Makale Arama

According to the fundamental nature of penile erection, insufficiency of the arteriel blood supply to the corpora cavernosa caused by an organic arteriel disease is found in a large fraction of case. Our experience in the treatmen of stenoses or obstruction of the common iliac arteries with PTA, rotacs and intra-arteriel stents in 27 patients, between 38-63 years of ages, are reported. Clinical finding were lower limb claudicatio in all patients and impotence in 12 patients. The underlying disease was atherosclerosis in all 27 patients. Restitution of potency was recorded 4-12 months after the PTA or intravasccular stent application. After the intervention of procedures in 9 (%75) of the 12 patients, potency was succesliilly restored. As a results we think that radiological interventional procedures are succesfull in treatment of impotency which has arteriel etiology.

Lung cancer is the most common among cause of cancer deaths in worldwide. NSCLC represent between 80% to 85% of all the diagnosed lung cancers cases. Systemic chemotherapy for patients with NSCLC has limited impact on overall survival. Patients eligible for chemotherapy should be selected carefully. The aim of this study analyzed prognostic factors for survival in NSCLC patients. We retrospectively reviewed 741 NSCLC patients between 2000 and 2012. Ten potential prognostic variables were chosen for analysis in this study. Univariate and multivariate analyses were conducted to identify prognostic factors associated with survival. Univariate and multivariate statistical methods were used to determine prognostic factors. Among the 10 variables of univariate analysis, three variables were identified to have prognostic significance: performans status (PS), diabetes mellitus (DM) and stage. Multivariate analysis included the 3 prognostic significance factors in univariate analysis. Multivariate analysis by Cox proportional hazard model showed that PS was considered independent prognostic factors for survival, as were DM and stage. In conclusion, PS, DM and stage were identified as important prognostic factors in NSCLC patients. These findings may also facilitate pretreatment prediction of survival and can be used for selecting patients for treatment.

Diagnostic and therapeutic cardiac catheterization attempts have recently been increasing. Numerous complications may develop after cardiac catheterization, including local complications, such as thrombosis, pseudoaneurysm, arteriovenous fistula, bleeding, infection, and distal embolization at the catheter insertion site, as well as complications associated with the anesthetic agents, such as respiratory depression, tachycardia and bradycardia. A total of 120 patients, who underwent cardiac catheterization between June 2010 and June 2012 were retrospectively evaluated. The patients were aged from 9 days to 15 years (mean 3.5±4.2 years) and 58 (48%) were female and 62 (52%) were male. Of the 120 patients, 102 (85%) underwent a diagnostic cardiac catheterization procedure, whereas in 18 (15%) patients an interventional procedure was performed. Complications were encountered in 7 (5.8%) patients, aged from 9 days to 15 years (3.5±4.2 years). There were femoral hematoma in two patients, femoral bleeding in one patient, femoral thrombosis in two patients, bradycardia in one patient, and a patient developed respiratory arrest during sedation (with midazolam). Femoral venous thrombosis, which was seen in two patients, was treated with low molecular weight heparin in one case and with low molecular weight heparin and pentoxifylline in the other. Two patients who developed femoral hematoma underwent local treatment. One patient developed resistant bradycardia, for which a temporary pacemaker was inserted. A patient with femoral hemorrhage was treated with protamine sulfate. One patient, who developed respiratory arrest due to midazolam, was treated with respiratory support. All patients were discharged in a good condition after the treatment. The complications in patients who underwent cardiac catheterization in our clinic, and the risk factors for these complications were analyzed retrospectively. Patients undergoing cardiac catheterization should be closely monitored in terms of possible local and general complications. The incidence of the complications can be reduced by taking appropriate measures. The morbidity and the mortality can be reduced by early diagnosis and treatment of the complications.

Regionally to determine cigarette smoking level and affecting factors in a population is an important part of fighting with cigarette smoking. In this study we aimed to evaluate the smoking rates, the factors effecting on smoking and to learn the knowledges about quiting in patients who applied Iğdır Government Hospital Chest Diseaes Department. 721 patient , 426 male ( 59,1 %) and 295 female ( 40,9 %) were enrolled in the study who applied to our hospital between 1 December 2008- 2 February 2009. All patients filled the questionnaire by acting face to face. Demographic characteristics and smoking condition were asked in questionnaire forms. 102 (% 14.1) of the patients were never smoking, 514 (%71.3) of them were still smoking and 105 ( % 14.6) of them were quited. Smoking rates were increasing with education level in females (p

Diabetic nephropathy is one of the important microvascular complications of diabetes mellitus. Diabetic nephropathy develops as major complication of both type 1 and type 2 diabetes mellitus. At the same time, it is currently the leading cause of end-stage renal disease. Two of the main risk factors for diabetic nephropathy are hyperglycemia and arterial hypertension, but the genetic susceptibility in both type 1 and type 2 diabetes is of great importance. Contribute to the development of diabetic nephropathy other risk factors such as hyperglycemia, hypertension, obesity, hereditary diseases, smoking, and advanced age. The progression from normal albuminuria to microalbuminuria is accepted as the initial step in diabetic nephropathy, and then distinctive proteinuria, decreased glomerular filtration rate, and end-stage renal failure develops.

The goal of this study was to determine ischemic modified albumin (IMA) levels and the carotid intima-media thickness (CIMT) in Primary Sjögren Syndrome(pSS) patients. We also aimed to search the relationship between inflammatory parameters and atherosclerosis with ischemic modified albumin levels. Twenty pSS patients and 20 healthy control subjects were enrolled in this study. Clinical evaluations were done by using clinical parameters [Visual analog scale (VAS), dryness of mouth and eyes] and laboratory parameters [erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP)]. All patients were females. The mean age of all subjects was 46.6±9.1. The mean age for pSS patients was 47.1±7.7 years, and 46.1±10 years for healthy subjects. The duration of disease in pSS patients was 5.8±4.4 years. There were no statistically significant differences between IMA levels of patients and healthy subjects (506.4±52.8 AbsU and 482.7±34.7 AbsU respectively; p=0.101). There were also no statistically significant corelation for clinical parameters. The CIMT were statistically significantly higher for patients when compared to healthy subjects (0.70±0.13 mm and 0.61±0.09 mm respectively; p= 0.016). When we analyzed the relationship between CIMT and clinical parameters, we determined statistically significant positive corelation between CIMT and age (r=0.700, p<0.001), and ESR (r=0.312, p=0.05). As a result, our study revealed normal IMA levels and higher CIMT levels, and no corelation between both of them. The higher levels of CIMT levels may be a precursor of cardiovascular disease in PSS patients without cardiovascular risk factors. Further clinical studies are now required to evaluate IMA levels in pSS

In this study, the serum total cholesterol, LDL-cholesterol, HDL-cholesterol. HDL2-cholesterol and HDL3- cholesterol levels of 23 hirsutic patient were compared with 18 normal women. HDL-cholesterol and HDL2-cholesterol levels were significantly lower in hirsutic group than in control (p<0.01). It is known that low levels of HDL-cholesterol can he considered as a risk marker for atherosclerozis. We conculuded that low HDL-cholesterol and HDL2- cholesterol leyel.s- in hirsutism may constitute an im-portant risk factor.

The purpose of this study was to determine the success rate of metallic endoprosthesis in treatment of occlusive disease of lower extremities. Twenty three lesions in 21 patients (1 women, 20 men) whose age ranged from 38 to 64 years with occlusive artery disease of lower extremity placed intraarterial stent in order to provide adequate blood flow. Intraarteriel self-expandable wallstent was 22 and strecker stent was 4. We didn’t encounter any technical problem during metallic endoprosthesis placement except one case. Primary technical success rate was 95.2% (20/21). One case with technical failure had bilateral arteria iliaca communis lesion. To obtain a sufficiently wide and smooth vessel lumen may not always possible by Perkütan Transluminal Anjiyoplasti. This insufficiency may minimize by the metallic intravascular stents after from PTA.

Background: We aimed to investigate the neurodevelopmental outcomes and school success of 11- to 12-year-old children born as moderate/late preterm infants and identify risk factors affecting prognosis.

Methods: Moderate/late preterm infants followed in the neonatal intensive care unit between January 2004 and December 2004 were included, and the children were examined again in our pediatrics outpatient clinic in 2016. Perinatal and neonatal histories were obtained from the hospital database. Physical growth characteristics were interpreted. Neurodevelopment was evaluated using the revised Wechsler Intelligence Scale for Children (WISC-R). The Pediatric Symptom Checklist (PSC) was also applied. The effect of socioeconomic level on neurodevelopmental outcome was examined. School performance was evaluated using report card grades.

Results: Forty-one children with a mean age of 11.6 years were evaluated. Risk factors associated with physical growth outcomes were maternal age of >35 years, fetal distress, and patent ductus arteriosus. Sepsis was associated with a decrease in verbal intelligence while periventricular leukomalacia had negative effects on both verbal and performance intelligence. Socioeconomic level showed a medium correlation with performance and full-scale intelligence. The intelligence quotients of the children with positive PSC scores were significantly lower.

Conclusions: Moderate/late preterm infants lag both neurologically and developmentally due to incomplete maturation of the brain and natal problems. Similarly, to early preterm infants, these children should be monitored for extended periods, and family support, rehabilitation, and special education needs should be met.

Serum selenium levels were investigated in both 65 cases who are living where white muscle disease of lambs were often observed and 33 cases where the disease seen rarely. The selenium level was 60.425±11.727 in first group and 70.849±12.868 pıgli, in the second and statistically significant difference was observed between the two groups (p<0.01). Particulary in the first group the selenium level was lower (han the values which reported as normal (78-320 !mit) selenium levels. Epidemiological and clinical studies indicate that low selenium levels can be an etiological cause for cardiovascular disease. Therefor it may be suggested that determination of coronary risk factors, incidance of coronary heart disease and fulfilling of prospective studies relatid with the subject would be usefil.

Aim: Atherosclerotic heart disease is the most causes of morbidity and mortality in chronic renal failure patients. We compared CAPD and HD patients for cardiovasculer disease (CVD) risk factors and increased mean carotid artery intima media tickness (MCIMT) that results early atherosclerosis. Method: 25 HD patients (12 M, 13 F, mean age 42.3 11.4 year, dialysis time 32.6 19.5 month) and 28 CAPD patients (10 M, 18 F, mean age 41.8 9.5 year, dialysis time 25.5 22.1 month) in our clinic were included to the study. All patients bilateral carotid arteries examined by B mode ultrasonography and measured MCIMT. Patients with diabetes mellitus and more than 10 years undergo dialysis excluded. Results: In HD patients homocystein level and MCIMT are higher when compaired with CAPD patients. (in order p=0.012 and p=0.011). But in CAPD patients plasma total cholesterol and triglycerid levels are higher than HD patients. (in order p=0.001 and p=0.008) There is a positive correlation between MCIMT and homocystein level in HD patients (p=0.001, r=0.677) but not yet in CAPD patients. Conclusion: In CAPD patients MCIMT; early sign of atherosclerosis and homocystein level are lower. CAPD may be more advantageous and defender for atherosclerosis with renal replacement therapy patients.

To analyse the clinical characteristics of globe lacerations known as the main cause of visual loss due to ocular trauma and determine the risk factors. Material and method: This retrospective study included perforating eye injuries followed at the Ophthalmology Department of Selcuk University. The following parameters of cases are recorded from registrations of our clinic: age, sex, affected eye, activity at the time of injury, causative agent, localization of injury, the length of time from injury to the initial examination in our clinic, initial visual acuity, surgical procedure, best corrected visual acuity measured at the last visit. Result: Of the 215 cases with perforating eye injuries 168 (78.1%) were male and 47 (21.9%) were female. The most common activity at the time of injury was home and work activities in 51.6% of cases caused by cutting and perforating matters in the majority. Analysis of injury localization revealed cornea as the most comman affected region in (110 cases 51.2%). The initial visual acuity was equal to or below 0.1 in 157 (77.3%) of cases. This number of cases decreased to 62 (31.5%) when the stabilised final visual acuity was determined. The surgical intervention was corneal or corneoscleral reparation in 149 (69.3%) cases, cataract surgery in addition to reparation in 52 (24.2%) cases, foreign body extraction in 5 (2.3%) cases and evisseration in 9 (4.2%) cases. Conclusion: Despite advances in technology, the high incidence of visual loss after perforating globe injuries pointed out the importance of preventive efforts. Increasing the knowledge of risk groups about eye injuries, taking the necessary preventive measures during risky activities would decrease perforating eye injuries.

Aim: Patients who diagnosed acute viral hepatitis between 1990-2004 were avaluated for etiological, epidemiological, clinical and laboratory characteristics, retrospectively. Material and method: Patients who had acute symptoms and physical examination findings suggesting acute viral hepatitis were evaluated by ELISA and PCR methods. Results: Mean age of the patient group was 26.76±14.51 years (7-77). 297 of the patient groups were male, 270 of them were female. Acute viral hepatitis A, B, C, D, E were diagnosed in 270 (48.2%), 233 (41.5%), 18 (3.2%), 3 (0.5%), 1 (0.2%) patients respectively. Hepatitis A + B coinfection were diagnosed in 4 (0.7%) patients whereas; in 29 patients (5.2%) diagnosis remained obscured. Acute viral hepatitis A was tend to occur in students during autumn and winter. Route of infection could not be identified in 377 (67.2%) patients. Weakness (73.8%), jaundice (67%), nausea (66.1%) and dark urine (56.9%) are the most frequent complaints whereas; jaundice (85%), hepatomegaly (44%) and splenomegaly (8.2%) were the most common signs noted during physical examination. Mean AST, ALT, total bilurubin values were 1433.38 (106-7963), 1951.96 (218-15596), 9.13 (1.3-35) respectively. Conclusion: Value of anti-hepatitis A and B virus vaccination is underlined because of lackness of any transmission-associated risk factors in majority of acute viral hepatitis patients.

Frequency of osteoporosis in postmenopausal women is rising depending on various factors. This study is aimed at to analyse the risk factors that cause osteoporosis for women living in Kütahya. The assessment of bone mineral density (BMD) of Lumbar vertebral bone (L1-L4) via dual energy X-ray absorptiometry (DEXA) machine in a-p position was carried out on 103 women, aged between 40- 82 who had already been in menopause and applied to Kütahya Devlet Hastanesi (Kütahya State Hospital) department of DEXA for assessment of bone mineral density. Study data were achieved from survey results. Experimental group was evaluated according to World Health Organisation (WHO)’s Osteoporosis Classifications via DEXA assessments as T score -1,0 SD> normal, T score -1,0 SD and -2,5 SD is osteopeni and T score <-2,5 SD is osteoporosis. It was observed that all the respondents are housewifes, primary school educated and have a low activity level. It was observed again that the responders who are osteoporosis and osteopenia are older,shorter; particularly, osteoporosis group is 3 cm shorter and have less weight than normal group of people. The group of people who are osteoporosis and osteopenia have a lower age of first and last menstruation than normal people. Yet, they have a higher breast-feeding duration. It was detected that the patients have a lower T scores who had used cortisone for a long time and had bone fracture than who didn’t have any. It was detected again that the scores fell down depending on tested people’s decreasing in come, however, they rose depending on tested people’s rising education status. It was detected that the T scores of people who are leading a rural life was lower than who are leading a urban life. As a result of our study it was noticed that risk of osteoporosis rises depending on age, life style, characteristics of sociodemographic are effective on falling of bone mineral density.

Pressure ulcers, a major problem worldwide, cause morbidity and lead to mortality. We aimed to conduct a prospective study which includes incidence of pressure ulcer and risk factors for pressure ulcers in intensive care unit of neurology. Forty-six patients were evaluated according to National Pressure Ulcer Advisory Panel during the ICU period strictly. Age, hospitalization period, mean arterial pressure, pressure ulcer degree, hemoglobin and albumin levels, and comorbidities were evaluated. The incidence of pressure ulcer in neurologic intensive care unit was 15%, and hypoalbuminemia, low muscular strength, and prolonged stay in intensive care unit are significantly high in pressure ulcer group than the control group. Primer prevention of pressure ulcers is one of the major issues in intensive care unit, especially to prevent protein malnutrition.

Aim: We aimed to determine the prevalence and risk factors of asthma and atopic diseases in preschool education centers in Afyonkarahisar. Material and Method: Of the 1288 children in 41 preschool education centers in Afyonkarahisar, 1084 children, whose parents have approved the study, were accepted. A standard questionnaire interrogating sociodemographical status, presence and risk factors of asthma and atopic diseases was filled by the parents of the children. Results: The mean age of 1084 children was 5.7 ± 0.7 (3-6), 505 (46.6%) of them were girls and 579 (53.4%) were boys. The prevalence of asthma was 3.1%, allergic rhinitis 5.0% and eczema 1.8%. Presence of asthma or an atopic disease in the family was significantly higher in the group with asthma (44.1%) than without (25.5 %)(P=0.015). Intake of breast milk in the infancy was significantly low in the group with asthma (P=0.039). Presence of an allergic disease in the family was found to cause a 2.3 folds and absence of breast milk intake a 2.7 folds increase in the risk for asthma. In the children with asthma, wheesing and allergic rhinitis frequency was significantly high. While there was no difference in froguency of eczema. Conclusion: Presence of an allergic disease in the family and a bsence of breast milk intake in the infancy was found as significant risk factors for asthma in 3-6 age children in pre-school education centers.

ABSTRACT

Aim: Sternal dehiscence is one of the most troublesome complications following cardiac surgery. Although it can be corrected by simple methods if detected earlier, treatment failure or delay in sternal dehiscence may result in mediastinitis, which is highly lethal.  In this study, we aimed to investigate alternative sternal closure systems, mainly sternal talon (STalon) and titanium sternal plates (SPlate). Patients and Methods: In between April 2015 and January 2018, patients with sternal dehiscence after any kind of open cardiac surgery were included in this study. These patients were retrospectively evaluated according to the their demographic data, risk factors for sternal dehiscence, type of operations, techniques used for fixation of the sternum, mainly focusing on the STalon and titanium SPlate fixation. Results: A total of 45 patients were taken into surgical correction because of sternal dehiscence.  Thirty-four (75.6%) of the patients male, whereas 11 (24.4%) were female. Mean time interval after the first operation to sternal dehiscence was 68.5 days (1-780 days). Mean body-mass-index (BMI) was 31.52 kg/m² (22.03-43.69 kg/m²). Before the sternal fixation, mean CRP value was 68.34, whereas it was 75.55 before discharge. Confounding risk factors were internal mammarian artery (IMA) harvesting for coronary artery disease, diabetes mellitus, bronchial asthma, chronic pulmonary artery disease and advanced age. Mean post-operative intensive care unit (ICU) length-of-stay (LOS) was 5.02 days (1-29 days), whereas hospital LOS was 17.18 days (2-74 days). Early mortality was observed in 3 patients (6.67%). The first choice of operation was simple closure and/or Robicsek closure. Apart from simple and Robicsek closure techniques, sternal talon and/or titanium plates were used in 24 patients (53.3%). DM was found to be related to extanded total hospital LOS, ICU LOS, and postoperative time to discharge. DM also increased the risk of both superficial and deep sternal infection rates (p<0.05).  Conclusion: Ideal sternal closure should stabilize the sternum, be cost-effective and provide shortest hospital LOS with minimal post-operative complications. In patients with intact intercostal spaces, sternal talon may eliminate serious complications, such as cardiac rupture mainly caused by dense adhesions. Sternal plates are mainly effective in fragmented fractures without stable intercostal spaces. All patients should be individualized according to type of lesions and sternal fractures.

Aim

This study aims to determine the prevalence of falls and associated risk factors among elderly living in Sinop, Turkey.

Materials and methods

The universe of this cross-sectional study consists of 32506 people older than 65 years old whom are registered to the family physicians’ information system and live in Sinop. After stratification for sex and age (65-74, 75 and over) a sample size of 2463 and 92.1% were reached. Data about some of the socio-demographic characteristics, falling status, daily living activity functionalities, depression status and awareness about falls of the participants were collected via a structuralized questionnaire. Relations between falls and associated risk factors were assessed by four different logistic regression models.

Results

The mean of falling prevalence after age 65 among elderly was 36.4%. Not being graduated from any school, having low scores for current health conditions, using more than one drug daily, not being able to walk without support and being positive for depression are found to be risk factors for falling among both sex and age groups. Having a chronic disease, living alone, having fear of falling, having low awareness about falls, being dependent in daily living activities and having inadequate knowledge about prevention from falls are found to be risk factors for at least two of the sex and age groups. There were no statistically significant relations between falling risk and previous or current employment status.

Conclusion

Falls are important public health concerns among elderly and the variability of risk factors depending on determinants such as age and sex should be considered while planning further implementations targeting fall prevention and control of risk factors for elderly.

Aim: The aim of this study was to contribute to the data about the ischemic stroke epidemiology. Material and method: We analyzed 99 patients with ischemic stroke regarding the stroke risk factors. The patients and the controls were compared in respect to stroke risk factors. Results: Hypertension, atrial fibrillation, and cigarette smoking was statistically significant as a risk factor in the stroke group compared with the control group (P<0.05). Conclusion: Diabetes mellitus and dyslipidemia have not been found as significant risk factors in patients with stroke when compared with the control group (P>0.05).

A 37 - year old woman was admitted to the co-ronary care unit (CCU) with the diagnosis of acute anteroseptal myocardial infarction. Three days post admission to the coronary care unit upon history of her menstrual status a pregnancy test was done and found to he positive. Her CCU care was continued and discharged without any complications. Her later phases of pregnancy was uneventful and underwent premature vaginal delivery at 8 months. This re-inforces the idea of close follow up of pregnant women with respect to possible angina pectoris if history reveals hypertension, diabetes. SMDking. overweight and other risk factors of myocardial in-farction.

\r\n Objective: Early diagnosis of cutaneous squamous cell carcinomas (CSCC) is the most important factor affecting prognosis and most patients have a good prognosis. Some patients defined as high-risk group have high rates of regional recurrence and distant metastasis, and follow an aggressive course. In addition, recently numerous studies have being performed for determining the importance of sentinel lymph node sampling, and sentinel lymph node (SLN) positivity has been associated with a poor prognosis. In this study, we aimed to determine prognostic importance of SLN outcomes in patients with high-risk patients diagnosed with CSCC.

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\r\n Patients & Methods: A total of 29 patients who underwent excisional operation in various body regions with the diagnosis of CSCC between 2009 and 2017, with available complete clinical and pathologic data were included in the study. At least 9-month clinical follow-up results, high risk factors and sentinel lymph node biopsy outcomes of the patients were recorded and analyzed. Patients with at least one of the American Joint Committee on Cancer (AJCC) criteria were considered as high-risk group.

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\r\n Results: Twenty-five of the 29 CSCC patients were in the high-risk group. SLN positivity rate was 12% (n: 3/25) in the high-risk CSCC patients, all patients in the low-risk group had negative SLNs. All patients with SLN positive underwent local complementary lymphadenectomy, and all of these patients were re-operated due to recurrence. The rate of recurrence was found as 100% (n= 3/3) in high-risk CSCC patients with positive SLN, and 18% (n= 4/22) in high-risk CSCC patients with negative SLN. High recurrence rates (41.6%) and SLN positivity were observed in patients with hand-foot localizations.

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\r\n Conclusion: High rates of local recurrence may be seen during progression of the disease in SLN positive patients. Hand-foot localization of CSCCs can be considered as a high risk factor regardless of a tumor diameter should be above 0.6 cm.

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We aimed to investigate the markers and possible risk factors of urinary infection in predialysıs patients with CRF and patients undergoing dialysis by comparing groups younger or older than 65 years of age. We evaluated 82 patients with chronic renal failure who have been followed by nephrology and infectous disease policlinic due to urinary infection during January 2012 and December 2012 in medical faculty of Kahramanmaras Sutcu Imam University. The patient in the predialysis period was accepted as group I, the patients ongoing dialysis and continuous ambulatory peritoneal dialysis (CAPD was accepted as group II. 58 (70,7%) of these patients were in dialysis program. 34 (29,3%) were in predialysis patients. The average age of the patients in predialysis group was 63, 62±15,482 and the average age of the patients in dialysis group were 50, 08±21,086. (45,1%) of these patients were ≥65 years old and compared with serum levels of the kolesterol, trigliserid ve albumin, levels in ≥65 years old cases were statistically significant than ≤65 years old cases. Escherichia coli was microorganism that the most commonly isolated in urinary cultures in both groups. (43.9%) of patients were diabetic. There was no statistical difference between the levels of serum CRP, ESR and leucocytosis between the groups (p>0.05). Fever, pyuria and nitrite positivity between the predialysis and dialysis groups was statistically no significant. Comorbidity in the group above 65 years of age may increase the tendency of infection.

A number of study investigating effects of HDL-C metabolism on atherosclerosis formation have been performed. These studies have shown that HDL-C has a protective role against at-herosclerosis. It has been staded that HDL-C levels of women are higher than those of men. It is not known whether this lower level of HDL-C in men de-pends on their life-style or endogen sex hormones. In our study, we investigated effects of HDL-C and male sex hormones on atherosclerosis. Patients were classified into three classes according to the number of arteries involved by coronary angioraphy as one, two and three arteries. Control group was choisen from subjects not showing any arterial in-volvement. Levels of serum total cholesterol, HDL-C, LDL-C , total testosteron, free testosteron and DHEA SO4 were analyzed in all subjects. A significant cor-relation was observed between free testosteron and HDL-C levels of all patients.

It is the sudden occlusion of the pulmonary artery and its branches by an object such as thrombus air, fat, tumor parcast coming through the bloodstream (1). In the USA, about 630 thousand people are exposed to pulmonary embolism every year and about 200 thousand people are exposed to it. While the mortality rate is 8% in those who can be diagnosed and are treated, it approaches 30% in those who cannot be felt (2). Deep thrombosis was found in 33% of the cases (3,4). Pulmonary thromboembolism is a known complication from the beginning of the 19th pain. Previously, the thrombus was thought to be inside the artery, but later it was defined as embolic. In 1858, Wirchow first demonstrated that the so-called pulmonary thrombosis was an embolism, and he described a triad. Accordingly, local travnia at the wall of the vessel stays with the tendency of the blood to clot (5). These factors still maintain their validity in etiology. ETIOLOGY The reasons leading to pulmonary thromboembolism are mainly thrombi and lysis: fat, air, amnion tumor tissue, parasite eggs, foreign bodies such as catheters. Pulmonary artery embolism was found in 1 out of 3 cardiac autopsies on average, with mitral stenosis being in de-cornized cases. The right heart may be the source of thrombi in cases with atrial fibrillation or past myocardial infarction. In addition, factors that facilitate ventricular thrombosis are among the risk factors for pulmonary enriboli. Situations where the risk of pulmonary embolism is increased.

Patients with isolated single coronary anomaly were retrospectively evaluated for clinical features, angiographic findings and treatment options. Medical records of 27714 patients, who had undergone diagnostic coronary angiography in Türkiye Yüksek İhtisas Hospital between October 2005 and October 2008, were researched and 10 patients with the diagnosis of isolated single coronary artery were recruited into the study. The mean age of patients were 60±13 years (ranging from 33 to 77), 4 of them were men (40%) and 6 were women (60%); mean ages 49±14,5 years (ranging from 33 to 68) and 67±8 years (ranging from 60 to 77), respectively. The patient’s clinical and demographic features on admission, the treatment method used were recorded and the records of coronary angiography were examined again and were classified according to modified Lipton’s classification. Isolated single coronary artery anomaly was diagnosed in 10 patients in the group of a 27714 patients who had undergone coronary angiography. Single coronary artery was originating from right sinus valsalva in 9 patients (90%), and from left sinus valsalva in a patient (10%). Four patients (40%) had severe atherosclerosis and 2 of them had undergone coronary by-pass surgery. The rest of the patients were followed-up under medical treatment. Although isolated single coronary artery anomaly is a rare entity, in hospitals in which coronary angiographic procedures are frequent, its incidence is incidentally more common. In most of the cases clinical outcomes are well and medical treatment and follow-up is enough. In cases which we plan coronary intervention, clinical features, presence of the atherosclerotic disease and the type of coronary anomaly should be watched out.

Urinary retention is not seen frequently after vaginal delivery. Prolonged first and second stage of labor, isolated second stage prolongation, forceps or vacuum application, perianal laceration, nulliparity are risk factor for postpartum urinary retention. Urinary retention may occur immediately after labor or later days. Treatment consists of urinary catheterizing, antibiotic administration and withdrawal of the catheter at regular intervals and checking spontaneous micturition. Treatment of urinary retention is achieved when there is no residual urine is seen after spontaneous micturition. In this article we presented a postpartum urinary retention case which treated with intermittent urinary catheterization in order to draw attention about this subject.

Aim: To investigate the effect of acupuncture therapy in obeses on body weight, levels of serum cholesterol, triglycerides, HDL cholesterol and LDL cholesterol. Methods: Electroacupuncture applied to 22 women with mean body mass index (BMI) of 34.8+3.3 and mean age of 39.8+5.3 and diet restriction to 21 women with BMI of 34.9±3.3 and mean age of 42.7+3.9. Control group also consisted of 12 vvomen with BMI of 32.2+3.4 and mean age of43.3±4.3. Electroacupuncture (EA) applied to earpoints of Hunger and Shen Men, and to body points of Ll 4, Ll 11, St 25, St 36, St 44 and Liv 3 as önce daily for 30 minutes. Diet restriction was applied for 20 days as 1425 kcalorie diet program. Results: VVeight loss of 4.8% follovving electroacupuncture application and 2.5% follovving diet restriction and also on reduction of serum levels of cholesterol, triglycerides, LDL cholesterol follovving EA and cholesterol and triglycerides follovving diet restriction were observed. Conclusion: VVe presume that elec­ troacupuncture application in obeses rises serum beta endorphin level and therefore possible creates lipolytical effect thus reduces the levels of serum cholesterol, triglycerides, LDL cholesterol, then this may reduces the risk factors at obesity and mobilizes the energy Stores and causes a vveight reduction.

Flow-mediated vasodilation (FMD) of the brachial artery, which is indicative of endothelial function is correlated with cardiovascular risk factors. The relationship between FMD and collateral formation in patients with coronary artery disease (CAD) has not been investigated up to date. In our study, we investigated this relationship. The study enrolled 91 (12 female, 79 male) patients with a mean age of 59±11. In patients with at least one coronary artery stenosis of %90 or greater were included in the study In the presence of angiographic coronary collateral classification was made according to Rentrop. Patients were divided into 2 groups as patients with poor collaterals vessels (Rentrop grade 0 or l; 42 patients) and good collaterals vessels (Rentrop grade 2 or 3; 49 patients). Using highresolution ultrasound, both the FMD and sublingual nitroglycerininduced vasodilation in the brachial artery were measured in all patients. FMD was not significantly different between the two groups (4.55±0.69 vs 4.52±0.64, p= 0.83). In conclusion, in this study, lack of association between an impairment of FMD in the brachial artery and the presence of poor collaterals was observed. The reason for this, collateral formation is a complex phenomenon consisting of several distinct processes.

Aim: Pulse wave velocity (PWV) and augmentation index (AI) are indicators of arterial stiffness and non invasive methods of detecting the severity of vascular injury. This study included large sample size and evaluated PWV and AI in chronic hemodialysis (HD) patients to detect the related risk factors. Method: 881 patients on chronic HD program (44% females) were included in this study. PWV and AI of the patients measured by single operator using pulse wave analysis device (Sphygmocor). Pulse wave was measured from carotid-radial distance. Aortic AI was obtained from aortic pulse wave forms derived from radial artery .for all patients, left ventricular geometry was evaluated by echocardiography and volume status was evaluated by bioimpedence device. Results: The average PWV in patient group was 10.0± 2.5 m/s, average AI was 27±11%. AI -HR75, the heart rate corrected form at 75 beat/minute of AI was found to be 29±11%. PWV and AI were found above limit value in 29% and 67% of the patients respectively. A positive relation was found between PWV and AI. when patients with high and normal AI were compared, albumin values were lower while average blood pressure values, cardiothoracic ratio(CTR) were higher and ejection time longer in patients with high AI. AI had a negative relation with height and weight. AI 75 was also negatively related to height and weight. In patients with high AI75 Araştırma Yazısı 151 more patients had left ventricular hypertrofy (LVH). Male patients percentage and average blood pressure was higher in patients with high PWV. In the analysis of PWV of the subgroup (n:408 patients), evident interdialytic weight increase was present in the group with PWV of ≥ 11.5 m/ sc compared to the group of < 8.5 m/sc. Conclusion: measures that can be used to evaluate vascular stiffness like PWV and AI are related to average arterial blood pressure, cardiothoracic ratio, hypoalbuminemia, interdialytic weight increase. We think that the relation between these parameters and cardiovascular morbidity and mortality will become clear in the follow up of our hemodialysis patients.

The latex allergy has been increasingly recognised in recent years in both adultsand children. After anaphylactic type reactions due to latex has been shown as case reports, latex allergy became an important problem especially in medical practice. The majör risk factors in latex allergy are intense exposure to latex allergens (surgical gloves, catheters, etc.), atopy hand eczema, female gender, history of multiple operations and dental interventions. Some occupational groups such as health-care workers and workers in latex industry are under greater risk due to their possible frequent contact with latex. An association between latex allergy and allergy to various fruits (banana, avocado, pineapple, kiwi, etc) has been reported. Latex allergy is responsible for a wide spectrum of clinical symptoms ranging from a mild dermatitis to severe anaphylaxis in both adults and children. There fore an allergologic investigation for latex allergy should be considered for those from high-risk groups. Then, it will be possible to take precautions in order to prevent life-threatining allergic reactions by exposure to latex

A screening program was perforrned at five hospital in Konya in which 4173 infants (range 3-24 months of age) were eamined. The goal of this study was to detection of incidense and related factors in the etiology of CDH. 56 infants with CDH were found (The incidense was 1.3%). The condition was 3 times more cornmon in girls than in boys (40 girls and 16 boys in this group). There was any infant with CDH who was delivered by ceserian section or breech presentation. Any teratologic CDH was detected. The relation of CDH with a definite family history and the hips were bundled in etension and adduction was found statistically significant.

Aim: Sitosterolemia -also known as phytosterolemia- is a rare autosomal, recessively inherited disease characterized by elevated plasma and tissue plant sterol concentrations. Sitosterolemia is characterized by tendon and tuberous xanthomas and by a strong propensity toward premature coronary atherosclerosis. In this article information concerning sitosterolemia disease are reviewed. Main Main Findings: In contrast to healthy subjects with total plasma plant sterols less than 1 mg/dl, patients with sitosterolemia have plasma phytosterol levels in the range of 12 to 40 mg/dl. The main plant sterols in patients with phytosterolemia are sitosterol and kampesterol but also elevated levels of stigmasterol, avenasterol, brassikasterol, kampestanol, sitostanol are found. Sitosterolemia has been shown to result from mutations in either of the genes for 2 proteins (ABCG5 or ABCG8). These ABC transporters preferentially pump plant sterols out of intestinal cells into the gut lumen, thereby decreasing sterol absorption. Results: We believe that it is important to measure blood sitosterol levels in suspicious patients in order to get correct diagnosis and treatment the sitosterolemia.

We investigated hypertension incidence among °at patients and the patients from the province in Konya. The first group included 1000 randomized out patients and the. second group included 2036 patients examined during health sereening studies in certain areas. We used World Health Organisation criterias for hypertension diagnosis. In first group hypertension incidence among patients under 45 years old was 22.5%, 46-60 years 44.5%, 61 years and over 60.3% and the mean 32.5%. In second group hypertension incidence among patients under 45 years oid was 14,2%, 46-60 years 42.2%, 61 years and over 44% and the mean 23,1%. The hypertension incidence increases gradually in older patients and most of them are mild cases, obesite and diabetes mellitus are important risk factors, cerebrovascular accident, cardiac and renal pathologies are the most common complications.

\r\n A decrease in retinal nerve fiber layer thickness can be secondary to glaucoma, several neurologic diseases, optic nerve diseases other than glaucoma, retinal diseases, toxic, nutritional or vascular causes such as shock optic neuropathy. Glaucoma, which is among the commonest causes of blindness worldwide, is a progressive optic neuropathy characterized by a decrease in retinal nerve fiber layer thickness secondary to retinal ganglion cell death, cupping of optic nerve head and visual field loss. Although the best known risk factor associated with glaucoma is high intraocular pressure, it is thought that systemic vascular disorders, which are among the risk factors of glaucoma, play role especially in the pathogenesis of normotensive glaucoma where intraocular pressure is low. In our study, we described a patient with decreased retinal nerve fiber layer thickness and thought normotensive glaucoma as the most probable diagnosis, who also had multiple systemic vascular diseases. 

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Risk factors and encountered problems during follow-up in babies with low birth weight (SGA) were investigated. 108 babies with SGA and who were follovved by our pediatrics department vvere evaluated. 52cases vvere male (48.2%) and 56 cases vvere female (51.8%) .40.7% of ali cases vvere prematüre and others (59.3%) vvere term babies. 53.7% of ali cases vvere applied from the city çenter. Low socioeconomic level, mother’s age lovver than 18 years, and preeclampsia vvere the most freguent risk factors. Infections (32.4%) , asphyxia (25.9%), hypoglysemia (21.3%) and polycythemia (19.4%) vvere the freguent problems. Important causes for mortality vvere infections, congenital abnormalities, and asphxy.

Aim: This study had been planned to detect the factors affecting the cost of care in intensive care units. Methods :Between 01 August 2002 and 01 August 2003 patient who stayed more than 48 hours in the intensive care units were followed. Results :The median value of cost was (3668 $). Cost was considered to be ‘increased’ if it was more than 3668 $. In multivariate analysis factors associated with risk of increased cost were hospital acquired infections (OR 4.2621 95% confidence interval 1.688-10.735 p = 0.002), being admitted for post opertive care(OR 2.746 95% confidence interval 1.086-6.947 p=0.033) increased length of stay (OR 3.807 95% confidence interval 1.510-9.597 p= 0.005). The invasive interventions ,severity of ilness scores (SAPS II and APACHE II) and age (>65) were not detected to be independent risk factors for increased cost. Conclusion : Infections, admission for post operative care and increased length of stay were found to be associated with increased cost inpatients followed in intensive care units.

 Achillestendonrupture is a commonmusculoskeletalinjury. Itusuallyoccursunilaterally in activemiddle-agedindividuals. Spontaneousruptureswithoutany risk factorspredisposingthepatient is uncommonandfor it tooccurbilaterally is veryuncommon. Wereport a case of bilateralspontaneousAchillestendonrupture in a 32- year-oldmanwithnocertainpreviousandcurrentrisk factors. Therupturesoccurredafterliftingbarbell in whichtheweightcaused a severe stressandelongation of thebilaterallygastrocnemiuscomplex.After a clinicalexaminationconfirmedthediagnosis, ultrasonographyof theAchillestendonsrevealedbilateralruptures. Thepatientunderwentbilateralprimarysurgicalrepair. Rehabilitationwasbegun 6weekslater. Weallowedtheweightbearingpartially at 8 weeksaftersurgery, fully at 12 weeksaftersurgery.Thepatient'sreturntopremorbidworkandsocial life wasuneventful.BilateralAchillestendonrupturesareveryrare but increasedawarenesswouldhelpavoid a rupture of thecontralateralsidebeingmissed.

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Aim : İn this study vve aimed at determining the prognostic factors and some risk factors in perforating eye in­ juries which have important role in preventable blindness. Method: VVe retrospectively evaluated data from a total of 157 patients, admitted to Fırat University Medical School, Department of Ophthalmology with perforated eye injuries, betvveen 1994-1999. One or two surgical interventions were performed in ali cases. They were eva­ luated with respect to patients’ age, sex and occupation; etiology of trauma, affected tissue, accompanying pat- hological findings, performed surgical intervention, delay betvveen the injury and surgery, Vision level before and after surgery and complication. Result: Of the total 157patients included in this study, 77.7% was male; 22.3 % female; and mean age of patients was 25.25 (4-85) years old. Perforated eye injuries vvere frequently seen (40.1%) in young patients (0-12 years old). This ratio was found to be 19.1% in vvorkers and 15.3 % in farmers. Among the most frequently injured tissues, cornea vvas the first (62.4%) and knives and Sharp tools were res- ponsible from most of the perforations (22.9%). Of the cases 76% vvas received surgical intervention in the first 24 hours' period. Before operation, visual level frequently found to be betvveen perception and projection (15.9). Most frequent complication among the follovv up period vvas ubnormal shaped pupil (29%) and corneal leukoma (25.9%). Conclusion: İt is knovvn that in perforated eye injury treatments, prevention of injuries is more important th an cure. Therefore prevention al public health Services ar e essential. Our results suggest that, urg en t admission to the hospital and possible early surgical intervention is important determinants of visual prognosis after per­ forated eye injuries.

The current study aimed to determine the in our country patients diagnosed peripheral arterial disease (PAD), the relationship with the atherosclerotic risk factors. A better understanding of the risk factors will make it possible to take precautions against the modifiable risk factors, and will facilitate the early diagnosis and implementation of effective therapy. The patients who had been diagnosed with PAD either clinically or by using ultrasonography underwent peripheral angiography for the arteries of the lower extremities. The patients were evaluated in terms of age, gender, and atherosclerotic risk factors. Of the 408 patients, 78.4% were males, and the mean age was 61.5±9.5 years. The patients had the following risk factors: hypertension (HT), 58.3%; diabetes mellitus (DM), 26.7%; a family history of CAD (Coronary artery disease), 15.9%; smokers, 48.2%; hypercholesterolemia, 49.7%. The extent of PAD observed during peripheral lower extremity angiography was associated with atherosclerotic risk factors. Particular attention should be focused on the co-morbidities of PAD. Non-invasive, as well as invasive tests, should be performed when indicated to decrease morbidity and mortality in patients at risk for PAD.

Aim: The aim of this study was to determine pressure ulcer prevention knowledge and attitudes among nurses who cared for surgical patients that were exposed to pressure ulcer risk factors such as immobilization and nutritional problems.

Materials and Method: This descriptive study was carried out with 150 nurses who were working in the surgical clinics and surgical intensive care units of a medical faculty hospital in XXXX and who had at least one year’s professional experience. Necessary permissions were obtained from the ethics committee and the institution prior to the research. Data were collected with a patient information form, the Pressure Ulcer Prevention Knowledge Assessment Instrument (PUPKAI) and the Attitude towards Pressure ulcer Prevention instrument (APuP) between October 1, 2018 and February 1, 2019.  Data were analyzed with the independent-samples t-test, the Mann-Whitney U test, the Kruskal-Wallis test, the correlation analysis and the multiple regression analysis.

Results: The mean age of the nurses was 29.91±6.48 years, 65.3% were female and half of them had undergraduate degrees. According to the PUPKAI total mean score (<60%), the pressure ulcer prevention knowledge of the nurses was inadequate and only 24% had a knowledge score ≥60%. Regression analysis results showed that, nurses' professional experience duration, working style, number of patients per shift and the experiences of giving care to patients with pressure ulcers were found to have a significant effect on the PUPKAI total mean score (p<0.05). According to the APuP total mean score (≥75%), the nurses had positive attitudes towards pressure ulcer prevention. It was also determined that the descriptive characteristics of the nurses did not significantly affect the APuP total mean score (p>0.05). There was no significant relationship between the total mean scores of the PUPKAI and APuP (p>0.05).

Conclusion: This study revealed that the surgical nurses had positive attitudes towards pressure ulcer prevention but they had inadequate knowledge about it. These findings highlight the need for institutional arrangements to ensure that nurses have access to evidence-based knowledge about pressure ulcer prevention.

It is a know that morbidity of cardiovascular disorders is high in diabetic patients. Besides obesity and hypertension, increased levels of triglycerides and very low density lipoprotein cholesterol were identıfied among high risk factors in the development of coronary arter disease in patients with abnormal oral glucose tolerance test. In this study, i1 is compared with risk factors and coronary heart disease among the patients with 60 abnormal glucose tolerance test and 60 type-II diabetes mellitus and 60 normal cases. Body muss index is found high in patients with' aıabetes melliıbıç and abnormal glucose tolerance les( It was higı- levels of systolic and diastolic blood pressuı e in patients with diabetes mellitus and abnormal glucose rolerance test. The level of triglycerids and totaı s holesterol and fasting blood sugaı were high in patıenıs with diabetes mellitus and abnormal glucose tolerance test, but it was low level of high density liport.teın cholesterol in both groups. It is identıfied mort ınactivelife standart regarding life style in both Finally these results suggested that the risk tactors of coronary artery disease increased in patients with abnormal glucose tolerance test lıke diabetes mellitus

Diabetes mellitus (DM) absolute or relative deficiency of endogenous insulin or resulting from peripheral ineffectiveness of chronic hyperglycemia, carbohydrate, protein and fat metabolism disorder, capillary membrane changes, and accelerated atherosclerosis associated with chronic, progressive disease (1). The main cause of vision loss in patients with diabetic macular edema(4). In the treatment of macula edema, laser photocoagulation, VEGF inhibitors and vitrectomy is recommended. Choroid, neuroretina, photoreceptors preserving particularly selective RPE laser damage seems to be the appropriate treatment method (24). It was seen that Fundus was preserved µs pulse duration and consecutive irradiation damage, selective RPE with photoreceptors (26,27). Suffered damage to the planned study of selective RPE treatment in diabetic macular edema, Afyon Kocatepe University School of Medicine, Department of Ophthalmology, Retina Unit, between October 2005 and February 2007 were followed up with a diagnosis of DRP, and triggers as a result of the examination detected the presence of macular edema over the age of 18, 99 eyes of 84 patients separated into 2 groups and administered SRL and grid laser treatment followed 6 months. As a result, SRL, and grid laser photocoagulation was effective in the treatment of DMÖ. 84.9 % increase in SRL-treated patients and stabilization of visual acuities were determined. It was confirmed that in Grid laser group and 6-month follow-up and stabilization as a result of an increase in visual acuity was 89.9%.

High-density lipoproteins (HDL) have preventive effects from developing atherosclerosis (11, 13, 24). In order to investigate the effects of long-term drugs nifedipine and propranolol on HDL cholesterol concentrations in the treatment of CHD and hypertension, 20 patients who were given nifedipine, 20 patients who were given propranolol and 20 healthy controls were studied. Serum HDL cholesterol concentrations were lower in patients with coronary heart disease (CHD) than in the control group (P <0.05). There was a significant decrease in HDL cholesterol levels in the propranolol group (P <0.01), but no change in those given nifedipine. Total cholesterol values ​​did not differ significantly, and there was no change with drug intake. Total / HDL cholesterol ratio increased in those given propranolol, but did not change in those given nifedipia. We concluded that administration of propranolol for long-term treatment of KH and hypertension reduces IIDL cholesterol levels, but administration to nifedipine did not.

\r\n Autism spectrum disorder is a neuro-developmental disorder characterized by social interaction and communication, and restricted and repetitive behaviors. Autism is seen in nearly one of 68 children. The incidence is reported to increase, and the increase is suggested to arise from increased information, awareness and alterations in diagnostic criteria. However, environmental factors and their relationships to several unknown genetic factors are also considered to contribute to the increase. The assessment of whether environmental factors lead to risks for autism spectrum disorder in perinatal period, especially when children are exposed to these factors in a neurodevelopmentally important and fragile stage, is so important. It is reported that in pregnancy, there is an association between autism spectrum disorder, and exposure to such drugs as valporic acid, terbutaline and Selective Seratonin Reuptake Inhibitors.Exposure to heavy metals and pesticides increases the risk of autism spectrum disorder.Intense smoking, and alcohol consumption and drugsdisrupt neurodevelopmental process, Also, gestational diabetes may elavate the risk of autism spectrum disorder due to autoimmunal disorders, infections and inflammatory pocesse of prolonged fever. Migration, seasons and air pollution exposed in pregnancy are also reported to affect autism spectrum disorder risk. The awareness level between environmental factors and autism spectrum disorder should be increased among prospective mothers, and these mothers should be trained as to the risk factors. Because prospective mothers avoid these factors, or the elimination of these factors should be beneficial for reducing autism spectrum disorder risk, analyzing related studies and enlightening risk factors are especially important. Here, we aimed at revising recent studies related to prenatal factors from a holistic perspective.

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Background and Aim: Carotid artery stenting (CAS) is an alternative approach to carotid endarterectomy in cerebrovascular diseases. The applicability of this procedure has increased as a result of development of cerebral protection devices. In the trial, the clinical and radiological characteristics and early and late outcomes of patients who received CAS were investigated.

 

Methods: The study had a retrospective design. The clinical and radiological characteristics and early and late outcomes after CAS of 76 patients (54 male, 22 female) who were admitted to a university hospital between 2008 and 2014 due to a diagnosis of internal carotid artery stenosis (ICA) were retrospectively reviewed.

 

Results: All patients were symptomatic during their admissions, and after their workups were completed, ICA stenosis was determined. Unilateral (Right ICA 34.2%, left ICA 47.4%) stenosis in 62 patients and bilateral stenosis (18.4%) in 14 patients were determined. The mean degree of stenosis was 82.1 (SD:11.36, range: 60-99%). All patients were treated with stenting for ICA stenosis (technical success rate: 100%). No complications occurred during these procedures. During the one-year follow-up, no recurrent ischemic attack occurred in any patients. Carotid artery disease is highly associated with hypertension, hyperlipidemia, diabetes mellitus, coronary artery disease, a history of cerebrovascular accidents and transient ischemic attack.

 

Conclusions: Carotid artery disease is a critical factor with co-morbidities and history of cerebrovascular incidents. The carotid artery stenting (CAS) procedure is a method that can be used safely because its serious complication rate is low in cases that are well-selected and have had risk analyses performed regarding medical treatments.

Aim: Post-myocardial infarction ventricular septal defects (PMIVSD) are rare but have extremely high
mortality and morbidity. Mortality rates and risk factors vary in many studies. We aimed to evaluate
the mortality rates and risk factors of ventricular septal defects (PMIVSD) after myocardial infarction
performed in our center .
Patients and Methods: We retrospectively enrolled the patients who underwent surgery for PMIVSD in
our clinic from January 2006 to April 2020 with the age ≥ 18.
Results: A total of 9451 patients admitted to our center with acute myocardial infarction between 2006
and 2020 were examined. Twenty-eight patients operated for PMIVSD were included in the study. Our
PMIVSD rate was 0.296%. When we compare those survivors and non-survivors the only thing which
statistically significant was length of stay in hospital. In survivors it was 13 days when it 2 days in nonsurvivors
group (p<0.001). One patient in survivor group was st ayed in hospital for 107 days.
Conclusion: Timing of the surgery for PMIVSD patients is still challenging. Further strategies like
implanting LVAD or percutaneous devices and waiting for a while before the surgery will be the better
approach for PMIVSD patients.

Between lune 1993 and July 1994 all 20 weeks gestational age and over and 500 grams birthweight and over live - stillboı-n newbor-n were examined fbr the investigating •ongenital malformations, that were delivered in Gynecology and Obstetrics De-partment of Selçuk University Medical Faculty, Our work alsa evaluated relationship hetween congenital malformations and sex. maternal education levels, maternal place of residence, maternal age, hirt-hweight, gestational age. par-ental •onsenquinity and prenatal risk factoı-s. Dııring this period 69 in-tants (%4.45) were established with ınalformations in the delivered 1552 newborn. The pı-evelance of major malformations were %2.13 and minor mal-formations were %2.32. Multiple malforrnations rate %1.42 and uni malfoı-mations rate %3.03 were en-countered. Muscle - skeletal system and central ner-vous system anomalies were the highest anomalies group that we encounteı-ed. There was relationship hetween congenital mal-formation and stillborn. death in the first days of the life, maternal place of residence, education levels, parental consenquinity, parity prematurity. low hirth weight. existence of stillborn siblings and relatives with congenital malformation, eclampsia. But not r-elationship was deterınined hetween congenital ınalfflı-mation and drug adrninistration, illnesses with fever and hemorrhage during preg-nancy, maternal age and undesire pregnaney.

The Coronary heart disease and üs risk factors were investigated in Konya, which is placed in the central pan of Central Anatolia in Turkey. In 'his study 280 asymptomatic people, who are middle aged and over (.40), were selected randomize from Bozkır, a small town of Kon" ya, which shows a ho-mogen structure of population. All of the cases which were investigated, cardio-vascular system was examined. ECG and teleradiog-raphy were taken. In 54 cases (19.3%) hypertension, 11 cases (3.9%) hyperglisemia and 58 male cases (59.8%) smoking were found. Obesite was seen 17% of male and 27% of female. Ilypercholesterolarnia in 12% of cases and hypertrigliseridemia in 7.4% of cases were also seen. In 40 cases, coronary heart dis-ease was deterrnined. Incidence of hypefrtension was increasing with age, but the rale of cigarette-smoking was not changed. With the understanding of posiıive results of struggle -withreversible major risk factors periodic examinations in cases with high risk; furthermore investigation of risk factors medical and preventive treatment procedures were pointed out clearly as important issues which mut be followed by physidans.