Amaç: Alt üriner sistem semptomlarýnýn (AÜSS) görülme sýklýðý yaþlanmayla birlikte artmaktadýr. Erkeklerde AÜSS’nin en sýk nedenlerinden biri benign prostat hiperplazisidir (BPH). AÜSS içinde hayat kalitesini en çok bozan noktüridir. Ancak BPH’nýn cerrahi tedavisi sonrasý noktüri alt gruplarýnda düzelme olup olmadýðý bilinmemektedir. Çalýþmamýzda prostatektomi yapýlan hastalarda alt gruplarýna göre noktüride meydana gelen deðiþiklikleri ve hayat kalitesi üzerine etkilerini inceledik. Yöntem ve Gereçler: Nisan 2006 - Mart 2009 arasýnda kliniðimizde BPH tanýsýyla prostatektomi yapýlan hastalar çalýþmaya dahil edildi. Uluslarasý Kontinans Derneði (ICS)’nin tanýmýna göre gece idrar yapmak için uyanmak noktüri kabul edildi. Noktüri, noktürnal poliüri, gece mesane kapasitesinde azalma, poliüri ve aþýrý aktif mesane olmak üzere 4 gruba ayrýldý. Hastalara ameliyat öncesi ve ameliyat sonrasý üçüncü ayda üç gün iþeme günlüðü doldurtuldu, üroflovmetri yapýlýp, iþeme sonrasý kalan idrar hacmi (PVRÝ) belirlendi, IPSS ve noktüriye özgü hayat kalitesi formu doldurtuldu. Prostat hacimleri abdominal USG ile ölçüldü. Birlikte bulunan kronik hastalýklarý ve kullandýklarý ilaçlar sorgulandý. Bulgular: Çalýþmada prostatektomi sonrasý hastalarýn yarýsýnda noktüride azalma olduðu bulundu (p< 0,001). Noktüri alt gruplarýna göre deðerlendirildiðinde en fazla düzelmenin AAM grubunda olduðu deðerlendirildi. Ayrýca prostatektomi sonrasý noktüri türünün deðiþebildiði saptandý. Sonuç: Prostatektomi öncesi noktüri türünün belirlenmesi noktürideki düzelmeyi tahmin etmek için faydalý olabilir.

Aim: The frequency of lower urinary tract symptoms (LUTS) increase with aging in males. Benign prostatic hyperplasia (BPH) is one of the
most common causes of nocturia in men. Nocturia, which is one of the main symptoms of the LUTS, impairs the quality of life significantly. However, it is not yet known if an improvement in nocturia occurs in patients after undergoing successful surgical treatment for BPH. We aimed to determine the changes that emerge in the number and the types of nocturia according to its subgroups, and the effects this has on the quality of life in men with BPH after surgical treatment. Materials and Methods: Patients with BPH who underwent prosta- tectomy from April 2006 to March 2009 were included in our study. In accordance with the definition made by the International Conti- nence Society (ICS), nocturia was recognized as waking up at night for voiding. We divided our patients into four subgroups of nocturia as follows; polyuria, nocturnal polyuria, reduced bladder capacity at night, and overactive bladder type. The patients were told to keep a diary of voiding for three days three months before and three months after the surgery. Their uroflowmetry and postvoiding urine volumes were recorded. They filled the IPSS and the nocturia specific quality of life (QOL) forms. Prostate volumes were measured with abdominal ultrasonography. The patients’ other chronic diseases and the recent medical treatments they received were recorded. Results: We found that nocturia decreased in half of the whole group of patients after undergoing prostatectomy (p<0.001). When evaluated according to the subgroups of nocturia, the greatest improvement occurred in the AAM group. In addition to this, we found that changes in subtypes of nocturia can occur postoperatively in some patients. Conclusion: The type of nocturia in men should be evaluated in detail before prostatectomy, as this may be of help in predicting possible improvements in nocturia after surgery.

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GÝRÝÞ ve AMAÇ: Bu çalýþmada acil servisimize ambulans ile getirilen hastalarýn demografik özelliklerinin, ambulans ile getirilirken yeterli týbbi tedavinin baþlanýp baþlanmadýðýnýn ve acil servisteki sonlanýmlarýna göre travma merkezi olarak da hizmet veren 3. basamak bir acil servise taþýnma gerekliliðinin analiz edilmesi amaçlandý.


YÖNTEM ve GEREÇLER: Bu çalýþmada; T.C. Saðlýk Bakanlýðý Saðlýk Bilimleri Üniversitesi Adana Numune Eðitim ve Araþtýrma Hastanesi’ ne 01 Mayýs- 31 Ekim 2016 tarihleri arasýnda 112 ambulansý ile getirilen eriþkin hastalarýn analizi prospektif olarak yapýldý. Hastalar cinsiyetlerine, acil servise baþvuru tarih ve günlerine, hastaneye varýþ sürelerine, hangi amaçla getirildiklerine ve alýndýklarý yerlere göre kayýt altýna alýndý. Ambulans ekibinin hastalara uyguladýðý tedavi ve giriþimler incelendi. Ambulans ekibinin ön tanýlarý ve acil serviste konulan tanýlar sýnýflandýrýldý. Hastalarýn sonlanýmlarý deðerlendirildi.
BULGULAR: Çalýþmaya 4976 olgu dâhil edildi. Olgularýn % 51,6’ sý erkek, % 48,4’ü kadýndý. Hastalarýn getirildiði tarih ve saate göre en fazla baþvuru % 21,2 ile mayýs ayýnda, % 15,7 ile cuma gününde ve % 45,5 ile de günün 16: 00-24: 00 saatleri arasýnda idi. Hastalarýn sadece % 21,3’ nün onam alýnarak sevk edildiði saptandý. Ambulansla getirilen hastalarýn en sýk travma nedeniyle taþýndýðý görüldü. Dünya Saðlýk Örgütü’ nün (DSÖ) acil durum tanýmý göz önüne alýndýðýnda getirilen tüm hastalarýn % 53,7’sinin ambulans ile taþýnma endikasyonunun olmadýðý belirlendi. Acil servise ambulansla getirilen hastalarýn % 78’inin acilden taburcu olduðu, % 21’inin yatýrýldýðý ve % 1’ inin ise eksitus olduðu saptandý.
TARTIÞMA ve SONUÇ: Hastane dýþý týbbi personel týbbi müdahale konusunda, 112 komuta kontrol merkezleri ise uygun hasta nakli konusunda yetersizdir. Bu durumun düzeltilebilmesi için hastane öncesi saðlýk personeline sürekli hizmet içi eðitim verilmesi gereklidir. Sevk edilen hastalarda sevk kuralarýna uyulmasý gereksiz sevkleri önemli derecede azaltabilir

INTRODUCTION: In this study, we aimed to analyze the demographic characteristics of patients who were brought to our emergency department by ambulance, whether or not adequate medical treatment had been initiated during transportation, and the necessity of moving to a 3rd stage emergency department which also serves as a trauma center according to the outcomes of said emergency service.


METHODS: In this study, the analysis of adult patients who were brought to the Republic of Turkey Ministry of Health Adana Numune Training and Research Hospital by ambulance between May 1 and October 31 in 2016 was prospectively performed. Patients were recorded according to their gender, their date of admission to the emergency service, the time it took for them to arrive the hospital, the reason why they were initially brought in and where exactly they were taken. The treatment and interventions of the ambulance team were evaluated. The preliminary diagnosis of the ambulance team and the diagnosis of the emergency services were classified, and the outcomes of the patients were evaluated.
RESULTS: 4976 cases were included in the study. 51.6% of the cases were male and 48.4% were female. According to the date and time the patients were brought in, the greatest number of applications was in May with 21.2%, on Fridays with 15.7%, and between 16: 00 and 24: 00 with 45.5%. It was determined that only 21.3 % of the patients were taken with consent. It was found that most of the patients were brought in the emergency services from trauma. According to the description of emergencies, as defined by the World Health Organization (WHO), it was determined that 53.7% of the patients did
not have an indication necessitating ambulance transportation. It was found that 78% of the transferred patients were discharged immediately, 21% were admitted and 1% were exitus.
DISCUSSION AND CONCLUSION: The out of hospital medical personnel and the 112 command and control centers are inadequate in terms of medical intervention and appropriate patient transfer respectively. In order to correct this situation, it is necessary to provide continuous in-service training for pre-hospital healthcare personnel. Adherence to the guidelines of referral can significantly reduce the unnecessary referrals.

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GÝRÝÞ ve AMAÇ: Bu çalýþmada göz rahatsýzlýðý nedeniyle acil göz servisimize baþvuran çocuk hastalarý epidemiyolojik yönden incelemeyi amaçladýk.


YÖNTEM ve GEREÇLER: Haziran 2017 – Ocak 2018 tarihleri arasýnda Saðlýk Bilimleri Üniversitesi Kartal Dr. Lütfi Kýrdar Eðitim ve Araþtýrma Hastanesi Göz Kliniðine acil göz rahatsýzlýðý nedeniyle baþvuran 18 yaþ altý hastalarýn bilgisayar kayýtlarý geriye dönük olarak incelendi. Hastalarýn yaþ, cinsiyet gibi demografik özellikleri, etkilenen göz, hastalýðýn tanýsý, travma sebepleri, travmaya sebep olan materyaller ve tedavi metodlarý SPSS 20 kullanýlarak istatistiksel olarak incelendi.
BULGULAR: Çalýþmamýzda göz acil servisine baþvuran 0-18 yaþ aralýðýndaki 1296 hasta retrospektif olarak incelendi. Kayýtlarý eksik olan hastalar çalýþma dýþý býrakýldý. Çalýþmamýza dahil edilen olgularýn 770’i (%59.4) erkek çocuk, 526’sý (%40.6) kýz çocuk idi. Yaþlarý 0-18 yaþ (ortalama 8.75 ) aralýðýnda olup, en sýk baþvuran yaþ grubunun 0-2 yaþ aralýðýnda olduðu görüldü. En çok etkilenen gözün, %42.8 ile
sol göz olduðu kayýt edilirken, sað gözün etkilenme sýklýðý %39.6 oranýnda, her iki gözün ayný anda etkilenme sýklýðý ise %17.6 oranýnda
izlendi. En sýk baþvuru sebebi konjonktivit (%39.7) olarak saptanýrken ikinci sýrada %24.5’lik oranla göz travmalarý takip etmiþtir. Hastalarýn %97.3’üne medikal tedavi uygulanýrken %2.7‘sinde cerrahi tedavi gerekmiþtir.
TARTIÞMA ve SONUÇ: Acil servise baþvuran çocuk hastalarýn tanýlarý incelendiðinde eriþkinler kadar geniþ bir taný serisi olduðunu gördük. Ayrýca çocuklarýn travmaya maruz kalma ihtimalleri yüksek olduðundan kaza ve yaralanma sýklýðýný azaltmak için hem alýnacak tedbirlerin hem de
eðitimin önemli bir yeri olduðunu düþünmekteyiz.

INTRODUCTION: In this study, our purpose was to evaluate the epidemiological features of pediatric patients with ocular complaints who were admitted to the emergency department of our ophthalmology clinic.


METHODS: The records of pediatric patients under 18 years of age who were admitted to the Health Sciences University Dr. Lütfi Kýrdar Kartal Training and Research Hospital emergency department with ocular complaints between June 2017 and January 2018, were retrospectively analyzed. We evaluated the patients’ demographic characteristics such as age and gender, as well as their affected eye, ocular pathologies, causes of trauma, causative materials, and treatment methods. Data were statistically evaluated with SPSS version 20.0.
RESULTS: In our study, 1296 patients between 0-18 years of age were retrospectively analyzed. Patients with missing records have been
excluded from the study. Of the patients who were included, 770 (59.4%) were male and 526 (40.6%) were female. Among the age range of 0-18 years, the mean was 8.75 years of age, and the majority of cases were in the 0-2 age group. In the greatest number of incidents, the left eye was solely affected with 42.8%, it was the right eye only in 39.6% of the cases, and both eyes were affected in 17.6% of the cases. The most common diagnosis was conjunctivitis (39.7%) and the se- cond most was ocular trauma with a rate of 24.5%. Of the patients, 97.3% were treated with medical therapy, and 2.7% needed surgical therapy.
DISCUSSION AND CONCLUSION: Our study demonstrates that pediatric ophthalmic emer- gency diagnoses are as wide in variety as those of adults. We also think that taking more precautions and providing better education may prove itself crucial in preventing the greater number of ophthal- mic injuries in the pediatric group, which has a high frequency of trauma.

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Baryum sülfat (BS) kullanýmý, düþük osmolalitesi ve önemli bir yan etkisi olmamasý nedeniyle yutma bozukluklarýnýn teþhisinde ve bronþ aspirasyonu sýrasýnda tercih edilen inert bir maddedir. BS; mukozadan emilimi olmadýðý için güvenli kabul edilmekte ve týpta yaygýn olarak kullanýlmaktadýr. BS’nin yanlýþlýkla aspirasyonu sýk görülmekte ve genellikle de sessiz seyir etmektedir. Yoðun bakým ünitesinde (YBÜ) hasta bakýmý sýrasýnda beslenmenin zamaný, hastanýn pozisyonu ve klinik durumunun yakýn takibi ile olasý komplikasyonlarýn azalacaðýný düþünmekteyiz. Bu olgu sunumunda, 75 yaþýnda ve anestezi risk grubu Amerikan Anesteziyolojistler Derneði Skoru 3 olan hastanýn total
tiroidektomi operasyonu sonrasý postoperatif YBÜ’deki beslenmesi sýrasýnda oluþan BS aspirasyonu anlatýldý ve literatürden elde edilen verilerle birlikte tartýþýldý.

Barium sulfate (BS) is an inert substance widely used in the detection of swallowing abnormalities and during bronchial aspirations, due to having no significant side effects and a low osmolality. BS is considered to be safe, as it has no mucosal absorption, and it is widely used in medicine. The accidental aspiration of BS has been recognized frequently, and the course after this event mostly remains silent. Herein, we think that, during patient care in intensive care units (ICU), the time of feeding, the position of the patient and a close follow-up of the clinical
course should decrease the rate of possible complications. In this case report, an incident of BS aspiration during post-operative feeding in the ICU after undergoing total thyroidectomy surgery was described in a 75-year-old patient with the anesthesia risk group American Society of Anesthesiologists score of 3, and a discussion was made in regard to data obtained from the literature.

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Spinal kord içinde yerleþen, içi sývý dolu nöroglial kavitelerden oluþan sirenksler yerleþim yerine göre duysal ve motor semptomlara neden olurlar. Klinik tablonun duysal semptom olmaksýzýn pür motor semptomla ortaya çýkmasý nadir bir durumdur. Burada pür motor semptomlu, duysal yakýnmasý olmayan, alt servikal bölgeden baþlayan ve torakal kord boyunca uzanan sirinks saptanan 38 yaþýnda kadýn olgu sunulmaktadýr.

A syrinx is a fluid-filled neuroglial cavity within the spinal cord which causes sensory and motor symptoms according to its location. It is rare for a clinical presentation to develop with pure motor symptoms, with no sensory symptoms. Herein, we report a case of a 38-year-old woman who had a syrinx extending along the thoracic cord from the lower cervical region, who had motor symptoms and no sensory complaints.

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Kuryeler vasýtasýyla uyuþturucu kaçakçýlýðý tüm dünyada olduðu gibi Türkiye’de de artmaktadýr. Türkiye, kaçakçýlar için hem hedef hem de transit bir ülke konumundadýr. Uyuþturucu maddeler kapsül, kondom, balon veya küçük paketler içerisinde, her biri 8-10 gr gelen, 50-100 pakete bölerek taþýnabilmektedir. Bu paketlerin emilebilir sistemlerde açýlmasý halinde, taþýyýcý kiþiler hýzla hayatýný kaybedebilir ve bu risk birçoðu tarafýndan maddi gerekçelerle göz ardý edilir. Bu sunumda Uluslararasý Ýstanbul Atatürk Havaalaný'nda aktarma sýrasýnda senkop ve kafa travmasý geçiren ve gastrointestinal sistemde rüptüre olmuþ uyuþturucu pa- ketlerinin cerrahi olarak çýkarýldýðý bir uyuþturucu kurye vakamýzý ve literatür özetlerini takdim edeceðiz.

Drug trafficking by the way of body packing is on the rise in Turkey, as well as all over the world. Turkey acts as both an end destination and a country of transit for drug smugglers. Drugs can be carried in capsules, condoms, balloons and small packets, usually divided into 50-100 packs of 8-10 grams each. If these packages are to be ruptured and absorbed in the gastrointestinal tract, it might result in a quick death for the carrier, the risk of which is usually ignored by many for monetary reasons. Herein, along with a review of the literature, we present a case of body packing in which the carrier suffered syncope and head trauma at the Istanbul International Airport during transfer, and needed surgery to
remove ruptured drug capsules.

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Elastofibroma dorsi göðüs duvarýnýn benign karakterde nadir görülen yumuþak doku tümörüdür. Genellikle 40-60 yaþ arasýnda, kadýnlarda daha sýk olmak üzere posterior torasik duvar ile periskapular bölge arasýnda görülür. Çoðunlukla unilateral olmakla birlikte, bilateral de görülebilir. Semptomatik hastalar hareket ile artan omuz aðrýsý veya kronik sýrt aðrýsýndan þikayetçidir. Manyetik rezonans görüntüleme tanýda en faydalý yöntemlerdendir. Semptomatik hastalarda cerrahi tedavide marjinal rezeksiyon uygulanmaktadýr. Elastofibroma dorsi omuz ve
sýrt aðrýsý yakýnmasý ile baþvuran hastalarda ayýrýcý tanýda akýlda bulundurulmalýdýr.

Elastofibroma dorsi is an uncommon, benign, soft tissue tumor which develops in the space between the periscapular region and the posterior thoracic wall. It is usually found in the 40- 60 age range, and mostly in women. Although it is usually unilateral in its manifestation, it may also be bilateral in some cases. Symptomatic patients typically complain from a shoulder pain which is aggravated by movement, or from chronic dorsal pain. Magnetic resonance imaging is one of the most useful diagnostic methods. In the surgical treatment of symptomatic cases, marginal resection is used. Elastofibroma dorsi should be taken into consideration in the differential diagnosis of cases with chronic shoulder and dorsal pain.

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Ön çapraz bað, diz stabilitesinde önemli role sahip olan bir yapýdýr. Ön çapraz bað yaralanmalarý, dizde güvensizlik hissi ve aðrýya neden olmakta; cerrahi tedavi ise bu þikayetleri ortadan kaldýrýp, diz eklemi fonksiyonalitesini tekrar elde etmek amacý ile uygulanmaktadýr. Bu derlemede ön çapraz bað anatomisi ve fonksiyonu ile ön çapraz bað yaralanmasýnda uygulanan güncel tedavi prensipleri ve seçenekleri özetlenmektedir.

The anterior cruciate ligament is a structure with important functions in knee stability. The injuries of the anterior cruciate ligament cause a sense of instability and pain in the knee, and the aim of a surgical intervention is to treat these symptoms and recover the functionality of the knee joint. In this review, the anatomy and the function of the anterior cruciate ligament are summarized, and contemporary treatment principles and options considered.

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