GÝRÝÞ ve AMAÇ: S proteini bir transmembran proteini olup bu proteine karþý geliþen antikorlar, aþý sonrasý ve geçirilmiþ enfeksiyon sonrasý baðýþýklýðý araþtýrmak için kullanýlmaktadýr. Bu çalýþmada saðlýk çalýþanlarýnda CoronaVac aþýsý sonrasý antikor düzeylerinin ve aþýnýn etkinliðinin araþtýrýlmasý amaçlanmýþtýr.
YÖNTEM ve GEREÇLER: CoronaVac aþýsý uygulanmýþ, 96 saðlýk personeline ait verinin analizi yapýlmýþtýr. Ýki aþý dozu arasýnda 28 gün býrakýlarak birinci dozdan itibaren beþ aylýk periodda aylýk antikor ölçümleri yapýldý. SARS-CoV-2’ye karþý oluþan total antikorlar (IgM ve IgG), elektrokemilüminesans yöntemi ve S1 antijeninin reseptör baðlanma alanýný temsil eden rekombinant protein içeren Elecsys® Anti-SARS CoV-2 S kiti ile saptandý ve karþýlaþtýrýldý.
BULGULAR: Yaþlarý 22–69 (39.75±11.19) arasýnda deðiþen gönüllülerin %51’i (n=49) kadýndý. Ortalama antikor konsantrasyonu birinci doz aþý uygulamasýndan bir ay sonra 8.93 U/mL, ikinci doz aþýdan bir ay sonra 171.30 IU/mL, ikinci doz aþýdan iki ay sonra 125.90 IU/mL, üç ay sonra 98.57 IU/mL, dört ay sonraysa 89.85 IU/mL olarak tespit edilmiþtir. Birinci ve ikinci aylarda antikor düzeylerindeki artýþ; üçüncü, dördüncü ve beþinci aylarda antikor düzeylerindeki azalmalar istatistiksel olarak anlamlý bulunmuþtur. Antikor pozitifliði ≥0.8 IU/mL gözlenen ve nötralizan antikor (≥15 IU/mL) geliþen gönüllülerin oraný ilk doz aþý sonrasý %68.75 ve %5.21 olarak bulunmuþtur. Nötralizan antikor geliþtiren birey oraný, ikinci doz aþý sonrasý ise aylara göre %100, %93.8, %91.7 ve %89.6 þeklindedir. Bir kiþide, ikinci doz aþýdan dokuz hafta sonra SARSCoV-2 D3L içeren varyant (Ýngiltere varyantý) PCR pozitifliði saptanmýþtýr.
TARTIÞMA ve SONUÇ: Uzun süreli takiplerde nötralizan antikor seviyesinin beþinci ayýn sonunda dahi anlamlý olarak yüksek bulunmasý aþýnýn koruyucu olduðunu göstermektedir. Aþý sonrasý antikor konsantrasyonlarýnýn düþmesi ve SARS-COV-2’nin yeni varyantlarýnýn ortaya çýkmasý, destek aþý dozunun faydalý olabileceðini düþündürmektedir.

INTRODUCTION: Antibodies against the S protein are used to investigate post-vaccine and post-infection immunity. In this study, it was aimed to determine the antibody levels and the efficacy of the vaccine after the CoronaVac vaccine in healthcare workers.
METHODS: Data from 96 healthcare workers who had the CoronaVac vaccine were analyzed. From the first dose, monthly antibody measurements were made over a 5-months period with an interval of 28 days between two vaccine doses. Total antibodies (IgM and IgG) against SARS-CoV-2 were detected by the Electrochemiluminescence method using the Elecsys® Anti-SARS-CoV-2 S kit, which contains recombinant protein representing the receptor-binding site of the S1 antigen.
RESULTS: 51% (n=49) of the volunteers aged 22-69 (39.75±11.19) were female. The mean antibody concentration was 8.93 U/mL one month after the first vaccine dose, 171.30 IU/ mL one month after the second vaccine dose, 125.90 IU/mL two months after the second dose, 98.57 IU three months later, and 89.85 IU/mL after four months. Increase in antibody levels in the first and second months; The decreases in antibody levels in the in the following months were statistically significant. The proportion of subjects with antibody positivity
≥0.8 IU/mL and developing neutralizing antibodies (≥15 IU/mL) was 68.75% and 5.21% after the first dose of vaccination. The rate of individuals developing neutralizing antibodies were 100%, 93.8%, 91.7%, and 89.6% with regard to the months after the second dose of vaccination.
One person had SARS-CoV-2 D3L-containing variant (UK variant) PCR positivity 9
weeks after the second vaccine dose.
DISCUSSION AND CONCLUSION: In the long-term follow-up, the neutralizing antibody level was found to be significantly higher even at the end of the 5th month, indicating that the vaccine is protective. The decrease in post-vaccination antibody concentrations and the emergence of new SARSCOV-2 variants suggest that a booster dose may be beneficial.

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GÝRÝÞ ve AMAÇ: Bu çalýþmadaki amacýmýz; acil servise baþvurup hastaneye yatýþý planlanan COVID-19 hastalarýnýn mortalite tahmininde CURB-65 skoru ve hekimlerin geþtaltýnýn prediktif performansýný ölçmek ve birbirleriyle karþýlaþtýrmaktýr.
YÖNTEM ve GEREÇLER: Bu çalýþma ileriye yönelik-gözlemsel olarak tasarlanmýþtýr. 1 Mayýs–1 Haziran 2021 tarihleri arasýnda acil servise baþvuran tüm COVID-19 hastalarý çalýþmaya dahil edilmiþtir. Hastaneye yatýþý yapýlan hastalarýn gestalt yüzdeleri ve CURB-65 skorlarý hesaplanmýþ, bu sonuçlara göre hastane içi mortalite tahmin güçlerinin analizi yapýlmýþtýr.
BULGULAR: Bu çalýþma dahil etme-dýþlama kriterleri uygulandýktan sonra 101 hasta ile tamamlanmýþtýr. Hastalarýn yaþ ortalamasý 75.9±9.31 olup 55’i erkek (%54.5) idi. CURB-65 için en uygun pozitiflik sýnýr deðeri (cut off) ≥2.50, Gestalt için en uygun pozitiflik sýnýr deðeri (cut off) ≥%35 olarak bulundu. CURB-65’in AUC (area under curve) deðeri, sensitivitesi ve spesifitesi sýrasýyla; 0.668, 0.500 ve 0.841 olarak hesaplandý. Gestalt için ise bu deðerler sýrasýyla; 0.630, 0.789 ve 0.444 olarak bulundu.
TARTIÞMA ve SONUÇ: Bu çalýþmada COVID-19 hastalarýnda hastane içi mortaliteyi öngörmede CURB-65 skoru ve hekim gestaltýnýn prediktif güçlerinin baþarýlý olduðu, ancak birbirlerine üstünlükleri olmadýklarý bulunmuþtur. Çalýþmamýzýn sonuçlarýna göre sýnýrlý kaynak veya kalabalýk acil servislerde çalýþan hekimler için gestalt kullanýmýný öneriyoruz.

INTRODUCTION: This study aims to measure and compare the CURB-65 score and the predictive performance of physician’s gestalt in predicting mortality for COVID-19 patients admitted to the emergency department (ED) and intended for hospitalization.
METHODS: This study was designed as prospective-observational. All COVID-19 patients admitted to the ED between May 1 and June 1, 2021, were included in the study. Based on these results, the gestalt percentages and CURB-65 scores of the hospitalized patients were calculated, and the in-hospital mortality predictive power was analyzed.
RESULTS: This study was performed with 101 patients after utilising the inclusion-exclusion criteria. The mean age of the patients was 75.9±9.31 years and 55 (54.5%) were male. The most suitable cut-off value for CURB-65 was found to be ≥2.50, and the most suitable cutoff value for Gestalt was found to be ≥35%. Area under the curve (AUC) value, sensitivity and specificity of CURB-65, was calculated as 0.668, 0.500 and 0.841, respectively. For Gestalt, these values were found as 0.630, 0.789 and 0.444, respectively.
DISCUSSION AND CONCLUSION: In this study, it was revealed that the predictive powers of the CURB-65 score and physician’s gestalt were successful in predicting in hospital mortality for COVID-19 patients, but they were not superior to each other. According to the results of our study, we suggest the use of gestalt for physicians working in limited-resource or crowded EDs.

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GÝRÝÞ ve AMAÇ: Covid-19 pandemisi saðlýk alanýndaki pekçok iþleyiþi etkilemiþ, bir süre ellektif olan týbbi ve cerrahi iþlemlerin ertelenmesine ya da bulaþýcýlýðý daha az olan alternatif yöntemlerin kullanýlmasýna neden olmuþtur. Pandemi döneminde yaþamý tehdit eden acil durumlarda giriþimsel bronkoskopik iþlemler ertelenmeyerek devam etmiþtir. Çalýþmamýzýn amacý, giriþimsel bronkoskopik iþlemleri daha uzun süre dünyayý etkileyecek gibi görünen bu virüsün varlýðýnda, hasta seçimi, aciliyet durumu, iþlem baþarýsý ve komplikasyonlarý açýsýndan deðerlendirmektir.
YÖNTEM ve GEREÇLER: Covid-19 hastalýðýnýn en yoðun görüldüðü 11 Mart 2020 ile 01 Haziran 2020 tarihleri arasýndaki ilk dalga sürecinde giriþimsel pulmonoloji ünitemizde acil olarak iþlem uygulanan 21 hastanýn bilgisayar ve dosya kayýtlarý retrospektif olarak incelendi.
BULGULAR: Çalýþmamýza alýnan, yaþ ortalamasý 54.7±17 yýl olan 21 hastaya 23 giriþimsel bronkoskopik iþlem uygulanmýþtý. Dokuz hastada malign, dokuz hastada benign hava yolu obstrüksiyonu mevcuttu. Üç hastaya ise hemoptizi ve pulmoner alveolar proteinosise baðlý solunum yetersizliði nedeni ile iþlem uygulanmýþtý. Multimodalite tedavi olarak uygulanan giriþimsel bronkoskopik iþlem baþarý oranýmýz %100, akut komplikasyon oranýmýz %4.7, kronik komplikasyon oranýmýz %4.7, prosedürel mortalitemiz %0.0 ve 30 günlük erken mortalite oranýmýz %9 idi. Tüm iþlemler gerekli önlemler alýnarak negatif basýnçlý giriþimsel pulmonoloji ünitesinde yapýldý, ekip üyelerimizden hiçbirinde koronavirüse baðlý herhangi bir belirti ve semptom görülmedi.
TARTIÞMA ve SONUÇ: Gerekli tüm önlemleri almak kaydý ile pandemi periodunda ortaya çýkan, cerrahi ve invazif giriþimlerin uygulanamadýðý yaþamý tehdit eden massif hemoptizi, santral hava yolu obstrüksiyonu ve diðer acil durumlarda giriþimsel bronkoskopik iþlemler yüksek baþarý ve düþük komplikasyon oranlarý ile hastalarýn hayatýný kurtaran, saðkalýmý uzatan ve primer tedavilerine kadar onlara zaman kazandýran bir role sahiptir.

INTRODUCTION: The Covid-19 pandemic has caused delays in elective medical and surgical procedures in accordance with the measures and precautions to be taken. Alternative, low transmission risk procedures had to be adopted. Urgent and emergent interventional bronchoscopic procedures (IBP) were continued to be performed in life-threatening conditions. We aimed to evaluate the IBP performed during the ongoing pandemic in terms of patient selection, diagnoses, emergency/urgency, type of procedure used, success, and complications.
METHODS: Patients who underwent IBP in the first wave of pandemic between March 11, 2020, when the first patient was diagnosed with Covid-19, and June 1, 2020, in Turkey.
RESULTS: Twenty-one patients with a mean age of 54.7±17 years underwent 23 emergent/urgent IBP. Nine patients had malignant and 9 had benign airway obstruction. The remaining 3 patients were diagnosed with hemoptysis and pulmonary alveolar proteinosis.The success rate of IBP treatment was 100%, the acute complication rate was 4.7%, the chronic complication rate was 4.7%, the procedural mortality was 0.0% and the 30-days early mortality rate was 9%. All procedures were performed in interventional pulmonology (IP) unit with negative room pressure with as few auxiliary staff as possible. None of our team members developed signs and symptoms of coronavirus disease with the contribution of the constantly updated literature to our increasing clinical experience and measures taken.
DISCUSSION AND CONCLUSION: IBP can be performed with high success and low complication rates, even under pandemic conditions, especially in emergent/urgent life threatening situations such as central airway obstructions, massive hemoptysis, and other diseases, in the absence of other surgical and invasive procedures. They have a life-saving, survival-prolonging and time-saving role up to primary therapy, provided that all necessary precautions are taken.

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GÝRÝÞ ve AMAÇ: Geriatrik hastalarda yoðun bakým ünitelerine kabul oranlarý ve ölüm oranlarý, COVID-19 enfeksiyonu olan popülasyonun geri kalanýndan daha yüksektir. Hidroksiklorokin sülfatýn etkinliði artýk kabul edilmiþ olmasýna raðmen, özellikle enfeksiyon sýrasýnda erken baþlandýðýnda, geriatrik hastalarda bu erken zaman noktalarýnda etkinliði araþtýrýlmamýþtýr. Bu çalýþmada birincil amacýmýz, hidroksiklorokin sülfatýn erken tedavisinin COVID-19 pozitif geriatrik hastalarda klinik semptomlara dayalý olarak, yoðun bakým öncesi ve hasta saðkalýmý üzerindeki etkilerini araþtýrmaktý.
YÖNTEM ve GEREÇLER: Yoðun bakým ünitesinde COVID-19 tanýsý alan toplam 147 geriatrik hasta üç gruba ayrýldý: Acil servisten yoðun bakým ünitesine kabul edilen ancak tedavi almayan hastalar (Grup 1); beþ günlük tedavi baþlatýlan ancak tamamlanmayan klinikten kabul edilen hastalar (Grup 2); ve beþ günlük ilaç tedavisini tamamlamýþ olanlar (Grup 3).
BULGULAR: Üç grup arasýnda demografik veriler benzer olmasýna raðmen, yaþ parametreleri aralarýnda önemli ölçüde farklýydý. Ayrýca ölüm oraný, taburculuk veya ekstübasyon zamaný açýsýndan gruplar arasýnda fark yoktu. Grup 1'de mortalite süresi ve mekanik ventilasyon süresi anlamlý olarak daha kýsa bulundu (p=0.001).
TARTIÞMA ve SONUÇ: Hidroksiklorokin sülfatýn erken uygulanmasýna dayalý olarak, hasta saðkalýmý ve sonucu üzerinde önemli bir etki görülmemiþtir. Ana bulgularýmýza göre, bu çalýþma COVID-19'u olan geriatrik kritik hastalarda baþvuru öncesi hidroksiklorokin tedavisi önermemektedir

INTRODUCTION: The admission rates to intensive care units and mortalities in geriatric patients are higher than the rest of the population with COVID-19 infection. Although the efficacy of hydroxychloroquine sulfate has been recognized, especially when started early during infection, its effectiveness at these early time points in geriatric patients has not been investigated. In this study, our primary aim was to investigate the effects of early treatment of hydroxychloroquine sulfate on COVID-19 positive geriatric patients, according to their clinical symptoms, situation before the intensive care, and patient survival.

METHODS: A total of 147 geriatric patients diagnosed with COVID-19 in the intensive care unit were divided into three groups: Patients who were admitted to the intensive care unit from the emergency department but did not receive treatment (Group 1); from the service for whose a 5-day treatment was initiated but not completed (Group 2); and those who completed 5-days of drug therapy (Group 3).
RESULTS: Although demographic data were similar between the three groups, the age parameters were significantly differed between them. Furthermore, there was no difference between the groups regarding mortality rate, discharge time, or extubation. The time to mortality and the duration of mechanical ventilation were found to be significantly shorter in Group 1 (p=0.001).
DISCUSSION AND CONCLUSION: No significant effect was observed on patient survival and outcome due to early administration of hydroxychloroquine sulfate.According to our main findings, this study cannot recommend pre-admission hydroxychloroquine treatment for critically ill geriatric patients with COVID-19.

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GÝRÝÞ ve AMAÇ: Saðlýk çalýþanlarý COVID-19 enfeksiyonu için yüksek risk altýndadýr. Dünyanýn birçok ülkesinde olduðu gibi Türkiye’de de aþýlama için saðlýk çalýþanlarýna öncelik verildi. Bu çalýþmadaki amacýmýz Hastanemizde Coronovac aþýsýnýn ilk dozunu olduktan sonra COVID-19 enfeksiyonu görülen saðlýk çalýþanlarýnýn incelenmesidir.
YÖNTEM ve GEREÇLER: Bu geriye dönük gözlemsel çalýþmada, 14 Ocak 2021 tarihinde hastanemizde çalýþan saðlýk personellerine Coronavac aþýsýnýn ilk dozu uygulanmýþtýr. Çalýþmaya aþý sonrasý bir aylýk dönemde RT-PCR testi ile konfirme edilen COVID-19 enfeksiyonu görülen her iki cinsiyetteki saðlýk çalýþanlarýnýn tümü dahil edilmiþtir. Bu hastalarýn genel demografik ve klinik verileri hastanenin elektronik hasta kayýt yönetim sistemi (HBYS) kullanýlarak taranmýþtýr.
BULGULAR: Hastanemizde 4.195 saðlýk çalýþaný bulunmaktadýr. Bunlarýn 3.259’una (%77.68) Coronavac aþýsýnýn ilk dozu uygulanmýþtýr. Taný alan saðlýk personellerinin 17’si (%56.7) kadýn, 13’ü (%43.3) erkek cinsiyetinde olup ortalama yaþlarý 38.96±11.23 olarak saptandý. Ýki hastanýn pandemi servisinde yatýþý gerçekleþti. Hastalarýn hiçbirinde mortalite veya yoðun bakým yatýþ ihtiyacý görülmedi.
TARTIÞMA ve SONUÇ: Özellikle saðlýk çalýþanlarý arasýnda tespit edilmemiþ COVID-19 olgularý hastalar ve diðer personel için tehlikeli olabilir. Bu nedenle saðlýk çalýþanlarýnýn tamamýnýn aþýlanmasý hedeflenmelidir. Aþýlansa bile COVID-19 enfeksiyonu geçirebileceklerini unutmamalý, hastalýkla mücadelede kiþisel koruyucu önlemlerini almaya devam etmelidir. Ýlk doz aþýdan sonra görülen COVID-19 olgularý, ikinci doz aþýnýn gerekliliðini göstermektedir.

INTRODUCTION: Healthcare workers (HCWs) are at higher risk of COVID-19 infection. As in many countries, priority has been given to the vaccination of healthcare in Turkey. Our aim in the present study is to examine healthcare workers who contracted COVID-19 infection after receiving the first dose of the CoronaVac vaccine in our hospital.
METHODS: In this retrospective observational study, the first dose of the CoronaVac vaccine was administered to healthcare workers in our hospital on January 14, 2021. All healthcare workers of both sexes, who were confirmed to have COVID-19 infection by RT-PCR test in the one month post-vaccination period, were included in the study. The patients’ demographics and general clinical data were analysed using the hospital’s electronic patient record management system (EPRMS).
RESULTS: There are 4,195 healthcare workers in our hospital. Of these, 3,259 (77.68%) received the first dose of the CoronaVac vaccine. Of all healthcare workers diagnosed with COVID-19 infection, 17 (56.7%) were female and 13 (43.3%) were male, with an average of 38.96±11.23 years. Two patients were admitted to the pandemic service. None of the patients were admitted to the intensive care unit or died.
DISCUSSION AND CONCLUSION: Undetected cases of COVID-19, especially among healthcare workers, can be dangerous for patients and other healthcare workers. Therefore, vaccination of all healthcare workers should be the primary goal. It should always be kept in mind that even if vaccinated, it is possible to become infected with COVID-19, and thus, personal protective measures should always be maintained in the fight against the disease. The occurrence of COVID-19 cases after the first dose of the.

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GÝRÝÞ ve AMAÇ: COVID-19’a komorbiditelerin sýk eþlik ettiði gösterilmiþtir olup komorbiditelerin olumsuz sonuçlar için risk faktörü olabileceði düþünülmektedir.Çalýþmamýzýn amacý, COVID-19 tanýsý ile kliniðimize yatýrýlan olgularda eþlik eden hastalýklarýn prevalansýný, komorbiditelerin hastalýðýn aðýrlýðý ve prognozu üzerine etkisini saptamaktýr
YÖNTEM ve GEREÇLER: Retrospektif, epidemiyolojik, tek merkezli çalýþmamýza, 15 Mart–15 Haziran 2020 tarihleri arasýnda SARS-CoV-2 ile enfekte olup hastaneye yatýrýlan, üst solunum yolundan boðaz ve burun sürüntü örnekleri kullanýlarak RT-PCR (reverse transkripsiyon-polimeraz zincir reaksiyonu) testi ile ve/veya korona virüsü pnömonisi ile uyumlu akciðer görüntüleme özelliðine göre klinik olarak teþhis edilen olgular alýndý. Hastalýðýn aðrýlýðý ve prognoz ile komorbiditelerin arasýndaki iliþki istatistiksel olarak deðerlendirildi.
BULGULAR: COVID-19 tanýsý alan toplam 258 hasta çalýþmamýza dahil edildi. Toplam 140 (%54.3) hastada altta yatan komorbidite mevcuttu. Hastalarýn 134’ü (%51.9) erkek ve 124’ü (%48.1) kadýn, yaþ ortalamalarý 54.2 (min: 18; maks: 92) yýldý. En yaygýn saptanan komorbidite hipertansiyon (%32.9) ve diyabet (%22.1) idi. Aðýr pnömoni geliþimi hipertansiyon varlýðýnda (%.47.0 vs %34.1), kalp yetersizliði varlýðýnda (%66.6 vs. %36.2) ve immünsupresyon varlýðýnda (%69.2 vs. %37.0) anlamlý düzeyde yüksek bulundu (p<0.05). Komorbiditesi olan hastalarda YBÜ’ye yatýþ %12.1 iken, olmayanlarda %6.8 saptandý (p=0.147). Komorbiditesi olmayan hastalarda ölüm oraný %4.2 iken komorbiditesi olan hastalarda mortalite %8.6 idi (p=0.162). Ek hastalýðý sýrasýyla olanlarda ve olmayanlarda ölüm oranlarý, hipertansiyon (%11.7–%4.0, p=0.019), immunsupresyon (%23–5.7, p=0.046), kalp yetersizliði (%22.2–%5.4, p=0.022), diabet (%14.0–%4.4, p=0.029) ve kronik böbrek hastalýðý (%33.3–%5.6, p=0.016) için anlamlý düzeyde yüksek bulundu.
TARTIÞMA ve SONUÇ: Çalýþmamýzda komorbiditesi olan hastalarda hastalýðýn daha aðýr seyrettiði, YBÜ’ye yatýþ ve ölüm gibi olumsuz sonuçlarýn daha fazla görüldüðü saptanmýþtýr. Bu nedenle hastalarýn öyküleri alýnýrken ek hastalýklarýnýn dikkatli sorgulanmasý önem taþýmaktadýr. Bu yaklaþým daha aðýr seyredebilecek hastalarý erken tespit etmemize, tedavi planýný ve yatýþ kararýný düzenlememize yardýmcý olacaktýr.

INTRODUCTION: Patients with coronavirus 2019 (COVID-19), the disease caused by infection with severe acute respiratory syndrome-related coronavirus 2 (SARS-CoV-2), frequently have comorbidities and this is thought to be a risk factor for poorer outcomes. The aim of this study was to determine the prevalence and effect of comorbidities on the severity and prognosis of patients hospitalized with a diagnosis of COVID-19.
METHODS: This was a retrospective, single-center, epidemiological study. Patients with a confirmed SARS-CoV-2 infection of the upper respiratory tract based on a reverse transcription-polymerase chain reaction test using throat and nasal swab samples and/or clinically diagnosed according to lung imaging features compatible with coronavirus pneumonia hospitalized between March 15 and June 15, 2020 were included in the study. The relationship between the severity and prognosis of COVID-19 and comorbidities was analyzed.
RESULTS: A total of 258 patients diagnosed with COVID-19 were included in the study; 140 (54.3%) patients had at least 1 comorbidity and 118 (45.7%) patients were categorized as patients without a comorbidity. In the group, 134 (51.9%) patients were male and 124 (48.1%) were female, with a mean age of 54.2±16.6 years (range: 18–92 years). The most common comorbidities were hypertension (32.9%) and diabetes mellitus (22.1%). The rate of development of severe pneumonia was significantly higher in the presence of hypertension (47.0% vs. 34.1%), heart failure (66.6% vs. 36.2%), and immunosuppression (69.2% vs. 37.0%) (p<0.05). Intensive care unit (ICU) admission was necessary for 12.1% of the patients with a comorbidity and 6.8% of the patients without a comorbidity (p=0.147). While the mortality rate was 4.2% in patients without a comorbidity, mortality was observed in 8.6% of the patients with comorbidities (p=0.162). The mortality rate was 11.7% vs. 4.0% (p=0.019) for hypertension, 23% vs 5.7% (p=0.046) for immunosuppression, 22.2% vs. 5.4% (p=0.022) for heart failure, 14.0% vs. 4.4% for diabetes mellitus (p=0.029), and 33.3% vs. 5.6% for chronic kidney disease (p=0.016).
DISCUSSION AND CONCLUSION: The findings indicated that the course of COVID-19 was more severe in patients with comorbidities, and negative effects, such as ICU admission and death, were more common. It is important to determine comorbid diseases when taking the medical history of COVID-19 patients in order to identify patients likely to have a more dangerous clinical course and to adjust the treatment plan accordingly.

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GÝRÝÞ ve AMAÇ: Bu çalýþmanýn amacý, farklý nedenlerle kronik enfeksiyon veya büyük doku defektleri geliþen göðüs cerrahisi hastalarýnda vakum yardýmlý kapatma (VAC) tedavisinin etkinliðini deðerlendirmektir.
YÖNTEM ve GEREÇLER: Þubat 2017–Aralýk 2020 tarihleri arasýnda kliniðimizde VAC tedavisi uygulanan toplam 10 hasta çalýþmaya dahil edildi. Hastalarýn yaþ, cinsiyet, hastanede kalýþ süresi, primer patolojinin etiyolojisi, VAC kalýþ süresi, sünger deðiþikliði sayýsý, yara yerine mikrobiyolojik kültür sonuçlarý, nüks, komorbidite varlýðý, morbidite ve mortalite verileri analiz edildi.
BULGULAR: On hastanýn yedisi erkek, üçü kadýndý. Ortalama yaþ 47 (23–71) idi. Ortalama hastanede kalýþ süresi 61.3 gün (13–141 gün) ve ortalama VAC kalýþ süresi 43.2 gün (12–102 gün) idi. VAC deðiþiklikleri üç–dört günlük aralýklarla planlandý ve ortalama 3.6 günde bir deðiþim yapýldýðý tespit edildi. Ýki hasta ateþli silah yaralanmasý, biri koroner baypas cerrahisi sonrasý sternal dehissens (SD), biri yüksekten düþmeye baðlý travmatik doku defekti, biri kist hidatik cerrahisini takiben geliþen ampiyeme baðlý ve ikisi pulmoner rezeksiyon sonrasý (primer akciðer kanseri) bronkoplevral fistül (BPF), üçü ise göðüs duvarý malign kitle (iki primer, bir metastaz) rezeksiyonu sonrasý kronik enfeksiyon için tedavi edildi. Yara kültürlerinde en sýk izole edilen mikroorganizma, psödomonas alttürleriydi. VAC tedavisi tamamlandýktan sonra iki hastaya ek tedavi gerekti. Hastalarda yatýþ sýrasýnda ve taburcu olduktan sonra ölüm görülmedi.
TARTIÞMA ve SONUÇ: VAC uygulamasý, normal iyileþmenin olmadýðý yara veya enfeksiyonlarda yara iyileþmesini desteklemek ve hýzlandýrmak için kullanýlan kontrollü negatif basýnç temelinde çalýþan bir sistemdir. VAC, torasik enfeksiyonlarýn yönetimi ve ölü alanýn azaltýlmasý için yararlý ve güvenli bir yöntemdir.

INTRODUCTION: The aim of this study was to evaluate the effectiveness of vacuum-assisted closure (VAC) therapy in thoracic surgery patients who developed chronic infections or large tissue defects for different reasons.
METHODS: A total of 10 patients who underwent VAC therapy in our clinic between February 2017 and December 2020 were included in the study. Age, gender, length of hospital stay, primary pathology etiology, duration of VAC stay, number of sponge changes, microbiologicalculture results from the wound site, recurrence, presence of comorbidity, morbidity, and mortality data of the patients were analyzed.
RESULTS: Of the 10 patients, 7 were male and 3 were female. The mean age was 47 (23–71). The average length of hospital stay was 61.3 days (13–141 days) and the mean VAC stay was 43.2 days (12–102 days). VAC changes were made at 3–4-day intervals and it was determined that changes were made every 3.6 days on average. Two patients were treated for gunshot wounds, one for sternal dehiscence (SD) after coronary bypass surgery, one for traumatic tissue defect due to fall from height, one for bronchopleural fistula (BPF) and empyema after cyst hydatid surgery, and three for chronic infection after chest wall malignant mass (two primary, one metastasis) resection and two for BPF after pulmonary resection (primary lung cancer). The most commonly isolated microorganism in wound cultures was the pseudomonas subspecies. Two patients were re-treated after the completion of VAC treatment. No mortality was observed in the patients during hospitalization or after discharge.
DISCUSSION AND CONCLUSION: VAC application is a system that works on the basis of controlled negative
pressure used to support and accelerate wound healing in wounds or infections where there
is no normal healing. VAC is a useful and safe method for the management of thoracic infections
and the reduction of dead space.

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GÝRÝÞ ve AMAÇ: Nötrofil-lenfosit oraný (NLO), çeþitli kanser türleri için prognostik deðeri olan, kolayca ölçülebilir bir parametredir. Küçük hücreli akciðer kanserinde (KHAK) NLO’nun prognoz açýsýndan rolü tartýþmalýdýr. Bu çalýþmanýn amacý; KHAK’li hastalarda NLO, TLO (trombositlenfosit oraný) gibi potansiyel faktörleri deðerlendirmek ve bunlarýn prognoz ile arasýndaki iliþkiyi araþtýrmaktýr.
YÖNTEM ve GEREÇLER: Retrospektif kohort çalýþmasý, 1 Ocak 2008 ile 31 Aralýk 2012 tarihleri arasýnda KHAK tanýsý konan 396 hastayý üçüncü basamak bir hastanenin göðüs hastalýklarý bölümüne dahil etmiþtir. Taný sýrasýnda NLO düzeylerine göre gruplandýrýlan hastalar; düþük NLO (<4) (Grup 1) ve yüksek NLO (≥4) (Grup 2) ayrýldý. Bu gruplar kaydedilen verilerle karþýlaþtýrýlmýþ ve mortalite ile ilgili prediktif deðerler analiz edilmiþtir.
BULGULAR: Yüksek NLO’ya sahip hastalar düþük NLO’ya sahip hastalara kýyasla daha kötü performans durumu, geniþ evre ve daha düþük yanýt oranýna sahipti. Genel saðkalým (OS) yüksek NLR grubunda daha kötü idi. Aksine, yüksek TLO OS ile iliþkili deðildi. Çok deðiþkenli analiz, yüksek NLO ve laktat dehidrojenaz, evre, sigara öyküsü, malign plevral efüzyon varlýðýnýn OS için baðýmsýz prognostik faktörler olduðunu göstermiþtir.
TARTIÞMA ve SONUÇ: Yüksek NLO kolayca ölçülebilir ve kötü prognozu yansýtan prognostik bir belirteç olarak kullanýlabilirken, TLO KHAK’li hastalar için saðkalým ile iliþkili deðildir.

INTRODUCTION: Neutrophil-to-lymphocyte Ratio (NLR) is an easily measurable parameter with prognostic value for various types of cancer. The role of NLR in terms of prognosis in small cell lung cancer (SCLC) is controversial. The aim of this study was to investigate the relationship between NLR, platelet-to-lymphocyte ratio (PLR), other potential factors and prognosis in patients with SCLC.
METHODS: A retrospective cohort study enrolled 396 patients diagnosed with SCLC between January 1, 2008, and December 31, 2012 in the department of chest diseases of a tertiary hospital. Patients were grouped according to their NLR levels at the time of diagnosis; low-NLR (<4) (Group 1) and high-NLR (≥4) (Group 2). These groups were compared with the recorded data and predictors of mortality and the results were analyzed.
RESULTS: Patients with low-NLR (<4) (Group 1) had worse performance status, extensive stage, and lower response rate compared to patients with high-NLR (≥4) (Group 2). Median overall survival (OS) was worse in the high-NLR group than in the low-NLR group (Group 1). In contrast, elevated PLR was not associated with OS. Multivariate analysis showed that elevated NLR and lactate dehydrogenase, stage, smoking history, presence of malign pleural effusion were independent prognostic factors for OS.
DISCUSSION AND CONCLUSION: Elevated NLR is easily measurable can be used as a prognostic marker that reflects poor prognosis, while PLR is not associated with survival for patients with SCLC.

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Amaç: Kliniðimizde 2015–2020 tarihleri arasýnda üçüncü ventrikül kolloid kisti nedeniyle mikroskopik anterior interhemisferik transkallozal
yaklaþýmla opere edilen olgular literatür eþliðinde tartýþýlmýþtýr.

Gereç ve Yöntem: Üçüncü ventrikül kolloid kisti nedeniyle opere edilen yedi hastanýn (4 kadýn, 3 erkek) baþvuru þikayetleri, nörolojik muayeneleri, saptanan kolloid kistlerin boyutlarý, hidrosefali eþlik edip etmediði, yapýlan cerrahi, cerrahi esnasýnda yapýlan kallosal kesi çaplarý, postop nörolojik durumlarý, komplikasyon, epilepsi, diskonneksiyon ve nörokognitif bozukluklar geliþip geliþmediði geriye dönük olarak incelendi.

Bulgular: Tüm hastalarýn ameliyat sonrasý nörolojik muayenelerinde bir defisit gözlenmedi. Altý hastanýn kolloid kistlerinin total olarak çýkarýldýðý görüldü. Takiplerinde hiçbir hastanýn þant gereksinimi olmadý, epileptik nöbet, diskonneksiyon sendromu ve nörokognitif bozukluklar gözlenmedi.

Sonuç: Anterior interhemisferik transkallosal yaklaþým, kýsa operasyon süresi minimal morbidite ile iliþkili, iyi total rezeksiyon için üçüncü ventrikül kolloid kistlerinin tedavisinde güvenli bir yoldur.

Objective: The cases operated using the microscopic anterior interhemispheric transcallosal approach due to third ventricular colloid cyst during 2015–2020 in our clinic were discussed in the light of the literature.

Methods: Seven patients (four females, three males) operated for colloid cyst of the third ventricle were examined retrospectively in terms of their presentation complaints, neurological examinations, size of the colloid cysts detected, presence/absence of accompanying hydrocephalus, surgery performed, callosal incision diameter used in the surgery, post-operative neurological conditions, complications, epilepsy, and development of disconnection and neurocognitive disorders.

Results: No neurological deficits were observed in the post-operative examinations of any patients. It was observed that the colloid cysts of six patients were completely removed. None of the patients required shunts during their follow-up, and epileptic seizure, disconnection syndrome, and neurocognitive disorders were not observed.

Conclusion: The anterior interhemispheric transcallosal approach is a safe way to treat colloid cysts of the third ventricle for a good total resection, with a short operative time. This is associated with minimal morbidity.

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GÝRÝÞ ve AMAÇ: Literatür, anevrizmal subaraknoid kanamadan sonra önde gelen mortalite ve morbidite nedeni olan vazospazmýn etiyolojisinde nöroinflamasyonun rolüne iþaret etmektedir. Resolvin D1’in nöronlar üzerinde apoptoza karþý koruyucu bir etkiye sahip olduðu ve anevrizmal subaraknoid kanamadan sonra nöroinflamasyon ve vazospazm üzerinde anti-inflamatuar etkisi olduðu varsayýlmaktadýr. Bu çalýþmada, anevrizmal subaraknoid kanamalý hastalarda serum resolvin D1 düzeylerini ve bunun vazospazm ve C-reaktif protein, nötrofil ve albümin gibi inflamatuar belirteçlerle olasý iliþkisini araþtýrmayý amaçladýk.
YÖNTEM ve GEREÇLER: Spontan anevrizmal subaraknoid kanamasý olan 15 hastanýn verileri, 17 saðlýklý gönüllünün verileriyle karþýlaþtýrýldý. Anevrizmal subaraknoid kanamalý hastalar iki gruba ayrýldý: anjiyografik vazospazm olan subaraknoid kanama grubu (8 hasta) ve anjiografik vazospazm olmayan subaraknoid kanama grubu (7 hasta). Subaraknoid kanamadan sonra 1, 4, 9 ve 14. günlerde seri serum resolvin D1 ölçümleri alýndý.
BULGULAR: Resolvin D1 seviyeleri, anjiyografik vazospazmý olan hastalarda subaraknoid kanamadan sonraki birinci günde istatistiksel olarak anlamlý derecede yüksekti (p=0.021). Ayrýca anjiyografik vazospazmý olan grupta da ölçülen tüm resolvin D1 deðerleri diðer gruplara göre daha yüksekti. Serum C-reaktif protein ve nötrofil düzeylerinin ölçümleri, kontrol grubuna kýyasla her iki grupta da subaraknoid kanamadan sonraki birinci günde istatistiksel olarak anlamlý derecede yüksek bulundu.
TARTIÞMA ve SONUÇ: Resolvin D1 seviyeleri, nöroprotektif ve antiinflamatuar özelliklerinden dolayý inflamasyona sekonder yükselme eðilimindedir. Böylece subaraknoid kanama + vazospazm grubunda yüksek resolvin D1 seviyeleri, anevrizmal subaraknoid kanama sonrasý anjiyografik vazospazmýn etyopatogenezinde inflamatuar süreçlerin rol oynadýðýný göstermiþtir. Sonuç olarak, resolvin D1, anevrizmal subaraknoid kanama sonrasý anjiyografik vazospazmýn tahmininde önemli bir biyobelirteç olabilir.

INTRODUCTION: The literature points to the role of neuroinflammation in the aetiology of vasospasm, which is the leading cause of mortality and morbidity after aneurysmal subarachnoid haemorrhage. Neuroinflammation has been found to contribute to early and delayed brain injury, both of which are associated with poor clinical outcomes. Resolvin D1 is hypothesised to have a protective effect on neurons against apoptosis and has anti-inflammatory and pro-resolving effects on the neuroinflammation and vasospasm after aneurysmal subarachnoid haemorrhage. In this study, we aimed to investigate the serum resolvin D1 levels and its possible relationship with vasospasm and inflammatory markers, such as C-reactive protein, neutrophil and albumin in patients with aneurysmal subarachnoid haemorrhage.
METHODS: Fifteen patients with spontaneous aneurysmal subarachnoid haemorrhage between June 2017 and May 2018 presenting at our institution were included in the study. Their data were compared with those of 17 healthy volunteers. Patients with aneurysmal subarachnoid haemorrhage were divided into two groups: the subarachnoid haemorrhage with vasospasm group (8 patients), which included patients with subarachnoid haemorrhage and angiographic vasospasm, and subarachnoid haemorrhage without vasospasm group (7 patients), which included patients with subarachnoid haemorrhage without angiographic vasospasm. Serial serum resolvin D1 measurements were taken on days 1, 4, 9 and 14 after subarachnoid haemorrhage.
RESULTS: Resolvin D1 levels were statistically significantly higher on day 1 after subarachnoid haemorrhage in patients with angiographic vasospasm (p=0.021). Additionally, in the group with angiographic vasospasm, all the measured resolvin D1 values were also higher compared to other groups. The measurements of serum C-reactive protein and neutrophil levels were found to be statistically significantly higher on day 1 after subarachnoid haemorrhage in both groups compared to the control group.
DISCUSSION AND CONCLUSION: Resolvin D1 levels tend to increase secondary to inflammation because of its neuroprotective and anti-inflammatory properties. Thus, high resolvin D1levels in the subarachnoid haemorrhage + vasospasm group indicated that inflammatory processes play a role in the aetiopathogenesis of angiographic vasospasm after aneurysmal subarachnoid haemorrhage. Consequently, resolvin D1 might be an important biomarker in the prediction of the angiographic vasospasm after aneurysmal subarachnoid haemorrhage.

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GÝRÝÞ ve AMAÇ: Bu çalýþmanýn amacý, T1-aðýrlýklý (T1A) FLAIR (sývý atenüasyon inversiyon geri kazanýmý) görüntülemenin rutin beyin manyetik rezonans (MR) incelemesindeki deðerini araþtýrmak; ayrýca T1A spin-eko (SE) ve hýzlý T1A FLAIR sekanslarý anatomik yapýlarýn tanýmlanabilirliði ve görüntü kalitesi açýsýndan karþýlaþtýrmaktý.
YÖNTEM ve GEREÇLER: T1A SE ve hýzlý T1A FLAIR sekanslarý, 30 saðlýklý olguda anatomik yapýlarýn tanýmlanmasý, genel görüntü kalitesi ve artefaktlarýn varlýðý açýsýndan kalitatif ve kantitatif olarak analiz edildi. Sinyal-gürültü oraný (SNR) ve kontrast-gürültü oraný (CNR) deðerleri, arka çukur ve talamus seviyelerindeki gri madde, beyaz madde ve beyin omurilik sývýsý dahil olmak üzere eþdeðer lokalizasyonlardan iki dizinin sinyal yoðunluðu deðerleri alýnarak belirlenmiþtir.
BULGULAR: SNR deðerleri T1A SE’de T1A FLAIR sekanslarýna göre talamus ve arka çukur düzeyinde anlamlý olarak yüksekti (p<0.001). Talamik seviyedeki ölçümler, beyin omurilik sývýsý-gri madde ve gri-beyaz madde için T1A FLAIR CNR deðerlerinin T1A SE’ye göre anlamlý olarak daha yüksek olduðunu gösterdi (p=0.0001). Arka çukur düzeyindeki ölçümler, gri-beyaz madde için T1A FLAIR CNR deðerlerinin T1A SE’ye göre anlamlý olarak daha yüksek olduðunu gösterdi (p=0.006).
TARTIÞMA ve SONUÇ: Bu çalýþmada, beynin T1A görüntülemesinde, T1A FLAIR sekansýnýn CNR deðerleri açýsýndan kalitatif ve kantitatif deðerlendirmelerde T1A SE’den üstün olduðunu bulduk. Bununla birlikte, SNR deðerleri T1A SE görüntülemede daha yüksek bulundu.

INTRODUCTION: The aim of this study was to investigate the value of T1-weighted (T1W)/FLAIR (fluid attenuation inversion recovery) imaging in routine brain magnetic resonance (MR) evaluation by comparing the T1W spin-echo (SE) sequence with the T1W rapid FLAIR sequence in terms of identifiability of anatomical structures and image quality.
METHODS: T1W SE and T1W rapid FLAIR sequences were qualitatively and quantitatively analysed with regard to the identification of anatomical structures, general image quality and presence of artefacts in 30 healthy cases. Signal-to-noise ratio (SNR) and contrast-to-noiseratio (CNR) values were determined using the signal intensity values of two sequences from equivalent localisations, including the grey substance, white substance and cerebrospinal fluid at the level of the posterior fossa and thalamus.
RESULTS: SNR values were significantly higher in T1W SE than in T1W FLAIR sequences at the level of the thalamus and posterior fossa (p<0.001). Measurements at the thalamic level revealed that CNR values of T1W FLAIR for cerebrospinal fluid-grey substance and grey white substance were significantly higher when compared to T1W SE (p=0.0001). The measurements at the posterior fossa level demonstrated that CNR values of T1W FLAIR for grey-white substance were significantly higher when compared to T1W SE (p=0.006).
DISCUSSION AND CONCLUSION: In this study, we found that in T1W imaging of the brain, T1W FLAIR sequence was superior to T1W SE in qualitative and quantitative evaluations in terms of CNR values. Nevertheless, SNR values were found to be higher in T1W SE imaging.

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GÝRÝÞ ve AMAÇ: Orta þiddette veya þiddetli fiziksel aktivite; sedanter geçirilen zamana bakýlmaksýzýn daha iyi kardiyometabolik risk faktörleriyle iliþkilendirilmiþtir. Bu araþtýrmada týp fakültesi öðrencilerinin kiþiliklerine göre fiziksel aktivite düzeylerinin belirlenmesi amaçlanmýþtýr.
YÖNTEM ve GEREÇLER: Araþtýrma verilerinin toplanmasýnda fiziksel aktivite düzeyi ve etkileyen faktörleri içeren sorulardan oluþan bir anket kullanýlmýþtýr. Ayrýca 10 Maddelik Kiþilik Ölçeði ve Uluslararasý Fiziksel Aktivite Anketi’nin (UFAA) Kýsa Formu kullanýlmýþtýr.
BULGULAR: UFAA’ya göre, tüm öðrencilerin %38.7’si düþük veya inaktif, %47.8’i orta ve %13.4’ü yüksek fiziksel aktif idi. Normal fiziksel aktiviteye sahip olduðunu düþünen öðrencilerin %10.9’u inaktif, %50.9’u orta düzeyde fiziksel aktif ve %38.2’si yüksek düzeyde fiziksel aktif idi. Algýlarýna göre yeterli fiziksel aktif olduðunu düþünen öðrencilerin %17.5’i inaktifti. Bisiklete binme, koþma, dans etme ve takým oyunlarýna katýlan öðrencilerin UFAA ile ölçülen fiziksel akivite düzeyleri, bu aktiviteleri yapmayanlara göre anlamlý derecede yüksek bulundu (p<0.05). Öðrencilerin kiþilik puanlarýna, beden kitle indeksi gruplarýna, bazý fiziksel aktivite tiplerine (yürüme ve yüzme) ve cinsiyete göre fiziksel aktivite düzeyleri arasýnda anlamlý fark yoktu.
TARTIÞMA ve SONUÇ: Yeterli fiziksel aktif olduðunu düþünen öðrencilerin %17.5’i UFAA’ya göre inaktifti. UFAA’ya göre öðrencilerin yalnýzca %13.4’ü yeterli fiziksel aktifti. Fiziksel aktivite düzeyi, kiþilik özelliklerinden etkilenmemekteydi.

INTRODUCTION: Moderate and vigorous physical activity (PA) has been associated with better cardiometabolic risk factors in adolescents, regardless of the quantity of sedentary time. The aim of this study was to determine the level PA engagement and perception of sufficient PA among students of a faculty of medicine and to investigate a correlation with personality traits.
METHODS: A questionnaire was used to collect data about the level of PA and factors that might influence participation. A 10-item personality inventory and the short form of the International Physical Activity Questionnaire (IPAQ) were also administered in student interviews.
RESULTS: According to the IPAQ scores, 38.7% of the students had a low level of activity or were inactive (LPA), 47.8% had a moderate level of participation (MPA), and 13.4% ranked as highly active (HPA). The results indicated that 10.9% of the students who reported regular PA were classified as LPA, 50.9% were graded as MPA, and 38.2% had an HPA score. Of the students who reported a perception of sufficient PA, 17.5% were scored as LPA. Students who participated in cycling, running, dancing, and team sports had a significantly higher IPAQ measurement (p<0.05). Personality scores, body mass index, some types of PA (walking and swimming), and gender were not correlated with PA level.
DISCUSSION AND CONCLUSION: The findings indicated that 17.5% of the students who thought that they engaged in sufficient PA actually had an LPA score. The IPAQ results revealed that only 13.4% of the students actually had a sufficient level of PA, as defined by the World Health Organization guidelines. The level of PA participation was not affected by personality traits.

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GÝRÝÞ ve AMAÇ: Saðlýk çalýþanlarýna yeterli eðitim verilmesi ve doðru koruyucu önlemlerin alýnmasý lateks alerjisi ile mücadelede etkin yollardan biridir. Biz de bu çalýþmamýzda saðlýk çalýþanlarýnýn bu konudaki yeterliliklerini saptamak amacý ile lateks alerjisi hakkýndaki bilgi düzeyleri, davranýþ modelleri ve lateks alerji görülme sýklýðýný incelemeyi hedefledik.
YÖNTEM ve GEREÇLER: Dört yüz on saðlýk çalýþanýna late ks alerjisi hakkýnda bilgi düzeyi ve kaçýnma yöntemlerini ölçen anket uygulamasý yapýldý. Doktor tanýlý lateks alerjisi olan ve lateks maruziyet ile semptom tarifleyen 53 kiþiye ikinci bir anket uygulamasý daha yapýldý.
BULGULAR: Çalýþmaya dahi ledilen 410 saðlýk çalýþanýn 240 (%61.9) kadýn ve median çalýþma süresi 5 (IQR: 0.13–38) yýldý. Lateks maruziyet sonrasý semptom tarifleyen saðlýk çalýþan oraný 74 (%18) ve bunlarýn median çalýþma süresi 34.50 (IQR: 21–50) yýldý. Bu grupta kiþilerin ise 41’inin (%78.8) lateks alerjisini saptamak amacý ile deri testlerini yaptýrmadýklarý saptandý. Lateks alerjeninden korunma yöntemleri hakkýnda bilgi düzeylerine bakýldýðýnda araþtýrma görevlileri ve hemþirelerin teknisyenlerden daha bilgili olduklarý saptandý (p=0.47, p=0.16, sýrasýyla). Endiþe düzeyleri meslek gruplarý arasýnda karþýlatýrýldýðýnda hemþirelerde ve teknisyenlerde araþtýrma görevlilerine gore anlamlý derecede yüksek bulundu (p=0.012, p=0.001, sýrasýyla).
TARTIÞMA ve SONUÇ: Elde edilen veriler genel olarak saðlýk çalýþanlarýnýn lateks alerjisi hakkýnda yeteri kadar bilgiye sahip olmadýklarý ve meslek gruplarýna baktýðýmýzda ise bunun teknisyenlerde daha da belirgin olduðu görüldü. Buna paralel olarak da endiþe düzeylerinin yüksek olduðu saptandý. Saðlýk çalýþanlarýndaki bu bilgi açýðýnýn eðitimlerle kapatýlmasý, lateks maruziyeti ile semptom varlýðýnda taný amaçlý deðerlendirilmesi ve etkin koruyucu önlemlerin alýnmasý lateks alerjisi ile mücadelede etkili olacaðý düþünülmektedir.

INTRODUCTION: Adequate training and protective measures are some of the effective ways to preventi latex allergy. This study aimed to assess the level of knowledge about latex allergy, behavioral patterns and the incidence of latex allergy.
METHODS: Four hundred ten healthcare workers (HCWs) were invited to participate in a survey and answer a questionnaire on the level of knowledge and protective methods of latex allergy. A second supplemental questionnaire was applied to 53 HCWs who were diagnosed with latex allergy or had symptoms of latex exposure.
RESULTS: The study population consisted of 410 HCWs; 240 (61.9%) were female and had a median working duration of 5 (IQR: 0.13–38) years. 74 (18%) HCWs described symptoms after latex exposure with a median working time of 34.5 (IQR: 21–50) years. Despite the symptoms, skin test was not performed 41 (78.8%) of 74 patients. When the knowledge levels of protection methods from the latex allergen were compared, research assistants and nurses were found to be more than the technicians (p=0.047, p=0.016, respectively). When the anxiety level was compared between occupational groups, it was significantly higher in nurses and technicians compared to research assistants (p=0.012, p=0.001, respectively).
DISCUSSION AND CONCLUSION: The data indicated that HCWs are not adequately informed about latex allergy, and comparing the occupational groups, this fact was more remarkable among technicians. Continuing education of HCWs regarding latex allergy, appropriate diagnostic tests in the presence of symptoms, and taking effective protective measures are essential steps in the fight against latex allergy.

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GÝRÝÞ ve AMAÇ: Göz içi lens gücü hesaplamasý için AL-Scan ve IOL-Master 500 optik biyometrileri kullanarak, katarakt cerrahisi sonrasý refraktif sonuçlarý karþýlaþtýrmak.
YÖNTEM ve GEREÇLER: Çalýþmaya katarakt ameliyatý geçiren ve ayný göz içi lensi (Eyecryl Plus HSAS600) implante edilen 78 ardýþýk hastanýn 78 gözü dahil edildi. Grup 1’de ameliyat öncesi biyometri AL-Scan ile ve Grup 2’de IOL Master 500 ile yapýldý. Ameliyat öncesi ve sonrasý altýncý ayda düzeltilmemiþ uzak görme keskinliði, düzeltilmiþ uzak görme keskinliði ve manifest sferik kýrýlma kusuru (MSRE) deðerlendirilmeleri yapýldý.
BULGULAR: Ortalama ameliyat sonrasý manifesr sferik refraktif kusur, grup 1 ve 2’de sýrasýyla -0.28±0.30 Diyoptri (D) ve -0.32±1.13 D olarak saptandý (p=0.38). Ameliyat sonrasý altýncý ay vizitinde, Grup 1’de gözlerin %92’si hedef refraksiyonun 0.50 D içindeydi ve Grup 2’de %93’ü 0.50 D içindeydi (p=0.99). Düzeltilmemiþ ve düzeltilmiþ uzak görme keskinliði her iki grupta da anlamlý olarak arttý (p<0.001). Ortalama ameliyat sonrasý düzeltilmemiþ uzak görme keskinliði, grup 1 ve 2’de sýrasýyla 0.72±0.12 ve 0.66±0.16 olarak bulundu (p=0.20). Her iki grupta da ameliyat sýrasýnda ve sonrasýnda görmeyi tehdit eden bir komplikasyon geliþmedi.
TARTIÞMA ve SONUÇ: Bu bulgular, AL-Scan biyometri cihazýnýn, ayný göz içi lenslerin implantasyonundan sonra IOL Master ile karþýlaþtýrýlabilir ameliyat sonrasý sonuçlar saðladýðýný göstermektedir.

INTRODUCTION: To compare refractive results after cataract surgery using AL-Scan and IOL-Master500 optical biometers for intraocular lens power calculation.
METHODS: 78 eyes of 78 consecutive patients undergoing cataract surgery and implanted with the same intraocular lens (Eyecryl Plus HSAS600) were included in the study. In Group 1, preoperative biometry was performed with AL-Scan, and in Group 2, with IOL Master 500. Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), and mean absolute refractive error (MARE) at preoperative and 6-month follow-up visits were recorded.
RESULTS: The postoperative mean MARE was -0.28±0.30 Diopter (D) and –0.32±1.13 D in Groups 1 and 2, respectively (p=0.38). At the 6th month visit, 92% of eyes in Group 1 were within 0.50 D of target refraction in Group 1 and, 93% of eyes in Group 2 were within 0.50 D (p=0.99). Uncorrected and corrected distance visual acuity improved significantly in both groups (p<0.001). The mean postoperative UDVA were 0.72±0.12 and 0.66±0.16 in Groups 1 and 2, respectively (p=0.20). No sight-threatening complication occurred during or after the operation in either group.
DISCUSSION AND CONCLUSION: These findings show the AL – Scan provides comparable postoperative results with the IOL Master after implantation of the same intraocular lenses.

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GÝRÝÞ ve AMAÇ: Bu çalýþmanýn amacý, kronik santral seröz koryoretinopatili (SSKR) hastalarýn 577 nm eþik altý sarý mikropuls lazer tedavisi (ESMLT) sonuçlarýný beþ yýllýk takip ile deðerlendirmektir. Ayrýca, baþlangýç klinik özelliklerinin nüks ve ESMLT tedavi yanýtlarý üzerindeki etkisini deðerlendirildi.
YÖNTEM ve GEREÇLER: Kronik SSKR’li 72 hastanýn 81 gözü en az beþ yýl takip edildi. Hastalar 577-nm ESMLT tedavi edildi. En iyi düzeltilmiþ görme keskinliði (EÝDGK), santral maküla kalýnlýðý (SMK), merkezi maküla hacmi (MMH), toplam maküla hacmi (TMH) ve subfoveal koroid kalýnlýðý (SFKK) spektral domain optik koherens tomografi (SD-OKT) ile ölçüldü.
BULGULAR: Ortalama EÝDGK 0.46±0.25 Log MAR’dan 0.11±0.22 Log MAR’a yükseldi ve ortalama SMK 404.60±72.46 μm’den 243.50±24.97 μm’ye düþtü (p<0.001). Son vizitte 70 gözde (%86.4) ESMLT seanslarý ile tam subretinal sývý (SRS) rezorpsiyonu ve 11 gözde (%13.6) rezidüel SRS vardý. Beþ yýl takipte 68 gözde (%83.9) nüks görülmezken, 13’ünde (%16.1) nüks görüldü. Çok deðiþkenli analizlerde, nüks ile SFCT≥ 416.00 μm (p<0.001) arasýnda istatistiksel olarak anlamlý bir korelasyon vardý ve baþlangýç SFCT≥ 474.00 μm ve baþlangýç EÝDGK ile ESMLT’ye yanýt vermeme ile anlamlý korelasyon saptandý (sýrasýyla p=0.025 ve p=0.040).
TARTIÞMA ve SONUÇ: ESMLT’nin uzun süreli izlemde güvenli ve etkili olduðu bulunmuþtur. Klinik özellikler ve bazý SD-OKT parametreleri, ESMLT’ye verilen tedavi yanýtýnýn ve nüksün belirleyicileri olabilir.

INTRODUCTION: The aim of the study was to assess the results of 577 nm subthreshold yellow micropulse laser treatment (SYMLT) in patients with chronic central serous chorioretinopathy (CSC) with a five-year follow-up. We also evaluated the effect of baseline characteristics on relapse and the SYMLT treatment responses.
METHODS: A total of 81 eyes of 72 patients with chronic CSC were followed for at least 5 years. Patients were treated with 577-nm SMYLT in multiple sessions at a 5% duty cycle. Best-corrected visual acuity (BCVA), central macular thickness (CMT), central macular volume (CMV), total macular volume (TMV) and subfoveal choroidal thickness (SFCT) were measured by spectral-domain optical coherence tomography (SD-OCT). Other basic SDOCT parameters were recorded.
RESULTS: The mean BCVA improved from 0.46±0.25 Log MAR to 0.11±0.22 Log MAR and the mean CMT decreased from 404.60±72.46 μm to 243.50±24.97 μm at last visit (p<0.001). At the last visit, 70 eyes (86.4%) had complete subretinal fluid (SRF) resorption with SYMLT sessions, and 11 eyes (13.6%) had residual SRF. While recurrence was not observed in sixty-eight (83.9%) patients within five years, it was observed in 13 (16.1%). In multivariate analyses, there was a statistically significant correlation between recurrence and SFCT≥ 416.00 μm (p<0.001) and baseline SFCT≥ 474.00 μm and baseline BCVA were significantly correlated with non-response to SYMLT (p=0.025 and p=0.040, respectively).
DISCUSSION AND CONCLUSION: SYMLT has been found to be a safe and effective in long-term follow-up. Clinical characteristics and some SD-OCT parameters might be predictors of treatment response to SYMLT and its recurrence.

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GÝRÝÞ ve AMAÇ: Bu çalýþmada, Ocak 2018–Eylül 2020 tarihleri arasýnda kadýn doðum ve jinekoloji kliniðinde yapýlan total laparoskopik histerektomi operasyonlarýnýn intraoperatif ve ameliyat sonrasý sonuçlarýnýn geriye gönük bir deðerlendirmesinin yapýlmasý amaçlanmýþtýr.
YÖNTEM ve GEREÇLER: Ocak 2018–Eylül 2020 tarihleri arasýnda benign endikasyonlar nedeniyle total laparoskopik histerektomi uygulanan 445 hastanýn dosyalarý ve operasyon vaka notlarý hastane bilgi yönetim sisteminden alýnarak intraoperatif ve ameliyat sonrasý sonuçlarý analiz edildi.
BULGULAR: Çalýþmaya dahil edilen 445 hastanýn ortalama yaþý 51.2±8.5 ve parite 2.98±1.85 idi ve en sýk histerektomi endikasyonu myoma uteri idi. Ortalama operasyon süresi 100.7±36.7 dakika olarak belirlendi. Genel majör komplikasyon oraný %3.2 ve laparatomiye geçiþ oraný %1.5 olarak bulundu.
TARTIÞMA ve SONUÇ: Vajinal histerektomiye uygun olmayan hastalarda total laparoskopik histerektomi, hasta konforunu artýrmasý ve cerrahi ekibin deneyiminin artmasýyla komplikasyon oranlarýnýn daha düþük olmasý nedeniyle makul bir seçenek olabilir.

INTRODUCTION: In the present study, it was aimed to retrospectively evaluate the intraoperative and postoperative outcomes of all laparoscopic hysterectomy procedures carried out at the obstetrics and gynecology department between January 2018 and September 2020.
METHODS: The files and operation case notes of 445 patients who underwent total laparoscopic hysterectomy for benign indications between January 2018 and September 2020 were retrieved from the hospital information management system and their intraoperative and postoperative outcomes were analysed.
RESULTS: The mean age of 445 patients included in the present study was 51.2±8.5 and parity 2.98±1.85, and the most common indication for hysterectomy was myoma uteri. The mean operation time was determined as 100.7±36.7 min. The overall major complication rate was 3.2% and the rate of conversion to laparotomy was found to be 1.5%.
DISCUSSION AND CONCLUSION: In patients who are not suitable for vaginal hysterectomy, total laparoscopic hysterectomy may be a reasonable option in terms of increasing the patient comfort, lower complication rates, and increasing the the experience of the surgical team.

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GÝRÝÞ ve AMAÇ: Elektif göðüs cerrahisi olgularýnda ultrason eþliðinde erektör omurga düzlem bloðunun etkilerini araþtýrdýk.
YÖNTEM ve GEREÇLER: Çalýþmamýza 18–70 yaþlarý arasýnda elektif torasik cerrahi geçiren 40 ASA I-II-III hasta dahil edildi. Her biri 20 hastadan oluþan ESPB ve kontrol gruplarýný ayýrdýk. Demografik özellikler, VKÝ, komorbiditeler, ameliyatýn tipi ve süresi, ilk saat içindeki petidin ihtiyacý, ilk analjezik ihtiyacý zamaný, 24 saat içindeki toplam analjezik miktarý kaydedildi.
BULGULAR: Ýlk analjezik gereksinim süresi ESPB grubunda 5.90±2.61 saat, kontrol grubunda 1.80±0.95 saatti. ESPB grubunda ameliyat sonrasý 24 saatte ortalama parasetamol gereksinimi 2.00±0.56 g, deksketoprofen gereksinimi 15.00±28.56 mg ve tramadol gereksinimi 30.00±47.01 mg idi. Kontrol grubunda ortalama parasetamol gereksinimi 2.90±0.31 g, deksketoprofen gereksinimi 22.50±30.24 mg, tramadol gereksinimi 80.00±76.78 mg idi. ESPB grubu 3.01±0.76, kontrol grubunda ortalama 4.03±0.51, ESPB grubunda ortalama dinamik VAS 3.65±0.76 ve kontrol grubunda ortalama 4.70±0.54 idi. Statik VAS deðerleri tüm takiplerde ESPB grubunda daha düþüktü. ESPB grubunda, tüm takiplerde dinamik VAS deðerleri de daha düþüktü.
TARTIÞMA ve SONUÇ: ESPB’nin ameliyat sonrasý analjeziyi iyileþtirdiði ve torasik cerrahide analjezi ihtiyacýný azalttýðý bulunmuþtur.

INTRODUCTION: We investigated the effects of ultrasound-guided erector spinae plane block in elective thoracic surgery cases.
METHODS: 40 ASA I-II-III patients, aged between 18–70 years who underwent elective thoracic surgery were included. We seperated Erector Spinae Plane Block (ESPB) and control groups, each containing 20 patients. The demographic features, Body Mass Index (BMI), comorbidities, the type and duration of surgery, pethidine requirement within the first hour, time of first analgesic requirement, the total analgesic amount within 24 hours were recorded.
RESULTS: The first analgesic requirement time was 5.90±2.61 hours in the ESPB group and 1,80±0,95 hours in the control group. The mean paracetamol requirement was 2.00±0.56 g, dexketoprofen requirement was 15.00±28.56 mg, and tramadol requirement was 30.00±47.01 mg in the ESPB group in the postoperative 24 hours. In the control group, the mean paracetamol requirement was 2.90±0.31 g, dexketoprofen requirement was 22.50±30.24 mg, tramadol requirement was 80.00±76.78 mg. The mean static VAS in the ESPB group was 3.01±0.76, the mean in the control group was 4.03±0.51, the mean dynamic VAS in the ESPB group was 3.65±0.76, and the average in the control group was 4.70±0.54. Static VAS values were lower in the ESPB group at all follow-ups. In the ESPB group, the dynamic VAS values were also lower at all follow-ups.
DISCUSSION AND CONCLUSION: ESPB was found to improve postoperative analgesia and reduce the need for analgesia in thoracic surgery.

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Pnömomediastinum ve pnömoraþi daha çok travmatik olmak üzere çeþitli patolojilere sekonder ortaya çýkan tablolardýr. Nadiren spontan olarak geliþebilen bu patolojilerin birlikteliði ise daha da nadir görülmektedir. Bu çalýþmada da 18 yaþýnda erkek olguda geliþen spontan pnömomediastinum ve pnömoraþi birlikteliði literatürler eþliðinde sunuldu.

Pneumomediastinum and pneumorrhachis may occur secondary to various pathologies, though it is usually a traumatic injury. The coexistence of these pathologies is rare. This report is a description of the spontaneous development of pneumomediastinum and pneumorrhachis in an 18 year-old male patient and a brief discussion of the relevant literature.

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