Makale Arama

In order to investigate the relation hetween the thyroid radionuclide scanning and the histopathological findings, we reviewed 125 patients operaled on from 1984 to 1988 in Korkuteli State Hospital. Sixty seven point five percent of patients had multinodular and 32.5% uninodular goiter. One hundred sir patients underwent thyroid radionuclide scanning and 85.8% revealed hypoactive, 6.6% hypoactive and normoactive, 3.8% hyperactive nodules and 3.8% other pathologies. Ali of the 125 patients were euthyroid at the time of operation. Mnety seven point six percent of the patients underwent unilateral or bilateral subtotal thyroidectomy. In 100 patients who had histopathologic exarnination had 131 hislopathologic diagnosis. In 81 patients who had hypoactive nodules determined with radionuclide scanning, 68.8% were diagnosed as multinodular goiter, 16.5% follicular edenoma, 7.4% chronic thyroiditis, 5.5% malig,nant thyroid disease and 1.8% colloidal cyst histopathologically. All cases with malignant thyroid disease had hypoactive nodules, five of them were multinodular and one solitary nodule.

Saddle block is an ideal procedure that can provide sufficient anesthesia by protecting hemodynamic stability especially in elder patients with high cardiac risk. A 52 years old male patient with bladder tumor who was scheduled for transurethral bladder resection (TUR-B) had history of hypertension, diabetes mellitus and congestive heart failure. Echocardiography showed that LVEF was 20%; RVEF was 28% and there were insufficiency (MVI) of third degree, insufficiency (TVI) of second degree, biventricular global hypokinesia and remarkable dilatation on the right and left structures of the heart. The patient was considered as having ASA class IV. He had TUR-B under saddle block. In conclusion, we considered that saddle blockade was a more safe and efficient anesthetic procedure rather than neuroaxial blockade or general anesthesia for the highrisk patient who had bladder tumor.

The purpose of this study was to evaluate the fear, vvorry and axieties of patients about anesthesia and surgery preoperatively by using a questionaire, and to measure their anxiety by using visual analogue scale (VAS). Five hundred and thirty six patients (>19 yr of age) were questioned about their worries, fears and request of Infor­ mation by means of a questionaire. The ansvvers were analysed with chi-square and correlation tests and p<0.05 was considered as significant. Fear from surgery was higher in the less educated patients (p<0.05). VVomen feared from anesthesia and surgery more than men (p=0.0001). Men prefered local anesthesia more than vvomen (p=0.00165). Fear and request of Information increased with increased income (p=0.01). VAS scores vvere high­ er in vvomen, illeterate and primary school graduates, and patients vvithout previous surgical or anesthesia expe- rience (p<0.05). No correlation was present betvveen VAS scores and income or increase or decrease of Informa­ tion requests (p>0.05). İt was concluded that not ali but some patients feared of surgery or anesthesia or vvanted Information. Informing these patients on the consequences of anesthesia and surgery may be usefull in alleviating their fears or vvorries. Positive correlation betvveen the results of the questionaire and VAS scores, leads us to con- sider that VAS scores may be usefull for measuring preoperative anxiety.

Aim: Distal femoral fractures are common seen both elderly and young population. These fractures are % 7 of all femoral fractures. Providing of alingment after distal femoral diaphyseal fractures is important for the development of deformity and shortness. In this study, it was aimed to determine whether the effect of intramedullary nail method applied in the treatment of distal femoral diaphyseal fractures that do not extend into the joint to the femoral alignment. Patients and Methods : 62 patients were evaluated who were treated with intramedullary nail with the diagnosis of distal femoral diaphyseal fracture between 2010 and 2016. Patients has at least 1 year of follow-up. Patients were divided into 3 groups according to fracture joint distance (<100 mm, 100-130 mm, >130 mm). Nail-joint distance (NJD), fracture line-joint distance (FJD), fracture-nail distance (FND), and the translation and alignment of the fracture line were evaluated for each group. Results: In group 1; NJD 17,1±6,8 mm, FJD 78,4±17,6 mm, FND 60,8±15,9 mm, translation 4±1,3 mm, and the malalignment was 2,9±1,7°. In Group 2; NJD 19±6,8 mm, FJD 119,5±8 mm, FND 100,6±8 mm, translation 3,9±1,7 mm, and malalignment 3±1,7°. In group 3; NJD 25,2±8,7 mm, FJD 143,3±7,8 mm, FND 118,1±11,7 mm, translation 3,5±1,8 mm, and malalignment was 2,5±1,4°. Conclusion: In our study, we found that as the distance between the fracture and the joint decreased, the degree of malalignment and translation increased, and when the distance between the nail and the joint was kept below 20 mm, the amount of malalignment and translation decreased. If distal femur fractures near the joint line will be treated with intramedullary nailing attention must be taken for the malalignment and translation. Especially when the fracture-joint distance is less than 100 mm, keeping the distance between the nail and the joint below 20 mm will keep the translation and malalingment at a minimum level.

Video-assisted thorocotomy (VATS) was performed to 10 patients to whom diagnosis couldn’t done with closed pleura biopsy betvveen June of 1995 and december of 1997 at the clinic of chest Surgery of Medical Faculty of Selçuk Üniversity. 5 of the cases were female and 5 of them were male. The smallest case was 28 years old, the eldest case was 80 years old and average age of ali cases was 55.7. VATS was performed to 5 of ali cases from the right, and to 5 of them from the left side. At the 9 cases biopsy was taken with VATS, İt 1 case biopsy vvasn't effective, for this reason öpen biopsy was one with thoractomy. Ali of the cases in whom biopsy were done with VATS absolute diagnosis have been done. İn the 4 of these cases diagnosis was malign mesotelioma, in 3 of them diagnosis was tubercülosis, in 2 of them diagnosis was nonspesific pleuritis. İn the thorocotomy performed patient the diagnosis was metastasis of adenocarcinoma. Complications and mortality vvasn't seen in any of the cases.

Mantle cell lymphoma represents 3-10% of all non-Hodgkin lymphomas. It is mostly a disease of the elderly and shows a male predominance. Patients with mantle cell lymphoma usually present with advanced stage. Extranodal involvements are common finding. In this paper, we presented a case of an 62 year old male admitting to hospital only right knee pain and swelling who had aggressive mantle cell lymphoma with unusual extranodal involvements.

Aim: The aim of this study is to evaluate the association between hematologic diseases and SARS-CoV-2
infection in patients who have been been diagnosed with a hemat ologic disease after COVID-19 infection.
Patients and Methods: The ones who had a previously history of COVID-19 infection among the patients
diagnosed with any malign or autoimmune hematologic disease were evaluated between April 1, 2020 – April
1, 2021, retrospectively. The Patients who had the COVID-19 infection and the patients who had not were
compared.
Results: Twenty-four (7.8%) patients of 305 newly diagnosed who had a previously history of COVID-19
infection were determined. The most common diagnosis was non-Hodgkin Lymphoma in both of the groups.
Although it was not statistically significant, frequency of NHL and aggressive NHL were most common in
the patients with history of COVID-19 (25.1% vs 23.1%; p=0.143 and 66.6% vs 56.9%, p=0.094). The basic
hematologic parameters were similar between the two groups. The median time between COVID-19 infection
and the hematologic diagnosis was 4.1 (0.6-11.8) month; the minimum duration was in the patient with
Immune Thrombocytopenic Purpura and the maximum was the one with Multiple Myeloma. The median time
up until the diagnosis was longer in the malign group (4.5 vs 2.5 months; p=0.070).
Conclusions: As a result of the study, it has been emphasized that COVID-19 may have an etiological factor
for malign and hematologic diseases with autoimmune pathogenesi s.

Aim: The aim of this study was to evaluate the demographic characteristics, emergency care needs and prognosis of patients aged 65 years and older who presented to our Emergency Medicine Clinic with abdominal pain for a period of one year.

Patients and Methods: In this single-center, retrospective, observational study included patients aged 65 years and older who presented to the emergency department with abdominal pain between June 15, 2015 and June 14, 2016. The related variables were recorded from the patients' electronic and written files. The general patient population and the differences of variables in the 65-74 age group, 75-84 age group and ≥85 age group were investigated.

Results: A total of 1330 patients were included in the study. The mean age of the patients was 75.2 ± 7.2 years and 582 (43.8%) were male. While 58.8% of the patients were discharged from the emergency department, the most common hospitalization wards were General Surgery (14.1%) and Gastroenterology (11.4%). The ICU admission rate increased with age (p<0.001; 3.3% - 5.8% - 11.6%). The mean length of stay in hospital was 5.9 ± 7.1 days and the in-hospital mortality rate was 3.4%. While 50.1% of the patients in the 65-74 age group were discharged from the emergency department without consultation, this rate decreased to 36.6% in the ≥85 age group and the difference was statistically significant (p<0.001). Abdominal ultrasound was performed in 34.1%, abdominal tomography in 20.0% and both of them in 7.5% of the patients.

Conclusion: The patients aged 85 years and older with abdominal pain are more likely to be characterized by more examination needs, more consultation needs, more hospitalization rates and higher mortality rates. Taking these differences into consideration during the management of the elderly patients with abdominal pain in emergency department will help to reduce morbidity and mortality rates while improving patient care quality.

The Zenker’s diverticulum (pharyngeal pouch) is a rare pulsion diverticulum of the mucosa of the pharynx just above the cricopharyngeal muscle. It occurs at the left side and was commonly seen in elderly patients. Maintypical symptoms include dysphagia, regurgitation, chronic cough, aspiration and weight loss. Symptomatic patients with large diverticulum should be treated surgically. Although in recent years successful results with endoscopic therapy has been reported, diverticulectomy and myotomy are still seems to be the best treatment. In this study, a case of 36 years old woman with rightsided Zenker’s diverticulum, clinical presentation, and management are reviewed.

Melanoacanthoma or pigmented seborrhoeic keratosis is a rare variant of seborrhoeic keratosis which commonly occurs as deeply pigmented lesion in the head and neck or trunk of elderly patients. Melanoacanthomas shows proliferation of dendritic melanocytes and basaloid keratinocytes on histology. The lesion can clinically mimic malignant melanoma and variants a histopathological examination for the right diagnosis and proper management.

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.

Between May 1984-April 1988 7 cases with destroyed lung were treated at S. Ü. Faculty of Medicine Thoracic and Cardiovascular Surgical Department. The youngest and oldest patients were 5 and 47 years old. Patients presented themselves with coughing, purulant sputum, dyspnea, pleural pain and hemoptysis. Clubbing of fingers was common in all cases. We obtained no perfusion in the destroyed lung side whom we could research. Surgical treatment with 5 pneumonectomy and 2 pleuropneumonectomy were corned out. There were 2 empyema as post operative complication with broncho-pleural fistula in one patient. This patient died following thoracoplasty. The other patient is still alive with open drainage.

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 decision to start treatment in sarcoidosis is made based on clinical and radiological findings and changes in pulmonary function test findings during follow-up, and more useful tools are needed in treatment management. F-18 fluorodeoxyglucose (18F-FDG) positron required important tomography / computed tomography (PET/CT) contains important information about the extent of sarcoidosis. On the other hand, the neutrophil/lymphocyte ratio (NLR) opens as a good prognostic marker for tissue-related inflammation. This study evaluated the relationship between the 18F-FDG PET/CT findings of sarcoidosis and NLR and other clinical findings.

Material and methods

The data of the patient who was diagnosed with sarcoidosis after 18F-FDG PET/CT examination in our clinic were retrospectively reviewed. Patients' age, gender, NLR values, smoking status, extrathoracic involvement and symptoms, and 18F-FDG PET/CT findings were compared.

Results

This study consisted of 41 patients. There was a strong correlation between NLR and whole body total lesion glycolysis (TLG), and moderate correlation between  MAIA and NLR (r values: 0.852, 0.660, both of them p value: <0.001, respectively). There was a significant difference between the groups showing only thoracic involvement and additional extrathoracic involvement with MAIA, TLG and NLR values (p values,: 0.002, 0.001 and, 0.003, respectively). In the classification made according to the symptoms of the patients, there was no significant difference between the groups with SUVmax, MAIA, TLG and NLR values. Median values were found to be significantly higher in the elderly group (p values: 0.037 and 0.040, respectively). In the classification made according to gender; there was no significant difference in both PET/CT parameters and NLR values.

Conclusion

The close relationship between the NLR value, which is accepted as a prognostic indicator in sarcoidosis, and the 18F-FDG PET / CT findings which show the involvement of the disease in the whole body, may provide the clinician with significant benefits in treatment management.

Aim: Vertebrobasillar insufficiency (VBI) is a common problem of elderly patients. However, diagnosis of VBI is generally difficult. The aim of this study was to determine the findings and efficiencies of MRA and CDUS in the diagnosis of VBI. Material and Method: We examined 40 patients (20 men, 20 women, mean age: 54.83±14.36 years) having signs and symptoms of VBI and 20 controls of the same age and sex. All of the patients, underwent cervical MRA, CDUS, cranial MRI. The diameter measurements and systolic and diastolic flow velocities of the vertebral arteries were compared between study and control group. Posterior circulation was also evaluated by cranial MRI in patients with VBI. Results: By CDUS, 9 patients with oclusion, 5 patients with kink or stenosis and 6 patients with only hypoplasia, and 2 patients with insufficient flow were diagnosed. MRA showed occlusion in 14 patients, stenosis in 4 patients, kink in 6 patients, tortuosity in 6 patients, and fenestration in one patient. MRA of the remaining 5 patients were normal. Cranial MRI of 7 patients was abnormal. On MRA, there was distal oclusion in five out of 14 patients having oclusion. CDUS showed low velocity and high resistance in the extracranial segment of these vessels. Conclusion: When only the extracranial pathologies of vertebral arteries were in concern, CDUS specifity was 81,5% and sensitivity was 84,6% according to MRA. If all the vertebrobasillary system pathologies were in concern CDUS sensitivity and specifity according to MRA were 57,1% and 60%, respectively.

Decubitus ulcers can develop in immobilized patient. Patients with spinal cord injury and elderly patients are at high risk. We presented 36 patient with pressure sore that we operated between May 1994 and January 2000 and our reconstructive procedures. Sacral, trochanteric and ischial pressure sores we are included the study, other sites were excepted. As 3 patient with ischial ulcer were accepted because of recurrence, there were no recur- rence for sacral and trochanteric ulcers. This recurrences were not depend on surgical techniçues perhaps due to pressure. Selecting the proper surgical technique for decubitus ulcer, is important eitherpreventing recurrence and funtional loss. We revievved our experience with reconstruction of decubit ulcers betvveen 1994 and 2000 years.

Eighty year old, male patient presented to our clinic with symptoms of difficult nose breathing, epistaxis and rarely hemoptysis. No abnormalities were seen during oral, anterior nasal and ear examination of the patient. A mass in the nasopharynx was observed during the fiberoptic nasopharyngoscopic examination. The patient was diagnosed as extramedullary plasmacytoma based on the deep biopsy from nasopharynx. Plasmacytomas are tumors of plasma cells, develop outside the bone marrow as solitary masses and they may be associated with multiple myeloma. Cases of extramedullary plasmacytoma (EMP) in the head-neck area develops rarely. Malignant tumors of the nasopharynx are treated surgically and/or via radiotherapy. Extramedullary plasmacytomas are known to be radiosensitive, however, many authors recommend a combined therapy of surgery and radiotherapy. All the treatment options were explained to the patient, however, the patient did not accept surgery. Therefore, the patient was started on radiotherapy and no recurrences were observed during the twenty-nine-month follow-up period. More caution should be exercised for elderly patients presenting with nasal obstruction, epistaxis, and their nasopharynx as well as nasal cavity should be endoscopically assessed in detail.

in this study, the risks of emergency surgical procedures in elderly patients and the effect of surgery on the morbidity and mortality were investigated. The records of 884 patients, those who were 65 years old or elder, and who were operated on in the Department of Surgery, University of Selçuk beetwen May 1991 and April 1997 were analyzed, retrospectively. One hundred eighty three patients (20.7%) were operated on urgently and 701 patients (79.3%) were elective. The ratio of male ifemale was 1.9 (120M/63F) and the mean age was 72.3 (range 65-95) in the emergency operations. Most frequent reason for the emergency operations were intestinal obstruction (49 cases), acute mesenteric ischemia (24 cases) and pepic ulcer perforation (23 cases). Mean hospital stay was 10.8 days (3-51 days) in the emergency and 7.2 days (1-41 days) in the elective operation (p<0.0001). The mor-tality was 18.6% in the emergency and 3.4% in the elective operations (p<0.0001). There was no correlation bet-ween mortality rates in different age groups (p>0.05). The highest mortality was observed in intraabdominal abs-cess and in perforated gallbladder disease. Intestinal resection and anastomosis was performed in 55.9% of expired cases. The majority of the patients (70.6%), who had died, had coexisting cardiopulmonary diseases. The main causes of death in alt patients were sepsis and cordio-pulmonary diseases. The main causes of death in all patients were sepsis and cardio-pulmonary failure. In conclusion, age is not a contraindication for an emergency operation and does not affect mortality which appears to be directly related to the severity and nature of the di-sease and to the coexisting cordio-pulmonary diseases. For this reason, timing is very important in the operations of elderly patients, and it is wise to perform the most conservative operation in some severe surgical conditions.

Between Januar). 1994 to Septemher 1996. 16 patients with mediastinal mass were surgically eAp-Iored. Among them 11 of them were males and 5 were .female. Their ages ranged 35 ta 68 vears (mean 53.8). For 13 patients right anterior me-diastinotomy were pe)formed (81.25%) and left an-terior mediastinotomy were perforıned for 3 pa-tients, respectiyely. 117 one case the right anterioı-mediastinotomy procedure failed and thoracotomy required. In 14 cases of 16 (87.50 %) pathologi• di-agnosis was made hy ınediastinal exploration. Par-hologic extıminations revealed that epidermoid can-cinonıa in 3 patients, sarcoidosis in 3 patients, oat cell carcinoma in 2 patients, lenfoğna in 2 patients. tuberculosis in 2 patients. adenocarcinoma in 1 pa-tient, and chronic nonspesıfic inflamation in 1 pa-tient refflectively. The patient who required tho-racotomy was diagnosed as sarcoidosis. Opeıyuive complication and moı-tality occured,

Bronchial carcinoid tumors constitute approximately 5 percent of all lung tumors. They occur with about equal frequency in both sexes. Most patients are young or middle aged adults. These tumors are not related to cigarette smoking or other known pulmonary carcinogenic factors. Dependent upon the location of the tumor within the lung clinical presentation and morphologic appearance, these tumors are four variants. These variants are the central carcinoid, the peripheral carcinoid, atypical carcinoid, tumorlet type bronchial carcinoid. In this study, two cases diagnosed as bronchial carcinoid turner in Pathology Depart-ment of Medical School of Selçuk University between May 1987 -April 1988 were presented and discusseJ.

Bronchial carcinoid tumors constitute approximately 5 percent of all lung tumors. They occur with about equal frequency in both sexes. Most patients are young or middle aged adults. These tumors are not related to cigarette smoking or other known pulmonary carcinogenic factors. Dependent upon the location of the tumor within the lung clinical presentation and morphologic appearance, these tumors are four variants. These variants are the central carcinoid, the peripheral carcinoid, atypical carcinoid, tumorlet type bronchial carcinoid. In this study, two cases diagnosed as bronchial carcinoid turner in Pathology Depart-ment of Medical School of Selçuk University between May 1987 -April 1988 were presented and discusseJ.

Aim: This study was aimed to determine the demography of family caregiver of dependent older adults and their attitude related to care and relationship between attitude and short time education. Material and Method: The study carried out as quasi-experimental design. Forty-eight family caregivers of dependent older adults were included from a randomly selected health center area in Karaman city center. The family caregiving questionnaire was applied by interviewing. The family caregivers were educated by co-researcher about care of elderly. The questionnaire was applied again after eight weeks of education. Results: The mean age of the family caregivers was 49±16, 71% of them were married and 35% were uneducated. Almost all of them were women and were not working elsewhere. In 26 items the average of positive attitude score of the family caregivers was 59±27 on 100 points. The attitude scores was not significantly different according to demographic features. The scores were higher in post-training compared to pre-training. Conclusion: It is concluded that education of family caregivers by public health nurses positively affect the quality of care of dependent older adults.

MEO was described by Chandler in 1968. it is a progressive exiernal otitis that usually occuring elderly diabetic patients caused by Pseudomonas Aeruginosa. Leads ta death by paratysis of multipl cranial nerves and other iniracranial complications when attaching ternporal bone and skull base. in this article, we present a patient who was diagnosed as MEO at arar clinic and üs etiopathogenesis, clinical features, diagnosis and Ireatment have been cliscused.

The aim of this study is exploring the effects of childbirth education, physiotherapy and psychotherapy-based interventions on fears and worries about childbirth and labour. Expectant mothers in the last trimester of gestation those did not have a delivery before were taken to the study. At first the participants were examined by a psychiatrist than sociodemographic data form Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ), Beck Depression and Beck Anxiety Inventories (BDI, BAI) were applied. Then 3 sessions each taking 60 minutes on possible physical and mental problems before birth were done, an exercise plan and recommendations for facilitating delivery were given to participants, information about possible physical and psychological problems after childbirth were given and their questions on these issue were answered. In results mean age of the group was found as 27.2±3.6. The mean gestational age was 35.7±2.3. Socio-demographic characteristics (age, education level, income level, etc.) was not found significantly correlated with the W-DEQ scores. W-DEQ 1 scores were positively correlated with BAI scores. In Wilcoxon test analyses W-DEQ 1 and W-DEQ 2 scores including all the subscales were significantly different p<0.001. As a conclusion on expectant mothers having their third trimester of pregnancy, education before childbirth was found helpful in reducing fears and negative thoughts related to childbirth.

The electrocardiography (EKG) is a usefid di-agnostic tool, extensiyely used in either cardiac pa-tient or normal infrequent that abnormal changes are obseryed. When EKG'_ç of the elderly people, not as.sociated with a cardiac disorder, are examined. The this study 400 subjects, having been exa-mined in the outpatient department were involved. The ECG's examined, revealed nn overall «ab-normality rate of % 32. A : 53 abnoı-mality was ob-served. in cardiac patient, whereas %12 of normal subjects clemostrated an abnormal ECG. Moreoyer, these changes in ECGs were not associated with a pathological coııdition.

Aim: Acute or chronic diseases, malnutrition, and the biological changes reagarding to aging can disrupt protective barriers, impair clearance mechanisms, and contribute to the expected age-related diminution in cellular immune responses to microorganisms such as Mycobacterium tuberculosis. Case Report: A 90 year old patient with the diagnosis of testicular tuberculosis after an operation because of a mass in testis was treated with isoniazide, rifampicin, ethambutol and morphozinamide. Conclusion: The extrapulmonary tuberculosis risk may increase in the elderly together with the increase in tuberculosis because aging may reduce the effectiveness of the body's immune system.

STUDY AIM: In this study, it was aimed to identify the accurate and inaccurate conceptions among the society on COVID-19 disease, which is considered as a public health problem and has a high risk of transmission. 

METHODS: The research was performed online at https://docs.google.com/forms in May 2020. The questionnaire form was composed of 40 queries, which were on sociodemographic characteristics and COVID-19. Following the study, the answers obtained from the questionnaire were analyzed by inserting related data to the software of SPSS. 

RESULTS: Of 580 participants involved in the study, 363 (62.6%) were female. The median age of the participants was 34.0 (18.0-77.0). Of the individuals who completed the questionnaire, 342 (59.0%) were married and 438 (75.5%) were university graduated and / or postgraduated. Of the individuals included in the study, 497 (85.6%) stated that they watched television / news channels to be informed about COVID-19. Most of the questions related to COVID-19 were answered accurately by the participants. The percentage of the premise, which was answered most accurately, was 577 (99.5%), whereas the lowest percentage of the accurately answered premise was 137 (23.6%). It was found that there was a statistically significant difference among the genders in terms of the percentage of accurate responses to the conceptions (p<0.05).

CONCLUSION: It was determined that the vast majority of the participants utilized from at least one news resource on COVID-19. Participants typically have accurate knowledge about COVID-19. Educational programs can be planned to enhance the awareness of the society about the conceptions, which were answered mostly inaccurately.

This study was carried out to find out the clinical affect, tolerance, side affect and metabolic affects of nitrendipine on 43 hypertensive patients. The pa-tients were divided tn to 3 groups as light, rnild and severe. In study group 11 patients had atherosciehot-ic heart disease, 3 had congestive heart failure and 13 had diabetes mellitus. Nitrendipine was giyen ta all patients 20 mg one dese daily in the morning. The patients were examined upon his application, in the firsth, the third and the sixth weeks. At the end of the six week treatment, the affect and the side affect of nitrendipine were evaluated. The success rate of nitrendipine in light hypertension was 86.66%, in mild hypertension was 81.81%, 64.70% in severe hypertension and considering the total 43 patients, the success was 76.74% in our study. While meaningful decrease in blood pressure in all hypertensive groups was observed at the end of six week treat►ent, meaningful increase in pulse rate was noticed in all except diabetic and the old pa-tients. The side affects such as particularly palpita-tion, headache and flushing, dizziness, feel of vomit-ing and exhoustion were noticed 44.18% of all groups. In conclusion, nitrendipine was proved to be ef-fectiw and reliable drug in all hypertensive patients.

Cartilaginous tumors of larynx are rare, but should be suspected in elderly patients with persistent hoarseness, dyspnea, or dysphagia after malign epithelial tumors has been disproved. 250 cases have been reported in the literatüre. These tumors were investigated by revievved of the literatüre.

Aim: Hypoxemia is a vital criterion used to determine prognosis in coronavirus disease (COVID-19)
cases. This study thus examined the effectiveness of capillary refill time (CRT) in defining hypoxiadependent
disease severity in COVID-19 patients.
Patients and Methods: This prospective study was conducted with COVID-19 patients and an agematched
healthy group. The optimum test ambiance was provided, and a stable smartphone platform
was used to record the measurements (in ms) to standardize our method. The captured videos were then
evaluated using a video processing program.
Results: In total, 39 patients with COVID-19 and 40 control groups participated in this study. The patients
were further divided into the moderate (n = 25) or severe group (n = 14) according to disease severity.
The mean oxygen saturation of both moderate/severe groups was above 94%. Per disease severity, the
CRT measurements were higher in the severe group than in the moderate group (p = 0.009). In patients
without lymphopenia (n = 18), CRT values were found to be increased in the severe group (p = 0.008).
The use of CRT in patients with Covid-19 was practicable (AUC: 0.91; 95% CI 0.848-0.978; P = 0.001).
Conclusions: Our results show that CRT prolongation can occur in patients with COVID-19. In patients
without lymphopenia and with normal O2 levels, detecting CRT prolongation may be a criterion for early
admission to ICU.

A case report of endocarditis patient due to Brucellosis who had gaye to open heart surgery and had an aortic walve replacement.

Bölgemizde oldukça yaygın olarak görülen Brusellosisin en korkulan ve en az görülen komplikasyonu endokarditisdir.

Aim: Aging is a major process that results in changes in cardiovascular structure and function in elderly people. The aim of this review to summarize the effect of aging on some aspects of cardiovascular structure and function. Result: Increased arterial stiffness alters afterload and left ventricular shape. Age related deteriorations in left ventricular structure and functions are impaired ejection reserve, increase in diastolic volume and an altered diastolic filling pattern. Reduction in the number of myocytes and deterioration of subcellular structure are also remarkable with advanced age. Significant alterations in cardiovascular function during exercise are also demonstrated in elderly people. Conclusion: Significant changes have been noted in the structure and function of the cardiovascular system in older people that are considered to be the result of aging. These changes can be regarded as either adaptive or early preclinical disease, but they occur in the absence of clinically manifest dysfunction.

Inguinal hernia operations are frequently performed at general surgery clinics. These procedures can be performed not only under general anesthesia but also with methods like spinal anesthesia, epidural anesthesia, and local anesthesia. Inguinal reparations can be successfully performed with local anesthesia especially on older patients, those with comorbidity and significant risk of anesthesia. An ample amount of studies in literature underline the fact that the results of hernia reparations performed under local anesthesia are no different than the results of hernia reparations done under general anesthesia. This report discusses the case of an 87-yearold male patient with comordid diseases like hypertension, diabetes mellitus, congestive heart failure, and chronic kidney failure as well as irreducible inguinal hernia who had to undergo emergency hernia reparation under local anesthesia. Although inguinal hernia reparation under local anesthesia has been comprehensively evaluated in literature, there is very limited information on the reparation of incarcerated inguinal hernias under local anesthesia. Consequently, we think that it is possible to use local anesthesia successfully to surgically treat incarcerated hernias with low risk of strangulation especially on senior and comorbid patients. However, we also believe that it would be of utmost significance to conduct a comparative study between emergency hernia operations performed under local anesthesia and general anesthesia in order to be able to recommend a safer solution on the subject.

Systemic Lupus Erythematous, autoimmune character, is a inflammative disease holding many systems. The disease can sometimes follow insidiously with symptoms of fever, asthenia and prostration for years. Central nervous system is common. It is the clinical variable and may be very mild or very severe. In most patients, the age of onset is between 16-55 years old and is found in cases diagnosed in advanced age. Here, it is presented an elderly patient developed dizziness and right side prostration when she was 80 and diagnosed lupus when she was 85. We thought as worth for presenting because of that both the patient is elder and that the lesions have similar features with demyelinating plaques. The lupus should not be forgotten in the central nervous system involvement in advanced age cases and separator diagnosis.

Towards the end of 2019, new coronavirus causing acute respiratory distress syndrome in patients was detected in Wuhan Province, China . This virus was called serious acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by the International Virus Taxonomy Committee. The disease caused by this new coronavirus was called coronavirus disease-2019 (COVID-19) by the World Health Organization. This virus was found to be in the subclass of Betakoronavirus caused by bats. The role of viral proteins such as envelopes, membranes, nucleocapsids and spike proteins responsible for viral infectivity in immunopathogenesis is being investigated in studies. It has been emphasized in studies in which multiple organ failure develops due to the development of cytokine storm, especially in the advanced stages of the disease. An effective host immune response, including natural and adaptive immunity to SARS-Cov-2, is essential for controlling and treating viral infection. Although there is no effective treatment for the disease today, the benefits of various immunosuppressive and immunomodulatory drugs have been shown in studies. In this article, the immunopathogenesis of SARS-CoV-2 and the treatment models that can be effective on immunopathogenesis are reviewed in the light of current literature.

Aim: This study aimed to evaluate the incidence of hypermetabolic axillary lymph nodes due to COVID-19
vaccines and the factors affecting hypermetabolic axillary lymph nodes in F18-fluorodeoxyglucose (FDG)
positron emission tomography/computed tomography (PET/CT) in on cology patients.
Patients and Methods: Among the patients who underwent FDG PET/CT in our institution between
January 15, 2021, and June 15, 2021, those who received one or two doses of COVID-19 vaccine
(CoronaVac or Biontech) were included in the study. Presence and number of ipsilateral hypermetabolic
axillary lymph nodes, FDG uptake, and whether there was a difference between these data after the 1st
and 2nd vaccination were investigated.
Results: Unilateral hypermetabolic axillary lymph nodes was observed in 9.9% (18/182) of the patients
[9.6% (9/94) after 1st dose, 10.2% (9/88) after 2nd dose] vaccinated with CoronaVac; It was detected in
37.5% (9/24) of the patients [35% (7/20) after 1st dose, 50% (2/4) after 2nd dose] who vaccinated with
Biontech. A negative correlation was found between the presence of hypermetabolic axillary lymph nodes
and age in patients who vaccinated with CoronaV ac.
Conclusion: The frequency of hipermetabolik aksiller lenf nodu after CoronaVac was lower than that
observed after mRNA vaccines, a small group of patients in our study, and lower than reported in the
literature. However, the statistical difference could not be evaluated due to the insufficient number of
patients in the Biontech group. A brief history of vaccination is recommended before FDG PET/CT to
reduce false positives. The potential role of FDG PET/CT in comparing the efficacy of vaccines produced
with dif ferent biotechnologies should be searched in studies with large r patient populations.

Purpose:

Primary and metastatic digestive system malignant melanomas are extremely rare. In our study, we aimed to compare lymph node metastasis with clinical and pathological parameters in gallbladder, stomach, small intestine and anorectal region malignant melanomas.

Materials and methods:

This retrospective study included 20 cases diagnosed with malignant melanoma in the gastrointestinal tract organs between January 2010 and January 2020 at XXXXXXXXXXXX. In our study, we wanted to evaluate the relationship between regional lymph node metastasis and age, gender, tumor localization, tumor size, extraintestinal melanoma history, melanin pigment, neutrophil-lymphocyte ratio and post-diagnosis life span in primary and metastatic malignant melanoma cases. We also reviewed the origin and literature of the cells from which melanoma originates in the digestive system.

Results:

There was a statistical relationship between tumor diameter and regional lymph node metastasis (p =0.000). As the tumor diameter increased, the lymph node metastasis rate increased. There was a relationship between survival and gender, tumor localization, distant metastasis, primary and metastatic digestive system melanoma (all p <0.05). Most of the men and those who did not metastasize away from the digestive system were alive. All patients with melanoma metastases to the digestive system and all patients with gallbladder and small intestine localization were alive. Our 70 year old patient with gallbladder primary malignant melanoma was the oldest patient we could identify in the literature.

Conclusions:

Regardless of cutaneous or origin, all melanomas originate from melanocytes, cells derived from embryological nerve crest. Malignant melanoma can be primary in every region, more frequently in the anorectal region in the gastrointestinal tract. The most common metastasis is to the small intestine. Accurate diagnosis is vital in places where it is rarely seen, such as the digestive system. Recently, in metastatic melanoma, immuno-oncological agents are used in adjuvant therapy to help prevent metastatic spread of the disease. Thanks to these treatments, it is reported that more than half of patients with melanoma who have the risk of metastasis after surgical resection provide recurrence-free survival. Although it is very rare, it should be kept in mind that there may be primary or metastatic malignant melanoma in the evaluation of digestive system biopsies.

167 vascular reconstructive operations have been performed in our clinic using a prosthetic vas-cular graft (Dacron or PTFE) and/or autogenous vein graft between the dates of January 1988 -March 1996. During their follow up in this period 6 graft infection (%3.56) have been developed. Our major treatment protocol in graft infections was to remove the infected graft totally and to use app-ropriate antibiotics according to culture results. Our morbidity was I amputation . In different series incidence of graft infections is reported to he between 1.3 - 6%.

Aim: The literature revealed that group of COVID-19 patients who experience anosmia and ageusia
symptoms is younger, is predominantly female, and experiences a milder course of the disease. This
study aimed to evaluate the relationship of the presence of anosmia and ageusia symptoms with the
severity of pneumonia and laboratory test results in hospitaliz ed patients with COVID-19.
Patients and Methods: A retrospective evaluation was made of patients who were hospitalized by
the Department of Pulmonology between October 2020-March 2021 and underwent thorax computed
tomography (CT). Thorax CT findings of the patients were scored with a severity score for each lobe and
a total score was obtained. Pneumonia was classified according to the shape, distribution and appearance
of the lesions, and laboratory test results were obtained. These findings were compared according to the
presence of anosmia and ageusia symptoms.
Results: Evaluation was made of a total of 177 patients, comprising 89(50.2%) males and 88(49.8%)
females with a mean age of 53.0±14.5 years (range, 18-89 years). The number of patients who experienced
at least one of the symptoms of anosmia and ageusia (Group 1) was 67(37.9%) and the rest (Group 2)
did not experience any of these symptoms. The Group 1 patients who experienced these symptoms was
younger (p=0.009). No difference was determined between groups regarding the total pneumonia score
and involvement patterns (p> 0.05). The groups were similar in terms of laboratory results(p> 0.05) .
Conclusion: The prevalence of anosmia and ageusia in hospitalized patients is not a small number and
is more common in the younger population. No association was seen between the presence of these
symptoms and milder pneumonia severity and laboratory results. These symptoms do not have prognostic
value for the severity of the disease in hospitalized patients.

Objective: To determine the effect of COVID-19 infection on anxiety level in pregnant women.

Material and Methods: In this study, a questionnaire and Beck anxiety scale were applied to pregnant women who referred to outpatient clinic for routine pregnancy control in June 2020 to determine their concerns that may be related to COVID-19. Pregnant women admitted with obstetric emergencies and obstetric risk were not included in the study.

Results: 177 pregnant women were included in the study and the pregnant women were divided into four groups according to their score on Beck anxiety scale. Anxiety level of pregnant women was 44.6%. The possibility of not being with his family at the time of birth and the fear of death due to COVID-19 were statistically significantly associated with higher anxiety levels.

Conclusions: In this process, it is important to provide psychosocial support in addition to the follow-up of pregnant women by a multidisciplinary team consisting of perinatology, newborn and intensive care specialists.