APPROACH TO CUTANEOUS LESIONS OF THE HEAD AND NECK IN THE GERIATRIC AGE GROUP: RETROSPECTIVE ANALYSIS OF 170 CASES

Introduction: The incidence of skin lesions increases with advancing age, especially in the head and neck region. The aim of this study was to evaluate the demographic data of head and neck skin lesions in the geriatric age group and the preferred surgical approaches. Material-Method: The records of 170 patients of an age >65 years who underwent surgical excision and reconstruction for head and neck lesions in our clinic were retrospectively reviewed. The histopathological results of the lesions and the repair method used were evaluated according to age and localization. Results: The mean age of the patients was 71.42 ± 14.20 years. The histopathologic distribution of the lesions were 75 (44.2%) basal cell carcinoma, 30 (17.6%) squamous cell carcinoma and 65 (38.2%) benign. The most frequent localizations were nose and cheeks, and the most preferred reconstruction methods were primary closure and advancement flap. None of the patients had serious complications. Conclusion: Basal cell carcinoma is the most common lesion in the head and neck region in elderly individuals. The lesions in this region can be detected in the early stage since they are in the visible region. The Surgical excision and repair with local flaps in the treatment provide very successful cosmetic results

Reliability and Validity of the Turkish Version of the Glasgow-Edinburgh Throat Scale: Use for a Symptom Scale of Globus Sensation in Turkish Population

Objective: In this study, we aimed to translate the Glasgow-Edinburgh Throat Scale (GETS) into Turkish and test its reliability and validity.Methods: A total of 69 patients with globus sensation and no signs of otolaryngologic or gastroenterological disease in etiology were included in the study. The patients were asked to complete the translated Turkish version (GETS-T) of GETS and the Hospital Anxiety and Depression Scale (HADS).Results: The Cronbach’s alpha coefficient of the patients in the study group was calculated based on the 12 questions in the GETS-T scale and found as 0.868. The correlation between the GETS-T total score and the total HADS score in the study group was found to be very low and statistically insignificant. As a result of factor analysis, it was found that the first 10 problems in GETS-T were divided into two sub-groups, unlike GETS.Conclusion: Translation of GETS into Turkish (GETS-T) showed high reliability and validity, suggesting that translation and cross-cultural adaptation was appropriate. The GETS-T can be used in studies about globus pharyngeus in future

TARİHİ SİLLE SUBAŞI HAMAMI TAŞIYICI SİSTEM ANALİZİ

TARİHİ SİLLE SUBAŞI HAMAMI TAŞIYICI SİSTEM ANALİZİÖzetBu çalışmada, 19. yüzyıl Osmanlı Dönemi’nde inşa edilen ve Konya İli Selçuklu İlçesi’ne bağlı Sille Ak Mahallesi’nde bulunan tarihi Subaşı Hamamı’nın mevcut durum değerlendirmesi yapılıp, yapının statik ve dinamik yükler altındaki durumu incelenmiştir. Yapının üç boyutlu modeli oluşturulmuş, sonlu elemanlar yöntemine göre lineer analizi yapılmış ve taşıyıcı elemanları üzerinde oluşan gerilmeler ile yerdeğiştirmeler incelenmiştir. Subaşı Hamamı mimari açıdan kesit ve iç tasvir olarak iki sıcaklık, iki ılıklık ve bir su deposundan oluşmaktadır. İki sıcaklık ve iki ılıklık mekanının üzeri tuğladan yapılmış kubbeden, su deposunun üzeri ise beşik tonoz ile örtülmüştür. 19.5x18 metre boyutuna sahip olan hamamın yapılan araştırma, inceleme ve analiz sonucunda, yapının mevcut kesitlerinin büyük olmasından dolayı basınç ve kesme gerilmelerine karşı yeterli dayanımının olduğu; kubbe, beşik tonoz ve kapı köşelerinde bazı çatlakların oluştuğu; modal analiz sonunda mod şekilleri incelendiğinde en fazla zorlanan kısmın beşik tonoz olduğu tespit edilmiştir.Anahtar Kelimeler: Tarihi Yapı, Yığma Yapı, Taşıyıcı Sistem Analizi, Statik Lineer AnalizSTRUCTURAL ANALYSIS OF HISTORICAL SILLE SUBASI BATH AbstractIn this study, the present situation of the historical Subasi Bath, which was built in the 19th century Ottoman Period and located in the Sille Ak District of the Selcuklu District of Konya Province, was evaluated and the status of the building under static and dynamic loads was examined. A three-dimensional model of the structure was created using a computer program, a linear analysis was made according to the finite element method, and the stresses and displacements on the carrier elements were examined. Subasi Bath consists of two the hottest rooms, two the tepidity rooms and one water reservoir in terms of architectural cross-section and internal depiction. The hottest and the tepidity rooms spaces are covered with a dome made of brick, while the water tank is covered with a cradle vault. As a result of the research, examination and analysis of the bath, which has a size of 19.5x18 meters, it has sufficient resistance against pressure and shear stresses due to the big cross sections of the building; there are some cracks in the dome, cradle vault and door corners; When the modal analysis was examined, the most critical part was found to be the cradle vault.Keywords: Historical Structure, Masonry Structure, Structural Analysis, Static Analysi

Association of serum and follicular fluid leptin and ghrelin levels with in vitro fertilization success

 Objectives: The aim of this study was to evaluate the relationship between in vitro fertilization (IVF) cycle outcomes, serum and follicular fluid (FF) levels of leptin and ghrelin. Material and methods: Forty-four women who underwent intracytoplasmic sperm injection cycles (ICSI) were enrolled in the study. On the third day (D3) of the menstrual cycle, venous blood samples were drawn for serum measurements of leptin and ghrelin. The follicular fluid (FF) and the corresponding oocyte were obtained from a single dominant preovulatory follicle at the time of oocyte pick-up. The FF and D3 serum leptin and ghrelin concentrations were measured by enzyme-linked immunosorbent assay. The relationship between pregnancy rate and serum, follicular fluid levels of leptin and ghrelin were analyzed. Results: Of the 44 cases included, nineteen achieved clinical pregnancy (43.18%). Follicular fluid ghrelin levels were significantly lower in the pregnant group than non-pregnant group (p < 0.05) With respect to FF leptin, there was no statistically significant differences between the pregnant and non-pregnant women (p > 0.05). There was no statistically significant difference in D3 serum ghrelin between pregnant and non-pregnant groups (p > 0.05). However, D3 serum leptin levels were significantly lower in pregnant women than non-pregnant women (p < 0.05). Conclusions: Lower ghrelin levels in the follicular fluid were associated with higher pregnancy rates. Also, D3 serum leptin levels were inversely correlated with clinical pregnancy rates. These findings support the potential role of these molecules on IVF outcomes

Examination of perception dimension of engineering technology and ergonomics principles in terms of healthcare personnel: a scale development study

In general terms, ergonomics is the conformity of human and equipment. Unconformity between human and equipment is more likely to give harm either to the equipment or to human. This conformity may go for both daily domestic tasks and work life. Domestic furniture and equipment are designed by taking average features of individuals into consideration. For example; chairs, tables, beds and similar things are manufactured with the measurements which are accepted as standard all over the world. People spend most of their time at their homes and workplaces. Similarly, the ergonomics considered in the manufacture of domestic furniture takes an important place in working life, as well. This is highly significant in terms of both health of workers and efficiency of the work done. On the other hand, ergonomics possesses importance in terms of patients except from workers and work efficiency in health sector. Working in non-ergonomic settings may both endanger health of healthcare personnel and cause decrease in work efficiency as well as posing negative effects for recovery of the patients. From this point of view, ergonomics in health sector becomes more important in many aspects. In this study, it was aimed to develop a scale with regard to finding out perceptions of the healthcare personnel on engineering technologies and ergonomics principles

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

Background Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide.Methods A multimethods analysis was performed as part of the GlobalSurg 3 study-a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital.Findings Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3.85 [95% CI 2.58-5.75]; p<0.0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63.0% vs 82.7%; OR 0.35 [0.23-0.53]; p<0.0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer.Interpretation Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised

Erken sakroiliit tanısında BT ve MRG’nin karşılaştırılması

Objective: A prospective study to compare the effectiveness and usefulness of CT and MR in diagnosis of sacroiliitis, and then to determine the most appropriate sequences to be used in MR. Material and Methods: The sacroiliac joints (SIJs) of 40 patients with strong clinical suspicion of inflammatory sacroiliitis (median duration of inflammatory low back pain of 5 months) were evaluated by MR imaging using T1, T2 fat saturated (FS), STIR, two-dimensional (2D) T2* FLASH and after i.v Gd contrast medium T1 fat saturated (FS) sequences on a 1.5 T system. The findings were compared with those obtained by CT. Results: Sacroiliitis was found in 25 patients by CT and 26 patients by MR. MR and CT had equal efficacy in the diagnosis of sacroiliitis. There was no significant difference between CT and MR in the determination of erosion and osseous sclerosis. Only MR allowed the determination of active inflammatory changes in the subchondral bone and joint space. Post contrast T1- weighted sequence did not contribute to the assessment of sacroiliitis. Conclusion: MRI and CT can determine destructive bony changes related with sacroiliitis in close estimates. On the other hand, only MRI can visualize early inflammatory changes such as bone marrow edema and enhancement in the joint space that can not be shown by CT. Another advantage of MRI is that it has no ionizing radiation. When available, MRI has to be first modality to choose in diagnosis of early sacroiliitis. In addition, coronal T1 and STIR should be considered as the first sequences.Amaç: Bu prospektif çalışmanın amacı, erken sakroiliit tanısında bilgisayarlı tomografi (BT) ve manyetik rezonans görüntülemenin (MRG) kullanılışlığını ve etkinliğini kıyaslamak ve sonrasında MRG’ de kullanılabilecek en uygun sekansları belirlemektir. Gereç ve Yöntem: Klinik olarak erken sakroiliit şüphesi olan ( hastaların inflamatuar bel ağrılarının ortalama süresi 5 ay’dır) 40 hastanın sakroiliiak eklemleri koronal planda T1, yağ baskılı T2, STIR, 2D T2* FLASH ve intravenöz (I.V) kontrast madde uygulanımı sonrasında yağ baskılı T1 sekansları kullanılarak 1.5 T MRG ile değerlendirildi. Elde edilen bulgular BT bulguları kıyaslandı. Bulgular: Kırk hastanın 26’sında MRG ile 25’inde ise BT ile sakroiliit saptandı. MRG ve BT sakroiliit tanısında benzer etkinliğe sahipti. Erozyon ve sklerozun tespitinde BT ve MRG arasında anlamlı bir farklılık saptanmadı. Bununla birlikte subkondral kemik ve eklem mesafesindeki aktif inflamatuar değişiklikler yalnızca MRG ile gösterilebildi. Kontrast madde kullanımı sakroiliitin değerlendirilmesinde ek bir fayda sağlamadı. Sonuç: Sakroiliit ile ilişkili kemik değişikliklerinin saptanmasında MRG ve BT arasında belirgin bir farklılık yoktur. Bununla birlikte; MRG BT’den farklı olarak erken inflamatuar değişiklikleri görüntüleyebilme özelliğine sahiptir. MRG’nin diğer bir avantajı iyonizan radyasyon içermemesidir. Ulaşılabilir olduğunda MRG erken sakroiliit tanısında kullanılacak ilk yöntem olmalıdır. Böyle bir durumda öncelikle koronal T1 ve STIR sekanslarından oluşan bir çalışma planlanabilir