Pub Date : 2023-09-29DOI: 10.4274/bmj.galenos.2023.2023.5-9
Gürkan Berikol, Uzay Erdoğan
Objective: The surgical decision in scoliosis patients exhibits variability based on angle parameters and the characteristics of patients in the adult or adolescent age group. Existing studies demonstrate that the Cobb’s angle, particularly in the range of 25-45, shapes the surgical decision depending on the measures and characteristics of the patients. This study evaluated the performance of a fuzzy logic-based decision support system in making surgical decisions
{"title":"Adolescent Idiopathic Scoliosis Surgery Decision Making with Fuzzy Model","authors":"Gürkan Berikol, Uzay Erdoğan","doi":"10.4274/bmj.galenos.2023.2023.5-9","DOIUrl":"https://doi.org/10.4274/bmj.galenos.2023.2023.5-9","url":null,"abstract":"Objective: The surgical decision in scoliosis patients exhibits variability based on angle parameters and the characteristics of patients in the adult or adolescent age group. Existing studies demonstrate that the Cobb’s angle, particularly in the range of 25-45, shapes the surgical decision depending on the measures and characteristics of the patients. This study evaluated the performance of a fuzzy logic-based decision support system in making surgical decisions","PeriodicalId":321087,"journal":{"name":"Medical journal of Bakirköy","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135243234","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}
Pub Date : 2023-09-29DOI: 10.4274/bmj.galenos.2023.2023.8-13
Hakan Polat, Deniz Noyan Özlü
{"title":"Appropriateness of the Empirical Antibiotherapy Choices of Primary Care Physicians for the Treatment of Uncomplicated Cystitis","authors":"Hakan Polat, Deniz Noyan Özlü","doi":"10.4274/bmj.galenos.2023.2023.8-13","DOIUrl":"https://doi.org/10.4274/bmj.galenos.2023.2023.8-13","url":null,"abstract":"","PeriodicalId":321087,"journal":{"name":"Medical journal of Bakirköy","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135243870","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}
Pub Date : 2023-09-29DOI: 10.4274/bmj.galenos.2023.2023.8-7
Necmiye Ay, Duygu Akyol, Funda Gümüş Özcan
{"title":"Evaluation of the Effectiveness of Transversus Abdominis Plane Block and Transversalis Fascia Plane Block in Postoperative Analgesia in Pediatric Patients Undergoing Lower Abdominal and Genitourinary Surgery: A Retrospective Study","authors":"Necmiye Ay, Duygu Akyol, Funda Gümüş Özcan","doi":"10.4274/bmj.galenos.2023.2023.8-7","DOIUrl":"https://doi.org/10.4274/bmj.galenos.2023.2023.8-7","url":null,"abstract":"","PeriodicalId":321087,"journal":{"name":"Medical journal of Bakirköy","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135245707","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}
Pub Date : 2023-09-29DOI: 10.4274/bmj.galenos.2023.2023.3-3
İsmail Yurtsever
Objective: Behçet’s disease (BD) is a chronic multisystem inflammatory disease of unknown etiology defined as recurrent aphthous oral and genital ulcers, skin lesions, and uveitis. BD is a type of systemic vasculitis that can affect arteries regardless of origin and size-the co-occurrence of chronic systemic vasculitis and acute systemic inflammation results in an endothelial abnormality of the vessels. The morphological thickness of the arterial wall is a crucial feature of atherosclerosis. Carotid intima-media thickness (IMT) is an endothelial cell dysfunction parameter associated with atherosclerosis. This study aimed to evaluate the hemodynamic properties of carotid-vertebral and renal arteries of BD with cutaneous lesions to prove the effects of subclinical morphology of atherosclerosis. Methods: The study consisted of 23 BD patients with oral and genital aphthae or cutaneous lesions. Color Doppler and B-mode ultrasonography examinations of the carotid-vertebral and renal arteries were performed in all patients. The assessment of the vascular structures included IMT, plaque thickness, resistive index, pulsatility index, peak systolic velocity, end-diastolic velocity, and the volumes of both kidneys were measured in the study. In addition, the flow rates of both vertebral arteries were calculated. Results: The most intriguing findings of our study were the detection of non-stenotic plaque in 3 patients, mild intimal thickening in most patients, and vertebra basilar insufficiency in 12 patients. In addition, hemodynamic alterations of the patient’s carotid arteries were compatible with the reported findings in the literature. Age, gender, disease duration, ophthalmic and neurological involvement, and IMT correlation were evaluated with the chi-square test, and no statistically significant correlation was found in this study. However, in the Mann-Whitney U test, a significant positive correlation was detected between kidney volume and IMT (p<0.035). Conclusion: We found no significant differences in vascular changes secondary to early atherosclerosis compared with the average population and literature in Behçet patients with cutaneous lesions. The increase in kidney size may be one of the early signs of atherosclerosis in Behçet’s cases.
{"title":"Assessment of Carotid-vertebral Artery and Renal Artery Doppler Ultrasound in the Behçet’s Disease with Cutaneous Lesions","authors":"İsmail Yurtsever","doi":"10.4274/bmj.galenos.2023.2023.3-3","DOIUrl":"https://doi.org/10.4274/bmj.galenos.2023.2023.3-3","url":null,"abstract":"Objective: Behçet’s disease (BD) is a chronic multisystem inflammatory disease of unknown etiology defined as recurrent aphthous oral and genital ulcers, skin lesions, and uveitis. BD is a type of systemic vasculitis that can affect arteries regardless of origin and size-the co-occurrence of chronic systemic vasculitis and acute systemic inflammation results in an endothelial abnormality of the vessels. The morphological thickness of the arterial wall is a crucial feature of atherosclerosis. Carotid intima-media thickness (IMT) is an endothelial cell dysfunction parameter associated with atherosclerosis. This study aimed to evaluate the hemodynamic properties of carotid-vertebral and renal arteries of BD with cutaneous lesions to prove the effects of subclinical morphology of atherosclerosis. Methods: The study consisted of 23 BD patients with oral and genital aphthae or cutaneous lesions. Color Doppler and B-mode ultrasonography examinations of the carotid-vertebral and renal arteries were performed in all patients. The assessment of the vascular structures included IMT, plaque thickness, resistive index, pulsatility index, peak systolic velocity, end-diastolic velocity, and the volumes of both kidneys were measured in the study. In addition, the flow rates of both vertebral arteries were calculated. Results: The most intriguing findings of our study were the detection of non-stenotic plaque in 3 patients, mild intimal thickening in most patients, and vertebra basilar insufficiency in 12 patients. In addition, hemodynamic alterations of the patient’s carotid arteries were compatible with the reported findings in the literature. Age, gender, disease duration, ophthalmic and neurological involvement, and IMT correlation were evaluated with the chi-square test, and no statistically significant correlation was found in this study. However, in the Mann-Whitney U test, a significant positive correlation was detected between kidney volume and IMT (p<0.035). Conclusion: We found no significant differences in vascular changes secondary to early atherosclerosis compared with the average population and literature in Behçet patients with cutaneous lesions. The increase in kidney size may be one of the early signs of atherosclerosis in Behçet’s cases.","PeriodicalId":321087,"journal":{"name":"Medical journal of Bakirköy","volume":"20 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135243872","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}
Pub Date : 2023-09-29DOI: 10.4274/bmj.galenos.2023.2023.5-13
Eylem Burcu Kahraman Özlü
{"title":"Transforaminal Epidural Injections in Neurosurgical Clinical Practice: A Single Surgeon’s Experience","authors":"Eylem Burcu Kahraman Özlü","doi":"10.4274/bmj.galenos.2023.2023.5-13","DOIUrl":"https://doi.org/10.4274/bmj.galenos.2023.2023.5-13","url":null,"abstract":"","PeriodicalId":321087,"journal":{"name":"Medical journal of Bakirköy","volume":"19 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135243851","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}
Pub Date : 2023-09-29DOI: 10.4274/bmj.galenos.2023.2023.6-2
İbrahim Acır, Abbas Musa Yılmaz, Alperen Güngör, Yusuf Çevik, Esra Derya Dinç Polat, Vildan Yayla
{"title":"Examining Biomarker Levels in Patients Diagnosed with Multiple Sclerosis","authors":"İbrahim Acır, Abbas Musa Yılmaz, Alperen Güngör, Yusuf Çevik, Esra Derya Dinç Polat, Vildan Yayla","doi":"10.4274/bmj.galenos.2023.2023.6-2","DOIUrl":"https://doi.org/10.4274/bmj.galenos.2023.2023.6-2","url":null,"abstract":"","PeriodicalId":321087,"journal":{"name":"Medical journal of Bakirköy","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135243854","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}
Pub Date : 2023-09-29DOI: 10.4274/bmj.galenos.2023.2023.1-6
Semiha Bahçeci Erdem, Hikmet Tekin Nacaroğlu, Ömer Akçal
Objective: There have been few studies on prognosis and factors influencing the prognosis in children with atopic asthma. We intended to evaluate the prognosis, clinical remission rate, and influencing factors of childhood atopic asthma. Methods: In 72 pediatric patients with atopic asthma who were followed up between 2016 and 2022 with a mean follow-up period of 6.03±2.19 years, demographic characteristics, family history, clinical symptoms, pulmonary function test results, and asthma control test scores were evaluated. Totally controlled patients who had not received any asthma treatment for ≥1 year were considered to be in “clinical remission.” Results: The study group included 72 children with atopic asthma (female/male: 28/44), with a mean age of 13.36±1.98 (8-18) years. 12.5% (n=9) of the patients had uncontrolled asthma, 45.8% (n=33) were partially controlled asthma, 41.7% (n=30) were complete controlled asthma. Clinical remission was seen in 23.6% (n=17) patients with total control. Patients who were symptomatic before the age of three and had a persistent course had a lower clinical remission rate (p=0.05). Conclusion: In our study, the clinical remission rate in atopic asthma in early adulthood was 23.6%. Our results reveal that the clinical remission rate was lower in patients who developed symptoms and had persistent wheezing before the age of three.
{"title":"Prognosis of Childhood Atopic Asthma: A 6-year Follow-up Study","authors":"Semiha Bahçeci Erdem, Hikmet Tekin Nacaroğlu, Ömer Akçal","doi":"10.4274/bmj.galenos.2023.2023.1-6","DOIUrl":"https://doi.org/10.4274/bmj.galenos.2023.2023.1-6","url":null,"abstract":"Objective: There have been few studies on prognosis and factors influencing the prognosis in children with atopic asthma. We intended to evaluate the prognosis, clinical remission rate, and influencing factors of childhood atopic asthma. Methods: In 72 pediatric patients with atopic asthma who were followed up between 2016 and 2022 with a mean follow-up period of 6.03±2.19 years, demographic characteristics, family history, clinical symptoms, pulmonary function test results, and asthma control test scores were evaluated. Totally controlled patients who had not received any asthma treatment for ≥1 year were considered to be in “clinical remission.” Results: The study group included 72 children with atopic asthma (female/male: 28/44), with a mean age of 13.36±1.98 (8-18) years. 12.5% (n=9) of the patients had uncontrolled asthma, 45.8% (n=33) were partially controlled asthma, 41.7% (n=30) were complete controlled asthma. Clinical remission was seen in 23.6% (n=17) patients with total control. Patients who were symptomatic before the age of three and had a persistent course had a lower clinical remission rate (p=0.05). Conclusion: In our study, the clinical remission rate in atopic asthma in early adulthood was 23.6%. Our results reveal that the clinical remission rate was lower in patients who developed symptoms and had persistent wheezing before the age of three.","PeriodicalId":321087,"journal":{"name":"Medical journal of Bakirköy","volume":"42 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135246784","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}
Pub Date : 2023-09-29DOI: 10.4274/bmj.galenos.2023.2023.3-4
Bülent Bozyiğit, Bilal Abbasoğlu, Caner Ünlüer, Göktuğ Ülkü, Abdullah Emre Taçyıldız, Hüseyin Hayri Kertmen
{"title":"Microendoscopic Discectomy for Lumbar Disc Herniations: A Series of 389 Cases","authors":"Bülent Bozyiğit, Bilal Abbasoğlu, Caner Ünlüer, Göktuğ Ülkü, Abdullah Emre Taçyıldız, Hüseyin Hayri Kertmen","doi":"10.4274/bmj.galenos.2023.2023.3-4","DOIUrl":"https://doi.org/10.4274/bmj.galenos.2023.2023.3-4","url":null,"abstract":"","PeriodicalId":321087,"journal":{"name":"Medical journal of Bakirköy","volume":"48 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135244022","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}
Pub Date : 2023-09-29DOI: 10.4274/bmj.galenos.2023.2023.8-14
Cansu Durak, Ebru Güney Şahin, Yaşar Yusuf Can, Alican Sarısaltık, Kübra Boydağ Güvenç, Fatih Varol
Objective: Nosocomial infections are an important preventable cause of increased morbidity and mortality in critically ill children. Our study compared the clinical features, laboratory data, and prognostic variables of nosocomial infections (NI) in children in the tertiary pediatric intensive care unit (PICU). Methods: A retrospective evaluation of 48 pediatric patients aged 1 month to 18 years who had been admitted between February 2022 and January 2023 at University of Health Sciences Türkiye, Sancaktepe Şehit Prof. Dr. İlhan Varank Training and Research Hospital was performed. Children with NI were included. Demographic clinical and outcome data were analyzed. Results: Twenty-seven patients (56.3%) were males. The median age was 32 months, and the length of stay in the PICU was 25 days (7-114). Respiratory diseases (50%) were the most common reasons for admission to the PICU, followed by sepsis (22.9%) and trauma (12.5%). The mortality rate was 18.8%. The requirement for renal replasman treatment was significantly higher in the non-survival group (p=0.017). Patients had similar prolonged PICU stay rates and requirements of mechanical ventilation, plasma exchange, and inotropic agents (p=0.472, p=0.320, p=0.432, p=0.068). Procalcitonin (PCT) (p=0.015), and procalcitonin/albumin ratio (PAR) (p=0.016) were also higher in the non-survival group than those in the survival group. Receiver operating characteristic (ROC) curves were used to predict mortality with PCT and PAR. According to ROC analysis, the cut-off values for PCT and PAR were found to be 1.705 (p=0.015), and 0.538 (p=0.016) respectively. Conclusion: Risk factors that cannot be changed, such as the underlying disease, should be considered in patients. Other modifiable risk factors for NIs will likely be the focus of efforts to enhance patient care.
{"title":"Evaluation of Nosocomial Infections in a Tertiary Pediatric Intensive Care Unit","authors":"Cansu Durak, Ebru Güney Şahin, Yaşar Yusuf Can, Alican Sarısaltık, Kübra Boydağ Güvenç, Fatih Varol","doi":"10.4274/bmj.galenos.2023.2023.8-14","DOIUrl":"https://doi.org/10.4274/bmj.galenos.2023.2023.8-14","url":null,"abstract":"Objective: Nosocomial infections are an important preventable cause of increased morbidity and mortality in critically ill children. Our study compared the clinical features, laboratory data, and prognostic variables of nosocomial infections (NI) in children in the tertiary pediatric intensive care unit (PICU). Methods: A retrospective evaluation of 48 pediatric patients aged 1 month to 18 years who had been admitted between February 2022 and January 2023 at University of Health Sciences Türkiye, Sancaktepe Şehit Prof. Dr. İlhan Varank Training and Research Hospital was performed. Children with NI were included. Demographic clinical and outcome data were analyzed. Results: Twenty-seven patients (56.3%) were males. The median age was 32 months, and the length of stay in the PICU was 25 days (7-114). Respiratory diseases (50%) were the most common reasons for admission to the PICU, followed by sepsis (22.9%) and trauma (12.5%). The mortality rate was 18.8%. The requirement for renal replasman treatment was significantly higher in the non-survival group (p=0.017). Patients had similar prolonged PICU stay rates and requirements of mechanical ventilation, plasma exchange, and inotropic agents (p=0.472, p=0.320, p=0.432, p=0.068). Procalcitonin (PCT) (p=0.015), and procalcitonin/albumin ratio (PAR) (p=0.016) were also higher in the non-survival group than those in the survival group. Receiver operating characteristic (ROC) curves were used to predict mortality with PCT and PAR. According to ROC analysis, the cut-off values for PCT and PAR were found to be 1.705 (p=0.015), and 0.538 (p=0.016) respectively. Conclusion: Risk factors that cannot be changed, such as the underlying disease, should be considered in patients. Other modifiable risk factors for NIs will likely be the focus of efforts to enhance patient care.","PeriodicalId":321087,"journal":{"name":"Medical journal of Bakirköy","volume":"41 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135243259","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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