GÝRÝÞ ve AMAÇ: Nüks retina dekolmaný olan hastalarda vitreoretinal cerrahinin sonuçlarýný deðerlendirmek ve ilk ameliyatý yapmýþ olan cerraha göre nüks cerrahisinin sonuçlarýný karþýlaþtýrmak.
YÖNTEM ve GEREÇLER: Bu çalýþmada, Ocak 2014 ile Aralýk 2016 tarihleri arasýnda tek cerrah tarafýndan nüks retina dekolmaný tanýsý ile vitrektomi yapýlmýþ olan hastalarýn kayýtlarý geriye dönük olarak tarandý. Cerrahi sonrasý takip süresi en az 12 ay olan hastalar çalýþmaya alýndýlar. Ýlk cerrahisi ayný cerrah tarafýndan yapýlmýþ olan hastalar A grubu, ilk cerrahisi farklý bir cerrah tarafýndan yapýlmýþ olan hastalar ise B grubu adý altýnda deðerlendirildiler. Çalýþmanýn temel sonlaným noktasý 12. aydaki anatomik baþarý oraný idi.
BULGULAR: A grubunda 12 hasta (%20.7) ve B grubunda 46 hasta (%79.3) vardý. Tüm grupta tek ikincil cerrahi sonrasý anatomik baþarý oraný %67.2 idi. A grubunda anatomik baþarý %75.0, B grubunda ise %65.2 idi (p=0.4). Çoklu cerrahiler sonrasý son anatomik baþarýya ise 58 hastanýn 46’sýnda (%77.6) ulaþýldý. Yine son anatomik baþarý A grubunda %91.7, B grubunda ise %73.9 idi (p=0.1).
TARTIÞMA ve SONUÇ: Ýlk cerrahi ile ayný cerrah tarafýndan opere edien nüks retina dekolmaný hastalarýnda anatomik baþarý oraný açýsýndan olumlu olarak yorumlanabilecek bir trend mevcuttu.

INTRODUCTION: To evaluate the outcomes of vitreoretinal surgery in patients with recurrent retinal detachment (RD) and compare whether these outcomes differ regarding the surgeon who carried out the first surgery.
METHODS: The medical records of the recurrent RD patients who underwent vitrectomy between January 2014 and December 2016 were reviewed for this retrospective single-surgeon study. The included patients had a postoperative follow-up period of at least 12 months. If the first surgery was carried out by the same surgeon, then the patients were included in group A, and if the patient was a referral patient and the first surgery was carried out by another surgeon, then the patient was included in group B. Primary outcome measure was the anatomical success at month 12.
RESULTS: There were 12 eyes (20.7%) in group A and 46 eyes (79.3%) in group B. The anatomical success after a single secondary operation was 67.2% in the whole group. It was 75.0% and 65.2% in groups A and B, respectively (p=0.4). Final anatomical success after multiple surgeries was achieved in 46 of the 58 patients (77.6%) in the whole group. The final anatomical success was 91.7% and 73.9% in group A and B, respectively (p=0.1).
DISCUSSION AND CONCLUSION: In conclusion, we detected a positive trend in anatomical outcomes after vitrectomy surgery in the subgroup recurrent RD patients that were operated by the same surgeon who carried out the first operation.

Makale Özeti | Tam Metin PDF

GÝRÝÞ ve AMAÇ: Helikobakter pilori (HP) enfeksiyonu tüm dünyada yaygýn olarak görülmektedir. Bu çalýþmanýn amacý, trombosit indeksleri olan; trombosit sayýsý, ortalama trombosit hacmi (MPV) ve trombosit daðýlým geniþliðinin (PDW) helikobakter pilori tedavisinin izlenmesinde yararlý, ucuz, invaziv olmayan biyobelirteçler olarak rolünü incelemektir.
YÖNTEM ve GEREÇLER: Çalýþmaya, HP pozitifliði, gastroskopik biyopsi ile tespit edilmiþ ve eradikasyon tedavisi verilmiþ toplam 72 hasta dahil edilmiþtir. Bu hastalarýn, tedavi sonrasý eradike olup olmadýðý, gaitada HP antijen testi yapýlarak deðerlendirilmiþtir. Hastalarýn 48’inde eradikasyon saðlandýðý görülmüþ olup, hasta grubunun tedavi öncesi ve sonrasý, demografik verileri ve laboratuvar parametreleri karþýlaþtýrýlmýþtýr.


BULGULAR: Çalýþmaya dahil edilen hastalarýn yaþ ortalamasý 41.1±12.1’di. Hastalarýn 54’ü kadýn, 18’i erkekti. HP eradikasyonu sonrasýnda trombosit sayýsýndan azalma ve PDW’de artýþ saptandý. Aradaki fark istatistiksel olarak anlamlýydý (sýrasý ile p=0.045 ve 0.015). HP eradikasyonu saðlanan hastalarda trombosit lenfosit oraný, nötrofil lenfosit oraný ve MPV açýsýndan anlamlý bir farka rastlamadýk (p>0.05).


TARTIÞMA ve SONUÇ: Çalýþmamýzda HP tedavisi alan ve eradikasyon saðlanan hastalarda, periferik trombosit sayýsýnda azalma ve PDW de artýþ saptadýk. MPV deðerinin ise deðiþmediðini gördük. Birçok saðlýk kuruluþunda çalýþýlabilen ve ucuz bir tetkik olan, trombosit sayýsý ve PDW deðerinin, HP eradikasyon tedavi sürecini takip etmek için kullanýlabilecek yararlý parametreler olabileceðini düþünüyoruz.

INTRODUCTION: Helicobacter pylori infection is common all over the world. The present study aims to have platelet indices; to examine the role of platelet count, mean platelet volume (MPV) and platelet distribution width (PDW) as useful, inexpensive, non-invasive biomarkers for monitoring helicobacter pylori therapy.

METHODS: A total of 72 patients who were determined using helicobacter pylori positivity, gastroscopic biopsy and administered eradication treatment were included in this study. Whether these patients were eradicated after treatment was evaluated by testing helicobacter pylori antigen in stool. Eradication was observed in 48 of the patients, and the demographic data and laboratory parameters of the patient group before and after treatment were compared.

RESULTS: The mean age of the patients included in this study was 41.1±12.1. Of the patients, 54 were female and 18 were male. After Helicobacter pylori eradication, a decrease in platelet count and an increase in PDW were detected. The difference was statistically significant (p=0.045 and 0.015, respectively). We did not find any significant difference concerning platelet lymphocyte ratio, neutrophil-lymphocyte ratio and MPV in patients with Helicobacter pylori eradication (p>0.05).
DISCUSSION AND CONCLUSION: In our study, we found a decrease in the number of peripheral platelets and an increase in PDW in patients receiving helicobacter pylori therapy and eradication. We saw that the MPV value did not change. Our findings suggest that platelet count and PDW value, which can be studied in many health institutions and are an inexpensive test, can be useful parameters that can be used to follow the Helicobacter pylori eradication treatment process.

Makale Özeti | Tam Metin PDF

GÝRÝÞ ve AMAÇ: Menisküs ve bað yýrtýklarýnda, diz fleksiyon ve ekstansiyon kuvvetlerindeki deðiþmeler çok incelenmemiþtir.Kuvvetlerin azalmasý ve birbirlerine oranlarýnýn deðiþmesiyle diz eklemi stabilitesinde bozulmalar olur. Fleksiyon ve ekstansiyon kuvvetlerinin ölçümleri menisküs yýrtýðý için taný koydurabilir araç olabilir mi?
YÖNTEM ve GEREÇLER: Klinik olarak menisküs yýrtýðý öntanýsý konulan ve MRG ile tanýsý onaylanan 45 hasta çalýþma grubunu, diger dizleri ise kontrol grubunu oluþturdu. Ayrýca dizleri saðlam olan yeni 45 hasta ile negatif kontrol grubu oluþturuldu. Kontrol ve negatif kontrol grubundaki dizlerin MRG'leri çekilmedi. Çalýþma ve kontrol grubundaki tüm dizlerin, negatif kontrol grubundaki birer dizin izokinetik egzersiz cihazý ile maksimal fleksiyon ve ekstansiyon kuvvetleri ölçüldü. Kuvvetlerin ölçümü için bir adet Nonius EnRaf R firmasý ürünü, kg birimli, hava basýncýyla çalýþan izokinetik egzersiz aleti kullanýldý. Dizlerdeki diðer patolojiler, aðrýnýn baþlangýcý, süresi, yaþ ve sað sol farklýlýðý deðerlendirmeye alýnmadý. Ýzokinetik kas ölçümlerinin tanýda deðeri olup olmadýðýný araþtýrmak için ROC analizi uygulandý.
BULGULAR: Yýrtýk olan dizlerde ayný hastanýn saðlam dizine göre ekstansiyon kuvvetlerinde %30, fleksiyon kuvvetlerinde ise %17 azalma vardý. Her iki deðer istatistiksel olarak anlamlýydý (p<0.05). Yýrtýðý olan dizlerde fleksiyon/ekstansiyon oraný 0.81 iken saglam dizlerin kuvvet oraný 0,687 idi. Sonuç olarak 32 ekstansiyon extansiyon deðerlerinde 45 hastadan 35’inde, 20 birim fleksiyon deðerlerinde sýrasý ile 45 hastadan 36’sýnda, 45 saðlam dizde ise 35 tanesi yakalanmaktadýr.
TARTIÞMA ve SONUÇ: Menisus yýrtýðý öntanýsý konmuþ dizlerin kas kuvvetindeki deðiþmeler menisküs yýrtýðý tanýsýnýn doðrulanmasýnda kullanýlabilir. Diz kuvvetlerinin diðer patolojilerle ölçülmesi tanýyý kesinleþtirip yaygýnlaþtýrabilir.

INTRODUCTION: Changes in the knee flexor and extensor strengths have not been thoroughly evaluated. When the forces decrease, there are disruptions in the knee joint balance. Could flexor and extensor strength measurements be used as diagnostic tools for meniscal tears?
METHODS: In this study, 45 patients clinically prediagnosed with a meniscal tear and confirmed with MRI were the study group. Their other knees were the control group. New 45 healthy patients were made up a negative control group. In the control and negative control groups, MRI was not taken. The maximal strengths of all knees in Study and Control Group and a series of the negative control Group were measured using Nonius EnRaf R, kg unit and air pressure isokinetic exercise device. Other pathologies in the knees, the onset of pain, duration, age, and left and right differences were not evaluated. Statistical ROC analysis was carried out.
RESULTS: There was a 17% of flexion and 30% of extension reduction in the knee with ruptured meniscus compared with intact knees. Both values were statistically significant (p<0.05). The mean knee flexor/extensor strength ratio in ruptured meniscus, patients was 0.687, while it was higher than 0.81 in other intact knees. As a result, the extension 32 units in 35 out of 45 patients, flexion 20 units in 36 out of 45 patients were affected, respectively, 35 out of 45 healthy knees were affected in other knees.
DISCUSSION AND CONCLUSION: Change in muscle strengths can be used to confirm with a prediagnosed meniscus tear in knees. Measurements of many knee forces with other pathologies can be definitive and widespread in the diagnosis..

Makale Özeti | Tam Metin PDF

GÝRÝÞ ve AMAÇ: Diyabetik nefropati %20-40 arasýnda deðiþen sýklýkla ve yüksek mortalitesi ile diyabetin major komplikasyonlarýndan biridir. Bilinen klasik tedavi yaklaþýmlarý dýþýnda nefropatinin ilerlemesi ve önlenmesi amacýyla deðiþik tedavi modaliteleri gerekmektedir. Bu çalýþmanýn amacý düþük molekül aðýrlýklý heparin olan nadroparinin mikrolabuminüri üzerine etkilerini araþtýrmaktýr.
YÖNTEM ve GEREÇLER: Çalýþmaya dahiliye polikliniði ve servisinden takipli 30-70 yaþlarý arasýnda 44 Tip II Diabetes Mellituslu hasta dahil edildi. Bunlardan rastgele seçilen 22 hastaya 1 ay süreyle LMWH olan nadroparin 3075 IU dozunda günde iki kez deri altý verildi. Diðer 22 hasta kontrol grubu olarak herhangi bir tedavi almadan takip edildi.
BULGULAR: Nadroparin kullanan hastalarýn bazal ve 1 aylýk tedavi sonrasýnda üre (43.2±18.3 ve 34.9±7.9) ve kreatinin (1.13±0.32 ve 0.9±0.3) deðerlerinde anlamlý oranlarda azalma saptanmýþtýr (p<0.05). Bu arada kontrol grubunda bazal ve bir ay sonraki deðerleri arasýnda anlamlý fark saptanmadý (p>0.05). Hastalarýn 1 aylýk tedavi süresi sonrasýnda kreatinin klirensi deðerlerinde istatistiksel olarak anlamlý olmayacak þekilde hafif bir artýþ saptandý (p>0.05). Nadroparin tedavisi sonrasýnda hastalarda %15’lik bir düþüþ saðlansada mikroalbuminürideki deðiþimde (137.6±99.3 ve 116.4±114.1) anlamlý düzeylerde deðildi.
TARTIÞMA ve SONUÇ: Sonuç olarak çalýþmamýzda istatistiksel olarak anlamlý olmasa da LMWH olan nadroparin uygulamasý sonrasýnda mikroalbüminüri seviyelerinde belli oranlarda düþüþ saðlanmýþ olup mikroalbuminürisi bulunan hastalarda standart tedavinin bir parçasý olmasa bile tedavinin yetersiz kaldýðý durumlar da dikkate alýnmasý gerektiðini düþünmekteyiz.

INTRODUCTION: Diabetic nephropathy is one of the major complications of diabetes, with a frequency of 20-40% and high mortality. Different treatment modalities are required for the progression and prevention of nephropathy apart from the conventional treatment approaches. The present study aims to investigate the effects of low molecular weight heparin, Nadroparin on microalbuminuria.
METHODS: Forty-four Type II diabetic patients between the ages of 30-70 who were followed up from the internal medicine outpatient clinic and service were included in this study. Nadroparin, an LMWH for one month, was administered subcutaneously at a dose of 3075 IU to randomly selected 22 patients. The other 22 patients were followed up without any treatment as a control group.
RESULTS: There was a significant decrease in urea (43.2±18.3 and 34.9±7.9) and creatinine (1.13±0.32 and 0.9±0.3) values between basal and after 1-month treatment of Nadroparin (p<0.05). Meanwhile, there was not any significant difference between the basal values and values after in the control group (p>0.05). There was a slight increase in creatinine clearance values after one month of treatment, which was not statistically significant (p>0.05). Although a 15% decrease in patients was achieved after treatment with Nadroparin, the change in microalbuminuria (137.6±99.3 and 116.4±114.1) was not significant.
DISCUSSION AND CONCLUSION: As a result, in our study, although it was not statistically significant, there were a decrease of microalbuminuria levels after the application of Nadroparin with LMWH, and our findings suggest that it should be considered in patients with microalbuminuria, even if it is not a part of standard treatment.

Makale Özeti | Tam Metin PDF

Piriformis sendromu (PS), siyatik sinirin piriformis kasý (PK) seviyesinde sýkýþmasý nedeniyle ortaya çýkan semptomlardan oluþan bir sendromdur. En sýk bildirilen þikayetler (kardinal özellikler) kalça aðrýsý, ipsilateral uylukta yansýyan aðrý ve uzun süreli oturmakla aðrýnýn artmasýdýr. Bu yazýda gluteal aðrý ve siyatalji olmadan peroneal nöropati semptomlarý ile baþvuran ve ultrason rehberliðinde PK enjeksiyonu ile baþarýyla tedavi edilen 64 yaþýnda bir kadýn olgu sunulmuþtur.

Piriformis syndrome (PS) is a syndrome consisting of symptoms that occur due to compression of the sciatic nerve at the level of the piriformis muscle (PM). The most commonly reported complaints (cardinal features) are radiation to the ipsilateral tight, buttock pain, and reproduction of pain on prolonged sitting. In this study, we report a 64 years old female case presented with peroneal neuropathy symptoms without gluteal pain and sciatica and treated using ultrasound-guided PM injection successfully.

Makale Özeti | Tam Metin PDF

Fýçýdaki Adam Sendromu (FAS) birçok hastalýðýn geliþ klinik tablosu olabilir. FAS klinik tablosu ile prezante olan amiyotrofik lateral skleroz (ALS) varyantlarý da vardýr. Hastalarýn ayýrýcý tanýlarýnýn yapýlarak, etyolojik nedenin belirlenmesi hastanýn tedavisi ve prognozu için önemlidir. Burada FAS tablosu ile gelen ve ALS tanýsý konan bir olgu sunulmaktadýr.

Man in the barrel syndrome (MBS) can be the clinical presentation in many diseases. The variants of amyotrophic lateral sclerosis (ALS) may be presented with MBS clinical picture. Determining the etiological cause by making a differential diagnosis is essential for the treatment and prognosis of the disease. Here, a case presented with the MBS clinical picture and diagnosed as ALS is reported.

Makale Özeti | Tam Metin PDF

Multiple miyelom kemiðin en sýk primer tümörü olup, Amerika Birleþik Devletleri’ndeki insidansý 3/100.000’dir. Plazma hücrelerinin monoklonal proliferasyonu ve kemik iliðinin infiltrasyonu ile karakterize osteolitik kemik hasarý meydana getiren bir neoplazidir. Multiple miyelom, Non-Hodgkin lenfomadan sonra en sýk görülen hematolojik habis tümör iken, yaþlý popülasyonda ise en sýk gözlenen primer kemik tümörüdür. Ortopedik þikayetler arasýnda aðrý, patolojik kýrýk, osteoporoz ve spinal kord basýsý yer almaktadýr. Asýl tedaviyi kemoterapi oluþturmaktadýr. Yapýlacak cerrahi giriþim mümkün olduðu kadar minimal olmalý ve kemoterapi olabildiðince erken baþlanmalýdýr. Enfeksiyon riski gözönüne alýnmalýdýr. Bu derlemede multiple miyelomlu hastalarda kemik tutulumunun taný ve tedavisinin özetlenmesi amaçlandý.

Multiple myeloma is the most common primary bone disease. Incidence has been reported as 3/100.000 in the United States. This neoplasia is characterized by osteolytic bone destruction and monoclonal proliferation of plasma cells. Multiple myeloma is the most common haematologic malignancy after Non-Hodgkin lymphoma and the most common primary bone malignancy in elderly population. Orthopaedic complaints include pain, pathologic fracture, osteoporosis, hypercalcemia and spinal cord compression. Chemotherapy constitutes the main treatment. Surgical intervention should be as minimal as possible and chemotherapy should be started as soon as possible. The risk of infection should also be considered. This review aimed to synthesize the diagnosis and treatment of bone involvement in myeloma disease.

Makale Özeti | Tam Metin PDF