Mevlana Medical Sciences Journal Archive

Aim: Invasive Candida infections are an increasing cause of mortality and morbidity, especially in patients being treated in intensive care patients. The delayed treatment of candidemia is an important determinant of patient progression. In this study, we aimed to determine the species distribution of Candida infections in intensive care units and to contribute to epidemiological data and empirical antifungal treatment selection.
Materials and Methods: Candida species isolated from blood cultures of patients hospitalized in intensive care units between 2019-2020 were examined in the study. Blood samples were cultivated and incubated in automated blood culture system media (BACTEC PLUS Aerobic/F, BACTEC 9120, USA). Positive signaling blood culture samples were inoculated on SDA and blood agar medium, and growing yeast isolates were identified using VITEK 2 Compact System (bioMérieux, France).
Results: Candida growth was detected in 95 patients in total. The most frequently isolated species was Candida parapsilosis (45%), followed by Candida albicans (37.5%), Candida glabrata (8.5%), Candida tropicalis (7.5%) and Candida famata (1%), respectively. The mortality rate of these patients with candidemia was found to be 76%.
Conclusion: We believe that this will contribute to the reduction of mortality and morbidity by determining the distribution of species and the treatment protocol to be selected for candida infections
in intensive care units.
Key words: Candida Species, Candidemia, Mortality

Aim: Early rehabilitation applications are an approach that should be initiated in risky babies as soon as they are born. In this study, it was aimed to investigate the knowledge and awareness level of healthcare professionals working in the departments and units of the Department of Child Health and Diseases about” Early Physiotherapy and Rehabilitation Practices” (EPRP) in risky infants and to examine the early physiotherapy and rehabilitation intervention procedures available in these units.
Materials and Methods: Information awareness about "Early Period Physiotherapy and Rehabilitation Practice" was evaluated with an 11-item questionnaire prepared for 57 health professionals working in the Department of Child Health and Diseases.
Result: Neither Center has an active neonatal physiotherapist. Only if necessary, the physiotherapist provides treatment with consultation to teach the family only joint range of motion exercises. It was determined that 70.17% of the healthcare professionals had no or insufficient information about EPRP. It was found that the most therapeutic positioning among EPRP modalities was used in the neonatal intensive care unit. It was reported that health professionals stated that the EPRP to be applied to risky babies in the intensive care unit is necessary (80.70%) and a neonatal physiotherapist (82.45%) is needed to perform these applications.
Conclusions: Caring about early physical therapy practices in newborns and positioning neonatal physiotherapists to serve in these units will fill a clinically important gap.
Key words: Early physiotherapy and rehabilitation applications, Early intervention,
Awareness, Risky baby, Healthcare worker, Newborn, Intensive care

Aim: The incidence of ischemic stroke has increased in cancer cases. Type, stage, and treatment of the cancer are responsible in etiopathogenesis. The aim of this study is to investigate cases who have an ischemic stroke while being followed up with a diagnosis of cancer.
Patients and Methods: The cases followed up with cancer and ischemic stroke diagnosis between January 2016 and February 2020 were analyzed retrospectively.
Results: 21 (11 Males, 10 Females) cases were included in the study. The average age was 64.8. Lung and stomach cancer were the most common cancers associated with ischemic stroke. When examined histopathologically, the rate of adenocarcinoma was 42.8%. The mean time between cancer diagnosis and stroke was 15.4 months in lung cancer, 10 months in stomach cancer, and 15.5 months in all cancers. At hospital admission The National Institutes of Health Stroke Scale( NIH Stroke Scale/Score) was 5.6 median. All cases with multiple infarct areas in magnetic resonance imaging (MRI) were metastatic cancer cases. 11 patients died, and the median value of these cases was 11 days. Platinum derivatives were the most commonly used chemotherapy.
Discussion and Conclusion: Cancer has been shown to increase the risk of stroke with various etiological factors. Stroke is not a rare condition that causes serious complications in cancer patients. Awareness of clinicians should be increased in order to be able to combat this issue effectively. 
Key words: Adenocarcinoma, Ischemic Stroke, Cancer, Cisplatin

Aim: Omalizumab is a humanized antibody that binds to the IgE receptor and its mechanism of action is still not fully understood although it is effective in the treatment of chronic urticaria. In this study, our aim is to investigate the effects of omalizumab treatment applied to patients with chronic urticaria on the hematological parameter and on IgE values.
Materials and Methods: In our study, the hematological parameter and IgE values of 36 patients, who received three cycles of omalizumab treatment due to chronic urticaria, were recorded before and after the treatment.
Results: Before the omalizumab treatment, neutrophil-lymphocyte ratio was found to be higher (p: 0.038), and platelet distribution width was found to be lower (p: 0.01) in patients with chronic urticaria than in the control group. After the treatment, neutrophil-lymphocyte ratio values of the patients with chronic urticaria, who received omalizumab treatment for 12 weeks, were observed to decrease (p: 0.05), and platelet distribution width values were observed to increase (p: 0.002). No significant
difference was observed between the patients with chronic urticaria and the control group regarding mean platelet volume, and there was no significant change at the end of the treatment. In the patient group, the IgE values before omalizumab treatment were higher than the IgE values at the 12th week (p: 0.001).
Conclusion: In light of data, our findings suggest that neutrophil-lymphocyte ratio, platelet distribution width and IgE values may be useful hematologic parameters for the evaluation and followup of remission in patients with chronic urticaria.
Key words: Ig E, Omalizumab, Urticaria

Aim: Bicuspid aortic valve (BAV) is the most common congenital valve anomaly causing early valve damage and aortic enlargement. In this study, the contribution of magnetic resonanceangiography (MRA) used for aorta imaging in addition to echocardiography (EC) in pediatric patients with BAV was investigated.
Methods: In a single center study, the medical records of 571 cases with a diagnosis of BAV under 18 years of age were retrospectively reviewed. In this group, 32 patients (21 female, mean age was 12.66 ± 3.92 years) who underwent MRA for aortic evaluation were included in the study. In MRA obtained by phase contrast method, the largest diameters of the annulus, ascending aorta, sinus valsalva, sinotubular junction, middle ascending arch, middle arch and proximal arch levels were measured electronically. Body surface area and arterial blood pressure values obtained and recorded during EC examination were obtained. Z scores were calculated. Ejection fraction, aortic stenosis (AS) and insufficiency (AI) founded with EC were recorded. Aortic arch geometry and supraaortic variations were determined with MRA. The EC and MRA findings, additional findings provided by MRA were evaluated.
Results: In EC, 62.5% of the participants had AI and 6.25% had combined valve disorder. There was no isolated AS, 31.25% of the participants had no valve pathology. The most important diameter change in valve dysfunction was detected at the level of the middle arch. The most common aortic arch was Romanesque (53%).
In the MRA, 15.5% of the participants had bovine arch variation and 3% had isolated left vertebral artery. No correlation was found between valvular disorder, z scores measured by MRA, arterial blood pressure, BSA, aortic geometry, supraaortic variations.
Conclusion: In addition to EC findings in children with BAV, MRA is useful for demonstrating aortic arch geometry and supraaortic variations known to affect hemodynamic changes.
Key words: Bicuspid aort valve, Aorta, Children, Echocardiography, MRI

Key words: Mouthguards, Electroconvulsive therapy, Dental trauma

Blue nevi are benign melanocytic lesions and are rare in the genital tract. Although it is seen everywhere in the lower genital system, it is most commonly seen in the endocervical canal. It is usually detected incidentally in the hysterectomy materials of middle-aged women. A 44-year-old female patient who presented with the complaint of abnormal uterine bleeding was found to have multiple myoma nodules, the largest of which was 6 cm in diameter. Laparoscopic hysterectomy and bilateral salpingoophorectomy were performed. Macroscopic examination of the hysterectomy material did not reveal any macroscopic pathology in the cervix. In microscopic sections prepared from the cervix, a tumoral lesion consisting of scattered uniform, spindle cells located in the endocervical canal stroma and melanin pigment within the lesion were noted. There was no mitosis, necrosis or atypia. In the immunohistochemical study, immunoreactions were observed in spindle cells with Melan-A, HMB-45, S-100. The case was reported as "blue nevus in the uterine cervix". Melanocytic lesions of the uterine cervix are usually benign, rarely malignant cases have been reported. 
Key words: Blue nevus, Nevus, Uterus, Cervix, Melanocytic tumor

Renal artery is a thick pair of arteries that separate from the aorta abdominalis. It is both the nutrient and functional vessel of the kidney. According to classical anatomy knowledge, each kidney has one arteria renalis, but there are many cadaver dissection and radiology studies in the literature that report that there may be more than one. Renal artery variations are common and the frequency of variation varies according to social differences. Variations of renal artery can be explained on an embryological basis. In our study, arteria renalis branch variation was detected as a result of the file scan in thearchive of Necmettin Erbakan University Meram Faculty of Medicine Department of Radiology. We present this case report in order to assist regional surgeons and contribute to the literature, since renal artery variations are important for kidney transplantations and regional surgical interventions.
Key words: Renal artery, Extra renal artery, Computed tomography