Hepatosellüler Karsinom (HSK), artan insidansý ile kanser iliþkili ölümlerde önde gelen nedenlerden biridir. Birçok tedavi seçeneði olmakla birlikte ancak olgularýn sadece %30-40'ýna küratif tedavi þansý olabilen erken evrede taný konulabilmektedir. Baþarýlý sonuçlarile HSK'lu hastalarda karaciðer naklinde ve organ daðýtýmýnda milan kriterlerinin (MK) uygulanmasý ile karaciðer nakli en uygun tedavi konumuna gelmiþtir. HKS tedavisinde yeni kriter arayýþlarý ve tedavi algoritmalarýndaki güncellemeler sýcak konulardýr. Asya ülkelerinde artan canlý vericiden karaciðer nakli (CVKN) deneyimi ile özellikle tümör sayýsý ve boyutundan baðýmsýz olarak MK dýþýndaki HSK'da CVKN uygulanmýþ ve benimsenmiþtir. CVKN greftleri özellikleri ile kadavra donörlerden toplumsal kaynak olmamasý ile farklýdýr. Canlý donor karaciðer grefti bir kiþiye baðýþlanmýþ özel bir hediyedir. Canlý donör karaciðer nakli organ daðýtýmýndan baðýmsýz olmasý sayesinde HSK tedavisinde yeni ufuklar açmýþtýr. Son dekatlarda,CVKNde olan ilerleme ile paralel olarak HSK tedavisinde çok baþarýlý ilerlemelere artan oranda literatürde rastlanmaktadýr. (SETB-2023-03-044)

Hepatocellular carcinoma (HCC) is one of the leading causes of cancer-related deaths, with increasing incidence. There are different treatment options, but only 30%-40% of HCC cases are diagnosed at an early stage for curative treatment. With the implementation of Milan Criteria for liver transplantation (LT) in HCC cases and its use for organ allocation with successful outcomes, LT has become an optimal treatment. Seeking new criteria for LT and developing updated algorithms for HCC treatment has become a hot topic nowadays. With the experience in living donor liver transplantation (LDLT), especially in Asian countries, LDLT was established and adopted with different criteria for HCC treatment, especially including criteria beyond Milan's size and number of tumors. Living donor grafts are uniquely different than deceased donor grafts as they are not considered a public resource. A living donor graft is rather a private gift intended for a specific recipient. Living donor livers are not limited by organ allocation systems, and this significant advantage of LDLT has opened new frontiers in the treatment of HCC. Improvements in LDLT have had remark-able parallel effects in the successful treatment of HCC as supported by a growing body of literature in the past decade.

Giriþ: Bu çalýþmanýn amacý, iki farklý yaklaþým kullanýlarak tedavi edilen kuadrilateral yüzey kýrýðý olan asetabular kýrýklý hastalarda cerrahi tedavi sonuçlarýný deðerlendirmektir.
Materyal-Metod: Çalýþmaya 2011-2020 yýllarý arasýnda kliniðimizde kuadrilateral yüzey kýrýklý asetabulum kýrýðý nedeniyle ilioinguinal (grup A) veya modifiye Stoppa (grup B) tekniði ile ameliyat edilen 106 hasta dahil edildi. Redüksiyon kalitesi Matta kriterlerine ve ameliyat sonrasý pelvik (anteroposterior, eksternal oblik, iliak oblik) radyografilere göre deðerlendirildi. Kalça fonksiyonunun deðerlendirilmesi Merle d'aubigne ve Postel Skoru ve Harris Kalça Skoru kullanýlarak kaydedildi.
Bulgular: Çalýþmaya dahil edilen hastalar arasýnda grup A'da 45, grup B'de 61 hasta vardý ve grup verileri karþýlaþtýrýldýðýnda modifiye stoppa yaklaþýmýnýn intraoperatif redüksiyon kalitesi, radyolojik veriler, Harris kalça skoru, Merle d'aubigne ve PostelScore açýsýndan daha üstün olduðu görüldü. (Sýrasýyla p=0.40, p=0.49, p=0.040, p=0.028)
Sonuç: Modifiye stoppa yaklaþýmý, kuadrilateral yüzeyide içeren asetabulum kýrýklarýnda ilioinguinal yaklaþýma göre daha iyi redüksiyon kalitesi ve kalça skorlarý ile baþarýlý klinik ve radyolojik sonuçlara sahiptir. (SETB-2023-08-137)

Objectives: The aim of this study was to evaluate the results of surgical treatment in patients with acetabular fractures with a fractured quadrilateral surface treated using two different approaches.
Methods: The study included 106 patients who were operated on with ilioinguinal (group A) or modified Stoppa (group B) technique for acetabular fracture with a fractured quadrilateral surface between 2011 and 2020 in our clinic. The quality of reduction was evaluated according to Matta criteria and postoperative pelvic (anteroposterior, external oblique, iliac oblique) radiographs. Evaluation of hip function was recorded using the Merle d'aubigne and Postel Score and Harris Hip Score.
Results: Among the patients included in the study, there were 45 patients in group A and 61 patients in group B. When the group data were compared, it was seen that the modified Stoppa approach was superior in terms of intraoperative reduction quality, radiological data, Harris hip score, Merle d'aubigne and PostelScore. (Respectively p=0.40, p=0.49, p=0.040, p=0.028). Conclusion: Modified Stoppa approach has successful clinical and radiological outcomes and better reduction quality and hip scores than ilioinguinal approaches in acetabular fractures involving quadrilateral plates.

Amaç: Bu çalýþmadaki amacýmýz yaþ, etiyoloji, defekt boyutu, lomber drenaj uygulanmasý ve cerrahi teknik gibi faktörlerin Beyin Omurilik Sývýsý (BOS) fistül onarýmý baþarý oranlarýna etkisini deðerlendirmektir.
Yöntemler: Kliniðimizin Elektronik Týbbi Kayýt (EMR) sistemi ile 2006-2020 yýllarý arasýnda ön kafa tabaný kaynaklý BOS fistülü nedeniyle endoskopik transnazal teknikle opere edilen olgular retrospektif olarak incelendi. Çalýþmaya toplam 35 hasta dahil edildi. Hastalar onarýmda kullanýlan katman sayýsýna (iki, üç veya dört katmanlý rekonstrüksiyon) ve defekt boyutuna (5 mm'den küçük, 5 ila 10 mm ve 10 mm'den büyük), etiyolojiye, defektin lokasyonuna ve lomber drenajýn uygulanmasýna göre (LD(+) ve LD(-) ) gruplandýrýldý. Komplikasyonlar ve ameliyat sonrasý, bos kaçaðýnýn tekrarlamasý gruplar arasýnda karþýlaþtýrýldý.
Bulgular: 2 katmanlý rekonstrüksiyon yapýlan hastalarda nüks oranlarý, 3 veya 4 katmanlý rekonstrüksiyon yapýlan hastalara göre anlamlý olarak daha yüksekti (p=0,049). LD (+) grupta nüks oraný (%41,7), LD (-) gruba (%4,3) göre anlamlý olarak daha düþüktü (p=0,012). Gruplar arasýnda yaþ, defekt boyutu, defekt yeri ve etiyoloji açýsýndan nüks oranlarý açýsýndan anlamlý fark yoktu.
Sonuç: Anterior kafa tabaný kaynaklý bos fistülülerinin endoskopik transnazal onarýmýnda rekonstrüksiyonun en az 3 kat planlanmasý ve lomber BOS drenajýnýn uygulanmasý baþarý oranlarýný arttýrmaktadýr. (SETB-2023-08-151)

Objectives: Our aim in this study is to assess the effect of factors such as age, etiology, defect size, application of lumbar drainage and surgical technique on Cerebrospinal Fluid (CSF) fistula repair success rates.
Methods: The Electronic Medical Records (EMR) system of our clinic was retrospectively reviewed for cases that were operated between 2006 and 2020 for CSF fistula originating from anterior skull base with endoscopic transnasal technique. A total of 35 patients were included in the study. Patients were grouped according to the number of layers used in repair (two, three or four-layered reconstruction) and defect size (smaller than 5 mm, 5 to 10 mm and larger than 10mm), etiology, location of the defect and application of lumbar drainage as LD (+) and LD (-). Complications and CSF leak recurrence were compared between groups. Results: Recurrence rates in patients who had 2 layered reconstructions were significantly higher compared to patients who had 3 or 4 layered reconstructions (p=0.049). The recurrence rate in LD (+) group (41.7%) was significantly lower compared to LD (-) group (4.3%) (p=0.012). There were no significant difference in recurrence rates between groups in terms of age, defect size, defect location and etiology.
Conclusion: In endoscopic transnasal repair of anterior skull base-derived bos fistulas, planning the reconstruction at least 3 times and applying lumbar CSF drainage increases the success rates.

Amaç: Bu çalýþmanýn amacý izole aort kapak replasmaný (AVR) yapýlan hastalarýn erken dönem sonuçlarýný supraanüler ve intraanüler AVR ile karþýlaþtýrmaktýr.
Metot: 2013-2019 yýllarý arasýnda izole AVR uygulanan 113 hasta (77 erkek; ortalama yaþ 57,8±16,36 yýl) deðerlendirildi. Hastalar supraanüler (n=59) ve intraanüler (n=54) AVR uygulananlar olmak üzere iki gruba ayrýldý. Ameliyatlarda en sýk kullanýlan kapaklar St Jude Medical Masters (St. Jude Medical, Minneapolis, MN, ABD), (n=35, %30,9), Sorin Mitroflow (Sorin Group Inc., Mitroflow Division, Kanada), (n=32, %28,3 ve Carbomedics Top Hat (Sulzer, Carbomedics, Austin, TX), (n=31, %27,4).
Bulgular: Supraanüler AVR uygulanan hastalarýn kros klemp (XCL) ve kardiyopulmoner bypass (KPB) süreleri intraanüler AVR uygulanan hastalara göre anlamlý olarak yüksek bulundu. Ancak ameliyat sonrasý advers etkiler açýsýndan iki grup arasýnda anlamlý fark yoktu. Ameliyat sonrasý birinci hafta transtorasik ekokardiyografi (TTE) bulgularýnda iki grup arasýnda anlamlý fark yoktu.
Sonuç: Ýzole AVR uygulanan hastalarda supraanüler ve intraanüler kapak konumlandýrma sonuçlarý karþýlaþtýrýldýðýnda, postoperatif komplikasyonlar, postoperatif TTE'deki gradyan farklýlýklarý ve ejeksiyon fraksiyonlarý açýsýndan gruplar arasýnda anlamlý fark bulunamadý. Özellikle küçük anulusa sahip hastalarda uygun anatomik özellikler varlýðýnda supraanüler kapak pozisyonlandýrýlmasý düþünülmelidir. Ancak ileride daha fazla hastayla yapýlacak prospektif çalýþmalarda bu konunun araþtýrýlmasý gerekmektedir. (SETB-2023-11-215)

Objectives: This study aims to compare the early results of patients who underwent isolated aortic valve replacement (AVR) with supra-annular and intra-annular AVR.
Methods: Between 2013 and 2019, 113 patients (77 males; mean age 57.8±16.36 years) who underwent isolated AVR were evaluated. The patients were divided into two groups those who underwent supra-annular (n=59) and intra-annular (n=54) AVR. The most commonly used valves in surgeries St Jude Medical Masters (St. Jude Medical, Minneapolis, MN, USA), (n=35, 30.9%), Sorin Mitroflow (Sorin Group Inc., Mitroflow Division, Canada), (n=32, 28.3%, and Carbomedics Top Hat (Sulzer, Carbomedics, Austin, TX), (n=31, 27.4%).
Results: The cross-clamp (XCL) and cardiopulmonary bypass (CPB) times of the patients who underwent supra-annular AVR were found to be significantly higher than the patients who underwent intra-annular AVR. However, there was no significant difference between the two groups in terms of postoperative adverse events. There was no significant difference between the two groups in the postoperative first-week transthoracic echocardiographic (TTE) findings.
Conclusion: When comparing supra-annular and intra-annular valve positioning results in patients undergoing isolated AVR, no significant difference was found between the groups in terms of postoperative complications, gradient differences in postoperative TTE, and ejection fractions. Supra-annular valve positioning should be considered, especially in patients with small annulus, in the presence of suitable anatomical features. However, this issue needs to be investigated in future prospective studies with more patients.

Amaç: Çalýþmamýzýn amacý, adrenal kitlelerin karakterizasyonunda farklý manyetik rezonans görüntüleme (MRG) parametrelerinin rolünü araþtýrmaktý.
Yöntem: Bu çalýþmada 150 hastada toplam 186 adrenal tümör retrospektif olarak deðerlendirildi. Sonuç hasta popülasyonu 17 feokromositoma, 3 adrenokortikal karsinoma, 24 metastaz, 31 lipid fakir adenoma ve 111 lipid zengin adenomadan oluþmaktaydý. Çalýþmamýzda FSE (Hýzlý spin eko)T2 aðýrlýklý görüntülerde görsel deðerlendirme gerçekleþtirdik ve ayrýca T2 sinyal intensite oranýný hesapladýk ve kimyasal faz görüntüleme ile, kalitatif deðerlendirme ve Adrenal- dalak sinyal intensite oraný and Adrenal sinyal intensite indeks formüllerini kullanarak kantitatif hesaplamalar yaptýk. Dinamik kontrastlý sekanslarda, geç arteriyal faz görüntülerde, kontrastlanma paternini görsel olarak deðerlendirdik ve ayrýca ortalama sinyal intensite ölçümlerini yaptýk. Tüm deðerlendirmeler klinik ve patoloji sonuçlarýný bilmeyen iki abdomen radyoloðu tarafýndan konsensüsa varýlarak yorumlandý. Ýstatistiksel analiz gerçekleþtirildi.
Bulgular: FSE T2 aðýrlýklý görüntülerde, karaciðer ile izointens ve karaciðere göre hafif derecede hiperintens olma durumu benign olgularda daha sýk görülürken, malign olgularda karaciðerden orta derecede veya belirgin derecede hiperintens olma durumu daha sýk görüldü (p = 0.001, p< 0.01). Adrenal tümör gruplarý arasýnda T2 sinyal intensite oraný deðerleri bakýmýndan istatistiksel olarak anlamlý fark saptandý (p = 0.001, p< 0.01). Lipid zengin ve lipid fakir adenoma gruplarýnda, T2 sinyal intensite oraný deðerleri feokromositoma ve metastaz olgularýndan anlamlý derecede düþüktü. T2 sinyal intensite oraný deðerleri, malign olgularda benign olgulara göre istatistiksel olarak önemli derecede yüksek bulundu (p = 0.001, p< 0.01). Kimyasal faz görüntüleme ile görsel deðerlendirmede, adrenal tümör gruplarý arasýnda istatistiksel olarak anlamlý fark saptandý (p = 0.001, p< 0.01). Lipid zengin adenoma grubundaki hastalarda genellikle orta derecede ve belirgin sinyal intensite kaybý saptanmasýna karþýn, diðer tümör gruplarýnda bu bulguya rastlanmadý. Benign ve malign adrenal tümör gruplarý arasýnda istatistiksel olarak anlamlý fark saptandý (p = 0.001, p< 0.01). Malign gruptaki tümörlerde, Adrenal-dalak sinyal intensite oraný deðerleri benign gruptaki tümörlere göre belirgin derecede yüksek olmasýna karþýn, Adrenal sinyal intensite indeks deðerleri benign gruba göre belirgin derecede düþük bulundu. Maliginite açýsýndan adrenal tümör gruplarý arasýnda istatistiksel olarak anlamlý fark saptandý (p = 0.001, p< 0.01). Benign olgularda, kapiller blush ve homojen tip kontrast tutulumu daha sýk görülmesine karþýn, periferal-yamalý ve belirgin kapiller blush kontrast tutulumu malign olgularda daha sýk görüldü. Malign tümörlerin arteriyal sinyal intensite deðerleri benign tümörlere göre istatistiksel olarak anlamlý derecede yüksek bulundu (p=0,001; p<0,01).
Sonuç: Kantitatif parametrelerin kombine olarak kullanýlmasý, aksi takdirde kararsýz kalýnacak olan daha fazla adrenal tümörün taný almasýný mümkün kýlar. (SETB-2023-08-152)

Objectives: The purpose of our study was to investigate the role of different magnetic resonance imaging (MRI) parameters in the characterization of adrenal masses.
Methods: A total of 150 patients who presented with 186 adrenal tumors were retrospectively evaluated in this study. Final patient cohort consisted of 17 pheochromocytomas, 3 adrenocortical carcinomas, 24 metastases, 31 lipid-poor adenomas and 111 lipid-rich adenomas. We carried out a visual assessment on FSE (Fast spin echo)T2 weighted images and also calculated T2 signal intensity ratio of all adrenal masses and also performed a qualitative assessment on chemical shift imaging (CSI) together with quantitative calculation using Adrenal to spleen signal intensity (si) ratio and Adrenal si index formulas. On dynamic contrast-enhanced sequences, visual assessment based on enhancement patterns on late-arterial phase images was performed and also mean signal intensity measurements were carried out. All examinations were interpreted by two abdominal radiologists in consensus who were blinded to the clinical and pathological findings. Statistical analysis was performed.
Results: On FSE T2 weighted imaging, isointense to liver and slightly hyperintense than liver was found higher in benign cases, however, in malignant cases moderately and strikingly hyperintense than liver was higher than in benign cases (p=0.001, p<0.01). There was a statistically significant difference between the T2 signal intensity ratio values of adrenal tumor groups (p=0.001, p<0.01). In lipid-rich and lipid-poor adenoma groups, T2 signal intensity ratio values was significantly lower than in pheochromo-cytoma and metastasis cases. In malignant group, T2 signal intensity ratio values were found statistically significantly higher than in the benign group (p=0.001, p<0.01). There was a statistically significant difference between CSI visual assessment of adrenal tumor groups (p=0.001, p<0.01). Although moderate and significant signal intensity loss was usually detected in lipid-rich adenoma group, never detected in other tumor groups. There was also a statistically significant difference between benign and malignant adrenal tumor groups (p=0.001, p<0.01). In the malignant group, Adrenal to spleen si ratio values were found significantly higher whereas, Adrenal si index values were significantly lower compared to benign tumors (p=0.001, p<0.01). Based on malignancy, there was a statistically significant difference between adrenal tumor groups (p=0.001, p<0.01). Although capillary blush and homogenous type enhancement were more common in benign cases than in malignant ones, peripheral-patchy and strikingly capillary blush type enhancement was more frequent in malignant tumors. Based on malignancy, mean arterial signal intensity values of malignant tumors were statistically higher than benign tumors (p=0.001; p<0.01).
Conclusion: Dynamic contrast-enhanced MRI protocol including CSI aids in the characterization of indeterminate adrenal masses. Herein, the combined use of qualitative and quantitative parameters enables more tumors to be recognized that otherwise would be indeterminate.

Amaç: Bu çalýþmanýn amacý, 60 yaþ üstü, spesifik bir vestibüler patoloji tanýsý konmamýþ bireylerin vestibülo-oküler refleksini (VOR) deðerlendirmektir.
Yöntemler: Katýlýmcýlara iki taraflý altý kanallý video head impulse testi, Baþ Dönmesi Engellilik Envanteri ve Avrupa Vertigo Deðerlendirmesi ölçekleri uygulandý.
Bulgular: Çalýþmaya toplam 103 katýlýmcý (75 erkek, 28 kadýn) dahil edildi ve yaþ ortalamasý 69,35 ± 7,41 yýl. 7. dekat grubunun yaþ ortalamasý 64,32±3,12 (59 katýlýmcý; 38 erkek, 21 kadýn), 8. dekat ve üzeri grubun yaþ ortalamasý 76,11±5,93 (44 katýlýmcý; 37 erkek, 7 kadýn) idi. Lateral ve vertikal semisirküler kanallarýn VOR kazançlarý arasýnda 7. dekat ile 8. dekat ve daha yaþlý gruplar arasýnda anlamlý farklýlýk bulunmadý (p>0.05). 8. dekat ve üzeri grupta, sað lateral kanal düzeltici sakkat ve sol arka kanal düzeltici sakkat varlýðý, ayný kanallarýn VOR kazanýmlarý ile pozitif orta düzeyde korelasyon gösterdi (r=0.455, p=0.002 ve r=0.518, p= 0,001, sýrasýyla). 7. dekat grubunda yaþ ile VOR kazancý arasýnda anlamlý bir korelasyon bulunmazken, 8. dekat ve üzeri grupta yaþ ile sol lateral kanal VOR kazancý arasýnda negatif yönde zayýf bir korelasyon vardý (r=-0.366, p=0.017).
Sonuç: VHIT kullanýlarak VOR'daki yaþa baðlý deðiþiklikler deðerlendirilirken, 70 yaþ üstü popülasyonda vestibüler sistemin yaþlanmasýna iliþkin bulgular ortaya çýkmaya baþlamaktadýr ve düzeltici sakkat bulgularý, bu deðiþiklikleri ortaya çýkarmada VOR kazanýmlarýndan daha bilgilendirici olabilir. (SETB-2023-07-127)

Objectives: The aim of this study was to evaluate vestibulo-ocular reflex (VOR) of individuals over 60 years of age who have not been diagnosed with a specific vestibular pathology.
Methods: Bilateral six-semicircular canal video head impulse test (vHIT), Dizziness Handicap Inventory and European Evaluation of Vertigo scales were applied to participants.
Results: In total, 103 participants were included in the study (75 male, 28 female), and the mean age was 69.35 ± 7.41 years. The mean age of 7th decade group was 64.32±3.12 (59 participants; 38 male, 21 female), and the mean age of 8th decade and older group was 76.11±5.93 (44 participants; 37 male, 7 female). No significant differences were found between the VOR gains of the lateral or vertical semicircular canals between the 7th decade and 8th decade and older groups (p>0.05). In the 8th decade and older group, the presence of right lateral semicircular canal corrective saccade and left posterior semicircular canal corrective saccade showed a positively moderate correlation with VOR gains of the same semicircular canals (r=0.455, p=0.002, and r=0.518, p=0.001, respectively). No significant correlation was found between age and VOR gain in the 7th decade group, however, there was a negatively weak correlation between age and left lateral semicircular canal VOR gain (r=-0.366, p=0.017) in the 8th decade and older group.
Conclusion: While assessing the age-related changes in VOR using vHIT, it must be considered that the changes related to aging of the vestibular system begin to emerge in the population over 70 years of age, and corrective saccade findings may be more informative than VOR gains in revealing these changes.

Amaç: Bu çalýþma, prognostik beslenme indeksinin (PNI) ve sistemik immün inflamatuar indeksin (SII), tip 2 diyabet (T2DM) ve koronavirüs hastalýðý (COVID-19) olan hastalarýn ciddiyetini ve prognozunu tahmin etmeye yardýmýný ortaya koymayý amaçladý.
Yöntemler: Bu retrospektif kohort çalýþmasýna Nisan 2020 ile Aralýk 2020 tarihleri arasýnda COVID-19 nedeniyle hastaneye yatýrýlan 501 T2DM hastasý (erkek, %42.1; kadýn, %57.9) dahil edildi. Hastalar hayatta kalanlar ve hayatta kalmayanlar olarak ikiye ayrýldý. Gruplar arasýnda demografik ve laboratuvar verileri karþýlaþtýrýldýktan sonra PBÝ ve SÝÝ'nin klinik ve laboratuvar verileriyle korelasyonu deðerlendirildi.
Bulgular: Hayatta kalmayan ve hayatta kalan gruplarýn ortanca (çeyrekler arasý) yaþlarý sýrasýyla 74 (15) ve 69 (14) yýldý ve fark anlamlýydý (p<0.001). PBÝ hayatta kalmayan grupta hayatta kalan gruba göre anlamlý derecede düþüktü (p<0.001). SÝÝ hayatta kalmayan grupta hayatta kalan gruba göre anlamlý derecede yüksekti (p<0.001). PBÝ, glukoz düzeyleriyle negatif korelasyon gösterdi (r=-0.115, p=0.011). Kesme PNI deðeri olan 29,1 kullanýldýðýnda, T2DM hastalarýnda hastalýðýn ciddiyetini ve ölüm riskini tahmin etmede duyarlýlýðý ve özgüllüðü sýrasýyla %76.2 ve %76.3 idi.
Sonuç: Sonuç olarak, PBÝ ve SÝÝ düzeyleri, COVID-19 ve T2DM hastalarýnda saðkalýmý ve hastalýk þiddetini tahmin etmede etkilidir. (SETB-2023-09-171)

Objectives: This study aimed to demonstrate how the prognostic nutritional index (PNI) and systemic immune-inflammatory index (SII) help predict the severity and prognosis of patients with type 2 diabetes (T2DM) and coronavirus disease (COVID-19). Methods: This retrospective cohort study included 501 T2DM patients (male, 42.1%; female, 57.9%) who were hospitalized due to COVID-19 between April 2020 and December 2020. The patients were divided into survivors and non-survivors. After comparing demographic and laboratory data between the groups, the correlation of PNI and SII with clinical and laboratory data was evaluated. Results: The median (interquartile) ages of the non-survivor and survivor groups were 74 (15) and 69 (14) years, respectively, and the difference was significant (p<0.001). The PNI was significantly lower in the non-survivor group than in the survivor group (p<0.001). The SII was significantly higher in the non-survivor group than in the survivor group (p<0.001). PNI was negatively correlated with glucose levels (r=-0.115, p=0.011). If the cut-off PNI value of 29.1 was used, it had a sensitivity and specificity of 76.2% and 76.3%, respectively, in predicting the severity of the illness and the risk of death in T2DM patients.
Conclusion: Consequently, the PNI and SII levels are effective in predicting survival and disease severity in patients with COVID-19 and T2DM.

Amaç: Diyabet yönetiminde özbakým yaklaþýmý çok önemlidir. Bu çalýþmada, diyabet hastalarýnýn davranýþlarýný inceleyen Kapsamlý Diyabet Kendi Kendini Yönetme Ölçeði'nin (Comprehensive Diabetes Self-Management Scale; CDSMS) Türkçe geçerlilik ve güvenilirliðinin yapýlmasý amaçlanmýþtýr.
Yöntemler: Çalýþma metodolojik tiptedir. Özgün halinden Türkçeye çevrilen ve dil geçerliliði test edilen CDSMS, önce pilot uygulamaya, ardýndan ana çalýþmaya dahil edilmiþtir. Ölçeðin geçerliliði Cronbach alfa katsayýsý ile deðerlendirildi. Ardýndan, kesme puanýný belirlemek için ROC analizi yapýldý.
Bulgular: Çalýþmaya katýlanlarýn ortalama yaþý 57,10 ± 11,20 yýl ve ortalama hastalýk süresi 9.96 ± 7,79 yýldý. CDSMS'nin iç tutarlýlýðý, Cronbach alfa kullanýlarak ölçülen 0,73 idi. ROC analizi sonucunda CDSMS'nin iyi glisemik kontrolü öngörmede optimal kesme noktasý 21,17 puan olarak belirlendi.
Sonuç: Bu çalýþmada, CDSMS'nin Türkçe versiyonunun Türk popülasyonunda geçerli ve güvenilir olduðu görülmüþtür. CDSMS'nin diyabetik hastalarýn hastalýk yönetim becerilerini göstermeleri açýsýndan klinikte çalýþan hekimlere faydalý olacaðý düþünülmektedir. (SETB-2023-08-139)

Objectives: A self-care approach is very important in diabetes management. In this study, it was aimed to make the Turkish validity and reliability of the Comprehensive Diabetes Self-Management Scale (CDSMS), which examines the behaviors of diabetes patients. Methods: The study is of methodological type. CDSMS, which was translated into Turkish from its original version and tested for language validity, was first included in the pilot application and then in the main study. The validity of the scale was evaluated by the Cronbach's alpha coefficient. Then, a Receiver Operating Characteristic (ROC) analysis was performed to determine the cut off score. Results: The mean age of the study participants was 57.10 ± 11.20 years and the mean disease duration was 9.96 ± 7.79 years. The internal consistency of CDSMS was 0.73, which was measured using Cronbach's alpha. After the ROC analysis, the optimal cut-point score of CDSMS to predict good glycemic control was determined as 21.17 points.
Conclusion: With this study, it was found that the Turkish version of CDSMS is valid and reliable for use in the Turkish population. It is thought that CDSMS will be beneficial to physicians working in the clinic in terms of showing the disease management skills of diabetic patients.

Giriþ: Osteosarkopenik hastalarda aerobik ve dirençli egzersiz kombinasyonunun günlük yaþam aktivitelerive düþme riski üzerine etkisinin deðerlendirilmesi amaçlanmaktadýr.
Yöntemler: Osteoporoz polikliniðinden takip edilen 70 yaþ üstü kadýn ve erkek hastalarda sarkopeni tarandý. Uygun hastalarda sarkopeni; yürüme hýzý, kavrama kuvveti ve iskelet kas kütlesi ile deðerlendirildi. Dýþlama kriterlerini karþýlamayan sarkopeni hastalarý 3 aylýk aerobik ve dirençli egzersiz programýna dahil edildi. 1. ve 3. aylarda iskelet kas kitlesi ölçümleri, fiziksel performans ve denge testlerindeki deðiþiklikler deðerlendirildi.
Bulgular: Osteoporoz ve osteopenisi olan 91 hastada sarkopeni tarandý. 27 hastada sarkopeni tespit edildi ve 23 hasta 3 aylýk çalýþmayý tamamladý. Hastalarýn ortalama yaþý 78,4± 5,7 yýl olup, kadýn hasta sayýsý 16 (%69,6) idi. Ýskelet kas kütlesi ölçümlerinde ve 1. ve 3. ayda yapýlan Katz Günlük Yaþam Aktiviteleri (GYA) Skalasý'nda anlamlý deðiþiklik saptanmadý (p>0.05). Kýsa Fiziksel Performans Bataryasý, Zamanlý Kalk ve Yürü Testi ve Berg Balans Testi’nin ilk ayda anlamlý düzeyde düzeldiði, üçüncü ayda da geliþiminin devam ettiði görüldü (p<0,05).
Sonuç: Osteosarkopenik hastalarda aerobik ve dirençli egzersiz kombinasyonu, iskelet kas kütlesinde anlamlý bir artýþa yol açmasa da, fiziksel performans ve denge üzerinde anlamlý bir etkiye sahiptir. Bunun kiþinin baðýmsýzlýðýný arttýrýrken düþme riskini de azaltacaðý öngörülebilir. (SETB-2023-09-175)

Objectives: It is aimed to explain the impact of the combination of aerobic and resistive exercise on activities of daily living and the risk of falls in osteosarcopenic patients.
Methods: Female and male patients over 70 years of age followed up from the osteoporosis outpatient clinic were screened. Appropriate patients were evaluated for sarcopenia gait speed, grip strength and skeletal muscle mass. Patients with sarcopenia who did not have the exclusion criteria were included in the 3-month aerobic and resistive exercise program. Changes in skeletal muscle mass measurements, physical performance and balance tests were evaluated at 1 month and 3 months.
Results: Sarcopenia was screened in 91 patients with osteoporosis and osteopenia. Sarcopenia was detected in 27 patients and 23 completed the 3-month study. The mean age of the patients was 78.4±5.7 years and the number of female patients was 16 (69.6%). There was no significant change in skeletal muscle mass measurements and Katz Activities of Daily Living Scale performed at 1 and 3 months (p>0.05). Short Physical Performance Battery (SPPB), Timed Up and Go Test (TUGT) and Berg Balance Test (BBT) were found to improve significantly in the first month, and it continued to develop in the third month (p<0.05).
Conclusion: Although the combination of aerobic and resistive exercise in osteosarcopenic patients did not lead to a significant increase in skeletal muscle mass, It has a significant effect on physical performance and balance. It can be foreseen that this will increase the independence of the person while reducing the risk of falling.

Amaç: Aterojenik plazma indeksinin (AIP) koroner arter hastalýðý (KAH) ve ateroskleroz ile iliþkisi bilinmesine raðmen, AIP ile stent içi restenoz (ISR) arasýndaki iliþki belirsizliðini koruyor. Ýlaç salýnýmlý stent (DES) ile tedavi edilen stabil anjina pektorisli (SAP) hastalarda AIP ile ISR arasýndaki iliþkiyi araþtýrmayý amaçladýk.
Yöntem: Bu gözlemsel ve retrospektif çalýþmada, Ocak 2015 ile Kasým 2019 arasýnda stabil angina sonrasý DES implantasyonu öyküsü olan hastalar deðerlendirildi. Çalýþmaya dahil etme kriterlerine uygun 608 hasta ISR+ (n=241) ve ISR- (n=367) olarak ikiye ayrýldý. ISR, %50 veya daha fazla darlýðýn varlýðý olarak tanýmlandý. AIP, log [TG/HDL-C] olarak tanýmlandý.
Bulgular: ISR geliþen hastalarda, geliþmeyenlere kýyasla AIP seviyeleri anlamlý derecede yüksekti (sýrasýyla 0,33 [0,15-0,52] vs 0,06 [-0,08-0,21], p < 0,001). ISR'yi ön gördürücü AIP seviyelerinin AUC deðeri 0,746 olarak bulundu (p < 0,001). Multivaryant lojistik regresyon analizinde; AIP, diyabet, yüksek LDL-K düzeyleri ve düþük LVEF deðerlerinin baðýmsýz olarak ISR ile iliþkili olduðunu ortaya konuldu.
Sonuç: Multivaryant lojistik regresyon analizinde, AIP'nin ISR ile güçlü bir þekilde baðýmsýz olarak iliþkili olduðunu ortaya koydu. Bu yeni, ucuz ve kolay hesaplanabilen endeksin kullanýlmasý, DES ile tedavi edilen SAP hastalarýnda ISR'nin erken tanýnmasýný saðlayabilir. (SETB-2023-11-216)

Objectives: Although the association of Atherogenic index of plasma (AIP) with coronary artery disease (CAD) and atherosclerosis is known, the relationship between AIP and in-stent restenosis (ISR) remains unclear. We aimed to investigate the relationship between AIP and ISR in patients with stable angina pectoris (SAP) treated with drug-eluting stent (DES).
Methods: Patients with a history of DES implantation following stable angina were evaluated between January 2015 and November 2019 in this observational and retrospective study. 608 eligible patients were dichotomized into ISR+ (n=241) and ISR- (n=367). ISR was defined as the presence of 50% or greater stenosis. AIP was defined as log [TG/HDL-C].
Results: AIP levels were significantly higher in patients who developed ISR compared with those who did not (0.33 [0.15-0.52] vs 0.06 [-0.08-0.21] respectively, p<0.001). The AUC value of AIP levels for predicting ISR was 0.746 (p<0.001). Multivariate logistic regression analysis revealed that AIP, diabetes mellitus, higher LDL-C levels and lower LVEF values were independently associated with ISR. Conclusion: Multivariate analysis revealed that AIP was strongly independently associated with ISR. Using this novel inexpensive and easily calculable index may provide early recognition of ISR in patients with SAP who were treated with DES.

Giriþ: COVID-19, dünya genelinde ciddi bir saðlýk tehdidi olarak kabul edilen bir viral hastalýktýr. Bununla birlikte, bazý çocuklarda COVID-19 sonrasý MIS-C olarak bilinen multisistemik enflamatuar bir sendrom geliþebilir. Bu çalýþma, bu iki hastalýk arasýndaki klinik ve immunolojik farklýlýklarý belirlemeyi hedeflemektedir.
Materyal ve metod: Kasým 2020 ve Þubat 2021 tarihleri arasýnda Ondokuz Mayýs Üniversitesi Hastanesi'nde yatan 18 yaþýn altýndaki 33 MIS-C hastasý ve eþit sayýda pozitif polimeraz zincir reaksiyonu (PCR) testi sonucu olan COVID-19 hastasý geriye dönük olarak deðerlendirilmiþtir. Immunolojik veriler de incelenmiþtir. Çalýþmaya toplamda 66 hasta ve 10 saðlýklý birey dahil edilmiþtir.
Bulgular: COVID-19 hastalarýnda ve MIS-C hastalarýnda farklý klinik özellikler saptanmýþtýr. MIS-C hastalarýnda lenfopeni, trombositopeni, anemi, nötrofilia gibi belirtiler COVID-19 hastalarýna göre daha belirgin olarak görülmüþtür (p<0.001). Serum Ig G, A, M ve E düzeyleri arasýnda önemli bir farklýlýk saptanmamýþtýr. Ancak, MIS-C hastalarýnda B hücrelerinde anlamlý bir artýþ (p<0.001), T hücrelerinde CD4/CD8 oranýnýn tersine dönmesi ve CD3+CD38+HLA-DR+ aktif T hücrelerinde artýþ (p=0.009) gözlemlenmiþtir.
Sonuç: Bu çalýþma, COVID-19 ve MIS-C arasýndaki klinik ve immunolojik farklýlýklarýn varlýðýný ortaya koymuþtur. Lenfopeni, B hücrelerinde artýþ, CD4/CD8 oranýnýn tersine dönmesi ve CD3+CD38+HLA-DR+ aktif T hücrelerinin gösterilmesi, MIS-C'nin erken teþhisinde yardýmcý olabilecek potansiyel belirteçler olarak deðerlendirilebilir. (SETB-2023-07-116)

Objectives: This study aims to uncover early detection markers through the immunological analysis of children diagnosed with multisystem inflammatory syndrome (MIS-C) and coronavirus disease-2019 (COVID-19).
Methods: We retrospectively analyzed immunological data from thirty-three MIS-C patients and an equivalent number of patients under the age of 18 with a positive polymerase chain reaction (PCR) test for COVID-19. These individuals were admitted to Ondokuz Mayis University between November 2020 and February 2021. In total, the study group consisted of 66 patients and an additional 10 healthy controls.
Results: Lymphopenia, thrombocytopenia, anemia, and neutrophilia, along with elevated levels of ferritin, D-dimer, and C-reactive protein, were more pronounced in MIS-C patients (p<0.001). No significant disparities were found in serum IgG, A, M, and E concen-trations. Notably, there was an increased proportion of B cells (p<0.001), an inversion of the CD4/CD8 ratio, and a marked presence of CD3+CD38+HLA-DR+active T cells (p=0.009) in the MIS-C cohort.
Conclusion: In the early diagnosis of MIS-C, lymphopenia, increase in B cells, reversal of CD4/CD8 ratio, and demonstration of CD3+CD38+HLA-DR+active T cells may be helpful.

Amaç: Fibromiyaljinin cinsel iþlevi etkilediði bilinmektedir ancak cinsel iliþki sýklýðýnýn fibromiyalji semptom þiddeti üzerindeki etkisi net deðildir. Bu çalýþmanýn amacý, fibromiyaljili kadýnlarýn cinsel aktivitede bulunma sýklýðýnýn hastalýk þiddeti üzerine etkilerini araþtýrmaktýr.
Yöntem: Katýlýmcýlarýn depresyon durumlarý Beck Depresyon Envanteri (BDÖ) ile deðerlendirildi ve son 3 aydaki aylýk ortalama cinsel iliþki sýklýðý kaydedildi. Fibromiyalji hastalarýnýn aðrý düzeyleri Görsel Analog Skala (VAS), aðrý prevalansý Yaygýn Aðrý Ýndeksi (WPI), semptom düzeyi Semptom Þiddet Ölçeði (SSS), fibromiyaljiye maruz kalma durumu Fibromiyalji Etki Anketi (FIQ) ile deðerlendirildi.
Bulgular: Çalýþmaya yaþ ortalamasý 37,11±6,2 olan 100 fibromiyaljili kadýn ve yaþ ortalamasý 36,53±5,85 olan 100 saðlýklý kontrol kadýn katýldý. Fibromiyaljili kadýn hastalarda BDI ve VAS skorlarý daha yüksek ve cinsel iliþki sýklýðý daha düþüktü (p<0,001). Cinsel iliþki sýklýðý ile VAS, FIQ, SSS ve WPI puanlarý arasýnda anlamlý bir iliþki görülmezken, ayda ortalama 8 ve üzeri cinsel iliþki yaþayanlarda BDI'nin daha düþük olduðu saptandý (p=0,02).
Sonuç: Bu çalýþma, FM'li kadýn hastalarda cinsel iliþki sýklýðýnýn düþük olduðunu ve cinsel iliþki sýklýðý yüksek olan FM'li kadýnlarda depresyonun daha az görüldüðünü ortaya koydu. (SETB-2023-07-129)

Objectives: Fibromyalgia is known to affect sexual function, but the effect of frequency of sexual intercourse on fibromyalgia symptom severity is unclear. This study investigated how frequently women with fibromyalgia engaged in sexual activity affected how severe the disease was.
Methods: The depression status of the participants was evaluated with the Beck Depression Inventory (BDI) and the mean monthly frequency of sexual intercourse in the last 3 months was noted. Pain levels of fibromyalgia patients were evaluated with Visual Analog Scale (VAS), pain prevalence Widespread Pain Index (WPI), symptom level Symptom Severity Scale (SSS), and fibromyalgia exposure status with Fibromyalgia Impact Questionnaire (FIQ).
Results: A hundred women with fibromyalgia with a mean age of 37.11±6.2 years and 100 healthy female controls with a mean age of 36.53 ± 5.85 years participated in the study. Female patients with fibromyalgia had higher BDI and VAS scores and lower frequency of sexual intercourse (p<0.001). While no significant relationship was observed between the frequency of sexual intercourse and VAS, FIQ, SSS and WPI scores, it was found that BDI was lower in those with an average monthly frequency of 8 or more sexual intercourses (p=0.02).
Conclusion: This study revealed that the frequency of sexual intercourse is low in female patients with FM and that depression is less common in women with FM who have a higher frequency of sexual intercourse.

Amaç: Çalýþmamýzýn amacý; yenidoðan yoðun bakým ünitesine alt solunum yolu enfeksiyonu tanýsýyla yatýrýlan bebeklerin demografik özelliklerinin deðerlendirilmesi, mikrobiyal etyolojinin, risk faktörlerinin ve yatýþ süresine etki eden nedenlerin belirlenmesidir.
Yöntem: Bu çalýþmada; hastanemiz yenidoðan yoðun bakým ünitesinde 01 Ekim 2022- 31 Mart 2023 tarihleri arasýnda alt solunum yolu enfeksiyonu nedeniyle yatýrýlan bebeklerin dosyalarý geriye dönük olarak incelendi. Hastalarýn demografik özellikleri, saptanan viral etkenler, yatýþ süresi ve risk faktörü oluþturabilecek durumlar çalýþma formuna kaydedildi. Viral etken tespit edilen ve edilemeyen bebekler iki gruba ayrýlarak klinik özellikleri karþýlaþtýrýldý. Ayrýca yatýþ süresine etki eden sebeplerin tanýmlanabilmesi için bebekler yatýþ sürelerine göre iki gruba ayrýlarak özellikleri incelendi.
Bulgular: Çalýþmaya 57 bebek dahil edildi. Bebeklerin %50,9’unda viral etken tespit edildi, en sýk saptanan viral etken %48,2 ile respiratuvar sinsityal virüs idi. Diðer saptanabilen viral etkenler; sýklýk sýrasýna göre Adenovirüs, SARS-CoV-2, Ýnfluenza A ve B idi. Viral etken pozitif ve negatif grup arasýnda demografik açýdan belirgin bir fark saptanmadý. Hastalar yatýþ sürelerine göre deðerlendirildiðinde viral etken pozitif saptanan, oksijen tedavi ihtiyacý olan bebeklerde yatýþ sürelerinin uzun olduðu görüldü (sýrasýyla p=0.02, p=0.03). Yatýþ süresi uzun olan grupta erkek cinsiyet oraný fazla ancak, bu fark istatistiksel anlamlý deðildi. Yatýþ süresi kýsa olan grupta sadece anne sütü ile beslenme oraný daha yüksek olmakla beraber bu fark istatistiksel anlamlý deðildi (p>0.05).
Sonuç: Alt solunum yolu enfeksiyonu nedeniyle hastaneye yatýrýlan yenidoðanlarda en sýk viral etken RSV idi. Etyolojide RSV saptanan bebeklerin hastaneye yatýþ süresinin daha uzun olduðu görüldü. Bu nedenle yenidoðanlarda alt solunum yolu enfeksiyonlarýnýn önlenmesinde RSV ile mücadele önem arz etmektedir. Sadece erken doðmuþ bebekler için deðil, tüm yeni doðan bebekler için RSV enfeksiyonuna karþý bir aþý veya immünoglobulin uygulamasýnýn geliþtirilmesi gerekmektedir. (SETB-2023-09-172)

Objectives: This study aims to determine the risk factors by examining the sociodemographic characteristics of infants hospitalized in the neonatal intensive care unit (NICU) due to lower respiratory tract infection (LRTI), to determine the factors that affect the duration of hospitalization, and to determine the underlying microbial factors and evaluate them in the light of the literature. Methods: This study evaluated the data of newborns hospitalized with LTRI between 01 October 2022 and 31 March 2023. Demographic characteristics of the patients detected viral agents, duration of hospitalization and risk factors were recorded in the study form. Babies divided viral LRTI and non-viral LRTI, and then compared with each other. Additionally, the facts that might affect the duration of hospitalization were investigated.
Results: The study included 57 babies. Viral agent was detected in 50.9% of the babies, the most frequently viral agent was respiratory syncytial virus (RSV) (48.2%). Other viral factors, in order of frequency; Adenovirus, SARS-CoV-2, Influenza A and B. There is no demographic difference between the viral agent positive and negative groups. The patients were evaluated according to length of hospitalization, it was seen that the hospital stay was longer in babies who were found to be viral positive and needed oxygen therapy (p=0.02, p=0.03, respectively). The male gender ratio was higher in the group with longer hospital stays, but this difference was not statistically significant. Although the rate of exclusive breastfeeding was higher in the group with a short hospitalization period, this difference was not statistically significant (p>0.05).
Conclusion: RSV is currently the most frequently detected viral agent in lower respiratory tract infections in newborns. The hospital stay of babies diagnosed with RSV is longer than those with non-RSV viral agents. So struggling with RSV is important in preventing lower respiratory tract infections in newborns. It is necessary to develop a vaccine or immunoglobulin application against RSV infection not only for preterm babies but also for all newborn babies.

Amaç: Bu çalýþmanýn amacý akut bronþiolitli çocuklarda hastanede yatýþ süresini etkileyen ve antibiyotik baþlanmasýna neden olan faktörleri belirlemektir.
Yöntemler: Bu çalýþma Konya Eðitim ve Araþtýrma Hastanesi'nde retrospektif olarak yapýlmýþtýr. Eylül 2017-Nisan 2019 tarihleri arasýnda (sonbahar, kýþ ve ilkbahar mevsimlerinde) çocuk servisinde izlenen 102 hastanýn demografik verileri, klinik özellikleri, laboratuvar ve radyolojik bulgularý, tedavi yöntemleri ve hastanede yatýþ süreleri hasta dosyalarýndan kaydedildi.
Bulgular: Toplam 102 hastanýn 67'si (%65.7) erkek, 35'i (%34.3) kadýndý. Ortanca yaþ 6.5 (11.0) aydý. Wang bronþiyolit klinik skorlamasýna göre hastalarýn 36'sý (%35.3) hafif, 51'i (%50.0) orta, 15'i (%14.7) þiddetli bronþiolit olarak saptandý. Polimeraz zincir reaksiyonunda (PCR) en sýk etken respiratuvar sinsityal virüs 60 ( %58.8), influenza virüs 20 (%19.6), rinovirüs 15 (%14.7), bocavirüs 15 (%14.7) ve parainfluenza virüs 12 (%11.7). Ortanca hastanede kalýþ süresi 7.0 (4.0) gündü. Hastalarýn 42'si (%41,2) ≤ 5 gün, 60'ý (%58,8) 5 günden fazla hastanede yattý. Hastanede kalýþ süresi, krepitan ral, lökositoz, nötrofili ve influenza virüsle koenfeksiyon ile anlamlý ve pozitif korelasyon gösterdi (sýrasýyla p=0,036, p=0,034, p=0,028, p=0,036). Hastanede kalýþ süresi, pH ve artmýþ havalanma ile anlamlý ve negatif korelasyon gösterdi (sýrasýyla p=0,002, p=0,003). Antibiyotik baþlanmasý, hýþýltýlý solunum, krepitan ral, lökositoz ve nötrofili ile anlamlý ve pozitif korelasyon gösterdi (sýrasýyla p=0,033, p=0,013, p=0,028, p=0,002)
Sonuç: Fizik muayenede krepitan ral, laboratuvarda respiratuar asidoz, PCR ile saptanan influenza virüsle koenfeksiyon ile 5 günden fazla hastanede yatýþ süresi arasýnda anlamlý iliþki bulundu. Fizik muayenede wheezing veya krepitan ral, laboratuvarda lökositoz veya nötrofili ile antibiyotik baþlanmasý arasýnda anlamlý iliþki saptandý. (SETB-2023-08-144)

Objectives: The aim of this study is to determine the factors affecting the duration of hospitalization and causing the initiation of antibiotics in children with acute bronchiolitis.
Methods: This study was conducted retrospectively in Konya Training and Research Hospital. Demographic data, clinical features, laboratory and radiological findings, treatment methods and duration of hospitalization of 102 patients followed up in the pediatric service between September 2017 and April 2019 (in autumn, winter and spring seasons) were recorded from patient files. Results: 67 (65.7%) of 102 patients were male, and 35 (34.3%) were female. Median age was 6.5 (11.0) months. According to Wang bronchiolitis clinical scoring, 36 (35.3%) of the patients were mild, 51 (50.0%) were moderate, 15 (14.7%) were severe bronchiolitis The most common agents in polymerase chain reaction (PCR) were respiratory syncytial virus 60 (58.8%), influenza virus 20 (19.6%), rhinovirus 15 (14.7%), bocavirus 15 (14.7%) and parainfluenza virus 12 (11.7%). The median duration of hospitalization was 7.0 (4.0) days. Forty-two (41.2%) of the patients were hospitalized for ≤5 days, and 60 (58.8%) were hospitalized for >5 days. Duration of hospitalization was significantly and positively correlated with crepitant crackles, leukocytosis, neutrophilia, and coinfection with influenza virus (p=0.036, p=0.034, p=0.028, p=0.036, respectively). Duration of hospitalization was significantly and negatively correlated with pH and increased aeration (p=0.002, p=0.003, respectively) Antibiotic initiation was significantly and positively correlated with wheezing, crepitant crackles, leukocytosis, and neutrophilia (p=0.033, p=0.013, p=0.028, p=0.002, respectively). Conclusion: A significant relationship was found between crepitant crackles in physical examination, respiratory acidosis in laboratory, co-infection with influenza virus detected by PCR and hospitalization for more than 5 days. A significant relationship was determined between wheezing or crepitant crackles in physical examination, leukocytosis or neutrophilia in laboratory and the initiation of antibiotic.

Amaç: Baþ aðrýsý yakýnmasý olan çocuk hastalarýn etyolojik ve klinik özelliklerini belirlemek amaçlandý.
Yöntem: Çocuk nöroloji polikliniðine baþ aðrýsý þikayeti ile baþvuran hastalarýn dosyalarý retrospektif olarak incelendi. Hastalarýn yaþý, cinsiyeti, baþ aðrýsýnýn özellikleri, baþ aðrýsýna eþlik eden semptomlar, mevcut kan tetkikleri, beyin manyetik rezonans (MR) ve elektroensefalografi (EEG) sonuçlarý kaydedildi.
Bulgular: Yaþlarý 3-17 yýl arasýnda deðiþen toplam 470 hastanýn 291'i (%61,9) kadýn, 179'u (%39,1) erkekti. Hastalarýn yaþ ortalamasý 12,38 ± 3,45 yýl idi. Yaþ gruplarýna göre 5 yaþ altý 16 (%3,4), 6-11 yaþ arasý 159 (%33,8), 12-17 yaþ arasý 295 (%62,8) hasta vardý. 289 (%61,5) hastaya primer baþ aðrýsý tanýsý konulurken, 122 (%26,0) hastaya sekonder baþ aðrýsý tanýsý kondu ve 59 (%12,5) hastanýn baþ aðrýsý sýnýflandýrýlamadý. En sýk görülen primer baþ aðrýlarý gerilim tipi baþ aðrýsý (GTB) (n: 177, %37,7) ve migren (n: 111, %23,6) idi. Sekonder baþ aðrýsý olan hastalarýn 86'sýna (%70,5) sinüzit tanýsý kondu. Sekiz (%1,7) hastada anormal nörolojik muayene bulgusu saptandý. Tüm hastalarýn 439'una (%93,4) beyin MR çekildi ve 52 (%11,8) hastada anormal beyin MR bulgusu saptandý. Tüm hastalarýn 205'ine (%43,6) EEG çekildi ve 24 (%11,7) hastada anormal EEG bulgusu saptandý.
Sonuç: Yaþ gruplarýna göre, baþ aðrýsý en sýk 12-17 yaþ grubunda görüldü. Baþ aðrýsýnýn en yaygýn nedenleri sýrasýyla GTB ve migrendi. En yaygýn ikincil baþ aðrýsý nedeni sinüzitti. Baþ aðrýsý nedenlerinin belirlenmesinde fizik ve nörolojik muayenenin hala önceliðini koruduðunu düþünüyoruz. (SETB-2023-08-132)

Objectives: It was aimed to determine the etiological and clinical features of pediatric patients with headache complaints. Methods: The files of patients who were admitted to the pediatric neurology outpatient clinic with headache were reviewed retrospectively. Patients' age, gender, features of headache, symptoms accompanying headache, available blood tests, brain magnetic resonance (MR) and electroencephalography (EEG) results were recorded.
Results: Of the total 470 patients, aged between 3 and 17 years, 291 (61.9%) were female and 179 (39.1%) were male. The mean age of the patients was 12.38±3.45 years. According to age groups, there were 16 (3.4%) patients under the age of 5, 159 (33.8%) between the ages of 6-11, and 295 (62.8%) patients aged 12-17 years. While 289 (61.5%) patients were diagnosed with primary headache, 122 (26.0%) patients were diagnosed with secondary headache, and headaches of 59 (12.5%) patients could not be classified. The most common primary headaches were tension-type headache (TTN) (n=177, 37.7%) and migraine (n=111, 23.6%). The 86 (70.5%) of the patients with secondary headache were diagnosed with sinusitis. Abnormal neurological examination finding was determined in 8 (1.7%) patients. Brain MR was performed in 439 (93.4%) of all patients and abnormal brain MR findings were detected in 52 (11.8%) patients. EEG was performed in 205 (43.6%) of all patients and abnormal EEG findings were detected in 24 (11.7%) patients.
Conclusion: According to age groups, headache was most common in the 12-17 age group. The most common causes of headache were TTN and migraine, respectively. The most common secondary headache cause was sinusitis. We think that physical and neurological examination still maintains its priority in determining the causes of headache.

Amaç: Yüksek aþýlama oranlarýna ulaþýlmasý diðer enfeksiyon hastalýklarýnda olduðu gibi COVID-19’un önlenmesinde de oldukça önemlidir. Bu çalýþma ile pediatri hekimlerinin, çocuklara COVID-19 aþýlamasý hakkýnda bilgi tutum ve davranýþlarýnýn deðerlendirilmesi amaçlandý.
Yöntem: Çalýþmamýz, tek merkezli, tanýmlayýcý- kesitsel, ileriye dönük olarak 20 Eylül 2022 - 30 Kasým 2022 tarihleri arasýnda yapýldý. Gönüllülük esasýna göre anket doldurmayý kabul eden 350 hekim örneklemi oluþturdu. Katýlýmcýlara sosyodemografik verileri, çocuklara COVID-19 aþýlamasý hakkýnda bilgileri, tutumlarý ve davranýþlarýyla ilgili toplam 21 sorudan oluþan bir anket formunu Google Forms üzerinden doldurmalarý istendi.
Bulgular: Çalýþmamýza %72,6’sý kadýn 350 pediatri hekimi katýldý. Katýlýmcýlarýn %51,4’ü Eðitim Araþtýrma Hastanesinde çalýþýyordu, %99,1’ü kendisi COVID-19 aþýsý olmuþtu. Pediatristlerin %65,7’si (n=230) tüm çocuklara COVID-19 aþýsýný önerirken, %27,7’si (n=97) sadece risk grubundaki çocuklara öneriyordu, %6,6’sý (n=23) çocuklara COVID-19 aþýsýný önermiyordu. Pediatristlerin aþýyý tüm çocuklara önermemelerinin ilk üç nedeni; %56,7 çocuklarda yeterli klinik araþtýrma olmamasý, %50 aþýnýn uzun dönem etkileriyle ilgili endiþeler, %27,5 aþýya baðlý yan etkilerdi. Katýlýmcýlarýn aþý önerdiði ilk üç risk grubu; %84,6 astým (kronik akciðer hastalýðý), %72 diyabet, %69,7 immun yetmezlikti. Pediatristlerin %68,9’u COVID-19 aþýsýnýn ülkemizde 12 yaþ ve üzerine yapýlmakta olduðunu biliyordu, %60,9’u COVID-19 aþýsýnýn çocuklar için güvenli olduðunu düþünüyordu. COVID-19 aþýsýnýn çocuklar için güvenli olduðunu düþünenlerin, çocuklara aþýyý önerme oraný daha yüksekti (p<0,001). Bilgi sorularýna verilen cevaplar incelendiðinde, çocuklara aþý önermeyenlerin bilgi düzeylerinin diðerlerine göre daha düþük olduðu (p<0,001) tespit edildi.
Sonuç: Çalýþmamýzda, pediatri hekimlerinin çocuklara çoðunlukla COVID-19 aþýsý önerdiðini saptadýk. Aþýnýn çocuklar için güvenli olduðu düþüncesinin ve COVID-19 aþýsýyla ilgili bilgi düzeyinin aþýyý önermekte etkili faktörler olduðunu tespit ettik. Bu nedenle pediatristlere COVID-19 aþýsýyla ilgili düzenlenecek eðitimlerin, çocuklara COVID-19 aþýsý önerme oranýný arttýracaðýný düþünmekteyiz. (SETB-2023-09-183)

Objectives: Achieving high vaccination rates is very important in the prevention of the coronavirus disease 2019 (COVID-19) as in other infectious diseases. This study aimed to evaluate pediatricians' knowledge, attitudes and behaviours about COVID-19 vaccination of children.
Methods: Our single-center, descriptive, cross-sectional, prospective study was conducted between September 20, 2022 and November 30, 2022. The sample consisted of 350 physicians who agreed to fill out the questionnaire voluntarily. Participants were asked 21 questions about their sociodemographic data, knowledge about COVID-19 vaccination of children, attitudes and behaviours via Google Forms.
Results: A total of 350 pediatricians, 72.6% of whom were women, participated in our study. 51.4% of the participants were working in a Training and Research Hospital, and 99.1% had received COVID-19 vaccination themselves. While 65.7% (n=230) of pediatricians recommended COVID-19 vaccination for all children, 27.7% (n=97) recommended it only for children in the risk group, and 6.6% (n=23) did not recommend COVID-19 vaccination for children. The most common reasons why pediatricians did not recommend the vaccine to all children were; 56.7% lack of sufficient clinical research on vaccination in children, 50% concerns about the long-term effects of the vaccine, 27.5% vaccine-related side effects. The most risk groups for which participants recommended vaccination were asthma (chronic lung disease) 84.6%, diabetes mellitus 72%, and immunodeficiency 69.7%. 68.9% of pediatricians knew that COVID-19 vaccine was used for children aged 12 years and older in Türkiye, and 60.9% thought that COVID-19 vaccine was safe for children. Those who thought that COVID-19 vaccine was safe for children were more likely to recommend the vaccine to children (p<0.001). When the answers given to the knowledge questions were analyzed, it was found that the knowledge level of those who did not recommend vaccination to children was lower than the others (p<0.001).
Conclusion: In the present study, pediatricians mostly recommend COVID-19 vaccine to children. The vaccine safety and the level of knowledge about COVID-19 vaccine are effective factors in recommending the vaccine. Therefore, we conclude that trainings to be organized for pediatricians about COVID-19 vaccine will increase the rate of recommending COVID-19 vaccine to children.

Granülomatöz apandisit (GA), apendiks duvarýnýn granülomatöz iltihabýdýr. GA genellikle idiyopatiktir; ancak Crohn hastalýðý, paraziter enfeksiyonlar ve tüberküloz gibi birçok hastalýk veya yabancý cisimler ile de iliþkili olabilir. Üç aydýr karýn aðrýsý ve safralý kusma þikayetleri olan 11 yaþýnda erkek hastada sað alt kadranda karýn hassasiyeti mevcuttu. Hastanýn beyaz küre sayýsý 8,6 x10^3/µL idi. Batýn ultrasonu plastron apandisit olarak deðerlendirildi ve apendektomi yapýldý. Mikroskobik olarak apendiks duvarýnda ödem, fibrozis ve lenfoid infiltrasyon ile kalýnlaþma gözlendi. Hasta GA'ya neden olan bir hastalýk saptanmadýðý için idiyopatik GA olarak deðerlendirildi. Apendiksin saðlam bir kývama sahip olduðu ve çevre dokulardan ayrýlmasýnýn zor olduðu durumlarda özellikle pediatrik yaþ grubunda malignite öncesi GA düþünülmelidir. Radikal cerrahiye karar vermeden önce apendektomi yapýlmalýdýr. (SETB-2022-12-267)

Granulomatous appendicitis (GA) is granulomatous inflammation of the appendix wall. It is generally idiopathic; however, it may also be associated with many diseases such as Crohn’s disease, parasitic infections, tuberculosis, or foreign bodies. An 11-year-old male patient, with a 3-month history of abdominal pain and bilious vomiting, had right lower quadrant abdominal tenderness. His white blood cell count was 8.6 x103/µL. An abdomen ultrasound was considered to show plastron appendicitis and an appendectomy was performed. Microscopically, thickening of the appendix wall with edema, fibrosis and lymphoid infiltration was observed. The patient was evaluated as idiopathic GA since no disease was detected that caused GA. When the appendix has a firm consistency and is difficult to separate from the surrounding tissues, GA should be considered before malignancy, particularly in the pediatric age group. An appendectomy should be performed before deciding on radical surgery.

Þarbon, Bacillus anthracis'in neden olduðu insanlarda nadir görülen zoonotik bir hastalýktýr. Bu hastalýðýn en yaygýn þekli kutanöz þarbondur. Nadiren göz tutulumu olabilir.
Bu vakada sol göz kapaðýnda þarbon bulunan dokuz yaþýnda bir erkek hasta sunulmaktadýr. Hastanýn öyküsünden gözün sol tarafýnda küçük bir papüler reaksiyon oluþtuðu, ardýndan lezyonun üç gün içinde büyüdüðü ve göz çevresinde ödem geliþtiði öðrenildi. Hastanýn preseptal selülit tanýsýnýn beþinci gününde göz lezyonlarýnda ilerleme ve göz çevresinde nekroz ve eskar oluþumu saptanýrken, hastanýn þikayetlerinin beþinci gününde Bacillus anthracis polimeraz zincir reaksiyonu (PZR) pozitifliði saptandý. Hasta siprofloksasin ve klindamisin ile tedavi edildi ve klinik yanýt alýndý.
Sonuç: Özellikle hayvanlar ile yakýn temasý olan hastalarda preseptal ve orbital selülitin ayrýcý tanýsýnda þarbon akýlda tutulmalýdýr. Palpebral þarbon zamanýnda etkili bir þekilde tedavi edilmezse göz kapaklarýnda izler býrakarak kalýcý þekil bozukluklarýna ve fonksiyon kayýplarýna neden olabilir. Erken taný konulup antibiyotik tedavisine baþlanmasý komplikasyon oluþumunu anlamlý derecede azaltýr. Bu olgu sunumunda þarbon hastalýðýnda nadir olarak görülen, göz kapaðý þarbonlu bir çocuk olgu sunulmuþtur. (SETB-2022-11-251)

Anthrax is a rare zoonotic disease in humans caused by Bacillus anthracis. The most common form of this disease is cutaneous anthrax. Rarely, eye involvement may occur.
In this case, a nine-year-old male patient with anthrax on his left eyelids is presented. From the patient's history, it was learned that a slight papular reaction occurred on the left side of the eye, then the lesion enlarged within three days, and edema developed around the eye. On the fifth day of the patient's preseptal cellulitis diagnosis, progress in eye lesions and necrosis and eschar formation around the eyes were detected, while Bacillus anthracis polymerase chain reaction (PCR) positivity was detected on the fifth day of the patient's complaints. The patient was treated with ciprofloxacin and clindamycin and a clinical response was achieved. Anthrax should be kept in mind in the differential diagnosis of preseptal and orbital cellulitis, especially in patients who have close contact with animals. If palpebral anthrax is not treated effectively on time, it can leave scars on the eyelids and cause permanent deformities and loss of function. Early diagnosis and initiation of antibiotic therapy significantly reduce the occurrence of complications. In this case report, a pediatric case with eyelid anthrax, which is rarely seen in anthrax disease, is presented.

COVID-19 ile iliþkili çok sayýda nörolojik tutulum bildirilmiþtir. Bununla birlikte, COVID-19 ile iliþkili abdusens sinir felci çok nadirdir ve çoðunlukla tabloya solunum belirtileri eþlik eder. Biz çift görme yakýnmasý ile baþvuran ve daha sonra bakýlan SARS-CoV-2 S antikorlarý pozitif, tek taraflý abdusens sinir felci olan 29 yaþýnda bir kadýn hastayý sunuyoruz. Baþvurduðunda herhangi bir solunumsal þikayeti olmayan hastanýn toraks bilgisayarlý tomografi (BT) incelemesinde viral pnömoni bulgularý vardý. Kranyal nörogörüntülemesi normaldi. Abdusens sinir felci kýsmen ve BT bulgularý tamamen favipiravir 2x1600 mg yükleme dozu ve daha sonra günde 2x600 mg idame, deksametazon 8 mg/gün, enoxaparin 6000 IU/gün tedavisi ile iyileþti. COVID-19 tedavisinin bitiminden bir hafta sonra, hastamýzda valasiklovir ile baþarýlý bir þekilde tedavi edilen Herpes simpleks keratiti de geliþti. Ýzole abdusens sinir felcinin, herhangi bir solunum belirtisi olmayan COVID-19 vakalarýnýn tek bulgusu olabileceði akýlda tutulmalýdýr. (SETB-2022-06-144)

Numerous neurological manifestations associated with COVID-19 have been reported. However, abducens nerve palsy (ANP) associated with COVID-19 is very rare and mostly related to accompanying respiratory symptoms. Here we present a 29-year-old woman with unilateral ANP manifesting with diplopia and positive SARS-CoV-2 S antibodies, which were checked later. On admission, she had signs of viral pneumonia in thorax CT without any respiratory symptoms. Her cranial neuroimaging revealed no abnormality. Following treatment with favipiravir 2x1600 mg loading dose and then 2x600mg daily maintenance, dexamethasone 8 mg/day and enoxaparin 6000 IU/day, her CT findings recovered completely whereas her ANP only partially resolved. One week after the end of COVID-19 treatment, she also developed Herpes simplex keratitis which was successfully treated with valacyclovir. It should be kept in mind that isolated abducens nerve palsy may be the only finding of COVID-19 cases without any respiratory symptoms.

Ýnternal karotid arterin (ÝKA) psödoanevrizmasý (PA) ve karotiko-kavernöz fistülü (KKF) endoskopik endonazal cerrahinin nadir bir komplikasyonudur ve vakalarýn %1'inde görülür. 37 yaþýnda bir kadýn hastada hipofiz adenomu nedeniyle iatrojenik ÝKA hasarýnýn neden olduðu ÝKA psödoanevrizma (PA) ve karotikokavenöz fistülü (KKF) için akým yönlendirici stentlerin (AYS) baþarýyla yerleþtirildiðini bildiriyoruz. Akým yönlendirici stent yerleþtirilmesinden sonra, belirli bir süre verilen ikili antiplatelet ajanlar ile takip anjiyogramý, tam anevrizma obliterasyonu ve hasarlý damarýn etkili endoluminal rekonstrüksiyonu kusursuzdu. ICA psödoanevrizmalarýnýn yönetiminde, akým yönlendirici stentlerin yerleþtirilmesi geçerli bir damar koruyucu tekniktir. (SETB-2023-08-150)

Pseudoaneurysm (PA) and carotid cavernous fistula (CCF) of the internal carotid artery (ICA) is an uncommon complication of endoscopic endonasal surgery that occurs in 1% of cases. We report on the successful placement of flow-diverting stents (FDS) to ICA pseudoaneurysm and caroticocavernous fistula caused by iatrogenic ICA injury for a pituitary adenoma in a 37-year-old female. After placement of the pipeline shield given a certain time, dual antiplatelet agents (DAPT) and follow-up angiogram verified complete aneurysm obliteration and effective endoluminal reconstruction of the injured vessel. In managing ICA pseudoaneurysms, the placement of flow-diverting stents is a viable vessel-sparing technique.