey. Considering Turkey’s unique geographic location, technological advancements, and ease of patient recruitment, the observed exponential increase in the number of CTs performed is not surprising. The higher number of late-phase CTs, as compared to early-phase CTs in Turkey, indicates that late-phase CTs may be more common in developing countries because they are less expensive to conduct that early-phase CTs and the pool of potential participants are naive.

Surgery is a treatment choice in the presence of a giant emphysematous bulla (GBE) that covers at least one third of a hemithorax. In this article, a 53-year-old male patient who presented with complaints of progressive shortness of breath, sputum, and inability to perform his daily activities, diagnosed as bilateral GBE after radiological examinations, and post-operative problems were discussed. The right side GBE was operated on. In the postoperative period, there was an air leakage (AL), and the expansion of the lung was insufficient. As soon as respiratory distress and purulent secretion occurred, this important problem was resolved with autologous blood administration. In the presence of GBE, it is difficult to predict the surgical outcome about the lung tissue in the preoperative period. Very serious problems can be encountered in the postoperative period. In the postoperative period, the prolongation of HK and the inability of the lung to expand are very serious problems. Autologous blood application is safe, easy and effective in solving these problems.

Lyme disease is a zoonosis that arises from Borrelia burgdorferi spp belonging to the Spirochaetales family, transmitted by Ixodes-type ticks. In the course of the disease, the heart, skin, nervous and musculoskeletal system may be affected. Central nervous system involvement, defined as neuroborreliosis, may be similar to Guillain- Barré syndrome (GBS), an immune-mediated acute neuropathy. In this article, a case that was followed up in the neurology clinic with GBS due to facial paralysis, muscle weakness and widespread muscle pain was shared. Neuroborreliosis was considered in the differential diagnosis of the patient whose clinical findings did not improve due to the presence of tick contact in history, and the diagnosis was confirmed by clinical and laboratory findings. In this case, it was emphasized that neuroborreliosis should be kept in mind in the differential diagnosis of the GBS.

Stump appendicitis is a rare complication of an appendiceal inflammation after an incomplete appendectomy. Diagnosis of stump appendicitis in patients who have a history of appendectomy and presenting with acute abdomen is frequently overlooked. Imaging methods are of great importance in diagnosis. In this case report, we aimed to present the imaging and operation findings of stump appendicitis with a history of right lower quadrant pain for two days and a history of laparoscopic appendectomy three months ago. The patient was discharged uneventfully following a stump appendectomy.