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Yayın Development of chondroblastic variant of osteosarcoma after root channel treatment in the base of maxillary sinus(Georg Thieme Verlag, 2024) Balsak, Serdar; Yabul Çelik, Fatma; Atasoy, Bahar; Yurtsever, Ismail; Yozgat, Can Yilmaz; Akcay, Ahmet; Yuzkan, Sabahattin; Alkan, AlpayA 21-year-old patient was admitted to the department of otolaryngology with complaints of swelling over the right side of the upper jaw for the last 6 past months. The patient also has difficulty in mastication as the size of the swelling had increased. The patient dental history was notorious for root canal treatment in the second molar tooth prior to the initiation of the swelling. The patient did not have any other illnesses and did not have any family history of malignancy. Of note, the patient did not have any notable addictions. The patient did not have any distant metastatic symptoms, and no other significant history of swellings anywhere else in his body. Physical examination in the department of otolaryngology revealed that around the second molar root expansible, rigid lesion was detected. Thus, the department of radiology was consulted and according to the patient’s maxilla-facial computed tomography (CT) showed that there was a 30×25 mm lesion in the nearby of the 2nd molar tooth. Also, the lesion resulted in bone destruction in the maxillary sinus base of the patient. The lesion in the center had diffused calcifications inside of the mass spreading throughout the maxillary sinus to retro molar trigon. Due to the central calcification content in the central of the lesion, the possibility of osteogenic tumour was thought ([Fig. 1]). To learn the contrast pattern of the lesion, contrasted maxilla-facial MRI was requested. According to the T2W sequence demonstrated that there was an increase in peripheral hyper intensity around the calcification lesion. Contrasted sequences revealed that demarcated thin peripheral and a central nodular enhancement was observed. The other parts of the imaging did not show any abnormalities ([Fig. 2]). A core needle biopsy was performed through intraoral route and the result of the biopsy report demonstrated that there was a cartilage tumour containing irregular lobulated areas. New bone formation was noted in areas compatible with the osteoid. There were many atypical looking chondroblastic variant of osteosarcoma cells. The result of pathological specimen was compatible with chondroblastic variant of osteosarcoma. Later, the patient was planned for mass excision.Yayın Slx5/Slx8 SUMO-targeted ubiquitin ligase deficiency shortens lifespan due to increased mutation accumulation in yeast(Oxford University Press, 2024) Thomas, Pınar Buket; Kaluç, Nur; Çavli, Irmak N.; Tuna, Bilge G.Chronological lifespan (CLS) in budding yeast Saccharomyces cerevisiae, which is defined as the time nondividing cells in saturation remain viable, has been utilized as a model to study post-mitotic aging in mammalian cells. CLS is closely related to entry into and maintenance of a quiescent state. Many rearrangements that direct the quiescent state enhance the ability of cells to endure several types of stress. SUMO-targeted ubiquitin ligases (STUbLs) play a critical role in mediating an adaptive response to various stresses. In this study, we investigated the effect of a STUbL, Slx5/Slx8, on CLS in budding yeast. We showed that both SLX5 and SLX8 deletions accelerate chronological aging, resulting in a decreased maximum and mean lifespan. slx5Δ cells were capable of entering or maintaining a quiescent state during aging. On the other hand, aging slx5Δ and slx8Δ cells had both increased spontaneous mutation accumulation. Our data together indicate that Slx5/Slx8 STUBL is required for normal rate of aging by preventing increased spontaneous mutation accumulation during aging.Yayın Intraoperative diaphragmatic stimulation by a cardiac resynchronization therapy defibrillator presenting as hiccups(Springer Nature, 2024) Aybar, HüseyinPacemaker-related diaphragmatic contractions are a phenomenon encountered in cardiology practice. With informed consent from the patient, this letter reports a case of this condition under general anesthesia, presenting as hiccups. A 44-yr-old female patient with a history of back pain was diagnosed with lumbar stenosis and presented for posterior instrumentation surgery. She had a height of 163 cm and weight of 104 kg; her known comorbidities included obesity (body mass index [BMI], 39.1 kg m-2), type 2 diabetes, and nonischemic dilated cardiomyopathy with a left bundle branch block and an implanted cardiac resynchronization therapy–defibrillator (CRT-D) device (INOGENTM X4 CRT-D model G148, Boston Scientific Corporation, Marlborough, MA, USA). General anesthesia (GA) was induced, the patient wa positioned prone, and neuromonitoring was initiated.Intravenous infusions of propofol and remifentanil were initiated for maintenance of GA. Preoperatively, a cardiologist reprogrammed the CRT-D device; the pacing mode was kept the same to ensure left ventricle (LV) functionality and tachycardia therapy was deactivated (even though magnet application effects on the device are the same as those of the abovementioned configuration, the prone position would have hindered the ability to maintain the position of the magnet).Yayın Associations between stages of diabetic polyneuropathy and quality of life, neuropathic pain, and well-being: A multicenter, cross-sectional analysis based on electroneuromyographic findings(Elsevier, 2024) Kılıçparlar Cengiz, Emine; Ekmekyapar Fırat, Yasemin; Karşıdağ, Sibel; Neyal, Abdurrahman; Erdemoglu, Ali Kemal; Çınar, Nilgün; Ekmekyapar, Tuba; Canbaz Kabay, Sibel; Akkoyun Arıkan, Fatma; Akdağ, Gonül; Çomruk, Gülsüm; Ates, Miruna; Kendirli Aslan, Sude; Çokal, Burcu Gökçe; Tosunoglu, Bünyamin; Bolu, Naci Emre; Yanık, Ece; Savrun, Feray; Tülek, Zeliha; Kılıçaslan, Kimya; Çakar, Egemen Kaan; Ergin Bakar, Ebru; Atmaca, Murat Mert; Yılmaz, Buket; Neyal, Ayşe MünifeAim: This study aimed to investigate the relationship between electrophysiological findings of diabetic neu ropathy (DN) and patients’ quality of life, neuropathic pain levels, and well-being. Materials and Methods: A cross-sectional study was conducted in 12 centers in Turkey. DN patients were cate gorized into four stages based on electrophysiological findings using the Baba classification. Scales such as Short Form-36 (SF-36), Douleur Neuropathique 4-Questions (DN4), Brief Pain Inventory (BPI), and WHO-5 Well-Being (WHO-5 WB) were used to assess quality of life, pain, and well-being. Additional factors like HbA1c levels and diabetes duration were analyzed. Results: Among 323 DN patients, 90 were in stage 1, 84 in stage 2, 72 in stage 3, and 77 in stage 4. There were no significant differences in age or gender between the stages. Diabetes duration and HbA1c levels were signifi cantly lower in stage 1 compared to later stages. SF-36 and WHO-5 WB scores declined, while DN4 and BPI pain interference scores increased in the later stages. These findings persisted after adjusting for confounders such as age, BMI, comorbidities, and diabetes duration. Conclusion: Patients with advanced-stage DN experienced a poorer quality of life, greater pain, and more frequent comorbidities compared to early-stage patients. Electrophysiological findings should be considered in the clinical management of DN.Yayın Investigation of the effects of blocking potassium channelswith 4-aminopyridine on paclitaxel activity in breastcancer cell lines(Wiley, 2024) Cüce Aydoğmuş, Esra Münire; İnhan Garip, Günseli AyşeBackground: Paclitaxel (PTX) has been used as a chemotherapeutic agent for several malignancies, including breast cancer, and efforts to increase the efficiency of PTX are continuous. Previous studies have shown that the voltage-gated K+ channels are over-expressed in breast cancer cell lines; therefore, blocking this type of K+ channel reduces cell proliferation and viability. Aims: In this study, FDA-approved 4-aminopyridine (4-AP), a voltage-gated potassium channel blocker, was used in combina tion with PTX to improve the anticancer activity of PTX in MCF-7 and MDA-MB-231 cell lines. Methods and Results: Viability was determined with trypan blue, a clonogenic assay was performed, and the cell cycle was determined with a flow cytometer and immunochemistry. To gain an insight into the mechanism, intracellular K+ concentration, intracellular Ca2+ (calcium) concentration, and transmembrane potential measurements were made with corresponding fluo rescent dyes. The apoptotic cell number was determined using Annexin /PI method by flow cytometer. Viability decreased with combination therapy and the clonogenic assay proved decreased colony formation. The apoptotic cell number was increased after treatment with the combination in both cell lines. Cell cycle measurements showed G1 arrest for both MCF-7 and MDA-MB-231 cell lines upon 4-AP treatment. PTX caused G1 arrest in MCF-7 cells and S phase arrest in MDA-MB-231 cells. Combination treatment caused S phase arrest in MCF-7 cells and S phase and G2/M phase arrest in MDA-MB-231 cells. Intracellular K+ con centration was increased after all treatments in both cell lines. Ca2+ concentration was increased significantly after combination treatment. Depolarization in the transmembrane potential was observed after all treatments in both cell lines. Conclusion: Biophysical parameters like the transmembrane potential and ion fluxes have been defined in cancer progression which can provide new aspects for cancer treatments. This study shows that the combination of 4-AP with PTX is a promising alternative the mechanism of which needs further investigation considering the results obtained for Ca2+, K+, and membrane potential.Yayın Molecular markers in embryo non-development: Analysis of gene expressions (Ki-67, hTERT, HIF-1α) in spent embryo culture medium(Licensee MDPI, 2024) Kılıç, Nergis Özlem; Kütük, Duygu; Öner, Çağrı; Aslan Öztürk, Senem; Selam, Belgin; Çolak, ErtuğrulAn embryo culture medium is a specialized set of ambient conditions, technological equipment, and nutrients that embryos require to grow properly. We aimed to investigate the Ki-67, hTERT, and HIF-1α gene expression differences between developing and non-developing embryos in spent embryo culture medium. Ki-67, hTERT, and HIF-1α gene expressions were determined from the spent embryo culture medium containing developing and non-developing embryos of 20 normoresponder patients admitted to the Bahçeci Umut IVF Center. An increase in hTERT gene expression (p < 0.05) and a decrease in HIF-1α gene expression (p < 0.001) were observed in mediums of developing compared to the non-developing embryos. No difference was observed in Ki-67 gene expression (p > 0.05). While there was a correlation between Ki-67 and HIF-1α genes in the non-growing group (r < 0.01); no correlation was observed in the developing group (r > 0.05). Both normoresponder groups will be similar in terms of proliferation rate. The low HIF-1α expression that observed high telomerase activity in embryo development maintains continuity and avoids mechanisms that result in cell death. A molecular study of the embryo development in patients with similar characteristics may help to understand the pathogenesis of the disease and establish a diagnosis and specific treatment.Yayın Long terms results of temporal facelift: 6 years of experience in 250 cases(Lippincott Williams & Wilkins Ltd., 2024) Şirinoğlu, Hakan; Tatar, Burak Ergün; Güvercin, EmreBackground: Temporal facelift (TFL) is an innovative technique for lifting the upper and mid-face. It is characterized by a unique dissection plane above the subgaleal fascia, which seamlessly transitions into the sub-superficial muscular apo neurotic system (SMAS) layer in the mid-face. This approach enables comprehensive mid-face elevation, robust canthopexy, and a significant brow lift in various vectors. Objectives: The authors present their experience with 250 TFL procedures over a period of 6 years. Patients and Methods: This retrospective study analyzed 250 of 441 patients who underwent TFL surgery. The surgical proce dures, conducted under general anesthesia by a senior surgeon following the TFL method, involved a vertical-vector deep-plane mid-face lift, canthopexy, and brow-lift triad. Close monitoring of complications and detailed photographic documentation of the outcomes were performed. Postoperative care included taping the operation area to reduce swelling, with subsequent follow-up examinations and interventions such as lymphatic massage and botulinum toxin injections for asymmetric brow movements or steroid injections for excessive mid-face swelling. Results: Among 250 patients (248 female, 2 male; mean age, 37 y), unilateral neuropraxia of the frontal branch of the facial nerve occurred in 5.6% and resolved spontaneously within 2.8 months. Persistent dimples (2.8%) resolved by the fifth postoperative month. Six patients (2.4%) underwent revision surgery with no observed complications like hematoma, ne crosis, infection, or seroma. Conclusions: The TFL technique represents a significant ad vancement in upper and mid-face lifting procedures and offers several advantages over the traditional methods.Yayın The association of piR-651 and piR-823 on metastaticand invasive characteristics of triple negative breastcancer cells(Taylor & Francis Group, 2024) Öner, Çağrı; Köser, Faruk; Çolak, ErtuğrulPIWI-Interacting RNAs are small non-coding RNAs derived fromsingle-stranded RNAs which plays a crucial role in epigeneticregulation through transposon silencing and mRNA degrada-tion via deamination. This study aimed to inhibit piR-651 andpiR-823 in MDA-MB-231 triple-negative breast cancer cells andto explore their potential effects on healthy HUVEC cells. Non-target, anti-piR-651, and anti-piR-823 sequences were trans-fected in bothHUVEC and MDA-MB-231 cells usingLipofectamine. Proliferation and motility were assessed at 24,48, and 72 h post-transfection in both cell lines. Based on themotility findings, MDA-MB-231 cells were underwent an inva-sion assay using crystal violet staining. The expressions of Ki-67,HIF-1α, MMP-2, and MMP-9 genes were measured at 48 h,when both cell lines exhibited the most significant effects ofinhibition. The optimal time for proliferation of anti-piR-651 andanti-piR-823 transfected MDA-MB-231 cells was determined tobe at 48 h, as indicated by decreased motility and invasionassay results (p < 0.001). NeverthelessHowever, there was no sig-nificant difference in the motility and proliferation of HUVECsstransfected with anti-piR-651 and anti-piR-823 compared to thecontrol group (p > 0.05). Asides from MMP-2 in anti-piR-823transfected HUVECs and HIF-1α in anti-piR-823 transfectedMDA-MB-231 cells, gene expressions of Ki-67, HIF-1α, MMP-2,and MMP-9 were reduced in both cell lines (p < 0.001). Inhibitionof piR-651 and piR-823 decreased the survival and metastasisof cancer cells, without causing vital structural changes inhealthy cells. Future research in cancer gene therapy or geneticmodification may benefit from investigating piR-651 and piR-823 as possible inhibitors of breast cancer invasion andmetastasis.Yayın Yeni yumurta-tavuk paradoksu: Sirkadiyen ritim ya da yaşam stili mi? Son hücre düzenleyici hangisidir? / The new egg-chicken paradox: Circadian rhythm or lifestyle? Which is the last cell editor?(T.C.Maltepe Üniversitesi, 2023) İzmirli, MüzeyyenBedenimizde, yaklaşık 24 saatlik, otonom bir mekanizma tarafından düzenlenen, zamana bağlı döngüsel çalışan bir sistem vardır ve bu sistem sirkadiyen saat ya da sirkadiyen ritim olarak adlandırılır. Bu ritim uyku-uyanıklık, vücut ısısı, hormonların salgılanması, lokomotor aktivite ve iştah gibi çeşitli fizyolojik işlevlerin günlük rutinler halinde devam etmesini sağlar. Diğer taraftan, yapılan son çalışmalar yenilen yemeğin kalitesinin, içeriğinin (protein, karbonhidrat ya da yağ ağırlıklı olabileceği gibi, vitamin, mineral ve gıda katkı maddeleri gibi), zamanlamasının (öğün aralıkları, aydınlık ve karanlık süreçlerde yemek yeme), günlük yaşamımızdaki egzersiz ve uyku kalitesinin sirkadiyen metabolizmayı belirgin şekilde değiştirdiğini rapor etmiştir. Bireyin beslenme alışkanlıkları, enerji metabolizması, sirkadiyen saat, bedenin ritmi bir arada değerlendirildiğinde ortaya karışık bir metabolik yolak ağı çıkıyor. Bu yüzden, bu derlemede yaşam stili ve özellikle diyet kompozisyonu, uyku ve egzersiz açısından bakıldığında, sirkadiyen saatin ve bedenin ritminin, moleküler hücresel süreçleri ile genetik ve epigenetik temelinin aydınlatılması amaçlanmıştır.Yayın Pulmonary Hydatid Cyst: Pathophysiology, etiopathogenesis, diagnosis and treatment / Pulmoner Hidatik Kist: Patofizyoloji, etiyopatogenez, tanı ve tedavi(T.C. Maltepe Üniversitesi, 2023) Kılıççalan, İbrahim; Cingöz, Orhun TunahanAim: Echinococcosis is a parasitic disease caused by cestodes of the genus Echinococcus, which often affects the liver and lungs. Pulmonary hydatid cysts are often transmitted in childhood and remain asymptomatic for a long time. As a result, the diagnosis is often incidental in noncomplicated cases. In some cases hydatid cysts may rupture and in this occurrence it is then called a complicated cyst. When a complicated pulmonary hydatid cyst occurs, various symptoms such as chest pain, shortness of breath, cough, and hemoptysis may be observed. For diagnosis radiologic methods and serologic tests may be used. The most commonly used radiological method for pulmonary hydatid cysts is chest radiography. Echinococcosis can be treated pharmacologically with medications under certain situations; nonetheless, surgical treatment is the gold standard. Pharmacological treatment includes benzimidazole group drugs such as albendazole and in surgical treatment, various techniques such as enucleation, pericystectomy, capitonated cystotomy are applied.Yayın Meme koruyucu cerrahi sonrası radyoterapiye bağlı sekonder gelişen skuamöz hücreli kanser: Bir olgu sunumu / Squamous cell cancer developing secondary to radiotherapy after breast conserving surgery: A case report(T.C. Maltepe Üniversitesi, 2023) Maden, Miray; Isgandarov, Ulvi; Eruyar, Ahmet Tuğrul; Utkan, Nihat ZaferRadyasyon tedavisi, meme kanseri için genel olarak kabul görmüş bir tedavi seçeneğidir. Meme koruyucu cerrahi sonrası adjuvan radyoterapi uygulanan hastalarda nadiren sekonder malignite gelişebilir. Bu yazımızda radyoterapi tedavisi sonrası sekonder skuamöz hücreli kanser gelişen olgumuzu sunmayı amaçladık.Yayın Role of presepsin in predicting sepsis and mortality in COVID-19 pneumonia / Presepsinin COVID-19 pnömonisinde sepsis ve mortaliteyi öngörmedeki rolü(T.C. Maltepe Üniversitesi, 2023) Siber, Veysi; Siber, Hatice Kübra; Aysin, Murat; Güler, Sertaç; Özbaş Demirel, Özlem; Dereyurt, Dursun Buğra; Erdaş, Sümeyye; Otal, Yavuz; Günaydın, Yahya Kemal; Okumuş, MehmetAim: Aim: We aimed to investigate the prognostic significance of Presepsin (PSP) in patients with Coronavirus Disease 2019 pneumonia who were admitted to the emergency department (ED). Material and Methods: This study was conducted as a prospective, case-controlled, observational study. 123 patients with a diagnosis of Covid-19 pneumonia were chosen for the case group and 123 volunteers were enrolled as a control group. 62 of the patients were classified into the sepsis group and 61 patients were placed into the non-sepsis group. The follow-up and treatment of the patients were carried out according to the Covid19 Severe Pneumonia, ARDS, Sepsis, and Septic Shock Management Guideline of the Türkiye Ministry of Health. The PSP level was studied in patients with and without sepsis diagnosed with Covid-19 pneumonia. Results: There was no statistically significant difference between the control group, the sepsis group, and the non-sepsis group when the PSP values were compared. However, when the ROC curve was studied for the case group, a statistically significant difference between the survivors and non-survivors was discovered (p<0.05). Conclusion: No statistically significant distinction in PSP values between the control group and the septic and non-septic patient groups with Covid-19 pneumonia was found. However, PSP values were shown to be statistically significant in mortality of Covid-19 pneumonia and survival.Yayın Aile sağlığı merkezine başvuran yetişkin bireylerde COVID-19 korkusu ve depresif belirti düzeyi arasındaki ilişki / The relationship between COVID-19 fear and depressive symptom level in adults applying to family health center(T.C. Maltepe Üniversitesi, 2023) Dursun, Raşit; Arslan, Şehide; Durmuş, Hasan; Balcı, ElçinAmaç: Bu çalışmada aile sağlığı merkezlerine başvuran 18 yaş ve üzeri bireylerde COVID-19 korkusu ve depresif belirti düzeylerinin belirlenmesi ve demografik özelliklerin değerlendirilmesi amaçlanmıştır. Materyal ve Metodlar: Kesitsel tipte planlanan bu araştırma 2022 yılı Ağustos ayında aile sağlığı merkezlerine başvuran 18 yaş ve üstü bireylerde yapıldı. Yüz yüze uygulanan anket formu tanımlayıcı sorular ile COVID-19 Korku Ölçeği ve Beck Depresyon Ölçeğinden oluşmaktaydı. Örneklem büyüklüğü 657 kişi olarak hesaplandı ve araştırma 799 kişi ile tamamlandı. İstatistiksel analizlerde ANOVA, t testi, Pearson Kikare testi ve korelasyon analizi testleri kullanıldı ve p<0,05 değeri anlamlı kabul edildi. Bulgular: Katılımcıların %49,3’ü COVID-19 geçirdiğini, %90,6’sı da en az bir doz COVID-19 ’a karşı aşı olduğunu belirtmiştir. Katılımcıların korku ölçeği puanı ortalaması 12,61±5,70 iken, Beck depresyon ölçeği puanı ortalaması 9,83±8,14 bulunmuştur. Depresyon ile COVID-19 korkusu arasında düşük düzeyde, pozitif yönde anlamlı bir ilişki saptanmıştır. Sonuç: Çalışma COVID-19 korkusu ve depresif belirtilerin hassas gruplarda daha yüksek düzeyde olabileceğini ve farklı grupların, pandemi şartlarından, psikososyal olarak farklı düzeylerde etkilenebileceğini göstermektedir. Bu nedenle toplum sağlığına bütüncül ve çoğulcu bir bakış açısıyla yaklaşılmalı, geliştirilen sağlık stratejilerinde toplumun geneliyle birlikte hassas gruplar da göz önünde bulundurulmalıdır.Yayın Sirotik hastalarda D vitamini eksikliği sık mı? / Is vitamin D deficiency frequently in patients with cirrhosis?(T.C. Maltepe Üniversitesi, 2023) Uyanıkoğlu, AhmetAmaç: Bu çalışmada kompanse ve dekompanse sirotik hastalarda, D vitamin eksiklik sıklığının kontrol grubu ile karşılaştırılması amaçlanmıştır. Materyal-Metotlar: Karaciğer sirozu olan 80 hasta ve 80 kontrol olgusu alınmıştır. Siroz tanısı klinik, laboratuvar ve görüntüleme yöntemleri ile konulmuştur. Asit, varis kanaması, bilirubin yüksekliği dekompansasyon bulguları olarak kabul edilmiştir.Bulgular: Sirotik 80 hastanın, 46’sı erkek (%57,5), yaş ortalaması 54,40±11,77, yaş dağılımı 18-75, kontrol grubunun 44’ü erkek (%55), yaş ortalaması 53,85±9,59, yaş dağılımı 18-75 idi. Dekompanse sirozlu hastalarda kompanse sirozlu hastalara ve kontrol grubuna göre 10 ng/ml altında vitamin D düzey düşüklük sıklığı istatistiki olarak anlamlı düzeyde daha sık saptanırken (p<0.05), 30 ng/ml üzerinde D vitamin düzey yüksekliği dekompanse sirozda kompanse siroz ve kontrol grubuna göre anlamlı düzeyde daha düşük sıklıkta saptanmıştır (p<0.05). Sirotik hastalarda MELD skoru, CHILD skoru ile D vitamin düzeyi arasında korelasyon saptanmadı. Sonuç: Child evresi, MELD skoru ile D vitamini düzeyi arasında korelasyon saptanmamıştır. Dekompanse sirotik hastalarda kompanse siroz ve kontrol grubuna göre replasman gerektirecek D vitamini eksikliği daha sıktır.Yayın The effect of self-esteem of obese and non-obese individuals on the body perception and the life quality / Obez ve obez olmayan bireylerin benlik saygısının beden algısı ve yaşam kalitesine etkisi(T.C. Maltepe Üniversitesi, 2023) Güneş, Dilek; Uncu, Fatoş; Mamur, ZekiAim: In this study, we planned to investigate the effect of selfesteem on the body perception and life quality of obese and nonobese individuals. Materials and Methods: This is a descriptive-relational study. The sample of the study was determined as 200 people. The Introductive Questionnaire, Rosenberg Self Esteem Scale, Body Perception Scale, and 36-Item Short Form Survey (SF-36) were used to collect the data. In addition to descriptive statistical methods, ANOVA, Student t-tests, and correlation tests wereused. Results: Compared to obese people, self-esteem was found to be higher in non-obese people, and their body perceptions were higher. When SF-36 of obese and non-obese individuals were compared, there was a significant difference between subdimension scores of the physical function and social function. Conclusion: It was found that the self-esteem of obese and nonobese individuals positively affects body perception and life quality.Yayın Hangi pediatrik travma skorunu kullanalım? İdeal pediatrik travma skoruna doğru / Which pediatric trauma score should we use? Towards the ideal pediatric trauma score(T.C. Maltepe Üniversitesi, 2023) Özkan, AbuzerDerginizin 2023 yılı ilk sayısında yayınlanan ve Çelik tarafından hazırlanan “Acil servise başvuran pediatrik travma olgularının değerlendirilmesi” isimli yazıyı büyük bir ilgi ile okuduk. Yazarlara ve editör ekibine yazarın pediatrik travma tecrübelerini güncel literatür eşliğinde tartışan yazıdan dolayı teşekkür ederiz. Bununla birlikte yazının tartışmasına katkı sunabilecek birkaç noktayı belirtmek isteriz. Travma skorlama sistemleri araştırma, kalite geliştirme ve travma merkezi karşılaştırması için uzun süredir kullanılmaktadır. Travma puanlama sistemlerinin performansı, bu alanlarda önemli bir etkiye sahiptir ve farklı popülasyonlarda puanlama sistemlerinin değerlendirilmesi gereklidir. Travmanın ciddiyetini tahmin etmek ve tıbbi kaynakları organize etmek için çeşitli skorlama sistemleri geliştirilmiştir . Temel olarak, bir travma hastası üç farklı şekilde puanlanabilir: travmadan etkilenen vücut bölgeleri, travmanın mekanizması ve travmanın şiddeti. Diğer skorlama sistemleri fizyoloji, anatomi veya ikisinin kombinasyonuna dayanmaktadır. Travma skorlamasının iki temel amacı triyaj karar desteği ve hastalık şiddeti veya ölüm tahminidir.Yayın Non-Steroid Anti-İnflmatuvar ilaç kullanımına bağlı multiorgan yetmezliği: Olgu sunumu / Multiorgan failure due to Non-Steroidal Anti-Inflammatory drug use: A case report(T.C. Maltepe Üniversitesi, 2023) Mamiş, Mehmet Selim; Uyanıkoğlu, AhmetBu olgu sunumunda acil servise bilinç bulanıklığı ile başvuran, non-steroid anti-inflamatuar ilaç kullanımına bağlı multiorgan yetmezliği gelişen hastayı sunmayı amaçladık. Acil servise 32 yaşında erkek hasta uykuya meyil ve bilinç bulanıklığı şikâyeti ile getirildi. Bilinen kronik herhangi bir hastalığının olmadığı, alkol kullanım ve madde bağımlılığı hikayesinin olmadığı söylendi. Hasta yakınlarından alınan anamnezde son 1 yıldır diş ağrıları için düzensiz ve kontrolsüz şekilde naproksen + kodein (550 mg / 30 mg) içeren tablet ilaç kullandığı öğrenildi. Genelde günde 1-4 tablet arasında kullanmak üzere, en son acil servisimize başvurduğu gün 3 tablet kullandığı öğrenildi. Yapılan fizik muayenesinde genel durumu orta, bilinci açık, uykuya meyilli ve letarjik, konuşma bozukluğu, terleme, pupillerinde bilateral miyozis saptandı. Oda havasında oksijen saturasyonu (SaO2) 89’lara kadar düşüp nazal oksijen desteği ile SaO2 >96 olması dışındaki vitalleri stabildi. Bakılan laboratuvar sonuçlarında 10 katı geçen transaminaz yüksekliği ve protrombin zamanında uzama saptanan hasta, akut karaciğer yetmezliği ön tanısı ile hastanenin yoğun bakım ünitesinde tedavi ve takibine devam edildi. Acil servise bilinç bulanıklığı ile hastaneye başvuran, herhangi bir komorbid hastalığı olmayan ve özellikle genç hastalarda ilaç kullanımının sorgulanması unutulmamalıdır. Karaciğer yetmezliği tespit edilen bu hastalarda, nakil yapılabilecek durumların gözden kaçmaması gerekir. Transplantasyon endikasyonu olması durumunda, organ nakillerinin yapıldığı merkezlerde tedavi ve takipleri yapılmalıdır.Yayın Egzersiz ilişkili rabdomiyoliz: Olgu sunumu / Exercise-associated rhabdomyolysis: A case report(T.C. Maltepe Üniversitesi, 2023) Özkan, Abuzer; Demirci, Burak; Coşkun, AbuzerRabdomiyoliz, iskelet kası yaralanması sonucu hücre içeriğinin dolaşıma girmesi ile karakterize klinik ve biyokimyasal bir sendromdur. Miyoglobin ve miyosit hücre zarı hasarına sekonder dolaşıma salınan elektrolitler komplikasyonların gelişmesinden sorumludur. En yaygın semptom üçlüsü kas ağrısı, çay rengi idrar ve azalmış idrar miktarıdır. Biz bu olgu sunumunda egzersiz ilişkili rabdomiyoliz olgusunu güncel literatür eşliğinde sunmayı amaçladık.Yayın Renal artery variations with clinical significance: Multiple renal arteries and their coexistent anatomical abnormalities: A cadaveric study / Klinik önemi olan renal arter varyasyonları: Çoklu renal arterler ve eşlik eden anatomik varyasyonlar: Bir kadavra çalışması(T.C.Maltepe Üniversitesi, 2024) Çetinok, HürriyetAim: This cadaveric study aimed to identify the multiple renal arteries and evaluate their association with other anatomical abnormalities. The possible clinical consequences of more than one renal artery were analyzed. Material and Methods: This study was carried out by accessing the Abdominal aorta (AA) from 20 American formalin-embalmed cadavers [12 males, 8 females, ages 50-96] donated to the C&DA Department of Albert Einstein College of Medicine. From the cadavers in the supine position, the branch points of the renal artery from the abdominal aorta on the right and left sides were checked to see if there was more than one. Renal artery (left side), celiac trunk, superior mesenteric artery, inferior mesenteric artery, and aortic bifurcation were measured in 3 ways: linear, longitudinal, and transverse. The obtained results were assessed using a comparative analysis with earlier research findings documented in the literature. Results: Among the 20 cadavers included in the study, two of males, were found to have two renal arteries on the right side, and both of them are hiler arteries. These Multiple renal arteries were coexistent with splenomegaly, tortuosity of the abdominal aorta, and deviation of the vertebral column at the level of the 3rd lumbar vertebra. 94.7% of the cadavers exhibited normal renal arterial anatomy. The most common branching location of the main renal arteries and multiple renal arteries (MRA) were the find from the abdominal aorta. Conclusion: Before surgical or radiological procedures in the anatomical region related to and adjacent to renal arteries, knowing the possible renal artery variations in the anatomy of the region is very important to reduce mortality and morbidity during surgical or interventional procedures. Knowing the anatomy of renal arteries and evaluating it radiologically will guide renal transplantation, hepatorenal surgery, interventional radiology, and nephrology the prevention and treatment of many conditions such as hypertension, and target organ damage them.Yayın Yargıtay kararları ışığında adli tıbbi açıdan intihara yönlendirme suçu; Bir kesitsel araştırma / In ligth of the decisions of the court of cassation, the crime of incitement to suicide from a medical perspective: A cross sectional study(T.C.Maltepe Üniversitesi, 2024) Erkman, Fatma TuğbaAmaç: İntihar eylemi, kişinin kasıtlı olarak hayatına son vermesi olarak tanımlanmakla birlikte kanunlarda suç olarak tanımlanmamaktadır. Ancak intihar suç olarak tanımlanmasa dahi Türk Ceza Kanunu 84. maddesinde intihara yönlendirme davranışı suç olarak belirtilmiştir. İntihara yönlendirme suçunun birçok unsuru bir arada içermesi ve olayın oluş vasfı açısından olay yeri ve adli tıbbi muayene özellikleri nedeni ile kasten yaralama, eziyet, cebir ve tehdit yolu ile kişiyi intihara mecbur etme suçları ile ayrımının yapılması gerekmektedir. Materyal ve Metodlar: Yargıtay’ın resmi internet sitesi ‘‘https://karararama.yargitay.gov.tr/YargitayBilgiBankasiIs temciWeb/’’ adresine girilerek “intihara yönlendirme”, “intihara azmettirme”, “intihar”, “intihara teşvik” anahtar kelimeleri kullanılarak saptanan 23.01.2012-14.09.2022 tarihleri arasındaki tüm kararlarda intihara yönlendirme suçunun demografik ve adli tıbbi verileri incelenmiş ve suçun oluşumunda ve değerlendirilmesinde adli tıbbi açıdan önemli olan noktalar taranmıştır. Ulaşılan Yargıtay kararı içerisinde karar içerikleri, suç tipleri ve ilk derece mahkeme (yerel mahkeme) kararının bozulma gerekçeleri belirtilen 38 karar çalışmaya dâhil edildi. Bulgular: Literatür verilerine göre en sık intihar yöntemi olarak ası kullanılmasına rağmen bizim çalışmamızda %37,5 oranla en sık intihar yöntemi ateşli silahtı. Yine ülkemizde yapılan çalışmalarda ölümle sonuçlanan olgularda erkek cinsiyet üstünlüğü varken bizim çalışmamızda vakaların %71,45’ini kadınlar oluşturdu. Sonuç: Suç vasfının ayrımı açısından ayrıntılı olay yeri incelemesi, özellikli vakalarda verbal otopsi, her iki taraf açısından da ayrıntılı psikiyatrik muayene, eşlik eden koşulların ayrıntılı olarak incelenmesi son derece kritiktir.
