GÝRÝÞ ve AMAÇ: Bu çalýþmanýn amacý yoðun bakýmda yatan kritik hastada 30 günlük mortalitenin erken prediksiyonunda þok indeks, modifiye þok indeks, Rapid Emergency Medicine Score (REMS), quick Sepsis Related Organ Failure Assessment (qSOFA) ve The Acute Physiology and Chronic Health Evaluation (APACHE II) skorlama sistemlerinin etkinliðini kýyaslamaktýr.
YÖNTEM ve GEREÇLER: Bu çalýþma tek merkezli, geriye dönük, gözlemsel kohort çalýþmasý olarak yapýldý. Mart 2020–Mart 2021 arasýndaki 12 aylýk dönemde COVID-19 enfeksiyonu sebebi ile yoðun bakýma alýnan hastalarý kapsamaktadýr. Otuz günlük mortaliteyi öngörmede skorlama sistemlerinin receiver operating characteristic (ROC) eðrileri çizilmiþ ve area under curve (AUC) deðerleri hesaplanmýþtýr. Ýstatistiksel anlamlýlýk olarak p deðeri 0.05 veya daha altý kabul edilmiþtir.
BULGULAR: Çalýþma toplamda 634 yoðun bakým hastasý ile tamamlandý. Hastalarýn %75.7 (n=480) inde mortalite ile görüldü. Deðerlendirmeye alýnan shockindex, modified shock index, REMS, qSOFAand APACHE 2 skorlarýnýn 30 günlük mortaliteyi tahmin etmede AUC deðerleri sýrasýyla 0.59, 061, 0.72, 0.59 ve 0.63 saptandý. Buna göre en etkin skorlama REMS olarak tespit edildi.
TARTIÞMA ve SONUÇ: Çalýþmamýza göre REMS skorlama sistemi COVID-19 enfeksiyonu geçiren yoðun bakým hastasýnda 30 günlük mortalteyi predikte etmede kullanýlabilecek bir skorlamadýr.

INTRODUCTION: To compare the effectiveness of shock index (SI), modified shock index (MSI), Rapid Emergency Medicine Score (REMS), quick Sepsis Related Organ Failure Assessment (qSOFA), and Acute Physiology and Chronic Health Evaluation (APACHE II) scoring systems in the early prediction of 30-day mortality in critically ill COVID-19 patients admitted to the intensive care unit.
METHODS: This study was conducted as a single-center, retrospective, observational cohort study and included patients admitted to the intensive care unit due to COVID-19 infection during the 12-month period between March 2020 and February 2021. The receiver operating characteristic curves of the scoring systems were constructed to predict 30-day mortality, and their area under curve (AUC) values were calculated. A p-value of 0.05 or less was accepted as statistically significant.
RESULTS: The study was completed with a total of 634 intensive care patients. Mortality occurred in 75.7% (n=480) of the patients. The AUC values of the SI, MSI, REMS, qSOFA, and APACHE II scores in predicting 30-day mortality were found to be 0.59, 061, 0.72, 0.59, and 0.63, respectively. The most effective scoring was determined as REMS
DISCUSSION AND CONCLUSION: According to our results, REMS is a scoring system that can be used to predict 30-day mortality in COVID-19 patients admitted to the intensive care unit.

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GÝRÝÞ ve AMAÇ: Bu çalýþmanýn amacý, Tükiye’deki bir akciðer nakli merkezine sevk edilen kistik fibrozis hastalarda aday listeleme ve akciðer nakli sonuçlarýný analiz etmektir.
YÖNTEM ve GEREÇLER: Ocak 2015–Temmuz 2022 yýllarý arasýnda kistik fibrozise baðlý son dönem akciðer hastalýðý nedeniyle akciðer nakli merkezimizde detaylý tetkik edilen 27 hasta geriye dönük olarak deðerlendirildi. Hastalarýn baþvuru anýndaki özellikleri, listeye alýnma durumu, sað kalým ve akciðer nakli sonuçlarý kaydedildi.
BULGULAR: Hastalarýn 14’ü (%52) kadýn, 13’ü (%48) erkekti. Ortalama yaþ 17.81±7.24, ortalama VKÝ 15.5±2.0 idi. Altý hastada (%22) KF iliþkili diabet mevcuttu. Yirmi beþ hasta (%92.6) uzun süreli oksijen tedavisi almaktaydý. Yirmi üç (%85.2) hastada düþük BMI, sekiz hastada (%29.6) osteopeni 15 hastada (%55.5) osteoporoz mevcuttu. Dört hastada (%14.8) karaciðer fibrozisi saptandý. Yirmi beþ hasta (%92.6) bekleme listesine alýndý. Bir hasta (%3.7) erken olgu bir hasta (%3.7) da düþük VKÝ nedeniyle listeye alýnmadý. Overall bekleme süresi ortalama 544.0±376.5 gün idi. Bekleme listesinde dokuz hasta (%45) hayatýný kaybetti. Bekleme listesindeki hastalardan beþine (%20) akciðer nakli (4 bilateral pulmoner+1 bilateral lober) uygulandý. Akciðer nakli yapýlan hastalardan biri erken dönemde hayatýný kaybetti.
TARTIÞMA ve SONUÇ: Geliþmiþ ülkelerin aksine ülkemizde KF nedeniyle akciðer nakli merkezine yönlendirilen hastalar pediatrik ve genç eriþkin hastalardan oluþmaktadýr. Akciðer naklinden en iyi faydayý saðlamak için Kistik fibrozisli hastalar, uzun bekleme süresi, donör kýtlýðý, modifiye edilebilen ko-morbiditelerin tespit ve tedavisi için transplantasyon merkezine erken dönemde sevk edilmelidir.

INTRODUCTION: This study aimed to analyze candidate listing and lung transplant outcomes in cystic fibrosis (CF) patients referred to a lung transplant center in Turkey.
METHODS: Between January 2015 and July 2022, 27 patients were evaluated retrospectively in our lung transplant center for end-stage lung disease due to CF. The characteristics of the patients at the time of admission, their status on the list, survival, and lung transplantation results were recorded.
RESULTS: Of the total patients, 14 (51.9%) of the patients were females and 13 (48.1%) were males. The average age was 17.81±7.24 years, and the mean body mass index (BMI) was 15.5±2.0 years. Six patients had cystic fibrosis-related diabetes (22.2%). Twenty-five patients (92.6%) were receiving supplemental oxygen. Low BMI was present in 23 (85.2%) patients, osteopenia in 8 patients (29.6%), and osteoporosis in 15 patients (55.6%). Four patients had liver fibrosis (14.8%). Twenty-five patients (92.6%) were added to the waiting list. Because of the early case and low BMI, one patient from each was omitted. The mean overall waiting time was 544.0±376.5 days. Nine patients (45%) on the waiting list died. Lung transplantation (4 bilateral pulmonary + 1 bilateral lobar) was performed on 5 patients (20%) on the waiting list. One of the lung recipients died in the early postoperative period.
DISCUSSION AND CONCLUSION: Contrary to developed countries, patients referred to our lung transplant center due to CF consisted of pediatric and young adult patients. Patient referral should be planned considering the long waiting period and the shortage of donors in Turkey, and the need for time to manage modifiable comorbidities. Patients with CF should be referred early to the transplantation center to obtain the best benefit from lung transplantation.

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GÝRÝÞ ve AMAÇ: Ankilozan spondilit (AS), kronik inflamatuvar bir hastalýktýr ve inflamatuvar bel aðrýsý ana semptomdur. Mevcut aðrýnýn nosiseptif yanýnda nöropatik komponenti ile ilgili çalýþmalar mevcuttur. Kronik aðrýlý durumlarda santraL sensitizasyon (SS) varlýðý çeþitli hastalýklarda vurgulanmaktadýr ancak AS’li hastalarda yeterli çalýþma bulunmamaktadýr. Bizim amacýmýz AS’de hastalýk aktivitesi,aðrý tipi, SS varlýðýný ve iliþkilerini deðerlendirmektir.
YÖNTEM ve GEREÇLER: Hastalar yaþ, cinsiyet, vücut kitle indeksi, hastalýk süresi, tedavide kullanýlan ilaçlar, aðrý tipi ve þiddeti, SS varlýðý, hastalýk aktivitesi ve yaþam kalitesi açýsýndan deðerlendirildi.
BULGULAR: Çalýþmaya 49 (%61.3) kadýn, 31 (%38.8) erkek toplam 80 hasta AS hastasý dahil edildi. PainDETECT, BASDAI, NRS, ASDAS-ESH, ASQoL skorlarýnda yükseklik, ve SF-12 fiziksel skorunda düþme(p<0.001***), SF-12 mental skorunda düþme (p<0.01**) ve yaþ artýþý (p<0.05*) ile SS varlýðý arasýnda istatistiki olarak anlamlýlýk tespit edildi.
TARTIÞMA ve SONUÇ: Bizim çalýþmamýz, AS tanýlý hastalarda SS varlýðýnýn çokluðunun, hastalarýn hem çok yönlü deðerlendirilmesi gerektiði, hem de tedavi yaklaþýmýnda sadece inflamasyonun baskýlanmasý yanýnda SS’e yönelik tedavilerin eklenmesi yönünde deðerlendirilmesinin önemini vurgulamaktadýr.

INTRODUCTION: Ankylosing spondylitis (AS) is a chronic inflammatory disease. Its main symptom is inflammatory low back pain. The presence of central sensitization (CS) in chronic pain conditions has been emphasized in several studies, but there are insufficient studies on AS patients. The aim of this study was to evaluate the relationship between disease activity in AS, the type of pain, and the presence of CS.
METHODS: Patients’ age, gender, body mass index, disease duration, drugs used in the treatment, pain type and severity, presence of CS disease activity, and quality of life were evaluated.
RESULTS: Evaluation was made on 80 patients, comprising 49 (61.2%) females and 31 (38.8%) males. A statistical significance was found between the presence of CS and high scores of painDETECT, Bath Ankylosing Spondylitis Disease Activity Index, Numerical Rating Scale for pain, Ankylosing Spondylitis Disease Activity Index-sedimentation, Ankylosing Spondylitis Quality of Life Index, low Short-Form-12 (SF-12) physical score (***p<0.001), low SF-12 mental score (**p<0.01), and increased age (*p<0.05).
DISCUSSION AND CONCLUSION: The results of this study demonstrated that as CS was present in the majority of AS patients, multidirectional evaluation of these patients is required, and in treatment approaches, evaluation is important in respect of treatments for CS in addition to the suppression of inflammation.

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GÝRÝÞ ve AMAÇ: Bu çalýþmada Suriye’nin kuzeybatýsýndaki pandemi hastanelerine COVID-19 nedeniyle yatan hastalarýn deðerlendirilmesi amaçlandý.
YÖNTEM ve GEREÇLER: Çalýþmada 1 Temmuz 2020–01 Aralýk 2020 tarihleri arasýnda Suriye’nin kuzeybatýsýndaki Pandemi hastanelerine COVID-19 nedeniyle pandemi acilden yatan tüm hastalar deðerlendirilmiþtir. COVID-19 nedeniyle yatan tüm hastalar için demografik, klinik, laboratuvar, görüntüleme özellikleri, 4C mortalite indeksi skorlarý ile tedavileri ve progresyonlarý retrospektif olarak araþtýrýldý.
BULGULAR: Çalýþmaya Suriye’nin kuzeybatýsýnda pandemi acilden yatan COVID-19 hastalarýnýn tedavi ve takiplerinin yapýldýðý Afrin Hastanesi’nden 114, El-Bab Hastanesi’nden 251, Azez Vatan Hastanesi’nden 527, Cerablus Hastanesi’nden 99 olmak üzere toplam 991 hasta dahil edildi. 4C mortalite skorlama sistemine göre hastalarýn ölüm ve yoðun bakýma yatýþ oranlarý karþýlaþtýrýldýðýnda Azez Vatan ve Cerablus Hastaneleri'nde yüksek risk skoru alanlarýn, El Bab Hastanesi’nde ise çok yüksek risk skoru alanlarýn ölüm ve yoðun bakým yatýþ oranlarý anlamlý olarak daha yüksek bulunmuþtur (p<0.05).
TARTIÞMA ve SONUÇ: Bu ve benzeri bölgelerde COVID-19 salgýnýna yaklaþýmýn deðerlendirildiði çalýþmalarla elde edilecek veriler mahrumiyet bölgelerinde saðlýk hizmetinin geliþtirilmesinde önem arz etmektedir. Bölgede COVID-19 nedenli yatan hastalarý yansýtan verilerimizin ilk ve tek olmasý nedeniyle çalýþmamýzýn literatüre önemli bir katký saðlayacaðýný düþünmekteyiz.

INTRODUCTION: The aim of this study was to investigate the patients treated for COVID -19 in pandemic hospitals in northwestern Syria.
METHODS: The study evaluated all patients hospitalized for COVID -19 by the pandemic emergency departments of hospitals in northwestern Syria between July 1, 2020 and December 01, 2020. Demographic, clinical, laboratory, and imaging characteristics, 4C mortality index scores treatments, and progressions of all patients hospitalized for COVID -19 were retrospectively reviewed.
RESULTS: A total of 991 patients admitted to hospitals in northwestern Syria by pandemic emergency services for treatment and follow-up were included. 114 patients from Afrin Hospital, 251 from Al-Bab Hospital, 527 from Azez Vatan Hospital, and 99 from Jarablus Hospital were included in the study. When comparing the mortality and hospitalization rates of the patients according to the 4C Mortality Score, it was found that the patients with high-risk score in Azez and Jarabulus hospitals and those with very high-risk score in El Bab hospital had significantly higher mortality and hospitalization rates in the ICU (p<0.05).
DISCUSSION AND CONCLUSION: The data that can be obtained from studies evaluating the approach to the COVID -19 epidemic in this and similar regions are important for the development of health services in disadvantaged regions. We believe that our study will make an important contribution to the literature, as it is the first and only data reflecting hospitalized patients with COVID -19 in this region.

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GÝRÝÞ ve AMAÇ: Uyumsal olmayan emosyon düzenleme biçimleri, kanserle iliþkili psikiyatrik belirtilerin altýnda yatan tanýlar üstü mekanizmalar olarak rol oynar. Emosyon düzenleme ve þefkat korkusu meme kanseri hastalarýnda incelenmiþtir ancak kolorektal kanser hastalarýnda psikiyatrik belirtiler üzerine etkileri araþtýrýlmamýþtýr. Emosyon düzenleme ve þefkat korkusunun depresyon ve anksiyete üzerindeki rolünü Türk kolorektal kanser hastalarýnda incelemeyi amaçladýk.
YÖNTEM ve GEREÇLER: Bu gözlemsel, kesitsel çalýþmaya, bir üniversite hastanesinin genel cerrahi bölümü tarafýndan takip edilen 38 kolorektal kanser hastasý alýndý. Emosyon Düzenleme Ölçeði, Þefkat Korkusu Ölçeði, Özbakým Gücü Ölçeði, Hastane Anksiyete ve Depresyon Ölçeði, Distres Termometresi, Sayýsal Aðrý Derecelendirme Ölçeði, ve Stomaya Uyum Envanteri uygulandý. Depresyon ve anksiyeteyi etkileyen faktörleri belirlemek için çoklu regresyon analizleri yapýldý.
BULGULAR: Çalýþmaya çoðu evli ve yüksek eðitimli (medyan yaþ= 56.5, 28–69) olan 29 erkek, 9 kadýn alýndý. Anksiyete düzeyleri üzerine dýþavurumu bastýrma (p=0.013) ve aðrýnýn (p=0.010) etkisi pozitif, özbakým gücünün (p=0.02) etkisi negatifti (Model, R2=0.42, p<0.001). Depresyon düzeyleri üzerineyse dýþavurumu bastýrma (p=0.017) ve erkek cinsiyet (p=0.020) pozitif yönde etki etmekteydi. (Model, R2=0.28, p=0.003). Biliþsel yeniden deðerlendirme ile depresyon ve ve anksiyete arasýnda iliþki saptanmadý. Stomaya uyum aktif stomalý hastalarýn (n=17) 11’inde düþük, altýsýnda ortaydý. Stomaya yüksek uyum gözlenmedi.
TARTIÞMA ve SONUÇ: Sonuçlar, kolorektal kanser hastalarýnda dýþavurumu bastýrmanýn anksiyete ve depresyon düzeylerini etkilediðini, biliþsel yeniden deðerlendirmenin ise bu düzeyleri etkilemediðini göstermiþtir. Þefkat korkusu anksiyete ve depresyonla iliþkili bulunmamýþtýr. Hekimler, hangi hastalarýn psikolojik veya psikiyatrik müdahaleye ihtiyaç duyduðunu anlamak için hasta ve bakýmverenin emosyon düzenleme biçimlerini ve dinamik ve etkileþimli psikolojik durumlarýný dikkatle gözlemelidir. Gelecek çalýþmalarýn kolorektal kanser hastalarýnda anksiyete ve depresyonu önlemek için dýþavurumu bastýrma paternini hedef alan müdahaleleri araþtýrmasýný öneririz.

INTRODUCTION: Maladaptive emotion regulation (ER) styles act as transdiagnostic mechanisms that underlie many psychiatric symptoms linked to cancer. ER and fear of compassion (FC) were studied in breast cancer, but their effects on psychiatric symptoms of colorectal cancer (CRC) patients are not studied. We aim to examine the role of ER and FC on depression and anxiety in Turkish CRC patients.
METHODS: This observational, cross-sectional study recruited 38 patients with CRC who were being followed up by the general surgery department of a university hospital. Emotion Regulation Questionnaire, Fear of Compassion Scale, the Exercise of Self-care Agency Scale, Hospital Anxiety and Depression Scale, Distress Thermometer, Numeric Pain Intensity Scale, and Ostomy Adjustment Inventory were applied. Multiple regression analyses were performed to identify factors affecting depression and anxiety levels.
RESULTS: Twenty-nine men and 9 women (median age=56.5, 28–69), most of whom were married and highly educated, were recruited. Expressive suppression (p=0.013) and pain (p=0.010) positively (Model, R2=0.42, p<0.001) and self-care agency (p=0.021) negatively influenced anxiety levels. Expressive suppression (p=0.017) and male gender (p=0.020) positively influenced depression levels (Model, R2=0.28, p=0.003). There was no association between cognitive reappraisal and levels of depression and anxiety. Among ostomates (n=17), 11 patients had low and 6 patients had medium adaptation to an active ostomy. No patient exhibited high adjustment to an ostomy.
DISCUSSION AND CONCLUSION: Findings indicate that in CRC patients, expressive suppression affects levels of anxiety and depression while cognitive reappraisal does not. FC was not found to be related to anxiety and depression. Physicians should carefully observe the patients’ and the caregivers’ ER strategies and the dynamic and interactive psychological states to understand which patients need psychological and psychiatric interventions. We suggest future studies explore the interventions that target expressive suppression patterns to prevent anxiety and depression in CRC patients.

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GÝRÝÞ ve AMAÇ: Konjenital Miyastenik Sendromlar (KMS), farklý mutasyonlar sonucu nöromüsküler iletinin sinaptik proteinlerindeki farklý yapýsal bozukluklara neden olduðu, immün aracýlý olmayan heterojen hastalýklar grubudur. KMS, mutant proteinin konumuna göre presinaptik, sinaptik bazal lamina ile iliþkili olan ve postsinaptik olarak sýnýflandýrýldý.Bu çalýþmada son derece nadir bir durum olan KMS tanýlý hastalarýn klinik özelliklerini ve tedavi yanýtlarýný deðerlendirerek daha ileri çalýþmalara yardýmcý olmayý amaçladýk.
YÖNTEM ve GEREÇLER: Mersin Þehir Hastanesi ile Aydýn Kadýn Doðum ve Çocuk Hastanesi’nde halen KMS kliniðine baþvuran 13 hastanýn klinik bilgileri gözden geçirildi. Tüm olgularýmýzda klinik tanýyý deðerlendirdikten sonra tüm ekzon dizilimi veya KMS paneli ile genetik taný koyduk.
BULGULAR: Çalýþmaya alýnan 13 hastanýn 11’i (%84.6) erkek, 2’si (%15.3) kýz çocuklardý. Hastalarýmýzýn taný anýnda yaþ ortalamasý 73.30±60.56 ay, yaþ ortalamasý 44±49.15 ay idi. KMS tanýsý alan hastalarýmýzda 9 (%69.2) COLQ, 2 (%15.4) CHAT, bir (%7.7) RAPSN ve bir (%7.7) SCN4A mutasyonu gözlendi. COLQ mutasyonu olan 9 hastanýn 8’ine efedrin baþlandý ve iyi yanýt alýndý. Tüm hastalarda pridostigmin baþlananlarda tedaviye iyi yanýt alýnamadý.
TARTIÞMA ve SONUÇ: KMS sýklýkla diðer nöromüsküler hastalýklarla kolayca karýþabilir. Pitozis, bulber bulgular, apne ve kas güçsüzlüðü ile baþvuran hastalarda KMS ön tanýsý akla gelmeli ve bu hastalarda genetik inceleme düþünülmelidir.

INTRODUCTION: Congenital myasthenic syndrome (CMS) is a heterogeneous group of diseases that are not immune-mediated. It is caused by structural defects in different synaptic proteins of neuromuscular transmission as a result of different mutations. CMS is classified according to the location of the mutant protein as presynaptic, synaptic basal lamina-associated, or postsynaptic. In this study, we aimed to help further the knowledge of this issue by analyzing the clinical features and treatment responses of patients with an extremely rare condition of CMS.
METHODS: The clinical information of 13 patients who attended the CMS clinic at Mersin City Training and Research Hospital and Aydýn Maternity and Child Hospital were reviewed. After considering the clinical diagnosis in all our cases, we performed a genetic diagnosis with whole exon sequencing or a CMS panel.
RESULTS: Of the 13 patients included in this study, 11 (84.6%) were males and 2 (15.4%) were females. The mean age of our patients was 73.30±60.56 months, and the mean age at the time of diagnosis was 44±49.15 months. In our patients diagnosed with CMS, 9 (69.2%) COLQ mutations, 2 (15.4%) CHAT mutations, 1 (7.7%) RAPSN mutation, and 1 (7.7%) SCN4A mutation were observed. Ephedrine was started in 8 of the 9 patients with COLQ mutations, and a good response was obtained. A good response to treatment was not observed in those patients who were started on pyridostigmine.
DISCUSSION AND CONCLUSION: CMS can often be confused with other neuromuscular diseases. In patients presenting with ptosis, bulbar findings, apnea, and muscle weakness, CMS should be prediagnosed, and a genetic examination should be performed on these patients.

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GÝRÝÞ ve AMAÇ: Acil serviste akut pankreatitten ölüm, ED-SAS (Emergency Department periferik kapiller oksijen satürasyonu, yaþ ve Sistemik inflamatuar yanýt sendromu) skorlama sistemi (ED-SAS) kullanýlarak tahmin edilebilir.
YÖNTEM ve GEREÇLER: Bu çalýþmada tek merkezli kohort gözlemsel araþtýrma yöntemi kullanýlmýþtýr. Tam bir vaka çalýþmasý tekniðinin kullanýlmasýna karar verildi. Hastane otomasyon sistemi ile acil servise akut pankreatit tanýsý ile baþvuran hastalarda retrospektif tarama yapýldý. ED-SAS skorlama sisteminin 30 günlük mortaliteyi tahmin etme yeteneðinin istatistiksel deðerlendirmesi için eðri altýnda kalan alan (AUC) ve alýcý iþletim karakteristik eðrisi (ROC) kullanýldý.
BULGULAR: Yaþ ortalamasý 62.5±18.4 olan toplam 112 hasta incelendi. Akut pankreatitli hastalarda ölüm tahmini için ED-SAS skorlama sisteminin AUC’si (yüzde 95 güven aralýðý: 0.696–0.856) 0.784 (Youden indeksi: 0.381) ve p deðeri 0.001’dir. ED-SAS’ýn duyarlýlýðý yüzde 57.1, özgüllüðü yüzde 80.9, pozitif öngörü deðeri yüzde 16.7 ve cut-off sayýsý 1’den büyük olduðunda negatif öngörü deðeri yüzde 96.6 idi.
TARTIÞMA ve SONUÇ: ED-SAS, acil serviste akut pankreatitli bireylerde 30 günlük mortaliteyi tahmin etmek için kullanýlabilir.

INTRODUCTION: In the emergency department, death from acute pancreatitis may be predicted using the ED-SAS (emergency department peripheral capillary oxygen saturation, age, and systemic inflammatory response syndrome) scoring system.
METHODS: One-center cohort observational research method was used in this study. It was decided to use a full case study technique. The hospital automation system was used to do retrospective screening on individuals who had presented to the emergency department with a diagnosis of acute pancreatitis. For the statistical evaluation of ED-SAS scoring system’s ability to predict 30-day mortality, the area under the curve (AUC) and receiver operating characteristic (ROC) curve were used.
RESULTS: A total of 112 patients were studied, with an average age of 62.5±18.4 years. The AUC (95% confidence interval: 0.696–0.856) for the ED-SAS scoring system for the prediction of death in patients with acute pancreatitis was 0.784 (Youden’s index: 0.381), and the p-value was 0.001. The ED-SAS’s sensitivity was 57.1%, specificity was 80.9%, positive predictive value was 16.7%, and negative predictive value was 96.6% when the cutoff number was greater than 1.
DISCUSSION AND CONCLUSION: The ED-SAS may be used to predict 30-day mortality in individuals with acute pancreatitis in the ED.

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GÝRÝÞ ve AMAÇ: Aterosklerotik kardiyovasküler hastalýk (ASCVD) tüm dünyada özellikle tip 2 diyabetli (T2DM) hastalarda önemli bir morbidite ve mortalite nedenidir. Çalýþmanýn amacý, T2DM tanýlý hastalarda, güncel kýlavuzlarda yer alan glisemik kontrol, serum düþük yoðunluklu kolesterol (LDL-K), trigliserit (TG) ve HDL dýþý kolesterol (Non-HDL-K) hedeflerine ulaþmada baþarý oranlarýný göstermektir.
YÖNTEM ve GEREÇLER: Bu çalýþmada önceden taný almýþ 389 T2DM hastasý (217 kadýn, 172 erkek) geriye dönük olarak deðerlendirildi. Hastalarýn kullanmakta olduðu ilaçlar, demografik özellikleri ve laboratuvar tetkikleri elektronik kayýt sistemi ve hasta dosyalarýndan kaydedildi. Hastalarýn ASCVD riskleri, 2019 Avrupa Kardiyoloji Derneði (ESC)/Avrupa Ateroskleroz Derneði (EAS) kýlavuzlarýna göre belirlendi ve LDL-K, TG, Non-HDL-K, HbA1c için hedef oranlarý kaydedildi.
BULGULAR: Hastalarýn tamamýndaki ortalama yaþ, vücut kitle indeksi (VKÝ) ve HbA1c deðerleri sýrasýyla 57.95±9.53 yýl, 31.45±5.36 kg/m2 ve %7.83±1.35 saptandý. Olgularýn %22.6’sý orta, %12.6’sý yüksek ve %64.8’i çok yüksek ASCVD riskine sahipti. LDL-K, TG ve Non-HDL-K deðerleri hedefte olan hasta sayýsýnýn düþük olduðu görüldü (sýrasýyla %7.8, %45.5, %8.9). Erkeklerde koroner arter hastalýk sýklýðý kadýnlara göre daha fazlaydý (p<0.001). Diyabetik polinöropati sýklýðý statin kullanan hastalarda daha fazlaydý (%52.5, p<0.001). Statin kullanmakta olan hastalarýn LDL-K deðerleri daha düþük olmasýna raðmen (p<0.001), hedef LDL-K deðerine ulaþma oraný her iki grupta benzerdi (p=0.239). T2DM hastalarýnda Non-HDL-K deðeri %8.9 oranýnda hedefteydi. Statin kullanan hastalarda Non-HDL-K deðerlerinin daha düþük olmasý ve daha iyi hedef oranlarýnýn gözlenmesi dikkat çekicidir. HbA1c <7% olan hastalarda LDL-K hedefe ulaþma oraný daha düþükken (p=0.028), Non-HDL-K hedef baþarýsý daha yüksekti (p=0.039).
TARTIÞMA ve SONUÇ: Bu çalýþmada T2DM tanýlý hastalarda, 2019 ESC/EAS kýlavuzunda önerilen lipid tedavi hedeflerine ulaþma oranlarýnýn düþük olduðu görülmektedir. ASCVD riski yüksek olan hasta gruplarýnda güncel kýlavuzlarda önerilen tedavi hedeflerine ulaþmak farkýndalýk gerektirmektedir.

INTRODUCTION: Atherosclerotic cardiovascular disease (ASCVD) is a major cause of morbidity and mortality worldwide. The aim of the study was to reveal the success rates of glycemic control, serum low-density lipoprotein cholesterol (LDL-C), serum triglyceride (TG), and non-high density lipoprotein cholesterol (non-HDL-C) targets in type 2 diabetes mellitus (T2DM) patients according to recent guidelines.
METHODS: The study was a retrospective observational study of 389 previously diagnosed T2DM patients (217 women and 172 men) in an outpatient diabetes clinic. Demographic characteristics, comorbidities, medications, and laboratory measurements were recorded from the electronic system. ASCVD risks and target rates for LDL-C, TG, non-HDL-C, and HbA1c were evaluated according to 2019 European Society of Cardiology (ESC)/European Atherosclerosis Society (EAS) guidelines.
RESULTS: In total subjects, mean values of age, BMI, and HbA1c were 57.95±9.53 years, 31.45±5.36 kg/m2, and 7.83±1.35%, respectively. Of the total cases, 22.6% had moderate, 12.6% had high, and 64.8% had very high ASCVD risks. The percentages of patients with target LDC C, TG, and Non-HDL-c values were low in overall patient group (7.8%, 45.5%, and 8.9%, respectively). Coronary artery disease was found more frequently in men with T2DM than in women (p=0.001). Diabetic polyneuropathy was seen more prominent in patients with statin treatment (p<0.001). Although lower LDL-C was seen in patients under statin treatment (p<0.001), the percentage of patients with target LDL-C was similar in both groups (p=0.239). In this study 8.9% of total T2DM patients were on target for Non-HDL-C values. It is noteworthy that, patients using statins have lower Non-HDL-C and better target rates (p<0.001 and p=0.029). In patients with >7% HbA1c, LDL-C target success rates were lower (p=0.028), but Non-HDL-C target success rates were higher (p=0.039).
DISCUSSION AND CONCLUSION: In this pilot observation, the rate of achievement of the lipid targets recommended by 2019 ESC/EAS was low. More attention is needed to achieve success rates of lipid parameters and manage the risk of ASCVD in T2DM patients.

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GÝRÝÞ ve AMAÇ: Bu çalýþmada SARS-CoV-2 pcr pozitifliði saptanan ve COVID-19 pnömonisi ile hastaneye baþvuran hastalarda meydana gelen plevral komplikasyonlarýn geriye dönük olarak deðerlendirilmesi amaçlandý.
YÖNTEM ve GEREÇLER: Mart 2020–Mayýs 2021 tarihleri arasýnda hastanemize baþvuran ve SARS-CoV-2 pcr pozitifliði saptanan ve COVID-19 pnömonisi tedavisi sýrasýnda plevral komplikasyonlarýn saptandýðý servis veya yoðun bakýmlarda takip ve tedavi edilen 164 hasta retrospektif olarak deðerlendirildi. Çalýþmamýzda mortalite hastalarýn hastaneye yatýþ sonrasý ilk 30 gündeki ölümleri olarak alýndý. Tedavi sýrasýnda meydana gelen plevral komplikasyonlar pnömotoraks ve pnömomediastinum olarak 2 grupta sýnýflandýrýlmýþtýr.
BULGULAR: Hastalarýmýzýn 69’unda (%52.3) izole PNX, 14’ünde (%43.7) izole PMN mevcuttur. 50’sinde PNX ve subkutan amfizem (%37.9), 13’sýnde (%40.6) PMN ve subkutan amfizem, üçünde (%9.4) PMN, PNX ve subkutan amfizem, ikisinde (%6.3) PMN ve PNX 12’sinde (%9.1) hidropnömotoraks ve birinde (%0.7) de PNX ve ampiyem birlikteliði mevcuttur. Hastalarda COVID-19 pnömonisi sebebiyle tedavi sýrasýnda meydana gelen plevral komplikasyon ile mortalite arasýndaki iliþki incelendiðinde PMN hastalarýnýn 14’ünde (%43.8) mortalite görülmesine raðmen PNX hastalarýnýn 104’ünde (%78.8) mortalite görülmüþtür (p<0.001). Cinsiyet ile mortalite arasýndaki iliþki incelendiðinde erkek hastalarýn 75’inde (%65.8) mortalite görülmüþken kadýn hastalarýn ise 43’ünde (%86) mortalite görülmüþtür (p=0.008).
TARTIÞMA ve SONUÇ: Sonuç olarak pozitif basýnçlý ventilasyon sonrasý meydana gelen pnömotoraks durumunun meydana gelen diðer plevral komplikasyonlara göre mortaliteyi daha çok artýrdýðýný, prognozu ise daha çok aðýrlaþtýrdýðýný saptadýk. COVID-19 pandemisi ile bundan sonra ortaya çýkabilecek ve plevral tutulum meydana getirebilecek pandemik hastalýklarda bu hususun literatüre katký saðlayacaðýný düþünüyoruz.

INTRODUCTION: This study aimed to retrospectively evaluate pleural complications in patients who were polymerase chain reaction (PCR)-positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and admitted to the hospital with COVID-19 pneumonia.
METHODS: A total of 164 patients who applied to our hospital between March 2020 and May 2021 with PCR-positive for SARS-CoV-2 were retrospectively evaluated and were followed up and treated in the service or intensive care unit. Pleural complications were detected during the treatment of COVID-19 pneumonia. In the current study, mortality was taken as the death of the patients in the first 30 days after hospitalization. Pleural complications occurring during treatment were classified into two groups: the pneumothorax (PNX) group and the pneumomediastinum (PMN) group.
RESULTS: Of the patients, 69 (52.3%) had isolated PNX and 14 (43.7%) had isolated PMN. PNX and subcutaneous emphysema were determined in 50 (37.9%) patients, PMN and subcutaneous emphysema were determined in 13 (40.6%), PMN, PNX, and subcutaneous emphysema were determined in 3 (9.4%), and PMN and PNX were determined in 2 (6.3%) patients. Hydro-PNX was determined in 12 (9.1%) patients, and PNX and empyema were determined in 1 (0.7%) patient. When the relationship between pleural complications occurring during treatment due to COVID-19 pneumonia and mortality was examined, mortality was observed in 14 (43.8%) of the PMN patients and 104 (78.8%) of the PNX patients (p<0.001). When the relationship between gender and mortality was examined, mortality was observed in 75 (65.8%) of the male patients and in 43 (86%) of the female patients (p=0.008).
DISCUSSION AND CONCLUSION: As a result, it was found that PNX after positive pressure ventilation increased mortality more than other pleural complications and worsened the prognosis. We think this issue will contribute to the literature in the COVID-19 pandemic and in pandemic diseases that may occur later and cause pleural involvement.

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GÝRÝÞ ve AMAÇ: Bir araþtýrma makalesinin toplam atýf sayýsý, bilimsel arenadaki etkisini belirlemek için kullanýlabilir. Tiroid cerrahisi ile ilgili yayýnlanmýþ ilk 100 makaleyi belirleyerek özelliklerini deðerlendirmeyi amaçladýk.
YÖNTEM ve GEREÇLER: Yazarlar, tiroid cerrahisi ile ilgili olarak 2010’dan 2021’e kadar yayýnlanan tüm makalelerin alýntýlarýný Thomson Reuters Web of Knowledge’da aradýlar. Her makale için atýf sayýsý, yazarlýk, yýl, dergi, yayýnlandýðý ülke ve kurum kaydedildi.
BULGULAR: Ýlk 100 makale arasýnda 86 orijinal makale, 12 inceleme ve 6 bildiri vardý. Ýlk 100 makale 3469 farklý dergi tarafýndan toplam 5285 atýf aldý (dergi baþýna ortalama 52,8 atýf ), ve en çok atýf alan makale 218 atýf aldý. Önde gelen kurumlar Harvard Üniversitesi (%12), Insubria Üniversitesi (%9), John Hopkins Üniversitesi (%7) idi. Ýlk 100 makale 25 farklý dergide yayýnlanmýþ olup, en yüksek sayýyý “Surgery” (n=14) alýrken, onu “World Journal of Surgery” (n=10) takip etmektedir. En çok alýntý yapýlan 100 makale en sýk ABD (%41), Ýtalya (%17) ve Almanya’da (%13) bulunmaktadýr.
TARTIÞMA ve SONUÇ: Bu çalýþma, tiroid cerrahisi hakkýnda en çok alýntý yapýlan makalelerin ayrýntýlý bir listesini üretmiþtir. Bu liste, tiroid cerrahisi ile ilgili klasik makalelerin yaný sýra bu alandaki araþtýrma eðilimlerini ve akademik baþarýlarý tanýmayý mümkün kýlar.

INTRODUCTION: The total number of citations of a research article can be used to determine its impact on the scientific arena. We aimed to identify the top 100 articles published on thyroid surgery and evaluate their characteristics.
METHODS: The authors searched the Thomson Reuters Web of Knowledge for citations of articles on thyroid surgery published from 2010 to 2021. The number of citations, authorship, year, journal, and country and institution of publication were recorded for each article.
RESULTS: Among the top 100 articles, there were 86 original articles, 12 review articles, and 6 proceeding papers. Top 100 articles received a total of 5285 citations (an average of 52.8 citations per journal) from 3469 different journals, and the most cited article received 218 citations. The leading institutions were Harvard University (12%), University of Insubria (9%), and Johns Hopkins University (7%). The top 100 articles were published in 25 different journals, with “Surgery” having the highest numbers (n=14), followed by “World Journal of Surgery” (n=10). The 100 most cited articles are most frequently based in the USA (41%), Italy (17%), and Germany (13%).
DISCUSSION AND CONCLUSION: The present study has produced a detailed list of the most cited articles on thyroid surgery. This list makes it possible to recognize classic articles on thyroid surgery, as well as research trends and academic achievements in this field.

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GÝRÝÞ ve AMAÇ: Son yýllarda, elektrikli mobiletler-scooter (E-mobilet) sosyal hayatýmýz içerisine hýzlý bir giriþ yapmýþ olsa da altyapý sorunlarý, hukuki sorunlar ve kullanýcý güvenliði açýsýndan birçok yeni sorun ortaya çýkarmýþtýr. Bu araþtýrmanýn amacý, E-mobilet kazasý nedeniyle acil servise (AS) baþvuran hastalarýn klinik ve demografik özelliklerinin retrospektif analizini gerçekleþtirmek, travma skorlarý ile korelasyonunu deðerlendirmek ve E-mobilet ile ilgili yeni yapýlan yasal düzenlemelerin yeterliliðini analiz etmektir.
YÖNTEM ve GEREÇLER: Çalýþmamýz, enine kesitli tanýmlayýcý bir çalýþmadýr. Çalýþmaya alýnan hastalarýn bilgileri, doküman ve belgeler geriye dönük olarak deðerlendirildi, hastalarýn The Injury Severity Score (ISS), Abbreviated Injury Scale (AIS), Trauma Injury Severity Score (TRISS) ve 15 yaþ ve altý çocuklar için Pediatric Trauma Score (PTS) hesaplandý.
BULGULAR: E-mobilet kazasý nedeniyle AS’ye baþvuran hastalarýn yaþ ortalamasý 27.20±11.90’dir. Kazalarýn %41.9’u (n=49) hafta sonu gerçekleþmiþ iken, %48.1’i (n=63) ise hafta içi gerçekleþmiþtir. Baþvuranlarýn hiçbirinde koruyucu ekipman kullanýmý görülmemiþtir. E-mobilet ile kaza yapanlarýn %96.6’sý (n=113) sürücü, %3.4’ü (n=4) ise sürücünün arka tarafýna binen yolcudur. Kaza yerleri incelendiðinde ise; %85.5’i (n=100) sahilde, %6’sý (n=7) caddede, %3.4’ü (n=4) yolda, %2.6’sý (n=3) kaldýrýmda, %2.6’sý (n=3) ise diðer yerlede meydana gelmiþtir. Kaza öncesinde E-mobilet hýzlarý 10 ile 30 km/saat deðiþmekte olup; hýz ortalamasý, 24.36±6.28’dir. Hastalarýn yaralanma bölgeleri incelendiðinde %49.6’sýnýn (n=58) üst ekstremite, %45.3’ünün (n=53) alt ekstremite, %35’inin (n=41) kafa/yüz, %8.5’inin %9’unun (n=10) toraks, %0.9’unun (n=1) servikal vertebra, %0.9’unun (n=1) torakal vertebra yaralanmasý mevcuttur. E-mobilet kazalarýnda yaþ, hastane baþvuru saati ve kaza hýzlarýnýn travma skorlarý ile arasýndaki korelasyona bakýldýðýnda; yaþ ile AÝS skoru (p>0.05) ve ISS skoru (p>0.05) arasýnda istatistiksel olarak anlamlý iliþki bulunamamýþ ve yaþ ile TRISS skoru arasýnda negatif yönlü %45.2 düzeyinde istatistiksel olarak anlamlý iliþki bulunmuþtur (p=0,001; p<0.01).
TARTIÞMA ve SONUÇ: E-mobilet kazalarýnýn hastalar üzerinde hafif yaralanmalara sebep olduðu görülse de teknik alt yapýdaki eksiklikler ve yasal kurallara uyulmamasý nedeniyle hedef kitle dýþýnda da kullanýlmakta ve hasarlara neden olduðu görülmüþtür.

INTRODUCTION: The recent increased use of electric scooters (E-scooter) in daily life has generated a great deal of discussion involving various areas, such as infrastructure problems, legal issues, and rider safety. This study aimed to manage the analysis of the clinical and demographic characteristics of patients who were admitted to emergency departments due to e-scooter accidents, especially during post-legal regulations in Turkey.
METHODS: The study is conducted as cross-sectional and descriptive research. The notice, data, and documents of the patients included in the study were scanned retrospectively, after which certain measurements were performed, such as the Injury Severity Score (ISS), Abbreviated Injury Scale (AIS), Trauma and Injury Severity Score (TRISS), and Pediatric Trauma Score (PTS) for children aged 15 years or under.
RESULTS: The age of the patients included in this study varies from 5 to 76 years, with a mean age of 27.20±11.90 years. When the injury regions of the patients were examined, the results were revealed as follows: 49.6% (n=58) to the upper extremities, 45.3% (n=53) to the lower extremities, 35.0% (n=41) to the head/face, 8.5% 9% (n=10) to the thorax, 0.9% (n=1) to the cervical vertebra, and 0.9% (n=1) to the thoracic vertebra. Considering the correlation between age, hospital admission time, and accident rates in the accidents with trauma scores, no statistically significant association was found between age and AIS (p>0.05) or ISS (p>0.05), and a statistically significant negative correlation of 45.2% was found between age and TRISS (p=0.001; p<0.01).
DISCUSSION AND CONCLUSION: Although it is revealed that E-scooter accidents lead to minor injuries to patients, the use is outside the target audience, causing injury due to mechanical deficiencies and noncompliance with legal rules.

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GÝRÝÞ ve AMAÇ: Metabolik sendrom, dünya çapýnda bir saðlýk sorunudur. Uluslararasý Diyabet Federasyonu (IDF) abdominal obezite tanýsý için bel çevresi sýnýrlarýnýn toplum ve ülkeye özgü tanýmýný önerir. Bu çalýþmada, Türk nüfusunun bel çevresi eþik deðerlerinin belirlenmesi amaçlanmýþtýr.
YÖNTEM ve GEREÇLER: Çalýþma rutin check-up ve kan testleri için hastanenin merkez laboratuara baþvuran ve çalýþmaya katýlmayý kabul eden 1379 gönüllü (767 kadýn ve 612 erkek) ile yapýlmýþtýr. Katýlýmcýlarýn metabolik sendrom tanýsý IDF kriterleri varlýðý (bel çevresi hariç) açýsýndan deðerlendirildi.
BULGULAR: Metabolik sendrom tanýsý için IDF tarafýndan tanýmlanan ≥2 risk faktörleri olan hastalarýn bel çevresi sýnýr deðerleri belirlemek için, cinsiyet ayýrýma göre ROC eðrisi çizilmiþtir. Erkek ve kadýn için ROC eðrisi altýnda kalan alan sýrasýyla 0.69 ve 0.75 idi. Kadýnlar ve erkekler için çoklu risk faktörleri varlýðýnda (en az %80 duyarlýlýk ile) tahmin etmek için bel çevresi eþik deðerler sýrasýyla 94 cm ve 96 cm idi.
TARTIÞMA ve SONUÇ: Türkiye için, metabolik sendrom taný kriteri olarak IDF’in Avrupa toplumu için önerdiði bel çevresi sýnýrý yerine, bu çalýþmada elde edilen bel çevresi sýnýrlarýný (yani, erkekler için 94 cm, kadýnlarda 96 cm) kullanmak daha gerçekçi olacaktýr.

INTRODUCTION: Metabolic syndrome is a worldwide health problem. The International Diabetes Federation (IDF) recommends a population- and country specific definition of cutoff points of waist circumference for the diagnosis of abdominal obesity. The purpose of this study was to determine the waist circumference cutoff values of the Turkish population.
METHODS: The study was conducted on a total of 1379 subjects (767 females and 612 males) who were admitted to the study hospital’s central laboratory for a routine check-up and blood tests and accepted to participate in this study. The participants were evaluated for the presence of the IDF criteria (other than waist circumference) for the diagnosis of metabolic syndrome.
RESULTS: To determine the cutoff values of waist circumference for predicting ≥2 risk factors defined by the IDF, a receiver operating characteristic (ROC) curve was plotted for each sex separately. The area under the ROC curve for men and women was 0.69 and 0.75, respectively. The cutoff values of waist circumference for predicting the presence of multiple risk factors (with at least 80% sensitivity) for men and women were 94 cm and 96 cm, respectively.
DISCUSSION AND CONCLUSION: For Turkey, it is more rational to use the waist circumference cutoff points identified in this study (i.e., 94 cm for men and 96 cm for women) than to use the IDF’s cutoff points recommended for the European subjects for the diagnosis of metabolic syndrome.

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GÝRÝÞ ve AMAÇ: Toraks cerrahisi morbiditesi ve mortalitesi nispeten yüksek olan bir cerrahidir. Bununla birlikte hemodiyalize (HD) giren hastalarýn riski normal popülasyona göre daha fazla olduðu için, cerrahi büyük bir özen gerektirir. Çalýþmamýzda kliniðimizde kronik renal yetersizlik (KBY) hastasý olup HD’ye giren hastalarda yapýlan majör toraks cerrahisinin sonuçlarýný literatür bilgileri ýþýðýnda irdeledik.
YÖNTEM ve GEREÇLER: Kliniðimizde Aralýk 2015–Ekim 2021 tarihleri arasýnda majör toraks cerrahisi uygulanan ve HD’ye giren hastalar çalýþmaya alýndý. Hastalar solunum fonksiyon deðerleri, sigara içimi, serum üre-kreatin deðerleri, ek komorbiditeler, ejeksiyon fraksiyonu, cerrahi tipi, drenaj miktarý, taburculuk süresi, yoðun bakým ihtiyacý, histopatolojik taný, morbidite ve mortalite kriterleri bakýmýndan analiz edildi.
BULGULAR: HD’ye giren 15 hastaya majör toraks cerrahisi uygulandý. Hastalarýn 12’si erkek ve üçü kadýndý. Yaþ ortalamasý 61.2±15.8 idi. Altý hasta video-yardýmlý torakoskopik cerrahi yöntemle, sekiz hasta torakotomiyle opere edilirken, bir hastaya sternotomi yapýldý. En sýk yapýlan cerrahi giriþim lobektomiydi. Ortalama yoðun bakým ünitesinde kalýþ süresi 0.9 gündü. Ameliyat sonrasý morbidite dört hastada izlendi (%26.6). Bir hastada ise pnömoni nedeniyle mortalite gerçekleþti (%6.6).
TARTIÞMA ve SONUÇ: Dünyada her geçen yýl HD gerektiren hasta sayýsý artmaktadýr. Bunun sonucunda akciðer kanserli veya baþka sebeplerden dolayý majör toraks cerrahisi gerektiren HD hastalarý da sürekli artýþ göstermektedir. Bu nedenle, detaylý bir risk deðerlendirmesi sonrasý, multidisipliner perioperatif yönetimle hastalarýn deneyimli merkezlerde opere edilmesi gerektiði kanaatindeyiz.

INTRODUCTION: Thoracic surgery is an operation with relatively high morbidity and mortality. It requires even greater care in patients undergoing hemodialysis (HD) because they are at greater risk than the general population. In light of the literature, we examined the results of major thoracic surgery performed at our clinic in patients with chronic renal failure (CRF) undergoing HD.
METHODS: Patients who underwent major thoracic surgery while receiving HD at our clinic between December 2015 and October 2021 were included in the study. The patients were analyzed in terms of pulmonary function values, smoking status, serum urea–creatinine values, comorbidities, ejection fraction, type of surgery, amount of drainage, discharge time, intensive care requirement, histopathological diagnosis, morbidity, and mortality.
RESULTS: Major thoracic surgery was performed in 15 patients receiving HD. Of the patients, 12 were males and 3 were females. The mean age was 61.2±15.8 years. The surgical approach was video-assisted thoracoscopic surgery in 6 patients, thoracotomy in 8, and sternotomy in 1. The most common surgical intervention was lobectomy. The mean length of stay in the intensive care unit was 0.9 days. Postoperative morbidity was observed in 4 patients (26.7%). Mortality due to pneumonia occurred in 1 patient (6.7%)
DISCUSSION AND CONCLUSION: The number of patients requiring HD is globally increasing every year. Therefore, HD patients with lung cancer or requiring major thoracic surgery for other reasons are constantly increasing. Therefore, after a detailed risk assessment, we consider that operations should be performed in experienced centers with multidisciplinary perioperative management.

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GÝRÝÞ ve AMAÇ: Abdominal tüberküloz gastrointestinal sistem, periton, lenf nodlarý, ve solid organlarýn Mycobacterium tuberculosis ya da Mycobacterium bovis ile infekte olmasý sonucu ortaya çýkan oldukça nadir görülen bir ekstrapulmoner tüberküloz çeþididir. Bu çalýþmada, abdominal tüberküloz tanýsý olan çocuk olgularýn klinik, laboratuvar, radyolojik, histopatolojik özelliklerinin deðerlendirilmesi, taný yöntemler ve prognozunu belirlemeyi amaçladýk.
YÖNTEM ve GEREÇLER: Çalýþmaya hastanemizde 01.01.2011–01.01.2021 tarihleri arasýnda abdominal tüberküloz tanýsý alan 13 hasta retrospektif olarak deðerlendirildi.
BULGULAR: Hastalarýn 10’u (%76.9) kýzdý. Ortalama yaþ 13,5 yýldý. tüberkulin deri testi 9’unda pozitifdi. Üç hastada TB temas öyküsü vardý. Taný konma ile semptomlarýn baþlangýcý arasýndaki süre ortanca 45 (15–150) gündü. En sýk baþvuru semptomu karýn aðrýsýydý. Hastalarýn 7’si kanýtlanmýþ tüberküloz tanýsý aldý. Beþ hastanýn kültürlerinde M. tuberculosis üredi. Ýkisinde dokuda TB-PCR pozitifliði saptandý. C-reaktif protein 9 (%69.2), eritrosit sedimantasyon hýzý 11 (%84.6) hastada yüksekti, 5 (%38.4) hastada albümin deðeri düþük, 10 (%76.9) hastanýn anemisi mevcuttu Hastalarýn 7’sinde tek abdominal alan, 6’sýnda multýpl abdominal alan tutulmuþtu. En sýk tutulan intraabdominal alan periton, ikincisi lenf noduydu. Ýki hastada izole abdomen tüberkülozda vardý. Dokuzunda (%69.2) pulmoner tüberküloz eþlik ediyordu. Onbir (%84.6) hastaya laparoskopi uygulandý. Bir hastada batýn içi abse komplikasyonu geliþti.Takip süresi ortalama 23 (18–61) aydý. Ölen hasta olmadý.
TARTIÞMA ve SONUÇ: Abdominal tüberküloz oldukça nadir olmasý ve klinik bulgularýn nonspresifik olmasý nedeniyle kolayca atlanabilmektedir. Kronik abdominal semptomu olanlarda akýlda tutulmalýdýr. Tüberküloz önlene bir bir hastalýk olmak ile birlikte erken taný ve tedavinin prognoz üzerindeki olumlu etkisi unutulmamalýdýr.

INTRODUCTION: Abdominal tuberculosis (ATB) is a very rare type of extrapulmonary tuberculosis that occurs as a result of infection of the gastrointestinal tract, peritoneum, lymph nodes, and solid organs with Mycobacterium tuberculosis or Mycobacterium bovis. In this study, we aimed to evaluate the clinical, laboratory, radiological, and histopathological features, diagnostic methods, and prognosis of pediatric cases diagnosed with ATB.
METHODS: Thirteen patients diagnosed with ATB in our hospital between January 1, 2011, and January 1, 2021, were evaluated retrospectively.
RESULTS: Ten (76.9%) of the patients were females. The mean age was 13.5 years. TST was positive in 9 patients. Three patients had a history of TB contact. The median time between diagnosis and onset of symptoms was 45 (15–150) days. The most common presenting symptom was abdominal pain. Seven of the patients were diagnosed with proven tuberculosis. M. tuberculosis grew in cultures of 5 patients. Tuberculosis polymerase chain reaction positivity was detected in the tissue of two of them. C-reactive protein was high in 9 (69.2%), sedimentation was high in 11 (84.6%) patients, albumin value was low in 5 (38.4%), and anemia was present in 10 (76.9%) patients. A single abdominal area was involved in 7 patients, and multiple abdominal areas were involved in 6 patients. The most frequently involved intra-abdominal area was the peritoneum, and the second was the lymph node. Two patients had isolated abdomen. Pulmonary tuberculosis accompanied in 9 (69.2%) patients. Eleven (84.6%) patients underwent laparoscopy. Intra-abdominal abscess complications developed in 1 patient. The mean follow-up period was 23 (18–61) months. None of the patients died.
DISCUSSION AND CONCLUSION: ATB can be easily overlooked because it is very rare, and its clinical findings are nonspecific. It should be kept in mind in patients with chronic abdominal symptoms. Although tuberculosis is a preventable disease, the positive effects of early diagnosis and treatment on prognosis should not be forgotten.

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GÝRÝÞ ve AMAÇ: Ameliyat öncesi bilyer stentleme (PBS) ameliyat öncesi dönemde enterohepatik sirkülasyonu onarmasýna raðmen ameliyat sonrasý sonuçlarý belirsiz kalmaktadýr. Bu çalýþma, pankreas cerrahisinde PBS’nin safra sývýsýnda bakteriyel kolonizasyon, ameliyat sonrasý morbidite ve mortalite oranlarý üzerine etkilerini deðerlendirmeyi amaçlamaktadýr.
YÖNTEM ve GEREÇLER: Periampullar tümör endikasyonuyla Ocak 2016–Mayýs 2020 arasýnda pankreatikoduodenektomi yapýlan toplam 70 hasta geriye dönük olarak analiz edildi. Hastalar PBS ve non-PBS olmak üzere iki gruba ayrýldý. Ýki grup arasýnda ameliyat sýrasýnda ve sonrasýnda sonuçlar karþýlaþtýrýldý.
BULGULAR: Safra kültüründe pozitif üreme oraný non-PBS grubuna (%9.5) kýyasla PBS grubunda (%89.2) anlamlý ölçüde daha yüksekti (p<0.001). Ameliyat sonrasý enfeksiyöz komplikasyonlarýn oraný PBS ve non-PBS gruplarýnda sýrasýyla %85.7 ve %28.5 bulundu (p<0.001). PBS grubunda ameliyat sonrasý komplikasyon oraný stentleme ile cerrahi arasýndaki zaman aralýðý ile orantýlý artmaktaydý (p=0.007). Ýki grup arasýnda hastanede yatýþ süresi ve ameliyat sonrasý mortalite açýsýndan anlamlý bir farklýlýk yoktu (sýrasýyla; p=0.186 ve p=0.294).
TARTIÞMA ve SONUÇ: Pankreatikoduodenektomi öncesi bilyer stentleme safra sývýsýnda bakteriyel kolonizasyon, ameliyat sonrasý yara yeri enfeksiyonu ve intraabdominal apse gibi komplikasyonlarý arttýrmaktadýr. PBS ve cerrahi arasý zamanýn uzamasý ameliyat sonrasý enfeksiyöz komplikasyon oranýný arttýrmaktadýr.

INTRODUCTION: Although preoperative biliary stenting (PBS) restores enterohepatic circulation during the preoperative period, its postoperative outcomes remain unclear. This study aimed to evaluate the effects of PBS on bacterial colonization in bile fluid and postoperative morbidity and mortality rate for pancreatic surgery.
METHODS: A total of 70 patients who underwent pancreaticoduodenectomy due to periampullary tumor between January 2016 and May 2020 were analyzed retrospectively. Patients were divided into PBS and non-PBS groups. Intraoperative and postoperative outcomes were compared between the two groups.
RESULTS: The rate of positive growth in bile culture was significantly higher in the PBS group (89.2%) compared with the non-PBS group (9.5%) (p<0.001). The rates of postoperative infectious complications were found to be 85.7% and 28.5% in PBS and non-PBS groups, respectively (p<0.001). In the PBS group, the rate of postoperative complications increased with the time interval between stenting and surgery (p=0.007). There were no significant differences in both groups in terms of length of hospital stay and postoperative mortality (p=0.186 and p=0.294, respectively).
DISCUSSION AND CONCLUSION: Biliary stenting before pancreaticoduodenectomy increases the complications such as bacterial colonization in bile fluid, postoperative wound site infection, and intra-abdominal abscess. The prolonged time between PBS and surgery increases the rate of postoperative infectious complications.

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GÝRÝÞ ve AMAÇ: Altý dakika yürüme testi deðerleri, akciðer transplantasyonu bekleyen son dönem akciðer hastalarýnda mortalite artýþýnýn bir göstergesi olmasý nedeniyle transplantasyon öncesi hasta yönetiminde önemli bir yere sahiptir. Ancak, akciðer transplantasyonundan sonra altý dakika yürüme testinin takipteki rolü konusunda yeterli çalýþma bulunmamaktadýr. Altý dakika yürüme testi yaygýn olarak kullanýlmasýna raðmen bazý durumlarda ve hastalýk gruplarýnda fonksiyonel dayanýklýlýðýn etkili bir ölçüsü olarak uygulanamayabilir. Bu nedenle, altý dakikada kat edilen klasik mesafe ile ilk bir veya üç dakikada yürünen mesafe arasýndaki iliþkiyi araþtýrdýk.
YÖNTEM ve GEREÇLER: Çalýþma, 2016–2021 yýllarý arasýnda akciðer nakli yapýlan hastalarýn ameliyat öncesi altý dakika yürüme testi sonuçlarý ve nakil sonrasý sonuçlarý ile karþýlaþtýrýldý. Nakil sonrasý bir, üç ve altý dakikada kat edilen mesafelerin korelasyonlarý analiz edildi. Ýzlemde altý dakika yürüme testini tamamlayan olgular çalýþmaya dahil edildi.
BULGULAR: Altýncý ayda nakil öncesi altý dakika yürüme mesafesi ile nakil sonrasý altý dakika yürüme mesafesi arasýnda anlamlý fark bulundu. Transplantasyondan sonraki birinci ayda bir dakika yürüme testi ile altý dakika yürüme testi mesafeleri arasýnda güçlü bir iliþki bulundu. Bir ve üç dakikalýk yürüme testi mesafeleri, transplantasyon sonrasý altýncý aylýk dönemde altý dakikalýk yürüme mesafeleri ile korelasyonu anlamlý idi.
TARTIÞMA ve SONUÇ: Özellikle transplantasyon sonrasý erken dönemde bu hasta grubunda fonksiyonel durumu deðerlendirmek için bir veya üç dakika yürüme testi altý dakika yürüme testine alternatif olabilir.

INTRODUCTION: The 6-minute walk test (6MWT) values have an important role in pretransplant patient management, as they are an indicator of increased mortality in end-stage lung patients awaiting lung transplantation. However, there are not enough studies on the follow-up role of the 6MWT after lung transplantation. Although the 6MWT is widely used, it may not be an effective measure of functional endurance in some conditions and disease groups. Therefore, we investigated the relationship between the classical distance covered in 6 min and the distance walked in the first 1 or 3 min.
METHODS: The study was compared with the preoperative 6MWT results and posttransplant results of patients who underwent lung transplantation between 2016 and 2021. The correlations of distances traveled during posttransplantation at 1, 3, and 6 min were analyzed. The subjects who completed the 6MWT during the follow-up were included in the study.
RESULTS: There was a significant difference found between the pretransplantation 6-minute walk distance (6MWD) and posttransplantation 6MWD in the sixth month. A strong correlation between the distances of the 1-minute walk test (1MWT) and the 6MWT was found in the first month of posttransplantation. 1MWT and 3-minute walk test (3MWT) distances were significantly correlated with 6MWD in the sixth month posttransplantation.
DISCUSSION AND CONCLUSION: In the early posttransplantation period, 1MWT and 3MWT can be an alternative to the 6MWT to evaluate the functional status in this patient group.

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GÝRÝÞ ve AMAÇ: COVID-19 enfeksiyonu pnömoniden akut respiratuar distres sendromuna ve mortaliteye kadar çeþitli klinik durumlara yol açabilir. Bu çalýþmanýn amacý, serum kortizol düzeylerinin COVID-19 hastalýðýnýn prognozuna etkisinin olup olmadýðýný deðerlendirmektir.
YÖNTEM ve GEREÇLER: 18.03.2020-31.05.2020 tarihleri arasýnda Ýstanbul Haseki Eðitim ve Araþtýrma Hastanesi dahiliye kliniklerinde yatan COVID-19 pnömoni hastalarýný içeren geriye dönük bir çalýþma yürütüldü. Hastalarýn demografik verileri, laboratuvar testleri ve klinik sonuçlarý kaydedildi. Hastalar yatýþlarýna göre 1–10 gün ve ≥10 gün olmak üzere iki gruba ayrýldý. Her iki grup da yaþ ortalamalarýna ve hastanede kalýþ/ taburcu olma sürelerine göre sýnýflandýrýldý. Laboratuvar parametreleri analiz edildi.
BULGULAR: Bu çalýþma 129 hasta üzerinde yapýldý. Exitus olan hasta sayýsý 13, hayatta kalanlarýn sayýsý 116 idi. Exitus olanlarýn yaþ ortalamasý 68.7±10.9, taburcu olanlarýn yaþ ortalamasý 55.7±15.9 idi (p=0.001). Hastanede uzun süreli yatanhastalarda serum kortizol düzeyleri daha yüksek saptandý. Hemogram ve biyokimyasal parametrelerde gruplar arasýnda anlamlý fark yoktu. Yapýlan korelasyon analizinde serum kortizol düzeyleri ile yatýþ süresi arasýnda yakýn bir iliþki saptandý. Korelasyon ve regresyon analizine göre yüksek serum kortizol düzeyleri anlamlý bulundu.
TARTIÞMA ve SONUÇ: Serum kortizol seviyeleri COVID-19 hastalarýnda hastanede kalýþ süresini ve prognozu tahmin edebilir.

INTRODUCTION: There are several clinical outcomes associated with coronavirus disease 2019 (COVID-19) infection, including pneumonia, acute respiratory distress syndrome, and death. The aim of this study is to evaluate whether serum cortisol levels affect COVID-19 prognosis.
METHODS: A retrospective study was conducted with COVID-19 pneumonia patients hospitalized in an internal medicine clinic at the Haseki Training and Research Hospital in Istanbul from March 13 to May 31, 2020. Demographics, laboratory test results, and clinical outcomes of the patients were recorded. The patients were divided into two groups based on whether they were hospitalized for 1–9 days or ≥10 days. Both groups were classified according to their average age and duration of hospitalization/discharge, and laboratory parameters were analyzed.
RESULTS: This study was conducted on 129 COVID-19 pneumonia patients, 13 of whom died during the study period. The mean age was 68.7±10.9 years for nonsurvivors and 55.7±15.9 years for survivors (p=0.001). Serum cortisol levels were significantly elevated in patients with a long hospital stay. While there was no significant difference in the hemogram or biochemical parameters of the two groups, correlation analysis showed a close relationship between serum cortisol levels and length of hospitalization.
DISCUSSION AND CONCLUSION: Cortisol is a reliable predictor of the length of hospital stay and prognosis of COVID-19 patients.

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GÝRÝÞ ve AMAÇ: Alt ekstremitede iskemi reperfüzyon (IR) hasarýna maruz kalan hastalarda görülen en önemli problemlerden birisi akciðer hasarýdýr. Bu çalýþmamýzda alt ekstremite IR sonrasý ortaya çýkan akciðer hasarýnda progesteronun (PG) rolü araþtýrýlmýþtýr.
YÖNTEM ve GEREÇLER: On sekiz adet erkek Sprague-Dawley sýçan üç gruba ayrýldý: (1) kontrol: sýçanlara genel anestezi sonrasý iki saat aralýkla iki kez serum fizyolojik (SF) enjeksiyonu yapýldý (intraperitoneal (i.p.)), (2) IR: sýçanlara turnike kullanýlarak iki saat iskemi sonrasýnda iki saat reperfüzyon uygulandý. Hem iskemi hem de reperfüzyon öncesi ayný dozda SF enjeksiyonu yapýldý, (3) IR+PG: sýçanlara IR grubuyla ayný deney protokolü uygulanmýþ olup hem iskemi hem de reperfüzyon öncesi PG enjeksiyonu yapýlmýþtýr (16 mg/kg, i.p.). Reperfüzyon sonrasý sýçanlar sakrifiye edilerek akciðer dokusu çýkartýlmýþ ve biyokimyasal ve histolojik analizler yapýlmýþtýr.
BULGULAR: IR+PG grubunda doku malondialdehit ve nitrik oksit seviyeleri IR grubuna kýyasla anlamlý düzeyde azalmýþtýr (p<0.01). Benzer þekilde IR+PG grubunda glutatyon seviyesi ve süperoksit dismutaz ve glutatyon S-transferaz aktiviteleri IR grubuna kýyasla anlamlý derecede artmýþtýr (p<0.05, p<0.01 ve p<0.05). Iþýk mikroskopik incelemede IR+PG grubunda akciðer parankiminde azalmýþ enflamatuvar hücre infiltrasyonu, alveol yapýlarda düzelme ve hafif vasküler konjesyon görülmüþtür. IR+PG grubunda IR grubuna kýyasla histopatolojik skorda anlamlý düzeyde iyileþme tespit edilmiþtir (p<0.001).
TARTIÞMA ve SONUÇ: Progesteron antioksidan fonksiyonundan dolayý alt ekstremite IR sonrasý görülen akciðer hasarýnýn azaltýlmasýnda etkili olabilir.

INTRODUCTION: Remote lung injury is one of the most challenging issues in patients undergoing ischemia reperfusion (IR) injury of the lower limbs. We examined the role of progesterone (PG) on the remote injury of the lungs seen after IR of the lower limbs.
METHODS: Eighteen male Sprague Dawley rats were divided into three groups. (1) Control: rats had only two physiological saline injections intraperitoneally (i.p.) 2 h apart under general anesthesia. (2) IR: underwent 2 h tourniquet induced ischemia for both lower limbs followed by 2 h of reperfusion. Animals were injected with physiological saline (i.p.) before both ischemia and reperfusion. (3) IR + PG: rats underwent the same IR protocol as the IR group and were injected with PG (16 mg/kg, i.p.) before both ischemia and reperfusion. After reperfusion, rats were sacrificed, and lung tissues were taken out for histopathologic and biochemical analyses.
RESULTS: In IR + PG group, tissue levels of malondialdehyde and nitric oxide decreased significantly compared with the IR group (p<0.01). Similarly, glutathione level and superoxide dismutase and glutathione S-transferase activities significantly increased in the IR + PG group than in the IR group (p<0.05, p<0.01, and p<0.05, respectively). In light microscopy, reduced inflammatory cell infiltration, amelioration in alveolar structure, and mild vascular congestion in the parenchyma were seen in the IR + PG group. A significant improvement in histopathologic score was seen in the IR + PG group compared with the IR group (p<0.001).
DISCUSSION AND CONCLUSION: PG might be effective in attenuating remote injury of the lung in lower body IR via its antioxidant function.

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GÝRÝÞ ve AMAÇ: Bu çalýþmada, ampulla karsinomlarý ile pankreas baþý karsinomlarý arasýndaki farklarý araþtýrdýk. Literatürde henüz yeterince ele alýnmamýþ olan bu konuya katkýda bulunabileceðimize inanýyoruz.
YÖNTEM ve GEREÇLER: Temmuz 2011 ile Temmuz 2020 arasýnda rezeke edilmiþ periampuller adenokarsinomlu 125 hastanýn verileri geriye dönük olarak incelendi. Hastalar ampuller ve ampüller olmayan karsinomlar olarak iki gruba ayrýldý ve klinik, demografik ve patolojik açýdan karþýlaþtýrýldý.
BULGULAR: Ampulla dýþý kanserlerin çoðunlukta olduðu 109 hasta çalýþmaya dahil edildi (%59.6’sý ampulla dýþý ve %40.4’ü ampulla). En sýk baþvuru þikayeti sarýlýktý. Ortanca takip süresi 24 aydý (aralýk: 1.4 ay–80.4 ay). Ortanca genel saðkalým (GS) 30.6 aydý (%95 güven aralýðý (GA): 24–37.1). Ortanca hastalýksýz saðkalým (HS) 11.6 aydý (%95 GA: 8.9–14.4). Hem GS hem de HS ampulla tümörlerinde ampulla dýþý tümörlere kýyasla istatistiksel olarak anlamlý þekilde uzundu (p=<0.001).
TARTIÞMA ve SONUÇ: Ampulla karsinomlarý, pankreas baþý karsinomlarýna göre daha iyi prognozlu ve daha uzun saðkalýma sahip nadir tümörlerdir. Pankreas tümörlerinden farklý bir kategoride deðerlendirilirse seçilmiþ hastalarda daha az agresif tedavi almak ve gereksiz toksisiteden kaçýnmak mümkün olabilir. Bu konuda daha ileri çalýþmalara ihtiyaç vardýr.

INTRODUCTION: The aim of this study was to investigate the differences between ampullary carcinomas and pancreatic head carcinomas and to contribute significantly to this issue, which has not been sufficiently addressed in the literature.
METHODS: The study was a retrospective descriptive study. The data of 125 patients with resected periampullary adenocarcinoma were retrospectively reviewed between July 2011 and July 2020. The patients were divided into two groups, ampullary and nonampullary carcinomas, and were compared in terms of clinical, demographic, and pathological aspects.
RESULTS: A total of 109 patients were included in the study with nonampullary carcinoma predominance (59.6% had nonampullary and 40.4% had ampullary). The most common admission complaint was jaundice. The median follow-up was 24 months (range: 1.4–80.4 months). Both median overall survival (OS) and median disease-free survival (DFS) were statistically significant longer in ampullary carcinomas compared with nonampullary carcinomas (OS: 74.5 months vs 16.9 months, 95% CI: 12.6–21.2, p<0.001; DFS: 21.6 months vs 8 months, 95% CI: 10.7–32.6, p<0.001).
DISCUSSION AND CONCLUSION: Ampulla carcinomas are rare tumors with a better prognosis and longer survival than pancreatic head carcinomas. If it is evaluated in a different category from pancreatic tumors, it may be possible to receive less aggressive treatment and avoid unnecessary toxicity for selected patients. Further studies are needed.

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SARS-CoV-2’nin akciðer, kalp ve baðýþýklýk sistemi gibi birçok organ ve sistemin ciddi þekilde etkilenebildiði yeni koronavirüs hastalýðý 2019’a (COVID-19) neden olduðu bilinmektedir. Þu an için tedavi süreci genel anlamda destekleyici ve palyatif bakým üzerine kurulmuþtur. Potansiyel olabilecek bazý ilaçlar ise tedavide denenmektedir. Ýþte bu noktada, son dönemlerde belki de birçok hastalýkta ileride umut verici bir tedavi yöntemi olabilecek kök hücre tedavisi gündeme gelmektedir. COVID-19’da kök hücre tedavisi özellikle dirençli ve aðýr vakalarda anahtar rolü üstlenebilecek bir tedavi yöntemi olabilir. Bu derlemede, kök hücre tedavisinin potansiyel mekanizmalarýný ve bu tedavi yöntemindeki geliþmeleri özetledik.

Severe acute respiratory syndrome coronavirus 2 is known to cause the new coronavirus disease 2019 (COVID-19), in which many organs and systems such as the lung, heart, and immune system can be severely affected. Currently, the treatment process is generally based on supportive and palliative care. Some potential drugs are being tested for treatment. At this point, perhaps a promising treatment method for many diseases in the future seems to be stem cell therapy in recent times. Stem cell therapy in COVID-19 may be a treatment method that can play an important role, especially in resistant and severe cases. In this review, we summarized the potential mechanisms of stem cell therapy and developments in this treatment modality.

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Nefes darlýðý þikayeti ile baþvuran elli altý yaþýnda kadýn hastayý malignite þüphesi ile ameliyat etmeyi planladýk. Ýntraperikardiyal bilobektomi superior yaptýðýmýz hastanýn nihai patolojisi primer akciðer fibrosarkomu olarak raporlandý. Primer akciðer fibrosarkomu oldukça nadir görülen
bir tümör olup tedavisinde cerrahi esas rolü oynamaktadýr. Olgumuz litaratüre katký amacýyla sunulmaktadýr.

We planned surgery a fifty six year-old female patient, who applied with the complaint of dyspnea, due to the suspected malignancy. We carried out intrapericardial bilobectomy superior and the final pathological examination showed primary pulmonary fibrosarcoma. Primary pulmonary fibrosarcoma is a very rare type of tumor and surgery is the main choice of treatment. We present this case to contribute to the literature.

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