INTRODUCTION:
METHODS:
RESULTS:
DISCUSSION AND CONCLUSION:

GÝRÝÞ ve AMAÇ: Göz içi yabancý cisminin (GÝYC) eþlik ettiði glob yaralanmalarýnda, 23-Gauge (G) pars plana vitrektominin (PPV) anatomik ve cerrahi sonuçlarýný, hastalarýn epidemiyolojik özelliklerini, postoperatif komplikasyonlarý ve fonksiyonel sonuç açýsýndan prognostik faktörleri deðerlendirmek
YÖNTEM ve GEREÇLER: Retrospektif çalýþmamýza, GÝYC’nin eþlik ettiði glob yaralanmasýyla baþvuran, 23-G PPV uygulanmýþ ve en az 12 ay takibi olan 63 hastanýn 63 gözü dahil edildi. Tüm olgularda iþlem öncesinde ve iþlem sonrasý son kontrollerinde en iyi düzeltilmiþ görme keskinliði (EÝDGK) ölçümü, rutin oftalmolojik inceleme yapýldý. Tüm olgulara rutin muayene ile birlikte 2 yönlü kafa grafisi, bilgisayarlý tomografi incelemeleri ve uygun olgulara A-B scan ultrasonografi yapýldý.
BULGULAR: Hastalarýn tamamý erkek olup ortalama yaþ 34.57 ± 12.82 yýl idi. Travma ile PPV arasýnda geçen süre ortalama 12.7±9.3 gün (min-maks: 2-50), ortalama takip süresi 16.8±6.5 ay (min-maks: 12-36) olarak kaydedildi. Preoperatif ve son muayenede ortalama EÝDGK deðerleri 1.50±1.26 logMAR ve 0.63±0.84 logMAR olarak saptanmýþtýr. Preoperatif ve postoperatif EÝDGK’ler karþýlaþtýrýldýðýnda istatistiksel olarak anlamlý bir artýþ görüldü (p=0.001). Regresyon analizinde, preoperatif EÝDGK’nin >1.0 logMAR olmasý (p=0.038), preoperatif proliferatif vitreoretinopati (PVR) varlýðý (p=0.024) ve retinal yerleþimli GÝYC (p=0.005) daha kötü final EÝDGK’ye yol açma açýsýndan anlamlý bulundu.
TARTIÞMA ve SONUÇ: GÝYC’lerde baþvuru anýndaki EÝDGK, preoperatif PVR varlýðý ve yabancý cismin yerleþim yerinin prognostik öneme sahip olduðu izlendi. Arka segment yaralanmalarýnýn eþlik ettiði GÝYC’lerde, 23-G PPV cerrahisi ile anatomik baþarýnýn yanýsýra, görsel fonksiyonlarýn da arttýðý saptandý.

INTRODUCTION: To evaluate the anatomical and surgical results of 23-G pars plana vitrectomy (PPV), the epidemiological features of the cases, the postoperative complications, and prognostic factors in terms of functional outcome in glob injuries accompanied by an intraocular foreign body (IOFB).
METHODS: : In our retrospective study, 63 eyes of 63 patients who applied with globe injury accompanied by IOFB, underwent 23-G PPV and were followed up for at least 12 months were included. In all cases, best corrected visual acuity (BCVA) measurement and routine ophthalmologic examination were performed before and after the procedure. Two-sided cranial radiography, computed tomography examinations and A-B scan ultrasonography were performed along with routine examination, in all cases.
RESULTS: All of the patients were male and the mean age was 34.57 ± 12.82 years. The mean time between trauma and PPV was 12.7 ± 9.3 days (min-max: 2-50), and the mean follow-up time was 16.8 ± 6.5 months (min-max: 12-36). The mean BCVA values in the preoperative and at the last examination were 1.50 ± 1.26 logMAR and 0.63 ± 0.84 logMAR, respectively. When preoperative and postoperative BCVA were compared, a statistically significant increase was observed (p = 0.001). In the regression analysis, having > 1.0 logMAR preoperative BCVA (p = 0.038), presence of preoperative proliferative vitreoretinopathy (PVR) (p = 0.024) and retinal IOFB (p = 0.005) were found to be significant in terms of causing worse final BCVA.
DISCUSSION AND CONCLUSION: It was observed that the BCVA at the time of admission, the presence of preoperative PVR and the location of the foreign body were of prognostic importance in IOFBs. It was determined that 23-G PPV surgery increased visual functions as well as anatomical success in IOFBs accompanied by posterior segment injuries.

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GÝRÝÞ ve AMAÇ: Romatolojik hastalýklarýn tedavisinde biyolojik ajanlarýn faydalarýnýn keþfedilmesinden sonra, kullanýmlarýnýn artmasýyla yan etkilerde de artýþ ortaya çýkmýþtýr. Latent tüberküloz enfeksiyonunun (LTBE) reaktivasyonu ana sorunlardan biri olduðundan, enfeksiyon taramasý biyolojik ajan tedavisinden önce önemli bir adýmdýr. Bu çalýþmanýn temel amacý, kronik inflamatuar artrit tanýsý alan ve biyolojik ajan tedavisinden önce LTBE için tarama yapýlan kiþilerde tüberkülin deri testi (TDT) ve interferon gamma salýným testleri (IGST) arasýndaki uyumun araþtýrýlmasýdýr.
YÖNTEM ve GEREÇLER: Biyolojik tedavi adayý olan kronik inflamatuar artrit tanýlý hastalarýn demografik ve klinik bilgileri, TDT ve IGST sonuçlarý kaydedildi. TDT ve IGST yöntemleri arasýndaki uyumluluk kappa katsayýsý kullanýlarak deðerlendirildi.
BULGULAR: Çalýþmaya dahil edilen toplam 47 hastadan 32’si (%68,1) TDT pozitif, 12’si (%25,5) IGST pozitifti. TDT pozitif olan 32 hastanýn 23’ünde (%48,9) IGST negatif saptanýrken, TDT negatif olan 15 hastanýn 3’ünde (%6,4) IGST pozitif bulundu. Her iki testin sonucu 9 (%19,1) hastada pozitifken, 12 (%25,5) hastada negatif bulundu. IGST ve TDT yöntemlerinin istatistiksel olarak uyumsuz olduðu görüldü (McNemar test: p<0.001), (kappa: 0,060).
TARTIÞMA ve SONUÇ: Çalýþmamýzýn sonuçlarý, IGST’nin kronik inflamatuar artritli hastalarda, özellikle de endemik popülasyonlardaki Bacillus Calmette-Guerin aþýlý bireylerde, biyolojik ajan tedavisine baþlamadan önce LTBE taramasý için TDT’ne göre daha iyi bir seçim olduðunu göstermektedir.

INTRODUCTION: After the discovery of benefits of biologic agents in the management of rheumatologic diseases, with increased use, we are witnessing an increase in side effects also. As the reactivation of latent tuberculosis infection (LTBI) is one of the main concerns, screening for infection is an essential step before treatment with biologic agents. Investigation of the diagnostic agreement between tuberculin skin test (TST) and interferon gamma release assay (IGRA) in chronic inflammatory arthritis diagnosed persons who were screened for LTBI before treatment with biologic agents is the main objective of this study.
METHODS: Clinical and demographic information, TST and IGRA results of patients with chronic inflammatory arthritis who are candidates for biologic therapy were collected for evaluation. The TST and IGRA methods were compared via Kappa coefficient.
RESULTS: A total of 47 included patients, 32 (68.1%) had a positive TST, and 12 (25.5%) had a positive IGRA. Of the 32 TST positive patients, 23 (48.9%) were IGRA negative. Of the 15 TST negative patients, 3 (6.4%) were IGRA positive. For both tests 9 (19.1%) patients were positive and 12 (25.5%) were negative. The McNemar test between the two methods was significant (p<0.001), and concordance between two tests with kappa was 0.060 (standard error = 0.097), both indicating discordance between the two methods.
DISCUSSION AND CONCLUSION: The results of our study suggest that IGRA is a better choice over TST for the screening of LTBI in chronic inflammatory arthritis diagnosed patients before starting the biologic agent treatment, especially in Bacillus Calmette-Guerin vaccination recipients in endemic populations.

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GÝRÝÞ ve AMAÇ: Anal fistül, cerrahi uygulamada sýk görülen bir durumdur. Ýyi huylu seyrine raðmen özellikle komplike fistüllerde tedavisi zordur. Anal fistül ameliyatý, nüks veya kontinans bozukluklarýna neden olabilir. Ýdeal tedavi, düþük inkontinans ve nüks oranlarý saðlamalýdýr. Geleneksel teknikler deðiþken bir baþarý oranýna sahiptir; Olasý risklerle birlikte sonuç, hastanýn anatomisine, fistüle ve hastanýn isteklerine baðlýdýr. Anal fistüller için, insanlara yönelik potansiyel riski en aza indirmek için hayvanlarda çeþitli yeni prosedürler uygulanmalýdýr.
Buhar Ablasyonu (SA), esas olarak insanlarda alt ekstremitelerde varis tedavisinde kullanýlan Lazer Ablasyon (LA) gibi bir uygulamadýr. Bu çalýþmada, sýçanlarda deneysel olarak oluþturulmuþ bir anal fistül modelinde SA tedavisinin etkinliðini deðerlendirmeyi amaçladýk.
YÖNTEM ve GEREÇLER: 16 adet Wistar Albino sýçanýn anüsünde 2 adet fistül traktý oluþturuldu. 30 gün beklendikten sonra traktlarýn birine SA uygulanýrken, diðer trakt kontrol olarak tedavisiz býrakýldý. Deneyin baþlangýcýndan 60 gün sonra hayvanlara ötenazi uygulandý ve perianal bölgeleri çýkarýlmak suretiyle örnekler patolog tarafýndan analiz edildi. Sonuçlarda p <0.05 deðeri anlamlý kabul edildi.
BULGULAR: Çalýþma grubunun %18.8’i tam iyileþmiþ, %31.3’ü orta düzeyde iyileþmiþ, %50’si iyileþememiþ ve Kontrol grubunun %0’ý tam iyileþmiþ, %37.5’i orta düzeyde iyileþmiþ, %62.5’i iyileþememiþ olup, aralarýnda istatistiksel olarak anlamlý bir farklýlýk bulunmamaktadýr (p>0.05).
TARTIÞMA ve SONUÇ: Sýçanlarda oluþan fistüllerin tedavisinde SA' nýn etkinliðini deðerlendirdiðimiz bu çalýþmada, tedavi grubunu kontrol grubu ile karþýlaþtýrdýk. BA grubundaki iyileþme kontrol grubuna göre daha fazlaydý, ancak gruplar arasýnda istatistiksel olarak anlamlý bir fark yoktu.

INTRODUCTION: Anal fistula is a common condition in surgical practice. Despite its benign course, treatment is difficult, especially in complicated fistulas.Anal fistula surgery can cause recurrence or continence disturbances. Ideal treatment should provide low incontinence and recurrence rates. Conventional techniques have a variable success rate; together with the potential risks, the outcome depends on the anatomy of the patient and the fistula and the wishes of the patient. For anal fistulas, various new procedures must be applied in animals to minimize the potential risk to humans.
Steam Ablation (SA) is an application like Laser Ablation (LA), which is mainly used in the treatment of varicose veins in the lower extremities in humans. In this study, we aimed to evaluate the efficacy of SA treatment in an experimentally created anal fistula model in rats.
METHODS: Two fistula tracts were formed in the anus of 16 Wistar Albino rats. After waiting for 30 days, SA was applied to one of the tracts while the other was left untreated as control. The animals were euthanized 60 days after the start of the experiment and the samples were analyzed by the pathologist by removing the perianal regions. Regarding the results, a value of p<0.05 was considered statistically significant.

RESULTS: 18.8% of the study group had a complete recovery, 31.3% had a moderate improvement, 50% did not seem any recover, and none of the control group showed a full recovery, 37.5% had moderate recovery, 62.5% had no recovery, among them There is no statistically significant difference (p> 0.05).
DISCUSSION AND CONCLUSION: In this study, where we evaluated the effectiveness of SA in the treatment of fistulas created in rats, we compared the treatment group with the control group. Improvement in the SA group was greater than in the control group, but there was no statistically significant difference between the groups.

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GÝRÝÞ ve AMAÇ: Bipolar bozukluðun (BB) intihar giriþimi ve eriþkin dikkat-eksikliði/hiperaktivite bozukluðu (DEHB) belirtileri ile iliþkili olduðu bilinmektedir. Biz bu çalýþmada BB tanýlý olup intihar giriþimi öyküsü olan ve olmayan hastalarýn DEHB belirti düzeyini karþýlaþtýrmayý amaçladýk.
YÖNTEM ve GEREÇLER: DSM-5 kriterlerine göre BB tanýsýyla hastanemizde takip edilen hastalar çalýþmaya dâhil edildi. Sosyodemografik veriler elde edildi. Belirti tarama listesi-90-düzenlenmiþ (SCL-90-R), global deðerlendirme ölçeði (GAS), DSM-5 için eriþkin DEHB öz bildirim tarama ölçeði (ASRS-5) ruhsal belirtilerin saptanmasýnda kullanýldý. xxxxxxxxxxxxxxxx Üniversitesi’nden etik kurul onayý alýndý.
BULGULAR: BB tanýsý olup intihar giriþimi öyküsü olanlar (olgu grubu, OG) ve olmayanlar (kontrol grubu, KG) diye iki grup oluþturuldu. Gruplar arasýnda ortalama yaþ (p=0,426), cinsiyet (p=0,757), BB baþlangýç yaþý (p=0,256) ve sigara (paket/yýl) (p=0,084) açýsýndan anlamlý farklýlýk saptanmadý. ASRS-5, GAS ve SCL-90-R’nin alt ölçekleri açýsýndan gruplar arasýnda anlamlý farklýlýklar saptandý (p<0,05). ASRS-5’in ROC eðrisi altýnda kalan alan 0,687 idi (p<0,038; % 95 CI (0,526-0,848)); ASRS-5 için optimal kesme deðeri 23,50 idi ve intihar giriþimi öyküsünü saptamadaki duyarlýlýðý ve özgüllüðü sýrasýyla %23,8 ve %95,2 idi. Ýkili lojistik regresyon analizine göre, intihar giriþimi öyküsü ile ilgili ASRS-5’in duyarlýlýðý %57,1 ve özgüllüðü %71,4 olarak saptandý (p=0.033; -2 Log likelihood=52.94; Nagelkerke R2=0.158).
TARTIÞMA ve SONUÇ: Eriþkin DEHB’ye klinisyenlerin ilgisi son yýllarda artmýþtýr. Bununla birlikte, eriþkin psikiyatri kliniklerinde DEHB belirtileri diðer birçok psikiyatrik belirtiye göre daha az sorgulanmaktadýr. Çalýþmamýzýn bulgularýna göre BB’de intihar giriþimi öyküsü azalmýþ iþlevsellik, artmýþ psikiyatrik komorbidite ve yüksek DEHB belirti düzeyi ile iliþkilidir. Diðer bir ifadeyle DEHB belirti düzeyi ile intihar giriþiminde bulunmuþ olma arasýnda anlamlý bir iliþki saptanmýþtýr. Klinisyenlerin BB tanýlý hastalarda DEHB belirtilerini sorgulamasý olasý intihar giriþimlerinin önüne geçilmesine katký saðlayabilir.

INTRODUCTION: Bipolar disorder (BD) is known to be associated with suicide attempt and adult attention-deficit/hyperactivity disorder (ADHD) symptoms. In this study, we aimed to compare the ADHD symptom levels of patients with bipolar disorder with and without a history of suicide attempt.
METHODS: Patients who were followed up in our hospital with a diagnosis of BD according to DSM-5 criteria were included in the study. Sociodemographic data were obtained. Symptom checklist-90-revised (SCL-90-R),global assessment scale (GAS),adult ADHD self-report screening scale for DSM-5 (ASRS-5) were used to determine mental symptoms.Ethics committee approval was obtained from xxxxxxxxxxxxxxxx University.
RESULTS: Two groups were formed, those with BD with a history of suicide attempt (case group,OG) and those without (control group,CG). There was no significant difference between the groups in terms of mean age (p=0.426),gender (p=0.757),onset age of BD (p=0.256) and smoking (pack/year)(p=0.084). Significant differences were found between the groups in terms of ASRS-5, GAS and SCL-90-R (p<0.05). The area under the ROC curve of ASRS-5 was 0.687 (p<0.038; 95% CI (0.526-0.848));The optimal cut-off value for ASRS-5 was 23.50 and its sensitivity and specificity in detecting a history of suicide attempt were 23.8% and 95.2%, respectively. According to the Binary logistic regression analysis, the sensitivity of ASRS-5 related to the history of suicide attempt was 57.1% and the specificity was 71.4% (p=0.033; -2 Log likelihood=52.94;Nagelkerke R2=0.158).
DISCUSSION AND CONCLUSION: The interest of clinicians in adult ADHD has increased in recent years.However, ADHD symptoms are less questioned than many other psychiatric symptoms in adult psychiatric clinics. According to the findings of our study,the history of suicide attempt in BD is associated with decreased functionality, increased psychiatric comorbidity and high ADHD symptom level.In other words,a significant relationship was found between ADHD symptom level and attempted suicide.Clinicians' questioning of ADHD symptoms in patients with BD may contribute to the prevention of possible suicide attempts.

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GÝRÝÞ ve AMAÇ: Bu çalýþmada, prostat kanserli hastalardaki radikal prostatektomi spesmeninde; prostat biyopsi materyaline kýyasla gleason skorundaki artýþýn, biyokimyasal rekürrensi öngörmedeki etkisini araþtýrmak amaçlanmýþtýr
YÖNTEM ve GEREÇLER: 2012-2018 yýllarý arasýnda radikal prostatektomi prosedürü uygulanan toplam 201 hasta çalýþmaya dahil edildi. Hastalar gleason skoru açýsýndan; Artan, Azalan ve Deðiþmeyen olmak üzere 3 gruba ayrýldý. Bu gruplar pozitif cerrahi sýnýr ve biyokimyasal rekürrens açýsýndan kýyaslandý.
BULGULAR: Gruplar arasýnda yaþ ve prostat biyopsi öncesi PSA deðeri açýsýndan anlamlý fark görülmedi. Artan grupta biyokimyasal rekürrens istatistiksel olarak anlamlý derecede daha fazla iken, pozitif cerrahi sýnýr açýsýndan herhangi bir fark izlenmedi. Çalýþmamýzýn ana sýnýrlayýcý etkeni kýsa takip süresiydi.
TARTIÞMA ve SONUÇ: Radikal prostatektomi sonrasý biyokimyasal rekürrensi öngörmek adýna birçok çalýþma yapýlmýþtýr. Bu çalýþma radikal prostatektomi sonrasý izlenen gleason skor artýþýnýn rekürrensi öngörmede baðýmsýz bir faktör olabileceðini göstermiþtir

INTRODUCTION: In this study, we aimed to investigate the effect of the Gleason score increase in the radical prostatectomy specimen compared to prostate biopsy material on predicting biochemical recurrence.
METHODS: A total of 201 patients who underwent radical prostatectomy between 2012-2018 were included in the study. Patients were assigned to three groups: upgrade, downgrade, and no change in Gleason scores. These groups were compared in terms of positive surgical margins and biochemical recurrence.
RESULTS: There was no statistically significant difference between the groups according to age and pre-biopsy PSA. Biochemical recurrence rate was significantly higher in the upgrade group, while there was no significant difference in positive surgical margins. The main limitation of our study was its short follow-up period.
DISCUSSION AND CONCLUSION: Numerous studies have been conducted to predict biochemical relapse after radical prostatectomy. This study demonstrates that pathological upgrade may be useful as an independent predictor of recurrence.

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GÝRÝÞ ve AMAÇ: Bireylerin beklenen yaþam sürelerinin artmasý kalp cerrahisine aday hasta popülasyonunun yaþ ortalamasýný da arttýrmaktadýr. Özellikle ileri yaþlý hasta grubunda operasyon öncesi risk deðerlendirmesi yapabilmek daha da önem arz etmektedir. Çalýþmamýzda üçüncü basamak kalp cerrahisi merkezimizde 80 yaþ ve üzeri hastalarda uzun yoðun bakým yatýþý için hangi faktörlerin etkili olduðunu ortaya koymayý amaçladýk.
YÖNTEM ve GEREÇLER: 2016 yýlý Ocak ayý ile 2019 yýlý Aralýk ayý arasýnda üçüncü basamak kalp cerrahisi merkezimizde 80 ve üzeri yaþtaki hasta grubuna uygulanan tüm elektif ve acil kardiyak cerrahiler retrospektif olarak analiz edildi. Yoðun bakým yatýþ sürelerinde üç günden az yatýþlar normal süre, üç gün ve üzerindeki yatýþlar uzamýþ yoðun bakým süresi olarak deðerlendirildi. Uzamýþ yoðun bakým süresi olan hasta ile normal yatýþ süresi olan hasta gruplarý aralarýnda karþýlaþtýrýldý.
BULGULAR: Hasta gruplarý karþýlaþtýrýldýðýnda Euroscore II deðeri 3,5 ve üzerinde olan hastalarda uzamýþ yoðun bakým süresi anlamlý oranda yüksek bulunmuþtur (p=0,01). Entübasyon süresi uzayan hastalarda (p<0,001), operasyon türü acil olan hastalarda (p=0,047), diyabet tanýlý hastalarda (p=0,005), preoperatif lökosit (p=0,013) ve nötrofil (p=0,049) yüksekliði olan hastalarda ve kan ürünü replasmaný yapýlan hastalarda (p<0,001) da yoðun bakým yatýþ süresinin uzamýþ olduðu saptanmýþtýr.
TARTIÞMA ve SONUÇ: Çalýþmamýzýn sonuçlarýna göre hastalarýn Euroscore II deðerleri, operasyon türü, DM tanýsý ve preoperatif WBC ve nötrofil deðerlerinin yüksekliði bizlere daha operasyon sürecine girmeden hastanýn uzun yoðun bakým yatýþý olabileceðini göstermektedir. Operasyon sürecinde kan ürünü replasmaný olmasý ve hastanýn entübasyon süresinin uzamasý ise peroperatif dönemde yoðun bakým yatýþýna iliþkin riski ortaya koymaktadýr.

INTRODUCTION: With longer life expectancy, an increase in the avarage age of cardiac surgery patients is expected. Preoperative risk assessment is especially important for octogenarians. Our aim is to determine the risk factors for extended intensive care unit (ICU) stay after cardiac surgery in octogenarians in our tertiary cardiac surgery center.
METHODS: We retrospectively analyzed all patients above 80 years of age who had cardiac surgery between January, 2016 and December, 2019 in our tertiary cardiac surgery center. Patients who stayed more than 3 days in the ICU made up the extended ICU stay group. Groups were compared for demographic and perioperative factors.
RESULTS: Patients with Euroscore II values > 3,5 (p=0,01) were at risk of extended ICU stay. Extended ICU stay was more common in patients with prolonged entubation ( p<0,001), emergency surgery(p=0,047), diabetes(p=0,005), high leukocyte (p=0,013) or neutrophil (p=0,049) counts, and blood transfusion (p<0,001).
DISCUSSION AND CONCLUSION: Patients with higer Euroscore II score, emergency surgery, diabetes, high leukocyte or neutrophil counts are the preoperative risk factors for extended ICU stay. In the perioperstive period, blood transfusion and prolonged entubation increase the risk of extended ICU stay.

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GÝRÝÞ ve AMAÇ: Bu çalýþmanýn amacý anevrizmal subaraknoid kanamalarýn cerrahi kliplenmeden sonra bir yýllýk prognozlarý ve mortalite oranlarýný sunmaktýr.
YÖNTEM ve GEREÇLER: Retrospektif olarak iki ayrý beyin cerrahisi kliniðinde cerrahi olarak kliplenen 75 subaraknoid kanamalý anevrizma olgusu incelenmiþtir. Endovasküler koil uygulanan olgular çalýþmaya alýnmamýþtýr. Hastalarýn klinik durumlarý HuntHess, Fisher ve GKS skalalarý kullanýlarak deðerlendirilmiþtir. Fonksiyonel durumlarý deðerlendirmede modifiye Rankin Skalasý(mRS) kullanýlmýþtýr.
BULGULAR: Deðerlendirilen 75 hastanýn 41(%54.7)’i erkek, 34 (%45.3)’ü kadýn, ortalama yaþlarý 49.4±11.5 idi. Glasgow koma skoru ortalama 14(range: 3-15), Fischer skoru ortalama 2 (range: 1-4) ve HuntHess skoru ise ortalama 2 (range: 1-5) idi. Fischer skalasý ile mortalite oranlarý arasýnda anlamlý iliþki saptandý. Ancak GKS ve HuntHess skorlarý ile prognostic faktörler arasýnda anlamlý iliþki görülmedi. Ayný þekilde yaþ, cinsiyet ve anevrizma lokalizasyonlarýnýnda mortalite iliþkisi görülmedi.
TARTIÞMA ve SONUÇ: Bu çalýþma Fischer skalasý ile mortalite arasýnda iliþki olduðunu göstermiþtir.

INTRODUCTION: The aim of this study was to estimate the prognosis and mortality rates of patients one year after surgical clipping of aneurysmal subarachnoid hemorrhage.
METHODS: This retrospective study included 75 patients treated with surgical clipping in multicenter neurosurgery clinics. Patients who were treated by endovascular coiling were not included in the study. Data related to the clinical status of the patients were obtained from the patient files. The HuntHess, Fisher and GCS scales were evaluated, and relationships between these scales and mortality.
RESULTS: Evaluation was made of 75 patients comprising 41 (54.7%) males and 34 (45.3%) females with a mean age of 49.4±11.5 years. The Glasgow Coma score was determined as median 14 (range, 3-15), the Fisher score as median 2 (range, 1-4) and the HuntHess score as median 2 (range, 1-5). A significant relationship was determined between the Fisher scale and the mortality rate. The GCS and HuntHess scales were not significant prognostic factors for mortality. No significant association was determined between age, gender, aneurysm location and mortality.
DISCUSSION AND CONCLUSION: The results of this study indicate a relationship between the Fisher scale and mortality.

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Kalça ve lomber vertebra problemleri birbirini taklit edebilmektedir. Doðru tedaviyi verebilmek için ayýrýcý tanýyý doðru yapmak önemlidir. Fizik muayene, görüntüleme ve elektrodiagnostik metodlar tanýyý desteklemekte yardýmcý olsa da bel kalça aðrýsýnda kesin bir tanýya ulaþmak her zaman kolay deðildir. Ultrason eþliðinde yapýlan tanýsal enjeksiyonlar bel ve kalça bölgesi aðrýlarýnýn ayýrýcý tanýsýnda baþarý ile uygulanmaktadýr. Burada, her biri Ultrason eþliðinde yapýlan tanýsal enjeksiyonlarla taný almýþ bel-kalça aðrýlý üç vakayý sunmaktayýz.

Hip and lumbar spine problems may mimic one another. The differential diagnosis is important in order to give the proper treatment. Although physical examination, imaging and electrodiagnostic methods help to support diagnosis,it is not always easy to make a definite diagnosis between low back and hip pain. Ultrasound (US) -guided diagnostic injections are successfully used in the differential diagnosis of pain in the low back and hip region. Herein we are presenting three cases with low back and hip pain, each differentially diagnosed with US guided diagnostic injections.

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Ailevi Akdeniz Ateþi, ateþ ile beraber, peritonit, plevrit ve artrit gibi serözal yapýlarýn inflamasyonu ile karakterize, ataklar ile seyreden, otozomal resesif geçiþli kalýtsal bir hastalýktýr. Ataklar sýrasýnda farklý cilt lezyonlarý görülebilmekte ancak en karakteristik olan ve nadir görüleni erizipel benzeri eritemlerdir. Plak þeklindeki bu lezyonlar, çoðunlukla alt ekstremitelerde, ayak bilek dorsal yüzde görülür. Artrit ve hassasiyet eþlik eder. AAA’nin ilk bulgusu olarak ortaya çýktýðý durumlarda, erizipel ya da selilüt þeklinde hatalý tanýlara neden olabilmektedir. Bu yazýda, ön planda yaygýn erizipel benzeri eritemler ile baþvuran 34 yaþýnda erkek hasta sunulmuþtur.

Familial Mediterranean Fever is a autosomal recessive hereditary disorder characterized by fever, inflammation of serous structures such as peritonitis, pleuritis and arthritis. Different skin lesions may be seen throughout exacerbations, but the most characteristic is erysipelas-like erythema. These rare plaque-shaped lesions are mostly seen in the lower extremities, dorsal ankle. Arthritis and increased tenderness accompany it. If the lesion is the first sign of FMF, it may be misdiagnosed as erysipelas or cellulite. In this article, we present a 34-year-old male patient with primary erysipelas like erythema.

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Fibröz displazi (FD), etiyolojisi bilinmeyen nadir görülen benign bir hastalýktýr. Normal medüller kemiðin yapýsal olarak zayýf fibröz kemik dokuyla yer deðiþtirmesi sonucu ortaya çýkan, mezenþimin lokalize benign bir hastalýðýdýr. Hastalýk vücuttaki herhangi bir kemiði tutabilir. Orbital, sfenoid, frontal, etmoid, temporal ve maksiller kemikler kraniyofasiyal bölgenin en sýk tutulan bölgeleridir. FD'de klivus tutulumu son derece sýra dýþý olup daha önce nadiren bildirilmiþtir. Klivus tutulumu baþ aðrýsý, boyun aðrýsý, kraniyoservikal instabilite veya hipoglossal sinir felci ile kendini gösterebilir. FD teþhisi radyolojik görüntüleme bulgularýna dayanýr ve esas olarak yüksek çözünürlüklü Bilgisayarlý tomografi (BT) tercih edilen araçtýr. Bu makalede kontralateral hafif iþitme kaybý ve tinnitus þikayeti ile baþvuran insidental olarak saptanan nadir bir klival FD olgusunun görüntüleme bulgularý sunuldu.

Fibrous dysplasia (FD) is an uncommon benign disorder of unknown etiology. It is a localized benign disease of the mesenchyme, which occurs due to the replacement of normal medullary bone by structurally weak fibrous osseous tissue. The disease can involve any bone in the body. Orbital, sphenoid, frontal, ethmoid, temporal and maxillary bones are the most commonly involved structures of the craniofacial region. Involvement of the clivus in FD is extremely unusual, and has rarely been reported previously. Clivus involvement may present headache, neck pain, craniocervical instability or hypoglossal nerve palsy. Diagnosis of FD is based in the radiological imaging findings and mainly the high-resolution Computed Tomography (CT) is the tool of choice. In this article, imaging findings of an incidentally determined rare clival FD case with contralateral mild hearing loss and tinnitus symptoms are presented.

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Onikofaji,genel populasyonda %20-30 görülen çocukluk döneminde baþlayan yaygýn ve kompulsif bir alýþkanlýktýr.Bedene yönelik tekrarlayan stereotipik bir davranýþ bozuklukluðu olup OKB spektrumunda deðerlendirilmesi muhtemeldir.Onikofaji; izole bir semptom olmayýp eþlik eden psikiyatrik bozukluklar ve stereotipik davranýþlar araþtýrýlarak psikososyal açýdan geniþ bir pencerede, farmakolojik tedavi ve biliþsel davranýþçý terapilerle kronik bir süreç gerektirir. Bu derlemede onikofaji ile ilgili literatür bilgileri gözden geçirilmiþtir.

Onychophagia is a common and compulsive habit that begins in childhood, which is observed in 20-30% of the general population. It is a stereotypic behavioral disorder related to the body and is likely to be evaluated in the OCD spectrum. It is not an isolated symptom and requires a chronic process with pharmacological treatment and cognitive behavioral therapies in a wide psychosocial perspective by investigating accompanying psychiatric disorders and stereotypical behaviors. In this review, literature information about onychophagia is reviewed.

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