Mevlana Medical Sciences Journal Archive

ABSTRACT
Aim: In this study, we aimed to determine the causes of axillary lymphadenopathy in adults, and to determine whether benign or malignant causes are related to the number and diameter of lymph nodes, age, gender, and malignancy history of the patient.

Materials and Methods: This retrospective study included 264 patients who presented at our hospital with the complaint of underarm swelling and were determined with a pathological lymph node. The cases were categorised according to the pathological diagnoses, and compared with the specified criteria.

Results: The diagnoses were reported as benign in 134 (50.8%) cases and malignant in 130 (49.2%). A statistically significant correlation was determined between lymph node diameter and the diagnosis being benign or malignant (p=0.004). Benign changes (59.5%), metastases (24.5%), lymphomas (16%) were seen in females, respectively, while lymphomas were observed in males 47.5%, benign changes (36.6%) and metastases (15.9%).

Conclusion: Axillary lymphadenopathy occurs due to benign conditions in 50.8%, lymphomas in 27.9%, and metastases in 21.3%. Malignant causes become more prominent in older adults and as the lymph node grows in size. It must not be forgotten that just as the growth of axillary lymph nodes may be reactive in patients followed up because of malignancy, it may also be a sign of recurrence or second malignancy.

Key words: Axilla, lymphadenopathy, lymphoma, metastasis

ABSTRACT
Aim: To determine the general views and behaviors of gynecologists and obstetricians about the daily practices of cervical cancer screening, management of cervical preinvasive lesions and HPV vaccination.

Method: The practices of gynecology and obstetrics specialists on these issues were determined through a questionnaire consisting of 10 questions. Again, these answers were graphed through the same program.

Results: 30.85% of the participants thought that cervical precancerous lesions could be managed by obstetricians and gynecologists. The rate of those who thought that such treatments should be performed by gynecological oncology specialists was 32.98%. The rate of those who think that it can be performed by anyone who is educated in this subject was 36.17%. It has been observed that there are many different applications for the HPV vaccine. 2.1% of the participants stated that they do not recommend HPV vaccination.

Conclusion: It was concluded that more on-the-job training on the management of cervical lesions, cervical cancer screening and HPV vaccines is necessary. Likewise, it was concluded that the Cervical Cancer screening program of the Ministry of Health of the Republic of Turkey should be better introduced to gynecologists and obstetricians.

Key words: Gynecologists and obstetricians, gynecologic oncology, cervical preinvasive lesions, cervical cancer screening, HPV vaccination.

ABSTRACT
Aim: COVID-19 causes critical illness in nearly one-third of patients. Modified Glasgow prognostic score (mGPS), and modified systemic inflammation score (mSIS) indicate systemic inflammation. The aim of this study was to assess the association between mGPS, mSIS and cardiopulmonary resuscitation(CPR) result(return of spontaneous circulation or death), through the comparison of blood test results among patients with COVID-19 and attempted CPR.

Material and Methods: Sixty-five patients who required hospitalization in an ICU due to COVID-19, and attempted CPR were screened retrospectively. Patients were separated into two groups; GroupEX covering deceased patients(n=45), and GroupROSC covering patients who attained return of spontaneous circulation(ROSC) (n=20). mGPS and mSIS of patients are calculated.

Results: In GroupROSC, neutrophil percentage, INR, and bilirubin values were found to be significantly low; monocyte percentage and albumin values were found to be significantly higher (p< 0.001, p=0.01, p=0.04, p= 0.01, p=0.004 , p<0.001 respectively). Additionally, there was a significant difference in mGPS between the groups(p=0.032). In the ROC analysis, mSIS and mGPS showed higher scores in GroupEX. mSIS sensitivity and specificity were detected at 83.7% and 68.4%, respectively (p=0.34), and mGPS sensitivity and specificity were detected at 95.3% and 68.4%, respectively (p=0.09). Conclusion: To our results, mGPS and mSIS can contribute to CPR result prediction.

Key words: COVID-19, mGPS, mSIS, serum biochemistry, resuscitation

ABSTRACT
Purpose: The effectiveness of intratympanic gentamicin (ITG) injection in controlling vertigo and the problems encountered in medically resistant Meniere's patients were investigated.

Materyal ve Metod: Files were reviewed retrospectively between 2000 and 2015. Twelve patients who were diagnosed with Meniere's disease in our clinic and who had ITG injection were included in the study. The diagnosis of Meniere's disease was made in these patients according to the criteria of the American Academy of Otolaryngology Head and Neck Surgery. Patients who underwent ITG were patients with severe sensorineural hearing loss (> 60 dB) unresponsive to medical treatment for at least 6 months. ITG was applied to the symptomatic ear in the bilateral affected patients. ITG was administered to these patients for 5 consecutive days at a dose of 40 mg/dl, 0.5-1 cc. The patients were evaluated according to American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS)vertigo recovery criteria 6 months after the last injection.

Results: The number of patients with complete and significant control of vertigo was 11 (92%). Partial control was achieved in one (8%) patient. Tinnitus control was successful in 5 (41%) patients, and aural fullness control was successful in 8 (66%) patients. Acute vestibular insufficiency and vestibular deafferentation syndrome developed in 10 (81%) patients. Injection-related complications such as myringitis, infection, perforation were not observed.

Conclusion: Intratympanic injections for vertigo control in Meniere's disease seem to be safe, inexpensive, effective and easily applied methods. There is a need for clinical and experimental studies for a specific algorithm on the dose, application period and method of gentamicin administered intratympanically.

Key words: Meniere's disease, vertigo, intratympanic injection, gentamicin

ABSTRACT
Aim: Tocilizumab (TCZ) has become a prominent antibody-based therapeutic option among treatment regimens during the Corona Virus 2019 (COVID-19) pandemic. This study aimed to evaluate laboratory changes, prognostic laboratory biomarkers, and the effects of the timing of TCZ application on mortality in COVID-19 patients who underwent TCZ.

Methods: This retrospective, sectional study was conducted with COVID-19 patients received additional TCZ-based treatment. TCZ was administered at a dose of 8 mg/kg/day. The patients' data were recruited from their follow-up records and the digital hospital information system.

Results: The data of 64 patients have been subjected to evaluation. The mean age of all patients was 62.43 ± 14.2. Half of the patients who placed in the intensive care unit had received invasive respiratory support. All patients had received favipiravir, hydroxychloroquine, and convalescent plasma-based therapy. The mean time of TCZ administration was 7 days after hospitalization. In general, ferritin and d-dimer levels stood out as prognostic biomarkers among the laboratory results, whereas in lymphopenic patients, the acute-phase reactants were favored. The presence of comorbidities was associated with an increase in hospital stay and mortality. Mortality was found to increase in patients who received early administration of TCZ.

Conclusion: Prognostic biomarkers previously addressed were also prominent in our study. Considering that early TCZ administration is deemed risky in the literature and may increase mortality, caution should be exercised in its early application.

Key words: COVID-19, disease severity, interleukin-6, mortality, tocilizumab

ABSTRACT
Objective: A standard has not been established in the health service provided to adolescent children who apply to health institutions in our country. Uncertainty remains about whether these patients should be hospitalized in pediatric or adult clinics. The aim of this study is to reveal the psychosocial developmental characteristics of children aged 15, 16, and 17. In parallel with this; We aimed to determine the tendencies of both the child and the child's parent regarding whether the treatment process is carried out in the pediatric or adult clinic.

Patients and Methods: This is a cross-sectional survey study conducted with children aged 15-17 admitted to Erzincan University Medical Faculty Mengücek Gazi Training and Research Hospital Pediatric Surgery Clinic and their parents. A total of 50 children and parents were asked to fill in the standardized scales used in the psychosocial analysis of the adolescent and to answer the question of whether they wanted to be hospitalized in the pediatric or adult clinic.

Results: 62% of the patients were male (n=31), 38% (n=19) were female, and the mean age was 15.84±0.84. For seventeen-year-old children, 81.2% of parents preferred adult services (p=0.044). Adolescents' aggressive behavior scores were higher in 17-year-olds than in 15-year-olds, and withdrawal/depression scores were higher in 16-year-olds than 17-year-olds, according to the scales filled in by their parents. It was determined that the scores of somatic complaints, disruptive behavior and introjection problems were higher in 16-year-olds than in 15-year-olds.

Conclusion: Adolescence is an important period of childhood that requires a different approach. Adolescents, especially in the age group of 17, are accepted as adults by both themselves and their parents. It would be beneficial to establish separate adolescent clinics for these patients. Giving these patients the right to choose the clinic where they will be treated will be beneficial in solving the problem.

Key words: Adolescent, anxiety, interview

ABSTRACT The success of treatment in the dentistry profession is closely related to three-dimensional thinking skills and the development of these skills. In order for dentists to make the correct diagnosis and correct treatment planning on the way to the right treatment, three-dimensional mental description skills and mental rotation performances are very important, accompanied by analytical thinking skills. Today, the presence of patients who are more conscious and have aesthetic concerns at the forefront than in previous years requires higher performance in all dentistry fields such as oral surgery, radiology, pedodontics, orthodontics, periodontology, prosthesis, endodontics and restorative treatment. In this direction, the dentist's ability to make quick decisions under the umbrella of analytical thinking can only be achieved if it is supported by three-dimensional thinking and mental rotation skills. This review has been prepared in order to raise awareness, since there are not enough studies on the mentioned aspects of the subject in the existing literature and it is an important issue concerning human health.

Key words: Skill, dentistry, mental rotation

ABSTRACT
Choledochal cyst and cecal duplication cyst are rare congenital abnormailities, and there are no cases of their coexistence reported in the literature. We report a case of giant choledochal cyst and cecal duplication cyst in an 8-month-old girl. Ultrasonography, magnetic resonance cholangiopancreatograhpy, intraoperative findings, and histopathological examination support the idea that these two entities may be related.

Key words: Choledoch, choledochal cyst, cecal duplication cyst

ABSTRACT
Klinefelter Syndrome (KS), the most common sex chromosome abnormality in men, is also one of the leading causes of male infertility. Generally, these individuals with 47, XXY karyotype are diagnosed during adulthood, during infertility examinations. In the adolescence period, there may be an increase in height growth rate, euicoid body structure, delay or pause in puberty, gynecomastia, small volume and hardness of the testicles, and less facial and body hair. In this article, an adolescent case who presented with the complaint of rapid stature, was diagnosed with KS, and was diagnosed with KS in the chromosome analysis of 47, XXY, which was performed by suspecting KS with clinical and laboratory data, is presented.

Key words: Klinefelter syndrome, tall, 47, XXY

ABSTRACT
Brunner's gland adenoma is a rare type of duodenum tumor. It is mostly found in the duodenum and varies in shape, number, and size. It is mostly asymptomatic and is discovered by chance during an esophagogastroduodenoscopy. The etiology and pathogenesis are not fully understood. Lipoma, neuroendocrine tumors, lymphoma, adenocarcinoma, GIST, leiomyoma, and carcinoid should all be considered in the differential diagnosis. There is no standard treatment and follow-up algorithm for Brunner's gland adenoma. Lesions in symptomatic patients should be resected endoscopically or surgically.

Key words: Brunner’s gland adenoma, Brunner’s gland hyperplasia, duodenal cancer

ABSTRACT
Portal vein thrombosis (PVT) is defined as a complete or partial occlusion of the portal vein due to a thrombus. The association of PVT with acute cholecystitis is rare, and only a few cases have been reported in the literature. If there is no response to treatment of acute cholecystitis; should be considered serious and rare complications such as PVT. In this case report, we present portal vein thrombosis associated with acute cholecystitis in children.

Key words: Portal vein, thrombosis, acute, cholecystitis, child