Medical Bulletin of Sisli Etfal Hospital最新文献

Objectives: Chronic spontaneous urticaria (CSU) is a common disease characterized by wheals and/or angioedema. Since it is a chronic, itch-related disease, it may substantially affect the psychological status and quality of sleep. In this study, it was aimed to evaluate the impact of CSU on depression, anxiety, stress, and quality of sleep, as well as their relation to disease-specific factors.

Methods: This prospective case-control study included 86 patients with CSU and 86 controls. The sociodemographic and clinical characteristics of the patients, such as scores of urticaria activity score (UAS7) and chronic urticaria quality of life questionnaire (CU-Q2oL), were recorded. Depression, Anxiety, and Stress Scales-21 (DASS-21), Pittsburgh Sleep Quality Index (PSQI), and Dermatology Life Quality Index (DLQI) were used to evaluate their psychological status, quality of sleep, and life.

Results: Of 172 participants, the patient group comprised 86 patients with CSU, and the control group comprised 86 age and sex-matched volunteers. Of 86 patients with CSU, 60 (69.8%) were females and 26 (30.2%) males with a median age of 34.5 years. In the patients with CSU, the median scores (interquartile range) for depression, anxiety, and stress, according to DASS-21, were 6 (8), 5 (6.25) and 6 (7), respectively. Additionally, the median scores of PSQI and DLQI were 7 (5) and 5.5 (11), respectively. The median scores for depression, anxiety, and stress according to DASS-21, the median scores of PSQI and DLQI were statistically significantly higher in the patient group than in the control group. According to the PSQI classification, 68 (79.1%) patients had poor sleep quality, while 18 (20.9%) patients had good sleep quality. When the patient group was examined in two groups, those with good and poor sleep quality, UAS7, depression, anxiety, stress, and DLQI/CU-Q2oL scores were statistically significantly higher in the patients with poor sleep quality than in the patients with good sleep quality.

Conclusion: Treatment of urticaria is typically symptomatic and aims to reduce the symptoms of itching and wheals. However, clinicians can contribute to the well-being of patients if they are aware of psychological comorbidities and sleep disturbances.

Objectives: This study aimed to evaluate the etiology, clinical characteristics, and outcomes of mesenteric lymphadenopathy (ML) in children, with an emphasis on its clinical significance and management strategies.

Methods: This cross-sectional, single-center study was conducted between July 2016 and May 2017 and included pediatric patients aged 1 month to 18 years diagnosed with ML via abdominal ultrasonography. Patients with malignancies, acute infections, ongoing corticosteroid or antibiotic treatment, or incomplete follow-up were excluded. Data collection included demographic, clinical, and laboratory findings. Statistical analyses were performed using IBM SPSS Statistics version 25. The Mann-Whitney U test was used for comparisons of numerical variables between groups, while the chi-square and Fisher's exact tests were applied for categorical variables. A p-value less than 0.05 was considered statistically significant.

Results: A total of 106 patients were included with a median age of 7.4 years (range: 8 months-16.4 years), of whom 55.7% were male. The majority (63%) were aged 6-11 years. Abdominal pain was the most common symptom (64.2%), and 99.1% of the ML cases were localized in the right lower quadrant. At 1-month follow-up, lymph node sizes regressed to normal in 71.7% of cases, while 28.3% remained pathological. Antibiotic use did not significantly affect lymph node regression. At 6 months, no new symptoms or diagnoses were reported in the 91 patients contacted. ML was most often idiopathic (76.4%), with secondary causes including gastrointestinal and respiratory infections, acute abdomen, and Familial Mediterranean Fever.

Conclusion: In children, ML is predominantly benign and self-limiting, and in most cases, it resolves without medical intervention. Although its association with symptoms such as abdominal pain may cause anxiety in parents, careful monitoring of patients can prevent unnecessary interventions. This study underscored the importance of conservative management and highlighted the need for further research with larger cohorts and extended follow-up periods to explore rare etiologies and long-term outcomes.

Objectives: The primary aim of this study was to evaluate the effects of nocturnal enuresis (NE) on Health-Related Quality of Life (HRQoL) in children with a special emphasis on the domains of HRQoL.

Methods: This was a case-control study in which consecutive children with NE were recruited along with their parents. Age and sex-matched children without enuresis served as controls. Age-appropriate children and proxy versions of the German Quality of Life Questionnaire (KINDL) were used to evaluate HRQoL and its domains. The clinicodemographic characteristics and family data were collected. HRQoL and the domain scores were compared between the patients and the control subjects.

Results: 100 children (50 of whom are males) with enuresis along with their parents were included in the study. 100 children served as the control group. The mean age of the patients was 9.58±2.77 years, and was no different from that of the control group. 55% of the children were receiving treatment for NE. The most common treatment was the nighttime waking (40%). The most commonly used drug was desmopressin. The median score of the health-related quality of life was 78.8 [69.2-83.3] in children with NE versus 90 [86.7-91.7] in the control group (p<0.001). In all domains, the median scores were significantly lower in children with NE compared with the controls.

Conclusion: Turkish children with NE had a significantly lower HRQoL score compared with children without NE. All the domain scores were also significantly lower in children with NE compared with the control subjects.

Objectives: Nutritional status significantly impacts outcomes in allogeneic hematopoietic stem cell transplantation (allo-HSCT). Among various indices, the Nutritional Risk Index (NRI), Prognostic Nutritional Index (PNI), and Controlling Nutritional Status (CONUT) scores hold potential as prognostic tools. This study compares their predictive utility for transplant outcomes.

Methods: A retrospective analysis was conducted on 41 patients who underwent their first allo-HSCT between October 2022 and July 2024. Nutritional scores were calculated using pre-transplant data, and their associations with mortality and non-relapse mortality (NRM) were assessed. Receiver operating characteristic (ROC) curves and multivariable logistic regression were employed to evaluate predictive accuracy.

Results: The high CONUT score demonstrated the highest prognostic accuracy for mortality (AUC: 0.771, p=0.026) and NRM (AUC: 0.806, p=0.047). It was the sole independent predictor of mortality (OR: 2.180, p=0.028). Both the NRI (AUC: 0.737, p=0.040) and PNI (AUC: 0.803, p=0.008) were also associated with mortality but lacked independent predictive value. Higher CONUT scores correlated with increased mortality rates.

Conclusion: The CONUT score emerged as the most effective nutritional scoring system for predicting mortality in allo-HSCT patients. Its simplicity and integration of key clinical parameters make it a valuable tool for early risk stratification and targeted interventions. Further studies with larger cohorts are warranted to validate these findings and refine nutritional management strategies.

Objectives: Venom-specific immunotherapy is recognized as the gold standard treatment for honey bee and wasp venom allergies. This study aims to evaluate the clinical characteristics and treatment outcomes of patients diagnosed with honey bee and wasp venom allergies who commenced immunotherapy.

Methods: This study encompasses data from 43 patients who presented with honey bee and wasp venom allergies at Ondokuz Mayis University and initiated venom immunotherapy (VIT). We retrospectively examined the patients' demographic characteristics, history of atopic diseases, allergy history, characteristics of honey bee and wasp venom stings, severity of reactions, laboratory values, administered treatments, and side effects.

Results: Among the 43 patients included in our study, 9 (20.9%) were female, and 34 (79.1%) were male. A history of atopic disease was present in 34.8% of the patients, and a family history in 51.1%. The severity of systemic reactions was evaluated according to Müller's classification, with grade 4 reactions being the most frequent (48.8%). Of the 43 patients who received VIT, 28 (65.1%) were treated for Apis mellifera, 9 (20.9%) for Vespula vulgaris, and 6 (14%) for both species. Twelve patients experienced side effects during VIT, leading to discontinuation in two cases due to patients' reluctance to continue. The remaining 22 patients, who were stung again during or after completing VIT, experienced milder systemic reactions.

Conclusion: This study delineates the demographic and clinical characteristics of patients with honey bee and wasp venom allergies, highlighting the efficacy of VIT treatment. Despite the occurrence of side effects related to VIT, both previous studies and our findings suggest that these side effects are not more severe than systemic reactions resulting from stings. The absence of severe systemic reactions in patients who were stung again during or after receiving VIT underscores the effectiveness of the immunotherapy.

Objectives: Hidradenitis suppurativa (HS) is a chronic inflammatory skin disorder in which patients with HS experience profound deterioration in their overall well-being, psychological state and quality of life. This study aimed to evaluate the psychological impact of HS and examined its associations with relevant factors, including sociodemographic and disease-related characteristics.

Methods: A prospective, single-center study was conducted involving 80 patients with HS. The demographic and clinical characteristics of patients were recorded. Depression Anxiety Stress Scale-21 (DASS-21), Dermatology Life Quality Index (DLQI), and General Health Questionnaire-12 (GHQ-12) were used to assess the psychosocial impact of HS.

Results: A significant proportion of patients with HS had severe and extremely severe scores in depression, anxiety and stress, with 48.75%, 52.5%, and 48.75% of patients, respectively. Sixty percent of the patients exhibited high psychological disorders while 53.8% experienced severe impairment in their quality of life (QoL). Sociodemographic and clinical factors were evaluated for associations with the scales used in this study. DASS-21 Anxiety (DASS-21A) was significantly positively correlated with lower education levels and higher body mass index (BMI) (p<0.05). There were no significant correlations between the Hurley stages and the other three scales, except for the DASS-21 Stress (DASS-21S) subscale. Patients with a family history had higher DASS-21A, DASS-21 Depression (DASS-21D), DASS-21S, and GHQ-12 (both Likert and traditional scoring) scores compared to those without a family history (p<0.05). Additionally, a positive family history significantly predicted higher scores on DASS-21A, DASS-21D, and DASS-21S (p=0.002; p=0.019; p=0.022, respectively).

Conclusion: Our findings confirm that a significant proportion of patients with HS had high or extremely high levels on all three scales assessing the psychological burden of HS. Patients were negatively affected psychologically at each Hurley stage. Family history proved to be a strong predictive factor contributing to impaired psychosocial status among individuals with HS. Thus, dermatologists should provide extra care, especially for those with family members affected by this condition.

Objectives: Epidural fibrosis occurs after laminectomy as part of the local repair mechanisms. Adhesion around the nervous tissue could cause pain and disability. In the current study, we investigated the possible antifibrotic effects of the plasminogen activator inhibitor-1 (PAI-1) antagonists in a rat laminectomy model.

Methods: The rats were randomly assigned to the control, the TM5441, and the TM5484 groups (n=6 per group). In the control group, just a laminectomy was performed. In the treatment groups, intragastric administration of PAI-1 antagonists was done after skin closure. Epidural fibrosis was investigated macroscopically and histopathologically four weeks later.

Results: In the TM5441 and TM5484 groups, the macroscopic epidural fibrosis score was less than the control group (p<0.001 for both groups). Microscopic epidural fibrosis score was also decreased in the TM5441 and TM5484 groups (p>0.05 for both groups). Fibroblast cell density classification scores in the TM5441 and TM5484 groups were lower when compared to the control group (p>0.05 for both groups). Fibrosis thickness was lower in the TM5441 and TM5484 groups when compared to the control group (p<0.01 for both groups).

Conclusion: Plasminogen activator inhibitor-1 antagonists could be a treatment alternative for the prevention of epidural fibrosis.

Objectives: In this study, it is aimed to examine the effects of septoplasty, functional endoscopic sinus surgery and septorhinoplasty on the acoustics of Turkish nasal consonants.

Methods: The prospective study was conducted by taking voice recordings of 72 patients preoperative, 1st and 3rd months postoperative and based on changes in nasalance values. Patients were asked to read aloud the predetermined speech materials. The speech materials were recorded and analyzed using the Praat Assisted Nasalance Meter (PANM) system. The effect of the type of surgery was investigated for the change of nasalance values in the 1st and 3rd months after surgery compared to the preoperative value.

Results: Septoplasty and functional endoscopic sinus surgery groups showed significant increases in nasal consonants and nasal sentence nasalance values in both male and female after surgery compared to the preoperative value. (p<0.05) In the septorhinoplasty group, no significant changes were observed in the values after surgery compared to the preoperative value in male patients (p>0.05). In the female septorhinoplasty group, nasalance values decreased after surgery compared to the preoperative value, but no significant differences were detected. (p>0.05).

Conclusion: Comprehensive information about the potential for resonance changes following rhinological surgery should be provided to professional voice users. Clear communication of results can support more informed decision making, manage patient expectations, and reduce the risk of postoperative dissatisfaction with voice quality.

Objectives: Alcohol consumption is a major risk factor for liver cirrhosis and chronic pancreatitis (CP). The interplay between pancreatic changes and alcoholic cirrhosis remains poorly understood due to limited diagnostic tools. Endosonography (EUS) offers high sensitivity for detecting pancreatic morphological changes, even in early fibrosis stages.

Methods: Between February 2010 and February 2017, 71 male patients diagnosed with alcoholic cirrhosis based on clinical, biochemical, and imaging findings were enrolled. Cirrhosis and pancreatitis from other causes were excluded. EUS, performed under midazolam and propofol sedation using a radial probe, classified pancreatic morphology per Rosemont criteria: normal, indeterminate for CP, suggestive of CP, or consistent with CP. Clinical data, including alcohol and smoking history, liver function, and portal hypertension markers, were recorded.

Results: EUS identified normal pancreatic morphology in 28 patients (39.4%), indeterminate findings in 18 (25.4%), and CP-consistent or suggestive changes in 25 (35.2%). Logistic regression revealed no significant association between pancreatic changes and age, smoking, alcohol intake, BMI, spleen size, INR, platelet count, diabetes mellitus (DM), or compensated cirrhosis. Kaplan-Meier analysis revealed no significant survival difference between patients with normal pancreatic morphology (median 3.9 years) and those with abnormal morphology (median 3.1 years; p=0.792). One patient (1.4%) with normal morphology developed pancreatic cancer after 3.3 years. Hepatic and extrahepatic malignancy incidence reached 18% over five years, with hepatocellular carcinoma (HCC) at 4.3%, yet no statistically significant association was found between pancreatic changes and malignancy development (p=0.639). Portal hypertension severity and mortality showed no correlation with pancreatic findings.

Conclusion: EUS proves valuable for assessing pancreatic changes in alcoholic cirrhosis, illuminating the complex relationship between alcohol consumption and pancreatic morphology.