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Kocatepe Tıp Dergisi
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  This is an Open Access Journal Open Access journal
ISSN (Print) 1302-4612 - ISSN (Online) 2149-7869
Published by Afyon Kocatepe Üniversitesi Homepage  [5 journals]

    • Authors: Muammer BÜYÜKİNAN ; Muhammed Yaşar KILINÇ
      Abstract: OBJECTIVE: Type 1 diabetes mellitus (T1DM) is an autoimmune disease that can affect immunologic response to vaccines by its effects on the immune system. We aimed to investigate hepatitis A (HA) and hepatitis B (HB) seroprevalences in patients with T1DM.MATERIAL AND METHODS: We included 144 patients with T1DM and 58 patients in control group between the ages of 1 and 18 who have been followed up in the Pediatric Endocrinology Clinic of Konya Training and Research Hospital between January 2014 and January 2017. We have recorded the age of the patient, diabetes diagnosis time, HBsAg, anti-HBs, anti-HAV IgG and HbA1c results from records of the patients retrospectively.RESULTS: The median anti-HBs levels (14,8 mIU/ml [interquartile range (IQR): 4,2- 100] and 37,7 mIU/ml [IQR: 7,16- 122,7], p=0,026), median anti-HAV IgG levels (11 mIU/ml [IQR: 9,88- 21,7] and 19,8 mIU/ml [IQR: 15,2- 80], p <0,001), hepatitis B virus (HBV) seropositive patient rate (%59 and %73,7, p=0,048) and hepatitis A virus (HAV) seropositive patient rate (%27,5 and %44,2, p=0,027) were low in patients with T1DM comparing to patients in control group. We have found no correlation between anti-HBs, anti-HAV IgG levels and age, duration of diabetes and HbA1C levels.CONCLUSIONS: The findings of low anti-HBs, anti-HAV IgG levels, HAV and HBV seropositive patient rates in patients with T1DM demonstrated that immunologic responses to HAV and HBV vaccines were insufficient. Given the facts that patients with T1DM have various risk factors for HBV exposure, HA infection in advanced ages result in increased complication risk, poor glycemic control with infections and low HAV and HBV seropositivity rates in T1DM patients, we need to test T1DM patients for HAV and HBV serology, vaccinate the seronegative patients and monitor the vaccine response.
      PubDate: Tue, 05 Jan 2021 00:00:00 +030

    • Authors: Ferdi DIRVAR ; Sevda UZUN DIRVAR , Ömer CENGİZ , Mehmet Ali TALMAÇ , Timur YILDIRIM , Şükrü Sarper GÜRSÜ
      Abstract: OBJECTIVE: The aim of this study was to investigate the costs covered by the hospital during the inpatient treatment process of the patients who underwent hip revision arthroplasty surgery in orthopedics and traumatology clinics of a public hospital and compare with the invoiced amount.MATERIAL AND METHODS: The demographic information and revision reasons of 60 patients who underwent total hip revision arthroplasty operation in a public hospital between 01.01.2016 and 30.09.2017 were determined through Hospital Information Management System records. The patients were categorized under two groups including septic and aseptic. For each patient, the costs of medical consumables, medicine/serum, medical treatment, surgery, anesthesia, imaging services, laboratory procedures, blood and blood products, meal and companion costs, device depreciation expenses, consultation, control examination, preoperative patient preparation stage, surgery, visit and other costs were calculated separately during the inpatient treatment.RESULTS: The total cost of an average patient was 21,956.00 ₺, while the average amount of invoice was 17,220.00 ₺, with a difference of 4,736.00 ₺. This difference was found to be 9,876.00 ₺ in the septic group and 2.534,00 ₺ in the aseptic group. The bill payment made by the Social Security Institution (SGK) to the institution covers 78.4% of the cost of revision hip arthroplasty. In the septic group, the duration of hospital stay, medical expenditure, medication, treatment, surgery, anesthesia, laboratory, imaging, blood center, consultation, visit, meal cost, total cost and invoice amount were found to be significantly higher than the aseptic group (p< 0.05).CONCLUSIONS: Regulations by the Social Security Institution are needed to ensure the fiscal sustainability of public hospitals. In addition, following the medical and technical treatment protocols in revision surgery can help reduce the costs.
      PubDate: Tue, 05 Jan 2021 00:00:00 +030

    • Authors: Hatice HAMARAT ; Tuncer TEMEL
      Abstract: OBJECTIVE: The aim of this retrospective study was to investigate the socio-demographic and clinical characteristics as well as the diagnosis and treatment of patients with Inflammatory Bowel Disease between 1990 and 2009.MATERIAL AND METHODS: Between 1990 and 2009, the records of 237 patients diagnosed with Inflammatory Bowel Disease in the Gastroenterology Clinic of Faculty of Medicine were examined. The age, sex, smoking history, endoscopy and histopathology findings of the patients, local and systemic complications developed in the patients, types of treatment applied and reasons for surgical treatment were examined.RESULTS: Between 1990 and 2009, 144 Ulcerative Colit, 73 Crohn Disease and 20 Indeterminate Colit patients were followed. The mean age of diagnosis, at the time of diagnosis of Ulcerative Colit patients was 37 years. 28.7% patients had left colon involvement, 25.2% patients had pancolitis, and 21% patients had proctitis (p<0.01). Erythema nodosum in one patient, sacroiliitis in 3 patients, primary sclerosing cholangitis in 3 patients, and malign transformation in one patient were determined as systemic complications. The mean age was 35 years in patients with Crohn Disease. Involvement of colon and small intestine was determined in %34 and %64,2 patients, respectively. Uveitis in 4 patients, sacroiliitis in 5 patients were determined as systemic complications. 222 patients were treated with 5-ASA. Immunosuppressive treatment was given to 6 patients. 159 patients were given mono treatment (5-ASA) while 19 patients were given combine treatment.CONCLUSIONS: Understanding of the prognosis and clinical course are important for determining medical and surgical treatment and follow up strategies for different subgroups of the patient.
      PubDate: Tue, 05 Jan 2021 00:00:00 +030

    • Authors: Dilek ÇAVUŞOĞLU ; Çiğdem ÖZER GÖKASLAN
      Abstract: OBJECTIVE: Neurofibromatosis type I (NF1), Tuberous sclerosis complex (TSC) and Sturge-Weber syndrome (SWS) are the most common neurocutaneous syndromes. The purpose of this study is to evaluate the clinical and neuroradiological manifestations of patients diagnosed with NF1, TSC, and SWS.MATERIAL AND METHODS: In our clinic, records of 15 patients with NF1, TSC, and SWS were retrospectively reviewed between December 2017 and May 2019. Clinical and neuroradiological manifestations of patients were detailed.RESULTS: 15 patients consisting of 9 NF1, 5 TSC, and 1 SWS were determined between the ages of 9 days and 13,83 years (5 females and 10 males). All NF1 patients had café-au-lait spots. One (11.1%) with lisch nodules, one (11.1%) with optic glioma, one (11.1%) with epilepsy, two (22.2%) with macrocephaly, two (22.2%) with hydrocephalus, one (11.1%) with optic glioma and seven (77.7%) with family history were established. All TSC patients had hypomelanotic macules and epilepsy. It was indicated cardiac rhabdomyoma in 3 (60%) patients, angiomyolipoma in one (20%) patient and polycystic kidney in one (20%) patient. The patient with SWS was showed available of facial angioma, glaucoma, and epilepsy. It was pointed UBOs (unknown bright objects) with 6 (66.6%) patients, 2 (22.2%) patients with hydrocephalus, one (11.1%) patient with subependymal nodule and one (11.1%) patient with optic glioma in NF1 patients. Brain magnetic resonance imaging of all TSC patients showed cortical/subcortical tubers and two patients with subependymal nodules. Cortical and parenchymal atrophy and calcification were presented in cranial computed tomography of the patient with SWS.CONCLUSIONS: Clinical and neuroradiological manifestations of neurocutaneous syndrome are guidance for diagnosis so that detailed examination and neuroradiological perspective on neurocutaneous diseases will provide convenience in diagnosis and follow-up.
      PubDate: Tue, 05 Jan 2021 00:00:00 +030

    • Authors: Suat ÇAKINA ; Selma YÜCEL , Cemre Çağan POLAT
      Abstract: OBJECTIVE: Apolipoprotein E (ApoE) is a glycoprotein that functions as a ligand in receptor-mediated endocytosis of lipoprotein particles. There are studies showing the association of APOE with neurogenerative diseases such as Alzheimer's disease and multiple sclerosis (MS). The aim of this study was to investigate whether there is a relationship between APOE gene expression and MS.MATERIAL AND METHODS: To determine the effect of APOE gene expression on multiple sclerosis patients, we have included 35 MS patients and 20 healthy subjects into the study. The level of APOE mRNA expression was determined by real-time quantitative reverse transcription polymerase chain reaction (qRT-PCR). For statistical analysis, t-test, chi-square test, Kruskal-Wallis test and Mann-Whitney U test were performed using SPSS package program and p <0.05 was considered as statistically significant.RESULTS: As a result, the comparison of ApoE gene expression in multiple sclerosis patients and healthy people using real-time PCR technique did not show any statistical significance between the groups (p=0.95).CONCLUSIONS: Our study does not support that ApoE gene expression may be related to MS. Further studies are needed to determine the role of ApoE in Multiple Sclerosis disease.
      PubDate: Tue, 05 Jan 2021 00:00:00 +030

    • Authors: Coşkun Fırat ÖZKEÇECİ ; Belma SAYGILI KARAGÖL
      Abstract: Mechanical ventilation for respiratory support is one of the most effective methods for mortality and morbidity in neonatal intensive care units. Skin care, pain management, airway safety, humidification, protection of body temperature, nutrition, physiotherapy are the main factors affecting the treatment process in the follow-up of babies with a mechanical ventilator. Regular, careful, adequate and appropriate care has a significant impact on mortality and morbidity rates. In this article, important key points in the care of babies who require respiratory support in the neonatal intensive care unit and whose respiration is supported by a mechanical ventilator will be discussed.
      PubDate: Tue, 05 Jan 2021 00:00:00 +030

    • Authors: Yıldıray Genç ; Özgür KORKMAZ
      Abstract: Ganglion cysts can be seen in various parts of the body. Intra-articular ganglion cysts can be seen with localized swelling of the knee or detected during MR imaging coincidentally. Ganglion cysts may originate from the anterior cruciate ligament, the menisci, the popliteus tendon, and the infrapatellar fat tissue, Hoffa. Excision of intra-articular knee ganglion cysts can be performed with open surgical procedure or arthroscopy assisted. Arthroscopically assisted ganglion cystic excision surgery is superior to open surgery in terms of reduced surgical morbidity, lower probability of restraint in the post-op period and patient comfort. The Surgeon should be careful not to leave residual ganglion cyst wall in arthroscopy procedure. Arthroscopic debridement is an easy and low morbidity surgical treatment for intra-knee ganglion cysts.
      PubDate: Tue, 05 Jan 2021 00:00:00 +030

    • Authors: Merih ŞİMŞEK
      Abstract: OBJECTIVE: Meat and dairy products, which have an important place for human health, create a very good media for the development of many microorganisms due to the substances in their structure. Based on this situation, it was aimed to investigate the microbiological characteristics and compliance with the standards of milk, yoghurt, cheese, sausage, pastrami and meat offered for sale in Afyonkarahisar.MATERIAL AND METHODS: A total of 60 products from samples of each food type, including 30 dairy products and 30 meat products, were transported in accordance with the cold chain rule and the products were examined microbiologically. Raw milk, yoghurt, fresh cheese, raw meat, sausage and bacon samples were included in this study for analysis. Total Aerobic mesophilic bacteria, yeast-mold, coliform bacteria, S. aureus, E. coli, Salmonella and Coliform group microorganisms were taken 10 g / ml from each of the food samples to be examined, and serial dilutions were prepared as 10-1, 10-2, 10-3, 10-⁴, 10-⁵. The numbers of aerobic mesophilic bacteria, yeast-mold, S. aureus, E. coli, Salmonella and Coliform group microorganisms were determined under suitable media and optimum incubation conditions.RESULTS: The highest number of aerobic mesophilic bacteria and coliform bacteria in milk is 5.5x10⁴ cfu/g and 1.5x103 cfu/g; The highest number of aerobic mesophilic bacteria, coliform bacteria and fungus in yogurt was 2.7x103 cfu/g, 3.0x10⁶ cfu/g and 2.2x103 units/g; The highest number of aerobic mesophilic bacteria, coliform bacteria and fungus in cheese were determined as 2.9x103 cfu/g, 3.7x103 cfu/g and 7.8x101 units/g. The highest number of fungus and staphylococci in sausage is 2.8x102 units/g and 6.0x102 cfu/g; The highest number of fungus and staphylococcus bacteria in pastrami was 3.9x103 units/g and 9.8x10⁴ cfu/g; The highest mesophilic aerobic bacteria and staphylococcus bacteria in raw meat were determined as 7.5x102 cfu/g and 3.8x10⁵ cfu/g. For milk and milk products, the percentages of the presence of aerobic mesophilic bacteria, coliform bacteria, mold-yeast and S. aureus were determined as 57%, 53%, 33%, 23%, respectively. For meat and its products, the percentages of the presence of aerobic mesophilic bacteria, mold-yeast, S. aureus were determined as 13%, 40% and 70%, respectively.CONCLUSIONS: Salmonella and E. coli were not found in any sample. It has been determined that most of the food samples comply with the Turkish Food Codex Meat and Dairy Products Communiqué and are of microbiologically sufficient quality. However, in some instances, it was thought that there might be certain levels of contamination of the products due to product handling, transportation and storage conditions. As a result, the data revealed the importance of hygiene in milking, not selling milk in the open and not choosing cheese production from raw milk. It was concluded that the microbiological control at slaughtering and sales points should be increased in order to prevent contamination of meat products and microorganism growth.
      PubDate: Tue, 05 Jan 2021 00:00:00 +030

    • Authors: Mehmet Nuri KONYA ; Feza KORKUSUZ , Recep ALTIN , Gökhan MARALCAN , Teyfik DEMİR
      Abstract: OBJECTIVE: Due to the decrease in the rate of bone cortex medulla with osteoporosis, insufficiency in screw fixation occurs. In the treatment of periprosthetic fractures, thermal necrosis, cold welding at the head of the screw, loosening and impaired bone circulation circulatory disturbance in the bone can be seen in plate-screw applications. In this study, we aimed to test the newly designed U-studded plate against cerclage systems and use it safely in the detection of periprosthetic fractures.MATERIAL AND METHODS: The tests were carried out by determining the fatigue limits of the samples in laboratory conditions. Three different model groups were tested as U-pin model, cable cerclage system and hybrid system.RESULTS: According to the results obtained, while the fatigue resistance was the lowest in the 1st group, there was no significant difference between the 2nd and 3rd groups. The results obtained have shown that the combination with U-pin plate and cerclage is superior to the cerclage system alone.CONCLUSIONS: The newly developed U-pin plate system was found to be more effective than fracture fixation by applying cerclage only. The use of the new implant is safe in periprosthetic fractures biomechanically whereas long term clinical studies should be necessary.
      PubDate: Tue, 05 Jan 2021 00:00:00 +030

    • Authors: Ahmet Cevdet CEYLAN ; Haktan Bağış ERDEM
      Abstract: OBJECTIVE: Chromosome segment variations involving more than 50 bases are called Copy Number Variations (CNV). Chromosomal microarray method is used to detect CNVs in a routine practice. Chromosomal microarray analysis (CMA) is a first-tier test in the evaluation of individuals with intellectual disability and developmental delay with the diagnostic yield ranging from 5 to 20% varying based on population examined. The International Standard for the Consortium of Cytogenomic Array recommended CMA as a first-stage cytogenetic diagnostic test for patients with CA and ID / GDD. This study aimed to compare the standard and new high resolution analyze methods.MATERIAL AND METHODS: Our study was carried out with retrospective evaluation of 500 patients with CMA with different indications with Affymetrix Cytoscan Optima chips in Ankara Atatürk Research and Education Hospital.RESULTS: In the standard analysis method, 313 CNVs was detected at 298 patients. New analyze method detected 939 CNVs at 362 patients. Standard analysis method could not detect 3 pathogenic CNVs which were below 100-Kb. While in the standard analysis, 56 pathogenic CNVs was found in the new analysis method. The number of CNVs classified as unknown clinically was 105 in the standard method and 318 in the new analysis method. In addition, 12 CNVs with a frequency of more than 1% were detected in our study.CONCLUSIONS: Although the new method has increased the diagnostic percentage of the test from 10.7 to 11.3, it increases the clinical significance and increases the false positive results. This has led to a higher sensitivity of the analysis, but has led to an increase in both the duration of the analysis and other results that can be called artifacts in the test. In addition, 10 CNVs which are relatively common in Turkish population have been reported in our study.KEYWORDS: , 
      PubDate: Tue, 05 Jan 2021 00:00:00 +030

    • Authors: Başak ÖZYILDIRIM KOÇ ; Özkan GÜLER , Bengü YÜCENS
      Abstract: OBJECTIVE: Anxiety and depression are common psychiatric symptoms, and an increased risk of suicide is also seen in cancer patients. It was aimed to evaluate clinical features, anxiety and depression prevalence, and suicide probability in patients with lung, colorectal and head-neck cancer, also to compare these psychological factors with those with a healthy control group.MATERIAL AND METHODS: The patients with 82 lung cancer, 99 colorectal cancer and 79 head-neck cancer and a control group of 98 healthy individuals were included in the study. Sociodemographic data form, Hospital Anxiety and Depression Scale (HADS) and Suicide Probability Scale (SPS) were administered to all the participants.RESULTS: The prevalence of anxiety symptoms was 29.2% and depression was 52.7% in cancer patients. HADS anxiety and depression subscales and SPS mean scores were higher in cancer patients than healthy controls. The patients with head-neck cancer were more anxious, more depressed, and suicidal than the healthy controls. The patients with lung cancer were only more depressed than the healthy controls. Additionally, it was found that female gender, fatigue, and pain experience in cancer patients were seen as factors that increased the frequency of anxiety and depression; advanced stage disease was only related to the frequency of depression, and a history of psychiatric treatment affected only the frequency of anxiety.CONCLUSIONS: Psychological factors varies in different types of cancer. The cancer patients should be evaluated in terms of psychiatric problems by the clinicians to determine the level of anxiety, depression, and suicidality.
      PubDate: Tue, 05 Jan 2021 00:00:00 +030

    • Authors: Fatma ŞİMŞEK
      Abstract: OBJECTIVE: Neuro-Behcet's Syndrome (NBS), occurs due to central nervous system involvement of Behcet's disease (BD), and it is one of the factors that increase mortality and morbidity. In this study, we aimed to investigate the clinical, demographic and radiological data of Neuro-Behcet patients living in our region.MATERIAL AND METHODS: In this study, the records of 14 patients who were followed up with the diagnosis of NBS at Atatürk University Neurology Clinic between January 2015 and January 2019 were reviewed retrospectively. Analyses were made by using SPSS 20 statistical program.RESULTS: The ages of patients were between 18 and 45 years. The average age was 32,07+9,06 years, and NBS onset age was 29,9+6,8 years. % 35,7 (n=5) of patients with NBS were female, and % 64,3 (n=9) of them were male. The most common reason for admission was headache with % 57,1. % 50 of the patients with NBS in magnetic resonance imaging had parenchymal, and 50% of the patients had nonparenchymal involvement. One patient had coexistence of NBS and multiple sclerosis while one patient had an acute infarct area with diffusion restriction in the brain stem. In our study, mortality rate in NBS was % 7,1 (n=1). % 35,7 of the patients had a previously known diagnosis of BS, and % 64,3 (n=9) of them had been diagnosed BD with NBS diagnosis. The result of HLA-B51 was positive in 4 patients.CONCLUSIONS: The rate of patients with NBS and BD at the same time is significantly higher than the literature. It was thought that the effective factor was low sociocultural level. Early diagnosis and treatment are important factors that reduce the risk of developing NBS. Rarely coexistence of NBS and MS'.
      PubDate: Tue, 05 Jan 2021 00:00:00 +030
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