YARDIMCI ÜREME TEKNİKLERİNDE İLERİ BABA YAŞININ PERİNATAL SONUÇLARA ETKİSİ

Amaç: İleri anne yaşının yardımcı üreme tekniklerinin (YÜT) başarı şansını düşürdüğü net bir şekilde ortaya konmuştur. İleri baba yaşının spontan gebeliklerde, olumsuz gebelik sonuçlarıyla ve perinatal sonuçlarla ilişkili olduğuna dair çalışmalar vardır. Ancak ileri paternal yaşın, YÜT sonuçlarına etkisine dair az sayıda çalışma vardır. Bu çalışmada in vitro fertilizasyon (IVF) tedavisi gören hastalarda, ileri paternal yaşın siklus sonuçlarına ve perinatal sonuçlara etkisini değerlendirmeyi amaçladık. Gereç ve Yöntemler: Bu çalışmada; Mayıs, 2021-Aralık,2022 yılları arasında Ankara’da özel bir tüp bebek merkezine başvuran IVF tedavisi alan çiftlerden erkek yaşının 45 ve üstü olduğu olguların retrospektif analizi yapılmıştır. Olguların siklus karakteristikleri değerlendirilerek gebelik olan ve olmayan olgular ile, canlı doğum ile sonuçlanan ve düşükle sonuçlanan olgular siklus özellikleri ve sperm parametreleri açısından karşılaştırılmıştır. Bulgular: Çalışmaya dahil edilen 76 siklustan 47’si(%61.8) embryo transferi (ET) ile sonuçlandı, geriye kalan 29(%38.2) siklusta, transfer yapılamadı. ET yapılan sikluslardan 29’u(%61.7) gebelik ile sonuçlanırken, 18’inde(%38.2) gebelik görülmedi. Gebelik olan 29 siklustan 13’ü düşük (%44.8), 16’sı (%55.2) ise canlı doğum ile sonuçlandı. Gebelik pozitif veya negatif olan sikluslarla, canlı doğum veya düşük ile sonuçlanan sikluslarda yıkama öncesi ve sonrası sperm parametreleri ile siklus sonuçları bakımından gruplar arasında fark gösterilemedi. Düşük oranı spontan gebelik ve YÜT gebeliklerinde görülenin üstünde bulundu. Sonuç: YÜT uygulanan hastalarda ileri baba yaşı artmış düşük oranlarıyla ilişkili olabilir, bu hasta grubunda siklus ve gebelik sonuçlarına etki eden faktörleri araştırırken kapsamlı semen analizleri yapılarak sperm sayısı ve motilitesi dışında YÜT sonuçlarını ve perinatal sonuçları etkileyebilecek ek parametrelerin değerlendirilmesi gereklidir

The awareness of chest physicians about nutritional assessment in chronic obstructive pulmonary disease

Introduction: The number of studies that target nonpharmacologic treatments for chronic obstructive pulmonary disease ( COPD) are increasing because no existing pharmacologic treatment modality for COPD leads to significant improvement in lung function. Positive effects can be observed in patients with COPD using nutritional support alone or as an adjunct to exercise. In this study, we aimed to evaluate the awareness of chest physicians about the nutritional state of patients with COPD

The Evaluation of the Diagnostic Performance of the BioFire FilmArray Meningitis/Encephalitis Panel in Children: A Retrospective Multicenter Study

Objective Acute bacterial meningitis (ABM) declined after implementing conjugate Haemophilus influenzae type B and the pneumococcal vaccines worldwide. However, it still contributes to significant morbidity and mortality. The Biofire FilmArray Meningitis Encephalitis (FAME) panel can rapidly diagnose common bacterial and viral pathogens. Several studies suggested that the use of FAME may accelerate diagnosis and decrease the time to pathogen-specific therapy. However, the clinical utility is still controversial due to scarce data and relatively high costs. Therefore, we aimed to evaluate the diagnostic performance of FAME in children. Methods A retrospective multicenter cross-sectional study was conducted to evaluate FAME in diagnosing ABM in children with a suspected central nervous system infection between January 2017 and May 2021. Results This study consisted of 179 children diagnosed with central nervous system infection who had parallel testing done using FAME and traditional microbiological diagnostic methods. Twenty-two FAME results were positive; 8 (36.3%) were bacterial pathogens and 14 (53.7%) were viral pathogens . The most common viral pathogen was human herpesvirus 6 (n =6; 27.2%), followed by herpes simplex virus 1 (n =4; 18.1%), Enterovirus spp. (n = 2; 9%), Parechovirus (n = 2; 9%), and Cytomegalovirus (n = 1; 4.5%). Bacterial pathogens included S. pneumoniae (n = 3; 13.6%), H. influenzae (n = 3; 13.6%), Neisseria meningitidis (n = 1; 4.5%), and Streptococcus agalactiae (n = 1; 4.5%). Bacterial culture confirmed S. pneumoniae infection in only 1 of 8 (12.5%) patients, while 7 of 8 bacterial meningitis were only detected by FAME. Conclusion FAME may also help with diagnosis and pathogen identification in patients who have already had antibiotics before cerebrospinal fluid collection. The use of FAME to detect infections quickly may minimize the improper use of medications, treatment duration, and the cost of hospitalization

An unexpected diagnosis during laryngeal intubation: osseous polypoid lesion of the tongue: osteoma or choristoma?

Soft tissue osteoma is a rare entity having a strong predilection for the head and neck region, mainly posterior region of the tongue. The so-called lingual osteoma is mostly manifested as an asymptomatic exophytic lesion. It can be diagnosed by physical or radiological examinations

Munchausen by Proxy Syndrome: A Case Series Study from Turkey

Munchausen syndrome by proxy (MSBP) is a rare form of child abuse in which a caregiver deliberately exaggerates, fabricates, and/or induces health problems in those in their care. The condition is extremely difficult to characterize and diagnose, as it manifests in many forms, often confusing the medical team. Insufficient knowledge regarding the syndrome and rare consideration of the differential diagnosis results in failure to recognize the problem. Literature suggests that an increase in physician awareness of the disorder can prevent or reduce its morbidity and mortality. For this reason, we believe that case series can help increase current knowledge on epidemiology, aetiology, diagnostic criteria, advised management of MSBP, and the psychological portrait of the perpetrator. Additionally, no data from Turkey has previously been presented on this issue. This study aimed to report characteristics of MSPB victims and alleged perpetrator, which were diagnosed and managed by a multidisciplinary team