Nephrology specialization, obtained by completing a three-year subspecialty training after internal medicine specialization in Turkey, focuses mainly on diagnosing and treating kidney diseases. For thousands of years before the advent of the nephrology specialty, doctors struggled to diagnose kidney disorders. Nephrology is a term of Greek origin, nephros, meaning "kidney," combined with the suffix -logy, meaning "the study of." The word "kidney" appears for the first time in Turkish in the Orkhon inscriptions as "bögür," which indicates the name of the space between the rib bone and the hip. In the historical periods of Turkish, it is in the form of words meaning "kidney, bögür, böğür, bügür, bögr, yan." Later, in the Ottoman Period, the word “böğrek” was probably used in the sense of kidney by adding the suffix "-ek" to the word “böğür.” Although the term "böğür" is still widely used among the public to associate it with where the organ is located, it is now referred to as "kidney = böbrek". In the history of nephrology, diseases were first tried to be diagnosed and treated with clinical findings and urine analysis. In the 1940s, the basic principles of fluid-electrolyte physiology, homeostasis, the physiopathology of fluid-electrolyte disorders, renal functions, and dysfunctions began to be understood.
{"title":"Turkish Nephrology on the 100th Anniversary of the Republic","authors":"Alparslan Ersoy","doi":"10.46310/tjim.1408413","DOIUrl":"https://doi.org/10.46310/tjim.1408413","url":null,"abstract":"Nephrology specialization, obtained by completing a three-year subspecialty training after internal medicine specialization in Turkey, focuses mainly on diagnosing and treating kidney diseases. For thousands of years before the advent of the nephrology specialty, doctors struggled to diagnose kidney disorders. Nephrology is a term of Greek origin, nephros, meaning \"kidney,\" combined with the suffix -logy, meaning \"the study of.\" The word \"kidney\" appears for the first time in Turkish in the Orkhon inscriptions as \"bögür,\" which indicates the name of the space between the rib bone and the hip. In the historical periods of Turkish, it is in the form of words meaning \"kidney, bögür, böğür, bügür, bögr, yan.\" Later, in the Ottoman Period, the word “böğrek” was probably used in the sense of kidney by adding the suffix \"-ek\" to the word “böğür.” Although the term \"böğür\" is still widely used among the public to associate it with where the organ is located, it is now referred to as \"kidney = böbrek\". \u0000 In the history of nephrology, diseases were first tried to be diagnosed and treated with clinical findings and urine analysis. In the 1940s, the basic principles of fluid-electrolyte physiology, homeostasis, the physiopathology of fluid-electrolyte disorders, renal functions, and dysfunctions began to be understood.","PeriodicalId":23372,"journal":{"name":"Turkish Journal of Internal Medicine","volume":"60 14","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139535116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: The earthquakes in February 2023 in Turkey had a major impact on Turkey's health system, causing damage to hospitals and health centres in the affected areas. Cancer patients are one of the groups that are highly influenced by the disaster. The aim of this study was to evaluate some of the demographic and clinical characteristics of cancer patients who are getting health care in earthquake-affected areas.
Material and Methods: Fifty cancer patients who lived in 11 cities of Turkey affected by the earthquake and were admitted to Gazi University Department of Medical Oncology after the earthquake between 15 February 2023 and 15 March 2023 were included in the study. Data such as demographic characteristics, cancer diagnosis, time of cancer treatment, and earthquake history were taken retrospectively from nationally-linked electronic records (E-nabız).
Results: Breast cancer was the most common diagnosis of these patients. Most of the patients were taking active treatment (60%). Chemotherapy and hormonotherapy were the most common treatment modalities (20% and 18%, respectively). The median delay in the active treatment of 14 cancer patients was 24 days (2-60).
Conclusions: The earthquake disaster has led to important impacts on cancer patients' care in most affected areas. The human, financial and medical resources should be improved. Especially if detailed nationally-linked electronic records are provided, cancer patients will not have difficulty seeking health care. This disaster should be an important stimulus for hospitals and healthcare systems to improve the care of patients during disasters.
{"title":"Earthquake disaster impact on health care of cancer patients: Single center experience","authors":"Oktay ÜNSAL, Ozan YAZICI, Nuriye YILDIRIM ÖZDEMİR, Gözde SAVAŞ, Ahmet ÖZET","doi":"10.46310/tjim.1327111","DOIUrl":"https://doi.org/10.46310/tjim.1327111","url":null,"abstract":"Background: The earthquakes in February 2023 in Turkey had a major impact on Turkey's health system, causing damage to hospitals and health centres in the affected areas. Cancer patients are one of the groups that are highly influenced by the disaster. The aim of this study was to evaluate some of the demographic and clinical characteristics of cancer patients who are getting health care in earthquake-affected areas.
 Material and Methods: Fifty cancer patients who lived in 11 cities of Turkey affected by the earthquake and were admitted to Gazi University Department of Medical Oncology after the earthquake between 15 February 2023 and 15 March 2023 were included in the study. Data such as demographic characteristics, cancer diagnosis, time of cancer treatment, and earthquake history were taken retrospectively from nationally-linked electronic records (E-nabız).
 Results: Breast cancer was the most common diagnosis of these patients. Most of the patients were taking active treatment (60%). Chemotherapy and hormonotherapy were the most common treatment modalities (20% and 18%, respectively). The median delay in the active treatment of 14 cancer patients was 24 days (2-60).
 Conclusions: The earthquake disaster has led to important impacts on cancer patients' care in most affected areas. The human, financial and medical resources should be improved. Especially if detailed nationally-linked electronic records are provided, cancer patients will not have difficulty seeking health care. This disaster should be an important stimulus for hospitals and healthcare systems to improve the care of patients during disasters.","PeriodicalId":23372,"journal":{"name":"Turkish Journal of Internal Medicine","volume":"65 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136133565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: The primary purpose of this study was to determine the frequency of musculoskeletal pain in nurses working in the internal medicine intensive care unit and to determine whether there were differences between nurses working in the internal medicine clinic. In addition, it was aimed to determine the individual and professional risk factors that will cause musculoskeletal pain in nurses working in the internal medicine intensive care unit.
Material and Methods: After evaluating eligibility, 82 volunteer nurses, 36 working in the internal medicine intensive care unit and 46 working in the internal medicine clinic, were included in this single-centre, cross-sectional and descriptive study. The demographic characteristics of the participants, their regular exercise status and the factors related to their working conditions were determined by the questionnaire form created by the researchers.
Results: Musculoskeletal pain was detected in 61.11% of internal medicine intensive care nurses. There was no statistical difference between the internal medicine intensive care and clinical nurses regarding musculoskeletal pain (p>0.05). A statistically significant relationship was found between the situation of changing the patient's clothes and positioning the patient and the occurrence of musculoskeletal pain (p
{"title":"The Frequency of Musculoskeletal Pain in Nurses Working in Internal Medicine Intensive Care Unit and Related Factors","authors":"Aytül COŞAR ERTEM, Uğur ERTEM","doi":"10.46310/tjim.1345172","DOIUrl":"https://doi.org/10.46310/tjim.1345172","url":null,"abstract":"Background: The primary purpose of this study was to determine the frequency of musculoskeletal pain in nurses working in the internal medicine intensive care unit and to determine whether there were differences between nurses working in the internal medicine clinic. In addition, it was aimed to determine the individual and professional risk factors that will cause musculoskeletal pain in nurses working in the internal medicine intensive care unit.
 Material and Methods: After evaluating eligibility, 82 volunteer nurses, 36 working in the internal medicine intensive care unit and 46 working in the internal medicine clinic, were included in this single-centre, cross-sectional and descriptive study. The demographic characteristics of the participants, their regular exercise status and the factors related to their working conditions were determined by the questionnaire form created by the researchers.
 Results: Musculoskeletal pain was detected in 61.11% of internal medicine intensive care nurses. There was no statistical difference between the internal medicine intensive care and clinical nurses regarding musculoskeletal pain (p>0.05). A statistically significant relationship was found between the situation of changing the patient's clothes and positioning the patient and the occurrence of musculoskeletal pain (p","PeriodicalId":23372,"journal":{"name":"Turkish Journal of Internal Medicine","volume":"65 4","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136133679","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mert TOKATLI, Neslihan Nisa GECİCİ, Meral Ilgaz ERGİN, Umit Yavuz MALKAN, Oguz Abdullah UYAROGLU
Primary adrenal lymphoma (PAL) is an extremely rare among the causes of adrenal incidentaloma. Most were diagnosed with adrenal insufficiency and B symptoms (unexplained weight loss, night sweats, fever). This article presented a 57-year-old woman who was investigated for bilateral adrenal masses found incidentally on computed tomography (CT). Physical examination and laboratory tests revealed no evidence of adrenal insufficiency or B symptoms. Only 24-hour urinary metanephrine and normetanephrine excretion were increased. Tumour F-18 fluorodeoxyglucose (FDG) positron emission tomography (PET/CT) scan showed the greatest dimension was 14 cm in the left adrenal mass and the maximum standardized uptake value (SUV max) was 26.1 (relative to mean SUV in the normal liver parenchyma, which was 2). An adrenal biopsy was performed after taking adequate precautions against the possibility of a catecholamine crisis. Histopathology revealed high-grade B-cell lymphoma. Bone marrow involvement and brain metastasis were not observed. She received the R-EPOCH (rituximab, etoposide, prednisone, vincristine, cyclophosphamide, and doxorubicin) regimen and intrathecal methotrexate therapy as central nervous system prophylaxis. The patient responded well to treatment, and close clinical follow-up continues. PAL should always be considered when a bilateral adrenal mass is detected.
{"title":"An Unusual Cause of Bilateral Adrenal Incidentaloma: A Case Report of Primary Adrenal Lymphoma","authors":"Mert TOKATLI, Neslihan Nisa GECİCİ, Meral Ilgaz ERGİN, Umit Yavuz MALKAN, Oguz Abdullah UYAROGLU","doi":"10.46310/tjim.1348432","DOIUrl":"https://doi.org/10.46310/tjim.1348432","url":null,"abstract":"Primary adrenal lymphoma (PAL) is an extremely rare among the causes of adrenal incidentaloma. Most were diagnosed with adrenal insufficiency and B symptoms (unexplained weight loss, night sweats, fever). This article presented a 57-year-old woman who was investigated for bilateral adrenal masses found incidentally on computed tomography (CT). Physical examination and laboratory tests revealed no evidence of adrenal insufficiency or B symptoms. Only 24-hour urinary metanephrine and normetanephrine excretion were increased. Tumour F-18 fluorodeoxyglucose (FDG) positron emission tomography (PET/CT) scan showed the greatest dimension was 14 cm in the left adrenal mass and the maximum standardized uptake value (SUV max) was 26.1 (relative to mean SUV in the normal liver parenchyma, which was 2). An adrenal biopsy was performed after taking adequate precautions against the possibility of a catecholamine crisis. Histopathology revealed high-grade B-cell lymphoma. Bone marrow involvement and brain metastasis were not observed. She received the R-EPOCH (rituximab, etoposide, prednisone, vincristine, cyclophosphamide, and doxorubicin) regimen and intrathecal methotrexate therapy as central nervous system prophylaxis. The patient responded well to treatment, and close clinical follow-up continues. PAL should always be considered when a bilateral adrenal mass is detected.","PeriodicalId":23372,"journal":{"name":"Turkish Journal of Internal Medicine","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136133553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Bone marrow failure is a disease that develops due to different etiologies. Aplastic anaemia (AA) and hypocellular myelodysplastic syndrome (HMDS) are the most common bone marrow failure disorders. Treatment options include supportive therapy, immunosuppressive therapy, and allogeneic hematopoietic stem cell transplantation (allo-HCT). Allo-HCT is the only curative treatment option. This study aimed to retrospectively evaluate the demographic characteristics, treatment, and transplantation results of patients who underwent Allo-HCT for bone marrow failure.
Material and Methods: This single-centre retrospective study enrolled 11 patients (9 with severe AA and 2 with HMDS) who underwent allo-HCT for bone marrow failure. The patients' records until 17.08.2023 were analysed. Age, gender, diagnosis, donor age and gender, type of transplantation, pre-transplant ferritin levels, time to transplantation, volume of infused product, number of CD34+ cells in the infused product, post-transplant engraftment times, discharge time, transplant-related complications, post-transplant follow-up and overall survival times were obtained.
Results: Eleven patients underwent 12 allo-HCTs for bone marrow failure. Seven patients were male, and four were female. The median age was 40, and seven patients were ≥40 years old at the time of transplantation. Eleven transplants were performed from HLA fully matched siblings and one from a 9/10 matched sibling donor. Bone marrow was used as a stem cell source in 8 transplants and peripheral blood in 4 transplants. The conditioning regimen was fludarabine/cyclophosphamide/anti-thymocyte globulin in all patients. The median time from diagnosis to transplantation was five months. The median time for neutrophil engraftment was 23 days. The median platelet >20.000/mm3 engraftment time was 16 days. A statistically significant positive correlation was found between ferritin levels and platelet >20.000/mm3 engraftment (days) (r=0.653, p=0.040) and platelet >50.000/mm3 engraftment (days) (r=0.720, p=0.029). There was a statistically significant negative correlation between the number of infused CD34 positive cells (10⁶/kg) and platelet >50.000/mm3 engraftment (days) (r=-0.670, p=0.024). Patients were discharged in a median of 23 days. Acute graft versus host disease (GvHD) was observed in one patient, while chronic GvHD was not observed in any patient. The median overall survival time was 48 months, and the median post-transplant follow-up was 37 months. Secondary malignancy and MDS were not detected in any patient during the follow-up period. All 11 patients who underwent Allo-HCT from a matched sibling donor are alive and continue to have a complete hematological response. There was no increase in mortality and morbidity in patients aged 40 years and older.
Conclusions: In patients with severe AA and high-risk HMDS without comorbidities between the ages of 40 and 50, allo-HCT should be consider
{"title":"Retrospective Evaluation of Patients Who Underwent Allogeneic Stem Cell Transplantation for Bone Marrow Failure","authors":"Tuba ERSAL, Vildan OZKOCAMAN","doi":"10.46310/tjim.1359793","DOIUrl":"https://doi.org/10.46310/tjim.1359793","url":null,"abstract":"Background: Bone marrow failure is a disease that develops due to different etiologies. Aplastic anaemia (AA) and hypocellular myelodysplastic syndrome (HMDS) are the most common bone marrow failure disorders. Treatment options include supportive therapy, immunosuppressive therapy, and allogeneic hematopoietic stem cell transplantation (allo-HCT). Allo-HCT is the only curative treatment option. This study aimed to retrospectively evaluate the demographic characteristics, treatment, and transplantation results of patients who underwent Allo-HCT for bone marrow failure.
 Material and Methods: This single-centre retrospective study enrolled 11 patients (9 with severe AA and 2 with HMDS) who underwent allo-HCT for bone marrow failure. The patients' records until 17.08.2023 were analysed. Age, gender, diagnosis, donor age and gender, type of transplantation, pre-transplant ferritin levels, time to transplantation, volume of infused product, number of CD34+ cells in the infused product, post-transplant engraftment times, discharge time, transplant-related complications, post-transplant follow-up and overall survival times were obtained.
 Results: Eleven patients underwent 12 allo-HCTs for bone marrow failure. Seven patients were male, and four were female. The median age was 40, and seven patients were ≥40 years old at the time of transplantation. Eleven transplants were performed from HLA fully matched siblings and one from a 9/10 matched sibling donor. Bone marrow was used as a stem cell source in 8 transplants and peripheral blood in 4 transplants. The conditioning regimen was fludarabine/cyclophosphamide/anti-thymocyte globulin in all patients. The median time from diagnosis to transplantation was five months. The median time for neutrophil engraftment was 23 days. The median platelet >20.000/mm3 engraftment time was 16 days. A statistically significant positive correlation was found between ferritin levels and platelet >20.000/mm3 engraftment (days) (r=0.653, p=0.040) and platelet >50.000/mm3 engraftment (days) (r=0.720, p=0.029). There was a statistically significant negative correlation between the number of infused CD34 positive cells (10⁶/kg) and platelet >50.000/mm3 engraftment (days) (r=-0.670, p=0.024). Patients were discharged in a median of 23 days. Acute graft versus host disease (GvHD) was observed in one patient, while chronic GvHD was not observed in any patient. The median overall survival time was 48 months, and the median post-transplant follow-up was 37 months. Secondary malignancy and MDS were not detected in any patient during the follow-up period. All 11 patients who underwent Allo-HCT from a matched sibling donor are alive and continue to have a complete hematological response. There was no increase in mortality and morbidity in patients aged 40 years and older.
 Conclusions: In patients with severe AA and high-risk HMDS without comorbidities between the ages of 40 and 50, allo-HCT should be consider","PeriodicalId":23372,"journal":{"name":"Turkish Journal of Internal Medicine","volume":"75 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136133677","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Talat AYKUT, Hakan OZER, İsmail BALOĞLU, Fatih SAÇKAN, Kültigin TÜRKMEN
Objective: The role of immunological evaluation is significant in selecting a suitable donor to reduce post-transplant complications in kidney transplantation (KTx). It is unknown how often donor-specific antibody (DSA) positivity causes rejection or how often rejection will develop in patients who do not develop DSA positivity. We aimed to evaluate the relationship between the DSA changes and the KTx patients' biochemical parameters.
Methods: The study was a cross-sectional study evaluating 45 KTx patients. Demographic and clinical characteristics of the patients, pre-transplant DSA values, post-transplant DSA values, and biochemical parameters were retrospectively scanned from the hospital system. The patients' data were divided into three groups according to DSA changes.
Results: DSA was negative in 21 (46%) patients and positive in 24 (54%) before transplantation. In the post-transplant follow-up, it was observed that the DSA value became positive in 7 patients and turned negative in 9 patients. Rejection developed in 22% of 9 patients whose DSA was positive before transplantation and turned negative after transplantation, and in 28% of 7 patients turned positive from negative. Estimated glomerular filtration rate (e-GFR) and creatinine levels in the post-transplant period were associated with the change in DSA. Also, e-GFR and neutrophil values were independently associated with rejection.
Conclusions: Although DSA change affects kidney functions, we found that DSA positivity alone cannot predict rejection, and rejection may occur in the DSA-negative group. Neutrophil count and e-GFR changes were closely related to rejection. Therefore, DSA levels should be monitored regularly, but DSA change alone is insufficient for rejection evaluation.
{"title":"What Do Donor-Specific Antibody Changes Mean in Kidney Transplant Patients?","authors":"Talat AYKUT, Hakan OZER, İsmail BALOĞLU, Fatih SAÇKAN, Kültigin TÜRKMEN","doi":"10.46310/tjim.1249847","DOIUrl":"https://doi.org/10.46310/tjim.1249847","url":null,"abstract":"Objective: The role of immunological evaluation is significant in selecting a suitable donor to reduce post-transplant complications in kidney transplantation (KTx). It is unknown how often donor-specific antibody (DSA) positivity causes rejection or how often rejection will develop in patients who do not develop DSA positivity. We aimed to evaluate the relationship between the DSA changes and the KTx patients' biochemical parameters.
 Methods: The study was a cross-sectional study evaluating 45 KTx patients. Demographic and clinical characteristics of the patients, pre-transplant DSA values, post-transplant DSA values, and biochemical parameters were retrospectively scanned from the hospital system. The patients' data were divided into three groups according to DSA changes.
 Results: DSA was negative in 21 (46%) patients and positive in 24 (54%) before transplantation. In the post-transplant follow-up, it was observed that the DSA value became positive in 7 patients and turned negative in 9 patients. Rejection developed in 22% of 9 patients whose DSA was positive before transplantation and turned negative after transplantation, and in 28% of 7 patients turned positive from negative. Estimated glomerular filtration rate (e-GFR) and creatinine levels in the post-transplant period were associated with the change in DSA. Also, e-GFR and neutrophil values were independently associated with rejection.
 Conclusions: Although DSA change affects kidney functions, we found that DSA positivity alone cannot predict rejection, and rejection may occur in the DSA-negative group. Neutrophil count and e-GFR changes were closely related to rejection. Therefore, DSA levels should be monitored regularly, but DSA change alone is insufficient for rejection evaluation.","PeriodicalId":23372,"journal":{"name":"Turkish Journal of Internal Medicine","volume":"5 3","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136133564","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Burcu YAĞIZ, Belkıs Nihan COŞKUN, Orkun SAKAR, Hüseyin Ediz DALKILIÇ, Yavuz PEHLİVAN
Background: This study aims to assess pregnant women's maternal and fetal outcomes with Takayasu’s arteritis (TA).
Material and Methods: The study comprised ten pregnant women at the time of diagnosis or afterwards among the 50 patients diagnosed with TA between 2003 and 2021. Twenty-one pregnancy outcomes of 10 patients were obtained from hospital records and telephonic interviews. Two pregnancies were excluded due to timing before diagnosis.
Results: Based on the angiographic classification, six patients had type 1, two had type 2b, and two had type 1+4 TA. 63.15% of pregnancies were planned, and the rheumatologist approved 42.10%. Live birth occurred in 16 (84.2%) of 19 pregnancies, three pregnancies (15.7%) resulted in abortion and two (10.5 %) of 19 pregnancies ended in neonatal death. In five (26.3%) of the 19 pregnancies, the disease was activated during pregnancy. Two neonatal deaths were from the two patients diagnosed with preeclampsia during pregnancy. Pre-existing hypertension and active disease are shared features of these two patients. After one year of follow-up, six pregnancies (31.5%) had active disease, and four (66.6%) had active disease both before and during pregnancy. While fetal data analysis revealed no congenital anomalies, four pregnancies resulted in low birth weight and intrauterine growth retardation (21.05%).
Conclusions: The risk of developing preeclampsia and neonatal death should be considered, especially in TA patients with pre-existing hypertension who become pregnant during active disease.
{"title":"Maternal and fetal outcomes in pregnant women with Takayasu’s arteritis: single center experience over ten years","authors":"Burcu YAĞIZ, Belkıs Nihan COŞKUN, Orkun SAKAR, Hüseyin Ediz DALKILIÇ, Yavuz PEHLİVAN","doi":"10.46310/tjim.1290999","DOIUrl":"https://doi.org/10.46310/tjim.1290999","url":null,"abstract":"Background: This study aims to assess pregnant women's maternal and fetal outcomes with Takayasu’s arteritis (TA).
 Material and Methods: The study comprised ten pregnant women at the time of diagnosis or afterwards among the 50 patients diagnosed with TA between 2003 and 2021. Twenty-one pregnancy outcomes of 10 patients were obtained from hospital records and telephonic interviews. Two pregnancies were excluded due to timing before diagnosis.
 Results: Based on the angiographic classification, six patients had type 1, two had type 2b, and two had type 1+4 TA. 63.15% of pregnancies were planned, and the rheumatologist approved 42.10%. Live birth occurred in 16 (84.2%) of 19 pregnancies, three pregnancies (15.7%) resulted in abortion and two (10.5 %) of 19 pregnancies ended in neonatal death. In five (26.3%) of the 19 pregnancies, the disease was activated during pregnancy. Two neonatal deaths were from the two patients diagnosed with preeclampsia during pregnancy. Pre-existing hypertension and active disease are shared features of these two patients. After one year of follow-up, six pregnancies (31.5%) had active disease, and four (66.6%) had active disease both before and during pregnancy. While fetal data analysis revealed no congenital anomalies, four pregnancies resulted in low birth weight and intrauterine growth retardation (21.05%).
 Conclusions: The risk of developing preeclampsia and neonatal death should be considered, especially in TA patients with pre-existing hypertension who become pregnant during active disease.","PeriodicalId":23372,"journal":{"name":"Turkish Journal of Internal Medicine","volume":"54 2","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136133678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kağan GÖKÇE, Aşkın Sena AKÇAY, Demet DOĞAN, Ahmet MİDİ, Ayşe Nimet KARADAYI
Cystic lymphangiomas are benign lesions originating from lymphatic endothelial cells. It occurs due to developmental anomalies of lymphatic vessels. They are usually localized in the head and neck region. Cystic lymphangiomas of adrenal origin are very rare. This presentation aims to report a case of left-sided adrenal cystic lymphangioma detected incidentally on radiological examination due to abdominal pain, with clinical, radiological, and pathological findings. A 65-year-old female patient was admitted to our clinic with abdominal pain. In the abdominal examination, the pain was detected in the epigastric region and left the upper quadrant with palpation. No pathology was observed in the complete blood count and biochemical parameters, except for a CRP elevation of 10.2 mg/dL. In examination with ultrasonography (US), in the left upper quadrant of the abdomen, in the localization of the adrenal gland, a multilocular cystic lesion with partially dense contents, which is not vascularised by Doppler US, containing thin echogenic septa was detected. Enhanced contrast multidetector computed tomography was performed to determine the nature and characterization of the mass. A 60x57 mm cystic lesion with multi-lobulated contour and fluid density was defined in the left adrenal gland. The patient was diagnosed with cystic lymphangioma radiologically and was operated upon due to symptoms and size. Pathological diagnosis was reported as cystic lymphangioma. Preoperative clinical and radiological correct diagnosis is critical because the treatment approach and prognosis may differ from other adrenal tumors or cysts.
{"title":"Adrenal Cystic Lymphangioma with Radiological, Clinical and Histopathological Findings, Case report.","authors":"Kağan GÖKÇE, Aşkın Sena AKÇAY, Demet DOĞAN, Ahmet MİDİ, Ayşe Nimet KARADAYI","doi":"10.46310/tjim.1336374","DOIUrl":"https://doi.org/10.46310/tjim.1336374","url":null,"abstract":"Cystic lymphangiomas are benign lesions originating from lymphatic endothelial cells. It occurs due to developmental anomalies of lymphatic vessels. They are usually localized in the head and neck region. Cystic lymphangiomas of adrenal origin are very rare. This presentation aims to report a case of left-sided adrenal cystic lymphangioma detected incidentally on radiological examination due to abdominal pain, with clinical, radiological, and pathological findings. A 65-year-old female patient was admitted to our clinic with abdominal pain. In the abdominal examination, the pain was detected in the epigastric region and left the upper quadrant with palpation. No pathology was observed in the complete blood count and biochemical parameters, except for a CRP elevation of 10.2 mg/dL. In examination with ultrasonography (US), in the left upper quadrant of the abdomen, in the localization of the adrenal gland, a multilocular cystic lesion with partially dense contents, which is not vascularised by Doppler US, containing thin echogenic septa was detected. Enhanced contrast multidetector computed tomography was performed to determine the nature and characterization of the mass. A 60x57 mm cystic lesion with multi-lobulated contour and fluid density was defined in the left adrenal gland. The patient was diagnosed with cystic lymphangioma radiologically and was operated upon due to symptoms and size. Pathological diagnosis was reported as cystic lymphangioma. Preoperative clinical and radiological correct diagnosis is critical because the treatment approach and prognosis may differ from other adrenal tumors or cysts.","PeriodicalId":23372,"journal":{"name":"Turkish Journal of Internal Medicine","volume":"74 6","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136133552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ahmet Bilgehan ŞAHİN, Safiye BAKKAL, Saide GÜLLÜLÜ, Ayşegül ORUÇ, Abdülmecit YILDIZ, Mehmet Fethullah AYDIN, Alparslan ERSOY, Gökhan OCAKOĞLU, Mustafa GÜLLÜLÜ
Background: Serum protein electrophoresis (SPEP) is an easy test separating serum proteins based on their physical and chemical properties. Although it is frequently used in the differential diagnosis of multiple myeloma and various chronic inflammatory diseases, its value in the etiologic classification of glomerular diseases has yet to be studied.
Material and Methods: We retrospectively reviewed the medical records of patients who underwent renal biopsy from 2008 to 2016 at our institution. We excluded patients who can not be classified as primary (PGn) or secondary glomerulonephritis (SGn). Univariate and multivariate logistic regression analyses were performed for the prediction of SGn.
Results: Four hundred thirty-two patients were included in the study. Of those, 57.9% had PGn. Rheumatological diseases, malignancies, and infections were the most common etiologic causes of SGn, accounting for nearly 75%. Univariate analysis revealed that alpha-1 (α1), gamma (Ɣ), and albumin fractions significantly differ between PGn and SGn groups. ROC curve analysis determined the cut-off value of (α1*Ɣ)/albumin ratio as 1.48. Multivariate analysis revealed that total serum protein and (α1*Ɣ)/albumin ratio were significantly independent predictors for SGn (p=0.020 and p
{"title":"An underestimated old friend: Serum protein electrophoresis in the differential diagnosis of glomerulopathies","authors":"Ahmet Bilgehan ŞAHİN, Safiye BAKKAL, Saide GÜLLÜLÜ, Ayşegül ORUÇ, Abdülmecit YILDIZ, Mehmet Fethullah AYDIN, Alparslan ERSOY, Gökhan OCAKOĞLU, Mustafa GÜLLÜLÜ","doi":"10.46310/tjim.1358169","DOIUrl":"https://doi.org/10.46310/tjim.1358169","url":null,"abstract":"Background: Serum protein electrophoresis (SPEP) is an easy test separating serum proteins based on their physical and chemical properties. Although it is frequently used in the differential diagnosis of multiple myeloma and various chronic inflammatory diseases, its value in the etiologic classification of glomerular diseases has yet to be studied.
 Material and Methods: We retrospectively reviewed the medical records of patients who underwent renal biopsy from 2008 to 2016 at our institution. We excluded patients who can not be classified as primary (PGn) or secondary glomerulonephritis (SGn). Univariate and multivariate logistic regression analyses were performed for the prediction of SGn. 
 Results: Four hundred thirty-two patients were included in the study. Of those, 57.9% had PGn. Rheumatological diseases, malignancies, and infections were the most common etiologic causes of SGn, accounting for nearly 75%. Univariate analysis revealed that alpha-1 (α1), gamma (Ɣ), and albumin fractions significantly differ between PGn and SGn groups. ROC curve analysis determined the cut-off value of (α1*Ɣ)/albumin ratio as 1.48. Multivariate analysis revealed that total serum protein and (α1*Ɣ)/albumin ratio were significantly independent predictors for SGn (p=0.020 and p","PeriodicalId":23372,"journal":{"name":"Turkish Journal of Internal Medicine","volume":"15 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136133554","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Contrast-enhanced imaging studies are widely used to diagnose and follow up acute cerebrovascular diseases. Exposure to contrast media may lead to nephropathy. This study investigated the incidence of contrast-induced acute kidney injury during intensive care follow-up of patients who underwent aneurysmal subarachnoid haemorrhage surgery and the impact of this condition on patient outcomes.
Material and Methods: Patients >18 years of age with no known renal injury and admitted to the intensive care unit after Fisher Grade IV aneurysmal subarachnoid haemorrhage and surgery between January 2017 and June 2022 were retrospectively analysed. Renal injury was defined as a renal injury occurring within 48 hours of exposure to contrast media in line with the Kidney Disease Improving Global Outcomes criteria.
Results: Among the 85 patients with subarachnoid haemorrhage who received at least one contrast medium, the mean age was 55, and 40% were female. 11.8% of the patients were found to have early acute kidney injury and were non-oliguric. At 48 hours, six, three, and one patients had Stage 1, 2, and 3 injuries, respectively. None of the patients required renal replacement therapy. Patients received a mean of 2 mL/kg/h saline infusion after contrast media administration and had a mean arterial pressure of 93.6 mmHg. There was no association between acute kidney injury and comorbidities, Glasgow coma scale, or APACHE II scores.
Conclusions: The study found that the incidence of contrast-induced acute kidney injury was low and transient in patients followed at the ICU after aneurysmal subarachnoid haemorrhage (Fisher Grade IV) surgery. Adequate hydration and hemodynamic stability were found to be effective in reducing acute kidney injury in these patients.
{"title":"Contrast-Induced Acute Kidney Injury in Patients Followed at the Intensive Care Unit after Aneurysmal Subarachnoid Haemorrhage (Fisher Grade IV) Surgery:A Retrospective Study","authors":"Hamide Ayben KORKMAZ, Rıfat AKDAĞ, İlkay CEYLAN","doi":"10.46310/tjim.1358676","DOIUrl":"https://doi.org/10.46310/tjim.1358676","url":null,"abstract":"Background: Contrast-enhanced imaging studies are widely used to diagnose and follow up acute cerebrovascular diseases. Exposure to contrast media may lead to nephropathy. This study investigated the incidence of contrast-induced acute kidney injury during intensive care follow-up of patients who underwent aneurysmal subarachnoid haemorrhage surgery and the impact of this condition on patient outcomes.
 Material and Methods: Patients >18 years of age with no known renal injury and admitted to the intensive care unit after Fisher Grade IV aneurysmal subarachnoid haemorrhage and surgery between January 2017 and June 2022 were retrospectively analysed. Renal injury was defined as a renal injury occurring within 48 hours of exposure to contrast media in line with the Kidney Disease Improving Global Outcomes criteria.
 Results: Among the 85 patients with subarachnoid haemorrhage who received at least one contrast medium, the mean age was 55, and 40% were female. 11.8% of the patients were found to have early acute kidney injury and were non-oliguric. At 48 hours, six, three, and one patients had Stage 1, 2, and 3 injuries, respectively. None of the patients required renal replacement therapy. Patients received a mean of 2 mL/kg/h saline infusion after contrast media administration and had a mean arterial pressure of 93.6 mmHg. There was no association between acute kidney injury and comorbidities, Glasgow coma scale, or APACHE II scores.
 Conclusions: The study found that the incidence of contrast-induced acute kidney injury was low and transient in patients followed at the ICU after aneurysmal subarachnoid haemorrhage (Fisher Grade IV) surgery. Adequate hydration and hemodynamic stability were found to be effective in reducing acute kidney injury in these patients.","PeriodicalId":23372,"journal":{"name":"Turkish Journal of Internal Medicine","volume":"21 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136133551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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