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Anatolian Clinic the Journal of Medical Sciences
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This is an Open Access Journal

Open Access journal
ISSN (Print) 2149-5254 - ISSN (Online) 2458-8849
Published by Hayat Sağlık ve Sosyal Hizmetler Vakfı

[1 journal]

Radiation and Its Effects on Human Health
- Authors: Ecem GÖKOĞLAN ; Meliha EKİNCİ , Emre ÖZGENÇ , Derya İLEM-ÖZDEMİR , Makbule AŞIKOĞLU
  Abstract: As humans are exposed to radiation from various sources in almost every area of life, effects of radiation on human health have been an important subject of research. Starting with the discovery of X-rays, studies in this field were accelerated by pivotal developments such as nuclear warfare (atomic bombings of Hiroshima and Nagasaki) and reactor accidents (the Chernobyl disaster). Type of radiation exposure and exposure time and dose have been determined to be the primary factors, while ionizing radiation has been proven to have more serious effects than does non-ionizing radiation. While ionizing radiation can lead to cancer development, non-ionizing radiation does not have carcinogenic effects shown by long-term studies. In this review, we compiled information about the effects of radiation on human health.
  PubDate: Thu, 29 Oct 2020 00:00:00 +030
The Effect of Computer-Assisted Visual Information on Dental Fear Before
Periodontal Surgery
- Authors: Mustafa Özay USLU ; Esra BOZKURT
  Abstract: Aim: Dental anxiety is the response of a patient to specific psychological stresses associated with dental practices. By using the Dental Fear Scale (DFS) and the State–Trait Anxiety Inventory (STAI), this study aimed to evaluate the dental anxiety levels in preoperative patients who received only verbal information or both verbal and detailed computer-assisted visual information about periodontal procedures. Materials and Methods: The study included 114 patients who were scheduled for surgical procedures at the Department of Periodontology of the Inonu University Dentistry Faculty. Patient data on sociodemographic characteristics, systemic and periodontal health conditions, dental visit frequency, past experiences of dental treatment, and reasons for seeing a periodontist were recorded. Dental anxiety was measured with the DFS. The STAI was used to determine the anxiety levels of the patients. The control group consisted of patients who were informed only verbally while the patients who received both verbal and detailed computer-assisted visual information formed the study group. Results: The control and study groups consisted of 59 (51.7%) and 55 (48.2%) patients, respectively. The DFS scores were found to be statistically significantly higher in patients aged between 14 and 19 years (n=20) than in the 20–29 age group (n=37) and the 50–59 age group (n=9) (p=0.026; p<0.05), and in female patients than in male patients (p=0.036; p>0.05). While no statistically significant difference was found between the groups in terms of STAI-II scores (p>0.01), the STAI-I and DFS scores were statistically significantly higher in the study group compared to the control group (p=0.001; p<0.01).Discussion and Conclusion: We observed that the patient anxiety scores increased with the level of information. Clinicians should be aware of how patient anxiety levels might change depending on the information provided by them.
  PubDate: Thu, 29 Oct 2020 00:00:00 +030
COVID-19 Vaccine Research and Ethical Issues in the Context of Gene
Editing Technologies
- Authors: İ̇brahim TOPÇU ; Nazım NASUHBEYOĞLU
  Abstract: Aim: Both around the world and in Turkey, the COVID-19 (coronavirus disease 2019) pandemic hasdrawn all attention to viruses, genetic modification of viruses, and vaccines. In this study, we aimedto review such clinical research and developments associated with gene-editing technologies andaddress issues related to research on COVID-19 vaccines and vaccination ethics.Materials and Methods: Recent literature on gene-editing technologies and COVID-19 vaccine research has been discussed in terms of issues related to vaccine safety, adequate production ofvaccines and access to vaccines, priorities in vaccination and herd immunity, and vaccine hesitancyand vaccine refusal.Results: In many countries, scientists have been working intensively in order to develop an antiviralmedication and vaccine against SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2).However, even if a vaccine is produced, it will probably not be available before 2021. Furthermore, itis still not clear how long the vaccine could remain protective, what side effects it might have, andwhether it will be accessible to all people. Although conspiracy theories that the virus is a productof laboratory work fuel the usual anti-vaccination discourses, it is unclear how much resistance thiscould raise against the vaccine in the current global environment of concern due to the pandemic.Discussion and Conclusion: During such a period where we have had to relive our experiences withall aspects of pandemics, vaccines based on gene-editing technologies and the ethical debate overthese innovative techniques may be so consequential as to shape our future view of vaccines andeven modern medicine
  PubDate: Thu, 29 Oct 2020 00:00:00 +030
Seasonal Influenza Vaccination-related Knowledge, Attitudes, and Behaviors
of Pregnant Women
- Authors: Gülnur KUL ; Nail ERDOĞAN
  Abstract: Aim: In pregnancy, influenza infection is associated with higher morbidity/mortality and an increase in maternal, fetal, and neonatal risks. Vaccination is the most effective strategy in the prevention of influenza. In this study, we aimed to evaluate the seasonal influenza vaccination-related knowledge, attitudes, and behaviors of a group of pregnant women. Materials and Methods: The study was a cross-sectional survey study and included adult pregnant women in the first, second, and third trimesters who visited our outpatient obstetric clinic between January and July 2019. Based on the literature review performed, a 17-item questionnaire was prepared by the researchers, which was then administered by face-to-face interview. The questionnaire inquired about the participants’ obstetric, demographic and socioeconomic characteristics, history of influenza vaccination during pregnancy, and knowledge, attitudes and behaviors in the context of influenza vaccination during pregnancy. Results: The study included a total of 227 pregnant women. Those who thought that influenza vaccines were safe during pregnancy were mostly university graduates. Only 19 (8.3%) reported having an influenza vaccination while they were pregnant. When the participants’ reasons for not being vaccinated were inquired, the main (71%) reason was “concern about the vaccine’s adverse effects on babies”, followed by “the vaccine being unnecessary and not adequately tested in pregnant women” (8.3%). Most (80%) of the participants who had an influenza vaccination during pregnancy received the information that they should be vaccinated from their family doctors.Discussion and Conclusion: We found that our participants’ knowledge about the influenza vaccine was generally insufficient, and that influenza vaccination was not adequately promoted by health-care workers, particularly physicians. Recommendations by family doctors, gynecologists, and obstetricians for influenza vaccination during routine follow-up visits play a central role in the information of pregnant women as a high-risk group.
  PubDate: Thu, 29 Oct 2020 00:00:00 +030
The Efficacy and Nephrological Side Effects of Treatment with Colistin in
Neonates
- Authors: Seyda IGNAK ; Yesim COSKUN , Demet YALCİN , İpek AKMAN
  Abstract: Aim: For many years, colistin has not been considered a first-line treatment due to its toxic side effects. However, its use has recently been reevaluated as a last resort in the treatment of neonatal infections caused by multidrug-resistant (MDR) gram-negative bacteria (GNB). Accordingly, in this study we aimed to contribute to the literature by investigating the efficacy and nephrological effects of colistin use in neonates. Materials and Methods: The retrospective study was conducted in the neonatal intensive care unit of a tertiary university hospital between January 2015 and February 2019 and included 30 patients who received intravenous treatment with colistin for culture-proven hospital-acquired GNB infections. We analyzed the serum sodium, potassium, phosphate, calcium and magnesium levels, urea, creatinine, aspartate aminotransferase and alanine aminotransferase values, and urine outputs measured on the 1st, 3rd, and 10th days of treatment. Results: All patients were treated with colistin for at least 10 days (mean 16.07±3.22 days) and the treatment dose was 5 mg/kg per day. We observed a statistically significant difference between the 1st- and 10th-day urea, creatinine, calcium, magnesium, and urine output values (p˂0.05). Similarly, when we compared the measurements recorded on the 1st and 10th days of treatment, we found that the magnesium and calcium levels were significantly decreased (p=0.008 and p=0.038, respectively) while the urea, creatinine, and urine output values were significantly increased (p=0.027, p=0.022, p=0.001, respectively).Discussion and Conclusion: Colistin is an effective agent in the treatment of MDR-GNB infections in neonates. Neonates should be closely monitored for nephrotoxicity during treatment with colistin. The efficacy and safety of neonatal treatment with colistin should be investigated with further, larger-sample studies.
  PubDate: Thu, 29 Oct 2020 00:00:00 +030
Comparison of Outcomes of Anterior Cruciate Ligament Reconstructions Using
Patellar Tendon or Hamstring Tendon Autografts with Femoral Cross-pin
Fixation
- Authors: Ömer Kays UNAL ; Ülkü SUR ÜNAL, Mirza Zafer Zafer DAĞTAŞ , Burak DEMİRAĞ
  Abstract: Aim: In this study, we aimed to compare outcomes of anterior cruciate ligament (ACL) reconstructions using bone–patellar tendon–bone graft (BPTG) or hamstring tendon graft (HTG) with cross-pin fixation at the femoral side.Materials and Methods: The retrospective observational study included records of 100 patients who underwent ACL reconstruction with femoral cross-pin fixation between May 2008 and August 2012. The patients were divided into two groups according to the graft type used: the BPTG group and the HTG group. The preoperative and postoperative 6th-month Tegner Lysholm Knee Scoring Scale (TLKS) scores, International Knee Documentation Committee Subjective Knee Evaluation Form (IKDC-SKF) scores, and Lachman test results were compared. The effects of meniscus lesion presence on the outcomes were also investigated.Results: Of the 100 patients, 93 were male and 7 female. The HTG and BPTG groups consisted of 62 and 38 patients, respectively. The mean age was 24.1±4.9 (18–38) years for the HTG group and 32.1±6.8 (21–54) years for the BPTG group. The mean pre- and postoperative TLKS scores were respectively 50.5 and 94.3 in the BPTG group, and 49.9 and 95.2 in the HTG group. The mean pre- and postoperative IKDC-SKF scores were 51.3 and 95.6 in the BPTG group, and 51.8 and 95.6 in the HTG group. The postoperative score improvement was statistically significant in all patients (p<0.05), but there was no significant difference between the two groups. The postoperative improvement in knee stability was statistically significant in all patients (p<0.05). The postoperative score improvement was less in patients with meniscal injury (p<0.05).Discussion and Conclusion: We found no significant difference between the two groups in terms of functional knee scores. However, the presence of meniscus lesions negatively affects the postoperative outcomes.
  PubDate: Thu, 29 Oct 2020 00:00:00 +030
The Periodic Fever, Aphthous Stomatitis, Pharyngitis, and Adenitis (PFAPA)
Syndrome in Children: A Retrospective Evaluation of 82 Patients
- Authors: Sevliya ÖCAL DEMİR
  Abstract: Aim: The periodic fever, aphthous stomatitis, pharyngitis, and adenitis (PFAPA) syndrome, characterized by sudden fever, stomatitis, pharyngitis, and adenitis, is the most common periodic fever syndrome in children. In this study, we aimed to increase awareness of the disease by evaluating clinical data of pediatric patients diagnosed with PFAPA syndrome. Materials and Methods: The retrospective study included 82 patients who had been on follow-up after a diagnosis of PFAPA syndrome at the Pediatric Infectious Diseases Outpatient Clinic of the Diyarbakır Children’s Hospital between 1 October 2017 and 30 June 2019. Patient data on demographic characteristics, clinical and laboratory findings, treatments received, and response to treatment were obtained from the medical records. Results: Of the patients, 52 were male and 30 female. The median age at onset of complaints was 18 (1–120) months while the median age at diagnosis was 53 (12–172) months. Of the 82 patients, all had fever and pharyngitis, 56 lymphadenitis, 48 cryptic tonsillitis, and 28 stomatitis. Laboratory tests revealed leukocytosis (46.38%), neutrophilia (59.7%), and lymphopenia (4.47%). C-reactive protein was positive in 86.56% of all patients, with a median value of 69.9 (6.19–279) mg/dl. The median erythrocyte sedimentation rate was 34 (7–101) ml/hour. Thirty-four (41.46%) patients had a history of at least one hospitalization for fever. Fifty-eight (71%) patients had first-degree relatives with a history of frequent attacks of tonsillitis, of whom 21 (25.6%) underwent tonsillectomy. All patients showed dramatic response to treatment with methylprednisolone. Discussion and Conclusion: In PFAPA syndrome, early diagnosis is important for preventing unnecessary testing, treatment, and hospitalization. PFAPA syndrome should be considered in the differential diagnosis of children under 5 years of age who present with recurrent fever and tonsillitis episodes, particularly those who have relatives with a history of frequent tonsillitis or tonsillectomy.
  PubDate: Thu, 29 Oct 2020 00:00:00 +030
Demographic and Clinical Characteristics of Patients with Pseudophakic
Retinal Detachment and Their Effects on the Success of Surgery
- Authors: Havva KALDIRIM ; Mehmet ÇAKIR , Ömer Faruk YILMAZ
  Abstract: Aim: In this study, we aimed to determine the demographic and clinical characteristics of patients who underwent surgical treatment for pseudophakic retinal detachment (PRD) and evaluate the effects of these characteristics on the success of the surgery. Materials and Methods: The study included 60 eyes of 60 patients who were diagnosed with PRD at the Retina Section of the 1st Eye Clinic of the Beyoğlu Eye Training and Research Hospital between February 2006 and January 2009. Demographic and pre-, peri- and postoperative clinical data of the patients were recorded.Results: The mean patient age was 58.45±14.91 years. Of the patients, 46 (76.7%) were male and 14 (23.3%) were female. Fifty-two (86.6%) patients underwent phacoemulsification surgery, 1 (1.6%) planned extracapsular cataract extraction, 1 (1.6%) intracapsular cataract extraction, 3 (5%) refractive clear lens extraction, and 3 (5%) lens extraction with irrigation/aspiration for diagnosed pediatric cataract. Twenty-two (36.6%) patients underwent posterior chamber lens implantation in the capsule, 32 (53.3%) posterior chamber lens implantation in the sulcus, 4 (6.6%) anterior chamber lens implantation, and 2 (3.3%) scleral-fixated lens implantation. In 44 (73%) patients, the posterior capsule integrity was impaired. A tear was detected in 27 (45%) patients during the preoperative retinal examination and in 18 (30%) patients during the surgery. No tear was detected in 15 (25%) of the patients. To treat the patients, four different surgical procedures were performed depending on factors including the proliferative vitreoretinopathy (PVR) stage, condition of the lens and posterior capsule, and location of the retinal tear: 360-degree scleral encircling band + local explant (Group I), 360-degree scleral encircling band + pars plana vitrectomy + tamponade (Group 2), 360-degree scleral encircling band + pars plana vitrectomy + intraocular lens removal + tamponade (Group III), and 23G pars plana vitrectomy + tamponade (Group IV). The mean follow-up was 18.3±5.2 (6–32) months. At the last follow-up visits, anatomical success was achieved in 58 (96.6%) of the 60 patients while 17 (32%) showed functional success. The functional success rate was higher in patients in the early stages (up to C1) of PVR (p<0.001).Discussion and Conclusion: According to our findings, PVR stage is directly related to anatomical and functional success in PRD. Surgical treatment is more successful in PRD patients with early-stage PVR.
  PubDate: Thu, 29 Oct 2020 00:00:00 +030
A rare etiology of pericarditis, Brucella spp.
- Authors: Tuba TATLI KIŞ ; Mehmet KIŞ
  Abstract: In brucellosis, pericarditis is usually a complication associated with endocarditis, and isolated pericarditis is rare. In this paper, we present a rare case of isolated pericarditis due to brucellosis without endocarditis, associated with cardiac signs and symptoms.In brucellosis, pericarditis is usually a complication associated with endocarditis, and isolated pericarditis is rare. In this paper, we present a rare case of isolated pericarditis due to brucellosis without endocarditis, associated with cardiac signs and symptoms
  PubDate: Thu, 29 Oct 2020 00:00:00 +030
An Investigation of the Relationship between SIRT1 Gene Polymorphisms and
Parkinson’s Disease
- Authors: Meryem KUŞÇU ; Esra ACİMAN DEMİREL , Esra ERMİŞ , Sevim KARAKAŞ ÇELİK
  Abstract: Aim: Parkinson’s disease is a disorder caused by insufficient dopamin production due to the loss of dopaminergic neurons concentrated in the substantia nigra of the brain. Oxidative stress and mitochondrial dysfunction play a central role in the pathogenesis. The Sirtuin1 (SIRT1) gene, shown to protect cells against oxidative stress, has been reported to be associated with predisposition to Parkinson’s disease. In this study, we aimed to investigate the relationship between Parkinson’s disease and the SIRT1 gene polymorphisms rs7895833 and rs2273773. Materials and Methods: The study included 40 patients with Parkinson’s disease (the patient group) and 50 healthy individuals (the control group). The polymerase chain reaction with confronting two-pair primers (PCR-CTPP) and polymerase chain reaction–restriction fragment length polymorphism (PCR-RFLP) methods were used for the rs7895833 and rs2273773 polymorphisms, respectively. Results: For the rs7895833 polymorphism, the genotype distribution for the patient and control groups respectively was as follows: AA (62.5%–53.1%), AG (27.5%–40.8%), GG (10.0%–6.1%). For the rs2273773 polymorphism, the genotype frequencies for the patient and control groups were as follows: TT (90.0%–98.0%), CT (10.0%–2.0%). No statistically significant difference was found between the patient and control groups in terms of rs2273773 and rs7895833 polymorphisms (p>0.05). Discussion and Conclusion: Our findings indicated that the SIRT1 gene polymorphisms investigated did not play a predisposing role in the development of Parkinson’s disease.
  PubDate: Thu, 29 Oct 2020 00:00:00 +030
Long-term Results of the Combined Use of Rotational Atherectomy and
Drug-Coated Balloon in Isolated Total Occlusion of the Superficial Femoral
Artery
- Authors: Fatih Avni BAYRAKTAR ; Cemal KOCAASLAN , Mehmet Şenel BADEMCİ , Emre SELÇUK , Ebuzer AYDIN
  Abstract: Aim: In this study, we aimed to evaluate the long-term results of combined treatment with rotational atherectomy (RA) and drug-coated balloon (DCB) in isolated total occlusion of the superficial femoral artery (SFA). Materials and Methods: The retrospective study was conducted between February 2016 and January 2018 and included a total of 23 limbs of 20 patients with isolated total occlusion of the SFA. Patient data on demographic and clinical characteristics were obtained from the hospital records. The stage of the disease was classified according to the Rutherford classification. The ankle–brachial index was measured pre- and postoperatively. Results: Of the patients, 19 (95%) were male and one (5%) was female. The mean patient age was 67.40±7.50 (49–77) years. The patient distribution according to the preoperative Rutherford classification was as follows: stage 5, four (17.40%) patients; stage 4, eight (34.80%) patients; stage 3, eleven (47.80%) patients. The rates of one- and two-year freedom from target lesion revascularization were 82.61% and 69.57%, respectively. Discussion and Conclusion: Our study results showed that combined treatment with RA and DCB was an effective method in SFA lesions with a high calcified plaque burden, providing high rates of primary patency and freedom from target lesion revascularization as well as low rates of complication.
  PubDate: Thu, 29 Oct 2020 00:00:00 +030
Stereotactic Biopsy Results of a Series of Patients with Nonpalpable
Breast Lesions in Our Hospital
- Authors: Nadir Adnan HACIM ; Ahmet AKBAŞ
  Abstract: Aim: Although screening mammography has a high sensitivity in the clinical detection of nonpalpable breast cancer, most mammographically suspicious lesions referred to biopsy are seen to be benign. The rate of malignancy in such lesions that are biopsied with needle–wire localization ranges from 10 to 36%. In this study, we aimed to compare with the literature the pathological results and Breast Imaging Reporting and Data System (BI-RADS) scores of lesions subjected to mammography and excisional biopsy after ultrasonography-guided needle–wire localization and calculate a positive predictive value for each category.Materials and Methods: By electronically reviewing patient files and using the International Statistical Classification of Diseases and Related Health Problems (ICD-10) codes, we identified patients who underwent excisional biopsy after stereotactic marking at the General Surgery Clinic of the Istanbul Sisli Hamidiye Etfal Training and Research Hospital between January 2003 and March 2009. A total of 64 patients were included in the study, of whom 43 had benign and 21 had malignant lesions on postoperative histopathological examination. Data on patient demographic characteristics, indications for marking, and histopathological diagnoses were recorded. The patient BI-RADS scores were determined based on the mammography and breast ultrasonography reports. The BI-RADS classification and histopathological examination results were compared in percentages. Results: The mean patient age was 48.9 (32–76) years. Based on the mammography reports, the most common indications for stereotactic marking and excisional biopsy were microcalcification cluster and spiculated mass. Histopathological examination results revealed malignancy in 8%, 51%, and 100% of the patients whose BI-RADS scores were mammographically determined to be BI-RADS 3, BI-RADS 4, and BI-RADS 5, respectively. Discussion and Conclusion: The BI-RADS-based classification of lesions detected by mammography and ultrasonography can help in predicting malignancy. While BI-RADS 4 and BI-RADS 5 lesions are referred to biopsy primarily, short-term follow-up of BI-RADS 3 lesions as an alternative to biopsy could reduce unnecessary biopsies.
  PubDate: Thu, 29 Oct 2020 00:00:00 +030
“Breast within Breast”' Radiological Features of Breast
Hamartomas
- Authors: Muhammed Akif DENİZ ; Zelal TAŞ DENİZ , Aydın ASLAN , Mehmet TURMAK , Çağlayan ÇAKIR
  Abstract: Aim: In this study, we aimed to discuss radiological imaging features of breast hamartomas (BHs), which are benign lesions, and contribute to reducing unnecessary examinations and biopsies by emphasizing the recognizability of hamartoma lesions based on those features. Materials and Methods: We retrospectively reviewed the mammography (MG), ultrasound (US), and magnetic resonance imaging (MRI) images of a total of 33 (32 females, 1 male) patients who were diagnosed with BH at our radiology clinic in the Dicle University Medical Faculty between January 2014 and July 2019. Six patients had MG, US, and MRI images, 21 had MG and US images, and 6 had only MRI images. For the male patient, MG and US images were available. Results: The mean patient age was 48.5 (28–74) years. The mean mass size was 3.4 (1.5–12) cm. The male patient admitted with a pre-diagnosis of gynecomastia had the largest mass, which occupied the entire left breast. The lesions were located in the right breast in 20 patients and in the left breast in the remaining 13. When the MRI images were reviewed, post-contrast images showed peripheral heterogeneous contrast enhancement in all lesions while contrast-enhanced series showed type 1 and 2 kinetic curves in 10 and 2 patients, respectively. No type 3 kinetic curve was identified in any of the cases. No statistically significant difference was found between the normal breast tissue apparent diffusion coefficient (ADC) and hamartoma ADC values (p>0.5). Discussion and Conclusion: BHs as benign lesions are seen in radiological examinations as small nodular lesions characteristically similar to the breast tissue, with the easily recognizable “breast within breast” appearance.
  PubDate: Thu, 29 Oct 2020 00:00:00 +030
Modified Visual Magnetic Resonance Scale and Neuropsychometric Corelations
in Alzheimer's disease
- Authors: Burcu POLAT ; Nesrin HELVACI YILMAZ , Sabriye Şennur BİLGİN , Lütfü HANOĞLU
  Abstract: Aim: Although more advanced neuroimaging techniques have been developed for research on Alzheimer’s disease (AD), structural magnetic resonance imaging (MRI) remains important in the clinical diagnosis of AD. The relationship between comprehensive MRI visual rating scales evaluating many parameters and cognitive and behavioral appearances of the disease has not been adequately investigated. In this study, we aimed to evaluate the correlation of the 7 sub-sections of the Modified Visual Magnetic Resonance Rating Scale (MVMRRS) with demographic, cognitive, and behavioral characteristics of patients diagnosed with AD.Materials and Methods: The retrospective study included a total of 42 patients aged 50 years and older whose brain MRI and neuropsychometric test results were available and who were diagnosed with AD according to the criteria of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) and of the National Institute of Neurological and Communicative Disorders and Stroke & the Alzheimer’s Disease and Related Disorders Association (NINCDS–ADRDA). By use of the Modified Visual Magnetic Resonance Rating Scale (MVMRRS), the brain MRI data were evaluated by a neuroradiologist blinded to the patient age, sex, and diagnosis data. Correlation of MVMRRS data with cognitive and behavioral test results was analyzed.Results: The mean patient age was 75.19±9.26 (53–92) years and 61.9% of all patients were female. The mean education level was 5.02±4.84 (0–15) years and the mean illness duration was 4.52±2.94 years. The mean Mini-Mental State Examination score was 18.51±5.43 (4–30) while the mean Clinical Dementia Rating (CDR) score was 1.07±0.42 (0.5–2.0). Sulcal atrophy scores were negatively correlated with long-term recall and facial recognition while ventricular atrophy scores were inversely correlated with the learning scores and fruit–human and facial recognition parameters. A significant relationship was observed between the immediate recall, learning score, spontaneous recall, fruit–human, and CDR variables and the medial temporal atrophy variable.Discussion and Conclusion: In dementia assessment, the use of MRI-based visual rating scales is an inexpensive and practical approach that also improves the diagnostic accuracy. Furthermore, the MVMRRS shows significant correlation with cognitive (executive functions, memory, attention, and language) data. Further studies to evaluate this scale in larger groups of patients with different patterns of cognitive impairment would be of clinical benefit.
  PubDate: Thu, 29 Oct 2020 00:00:00 +030
The Crab and the Egg: A History of Cancer Research Using Chick Embryos
- Authors: Serap USLU ; Mahmut Alpertunga KARA
  Abstract: Aim: Chick embryos have long been used as a source in research on embryonic development. Although cancer has also long been known as a nosological entity, the joint investigation of embryogenesis and oncogenesis has mostly occurred during the last one hundred years. Chick embryos provide a suitable model for understanding oncogenesis. In this study, we aimed to investigate the historical process that has led to joint studies of embryogenesis and oncogenesis, which were previously studied separately. Materials and Methods: We evaluated findings that resulted from an extensive literature review of studies on the history of chick embryology and cancer research and recent reviews on the usability of chick models in cancer research. Results: Both developmental biology and clinical and etiological characteristics of cancer have been an area of study since antiquity. The two fields were worked on separately and in line with different theories prevailing at different periods of time. The introduction of the microscope, the subsequent progressive advance in techniques and technology, and the widespread adoption of cellular pathology paved the way for joint studies of embryogenesis and oncogenesis. The early 20th century saw the first experiments of cancer transplantation in chick embryos, and various signaling pathways were discovered toward the end of the same century. While the use of chick embryos continues, other models were also introduced during this period.Discussion and Conclusion: Given the similarities in molecular signal pathways involved in embryogenesis and oncogenesis, developmental biology and cancer biology are closely linked to each other. Chick embryo models constitute a useful study model in both fields. It is expected that these models will continue to be used, being enhanced by stem cell and gene manipulation research.
  PubDate: Thu, 29 Oct 2020 00:00:00 +030
Effects of Amputation Level on Hospital Costs and Length of Hospital Stay
in Diabetic Foot Disease
- Authors: Ömer Naci ERGİN ; Koray ŞAHİN , Emre KOCAZEYBEK , Ahmet Müçteba YILDIRIM , İ̇rfan ÖZTÜRK
  Abstract: Aim: Diabetic foot disease (DFD) is a serious complication of diabetes mellitus and also represents a considerable financial burden to society. In this study, we aimed to evaluate the effects of amputation level on hospital costs and length of hospital stay in patients with DFD who were treated with major amputations.Materials and Methods: Data of 72 patients who were hospitalized and underwent major amputations after a DFD diagnosis at our hospital between 2010 and 2017 were reviewed retrospectively. According to the level of amputation performed, three patient groups were identified: below-knee amputation (BKA) group, above-knee amputation (AKA) group, and two-stage (first BKA and then AKA) amputation (TSA) group. Data on hospital costs and length of hospital stay were reviewed. Hospital costs were evaluated under four categories: drug costs, resource/material costs, examination/treatment costs, and total costs. Results were compared with Kruskal–Wallis one-way analysis of variance.Results: The BKA, AKA, and TSA groups consisted of 50 (25 males, 25 females), 11 (10, 1), and 11 (9, 2) patients, with a median patient age of 66, 64, and 66 years, respectively. For the BKA, AKA, and TSA groups, the median drug cost was $1,058, $1,072, and $2,240, the median resource/material cost was $223, $405, and $1,349, the median examination/treatment cost was $2,628, $2,405, and $3,587, the median total cost was $4,612, $5,832, and $6,848, and the median length of hospital stay was 35 days, 33 days, and 63 days, respectively. In terms of all cost categories and length of hospital stay, no statistically significant difference was found between the three groups (p>0.05).Discussion and Conclusion: In DFD patients treated with major amputations, amputation level does not appear to make a significant difference in the amount of hospital costs and length of hospital stay.
  PubDate: Thu, 29 Oct 2020 00:00:00 +030
Management of Gastric Neuroendocrine Tumors
- Authors: Mehmet Fatih DAŞIRAN ; Ahmet AKBAŞ
  Abstract: Aim: The widespread use of endoscopy has led to a marked increase in the reported incidence and prevalence of gastric neuroendocrine tumors (NETs). In this study, we aimed to investigate these rare and poorly understood tumors in patients from a single center.Materials and Methods: We retrospectively reviewed the medical records of patients who were treated with a diagnosis of gastric NET between January 2010 and December 2018. Data on patient demographic characteristics, diagnostic work-up, endoscopic and surgical treatment patterns, histopathological features, and outcome parameters were documented. The Ki-67 proliferation index, mitosis ratio, and immunohistochemical staining with chromogranin A and synaptophysin were evaluated by histopathological examination.Results: The study included 17 patients (9 males, 8 females), with a mean age of 61.7 years. Nine patients had a tumor located in the fundus, 5 in the antrum, and 3 in the corpus. Histopathological evaluation diagnosed 6 well-differentiated type I NETs and 11 poorly differentiated type III NETs. Seven (41%) patients underwent surgery (with adjuvant chemotherapy when indicated), 6 (35%) only endoscopic treatment, and 4 only chemotherapy. Seven (41%) of the 17 patients had distant metastases at the time of diagnosis, with the liver being the most commonly involved organ.Discussion and Conclusion: Gastric NETs are categorized into three groups according to mitotic activity and the Ki-67 index. Data on serum gastrin levels and endoscopic and radiological work-up are required for this categorization. Treatment approach varies according to the type and stage of the disease.
  PubDate: Thu, 29 Oct 2020 00:00:00 +030