Northern Clinics of Istanbul最新文献

Objective: The aim of the study is to investigate the validity and reliability of the "Telemedicine Awareness, Knowledge, Attitude, and Skills (AKAS) of Telemedicine" questionnaire and to convert the questionnaire to Turkish.

Methods: The study is methodological research conducted among medical faculty students and medical residents. For the validity and reliability analysis of the "AKAS of Telemedicine" questionnaire, 425 medical faculty students and medical residents were included in the study, and the sample was 7-10 times the number of questionnaire items. Exploratory factor analysis was performed for construct validity. The test-retest method was engaged to assess reliability. Cronbach's alpha reliability coefficient and the item-total correlation coefficient were calculated for internal consistency. Descriptive statistics were given as mean, standard deviation, median, and first and third quartile values for numerical variables, and numbers and percentages for categorical variables. The Mann-Whitney U test, the Kruskal-Wallis test, and Spearman's correlation coefficient were conducted to evaluate the correlation between variables.

Results: The Cronbach alpha reliability coefficient of the "AKAS of Telemedicine" questionnaire was found to be 0.950, 0.851, 0.970, and 0.952 in the sub-areas, respectively. When an item was removed, the Cronbach alpha reliability coefficient values ranged between 0.826 and 0.969, and no significant difference was detected. As a result of test-retest reliability analysis, a strong positive correlation was found between the total scores (awareness r=0.848, knowledge r=0.792, attitude r=0.787, and skill r=0.816; p<0.001 for each score).

Conclusion: The Turkish form of the "AKAS of Telemedicine" questionnaire is a valid and reliable measurement tool that can be used to evaluate the level of AKAS among physicians. It was concluded that research using the "AKAS of Telemedicine" questionnaire would be useful to determine the telemedicine AKAS levels among Turkiye, particularly in health sector workers.

Fabry disease is a rare genetic disease caused by a deficiency of α-galactosidase A gene (α-Gal A). Two intravenous enzymes administered every two weeks, agalsidase alfa and beta can slow disease progression and increase survival if administered early, before organ damage occurs. In this case report, we present a patient with a history of anaphylaxis to agalsidase beta who was successfully treated with agalsidase alfa.

Although hydatid cyst infects many organs, it most commonly involves liver, lungs, and central nervous system. The goal of hydatid cyst treatment is to completely eliminate the parasite and to prevent recurrences with minimal mortality and morbidity. The procedure of puncture, aspiration, injection of a scolicidal, and reaspiration (PAIR) of a cyst has been introduced as an alternative to surgical method since it is less invasive and less morbid and is associated with a shorter hospital stay and a lower cost. Herein, we report an 11-year-old girl who developed anaphylaxis during the puncture of a hepatic hydatid cyst. The patient who developed anaphylaxis during the PAIR procedure was administered intravenous adrenaline, methyl prednisolone, and antihistaminic medication. She was intubated and provided assisted ventilation using a mechanic ventilator. The child was extubated 4 h after her admission to the pediatric intensive care unit. During follow-up, the contents of her hepatic hydatid cysts were aspirated through a catheter, followed by their irrigation with 20% sodium chloride and re-aspiration. Then, 97% ethyl alcohol was injected into the cyst cavity to make it collapse. The goal of this report was to draw attention to the rare occurrence of anaphylaxis during the PAIR procedure and to stress that clini-cians should be vigilant for this complication.

Objective: Nephrolithiasis is a common cause of kidney insufficiency. Nephrolithiasis is proven to be the result of various biochemical and inflammatory processes that result in crystal formation and subsequent aggregation. Cotinuscoggygria L. (CCog) is a plant extract which has been used as a Turkish remedy for kidney stones. With this study, we planned to evaluate the effects of CCog extract in ethylene glycol (EG)-induced nephrolithiasis model in rats.

Methods: The study group comprised 32 Wistar albino rats which were divided into Control (C), EG, CCog Prophylaxis (CC+EG+CC), and CCog Treatment (EG+CC) groups. Stone formation was induced by adding EG (0.75%) into rat's drinking water. Normal drinking water was given to Control group for 8 weeks. Throughout the study period of 8 weeks, EG group was given only EG (0.75%) and CC+EG+CC group was given both EG and CCog. In EG+CC group, EG (0.75%) was given for 8 weeks whereas CCog was given for the past 4 weeks. After the 8^th week, 24-h urine samples were collected. Rats were then sacrificed and kidney tissue samples were harvested.

Results: Metabolites (calcium, citrate) and creatinine in 24 h urine samples were decreased in CC+EG+CC and EG+CC groups. While hyperoxaluria was observed in the EG group, oxalate levels were similar to control levels in the P-CCog and C-CCog groups. The N-acetyl-β-glucosaminidase and myeloperoxidase activities were both increased in EG group and these parameters were significantly decreased on CCog treatment.

Conclusion: We can conclude that C. coggygria extract can have beneficial effect on lowering concentration of stone-forming metabolites in urine and consequently protect renal tissues from damage due to nephrolithiasis. C. coggygria extract can be considered as a potential prophylactic and therapeutic option in high-risk stone formers. Furthermore, our data confirm ethnobotanical use of CC against nephrolithiasis.

Objective: Genome-length association studies have shown that Gasdermin B (GSDMB) and Orosomucoid-like 3 (ORMDL3) genes located on the long arm of chromosome 17 are associated with asthma. In this study, it was aimed to determine the possible relationship between asthma control test (ACT), exercise provocation test (ECT), and fractional nitric oxide (FENO) levels and GSDMB and ORMDL3 gene expressions.

Methods: 59 asthmatic and 38 non-asthmatic children were included in the study. We divided the patient group into two subgroups as mild persistent asthma (29 patients) and moderate persistent asthma (30 patients). ORMDL3, GSDMB gene expression levels, ECT, total IgE levels, and eosinophil counts were measured in all cases. In addition, ACT and FeNO levels were measured in children with asthma. Afterward, the relationship of ORMDL3 and GSDMB gene expression coefficient changes with ECT, ACT, and FeNO was examined.

Results: When patients with ACT ≤15 were compared with patients with ACT ≥20, ORMDL3 and GSDMB gene expressions were increased 6.74 and 11.74 times, respectively. Comparing patients with ACT ≥20 and ACT ≤15 in terms of coefficient changes (ΔCq), higher change values were observed for ΔCq ORMDL3 in patients with ACT ≤15 (p=0.015). Similarly, when patients with FENO ≤25 ppb were compared with patients with FENO >25 ppb, ORMDL3 and GSDMB gene expressions were increased by 2.93 and 3.56 times, respectively. When the coefficient changes were compared, no significant difference was found between FENO≤25 and FENO >25 patients. There was a slight negative correlation between ΔCq values and ACT score (p=0.003, r=-0.418 for ORMDL3, and p=0.016, r=-0.345 for GSDMB). In addition, we observed a statistically significant positive correlation between ORMDL3 and GSDMB gene expressions (r=0.80, p<0.001).

Conclusion: We showed that increased ORMDL3 and GSDMB gene expression levels may be associated with ACT scores, FeNO and ECT in asthma. These findings may encourage future studies with larger numbers of subjects that can use gene expression levels in various asthma phenotypes for prognostic prediction.

Objective: Cyclin D1 (CDDN1) is a protein required for mitotic cell cycle progression through the G1 phase, as well as a regulatory component of the cyclin-dependent kinases CDK4 and CDK6. In this study, we wanted to evaluate the relationship between CDDN1 expression and clinicopathological features in breast cancer (BC) cases and whether CDDN1 could be used as a prognostic biomarker for BC cases.

Methods: A total of 70 cases, 30 cases each with limited and advanced-stage BC, and as the control group, 10 healthy breast tissue, without a cancer diagnosis, with examined for benign reasons (mammoplasty, breast reduction surgery, etc.) were included in this study. The pathological specimens from the cases were stained, immunohistochemically, and categorized as a "low" (L) group or a "high" (H) group for CDDN1 expression. The cases' clinicopathological features and survival rates were evaluated statistically, within a 95% of confidence interval, p<0.05, retrospectively.

Results: The median follow-up period of the cases was 48.00 (range, 6-150) months. CDDN1 expression was significantly higher in advanced-stage BC cases than in normal breast tissue and limited-stage BC cases. The median overall survival (OS) was 96 months (CI 95%: 67.74-117.59) in the H-CDDN1 group, compared to the L-CDDN1 group not reached, but there was no relation (p>0.05). CDDN1 overexpression was more prominent in low-grade advanced BC cases (p=0.004). The median OS of advanced-stage BC cases with Grade 1 was significantly longer than those with other grades (p=0.04).

Conclusion: Our results suggest that CDDN1 expression can be used as a potentially appropriate positive prognostic biomarker for advanced-stage BC cases.

Objective: The aim of this study was to compare the ultrasonographic thickness of selected major muscles of patients with fibromyalgia syndrome (FMS) and asymptomatic control subjects and to evaluate the relationship between muscle thickness and muscle strength, physical performance, kinesiophobia, and clinical variables.

Methods: Twenty-two FMS patients and 18 asymptomatic control cases who applied to the physical medicine and rehabilitation outpatient clinic were included. The thickness of the gastrocnemius medialis/lateralis, trapezius, and upper arm muscle was evaluated with ultrasonography. Muscle strength was evaluated with hand grip strength, muscle performance with chair stand test (CST), walking performance with 10 m walking test, disease severity with Fibromyalgia Impact Questionnaire-Revised, pain severity with VAS, and kinesiophobia with TAMPA kinesiophobia scale.

Results: The mean thickness values of all the muscles measured were significantly decreased in the FMS group compared with the control (p<0.05). There were positive correlations between gastrocnemius medialis/lateralis and upper arm muscle thickness with hand grip strength (p<0.01, r=0.602, r=0.663, r=0.567, respectively) and positive correlations between gastrocnemius medialis/lateralis muscle thickness with CST (p<0.05, r=0.507, r=0.512, respectively). TAMPA was significantly negatively correlated with gastrocnemius medialis/lateralis and upper arm muscle thickness.

Conclusion: Muscle thickness, strength, and performance decrease in FMS patients. This reduction in muscle strength, performance, and size is associated with kinesiophobia. Strengthening exercises should be included in the management of FMS patients. However, caution should be exercised when prescribing exercises that require extreme muscle performance, considering that it may cause kinesiophobia.

Objective: With the prolongation of the average life expectancy worldwide, diseases including dermatological disorders of the elderly are gaining importance. The presence of comorbidities in this age group may affect the treatment strategies; compliance with follow-up and adherence to medication can be poor. The aim of this study is to evaluate the dermatological disorders of patients aged 65 and over and determine their adherence to dermatologic treatment.

Methods: A retrospective and cross-sectional study was conducted on patients aged 65 and over applied to a single tertiary dermatology clinic between April 2021 and April 2022. Diagnoses were that clinical and diagnostic tests were performed when only necessary.

Results: A total of 207 admissions to the dermatology clinic by 135 patients were evaluated. Eczema (23.05%) and infections (25.2%) were the most common dermatological diagnoses. The percentage of patients with precancerous and cancerous lesions was 11.9%. Among 123 patients who need at least a follow-up visit, only 37 patients (30.1%) applied for follow-up as advised, and medicines were taken regularly by 23 of these patients (62.2%). Compliance with follow-up was lower among men (OR 0.365, 95% CI 0.160-0.834, and p=0.02) and patients who were treated only with local therapy agents (OR 0.345, 95% CI 0.138-0.863, and p=0.20).

Conclusion: Eczema and infections were the most common dermatological diagnoses among geriatric patients in the present study. The majority of geriatric patients with skin conditions were not applying for follow-up visits. Women and patients treated with systemic therapy agents were more compliant. The prevalence of basal cell carcinoma was not low, and this emphasizes the importance of a careful dermatological examination regardless of primary complaint in this age group.

Colorectal cancers (CRCs) have an important share in the prevalence and mortality among all cancers. It was aimed to make a systematic review and meta-analysis of researches about the prevalence of knowing fecal occult blood test (FOBT) and colonoscopy, which are among the CRC screening methods, and the prevalence of having these tests at any time in life. A literature search using five different databases were screened both in Turkish and English language and a total of 1176 studies were reached. Of these, 22 studies were selected to be included in this study. In the evaluation of the researches included in the study, the studies were read in a way to look for answers to PICOS questions. Open Meta-analyst demo program and random effects model was used. The prevalence rate and 95% confidence interval of knowing and having FOBT and colonoscopy were calculated. According to the meta-analysis results, the prevalence of knowing the FOBT among the CRC screening tests was 19.3%, the prevalence of having the FOBT was 13.2%, the prevalence of knowing colonoscopy was 31.7%, and the prevalence of having colonoscopy was 10.0%. As a conclusion prevalence of knowing and having FOBT and colonoscopy was low in risky individuals in Turkiye.

Objective: Acute appendicitis (AA) is the most common cause of acute abdomen and appendectomy is one of the most common surgical procedures. In this study, we aimed to compare open appendectomy (OA) and laparoscopic (LA) surgical techniques in the treatment of AA.

Methods: The data of 236 patients treated with the diagnosis of AA in 2019-2020 were analyzed. Of these patients, 85 patients who received OA and 84 patients who received LA were included in the study. Then, the two groups were compared in terms of demographic, laboratory, clinical, and surgical treatments.

Results: A total of 169 patients were included in the study. The mean age was 34.9 years (range 16-78), and the male-to-female ratio was 0.69. Statistical analysis revealed that the OA group had more leukocytosis, more female gender, and longer operation time than the LA group, but the LA group's complication rate was lower (p<0.05).

Conclusion: LA offers less morbidity, a shorter duration of hospital stay, and a fast return to normal activities compared to OA. In the surgical treatment of AA, LA can be applied as a routine and first-line treatment.