Organ Donation Course in Medical Education Program

The number of patients waiting for organ transplantation is increasing. Today, living donors and cadaveric donors comprise the donor pool. Although it varies from country to country, organ transplants are mostly based on living donors because the cadaveric donor pool is not enough. There are different alternatives to increase the cadaveric donor pool. One of them is to raise awareness of organ donation in undergraduate medical education. Unfortunately, its effectiveness is controversial. In this section, to increase the effectiveness of the organ donation course given in medical education programs, a method proposal is presented. Medical professionals’ knowledge of and attitudes toward donation have an impact on donation rates. It is possible that these attitudes and knowledge are molded during pre-graduation. As such, educating medical students may be an important factor in increasing organ donation. Learners’ participation in an educational program is one of the most important factors contributing to learning. Flipped classroom is a student-oriented education method based on the combination of in- and out-of-class activities. With the use of the flipped classroom method in organ donation courses offered in medical education programs, students’ knowledge and skills that enable them to discuss the topic of donation with patients can be improved

Relationship Between the Neutrophil to Lymphocyte Ratio and the Presence and Size of Thyroid Nodules

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Does insulin resistance trigger thyroid nodule?

The relationship between insulin resistance and thyroid nodules is not clearly understood. The purpose of this study is to investigate the relationship between insulin resistance and thyroid nodules in non-diabetic patients. 410 patients who applied to the Internal Medicine outpatient clinic from June 2018 to July 2019 were reviewed retrospectively. A total of 216 non-diabetic patients were divided into two groups. The relationship of 105 patients with thyroid nodules and 110 patients without thyroid nodules with insulin resistance was investigated. Homeostasis model assessment of insulin resistance value, serum triglycerides and total cholesterol level, and the ratio of women were higher in the group with thyroid nodules (p < 0.05). There was a positive and significant relationship between homeostasis model assessment of insulin resistance value and thyroid nodules (r + 0.29, p < 0.05). In non-diabetic thyroid nodule patients, a significant relationship was detected between nodule formation and insulin resistance. However, these data must be confirmed by other studies in the future

An endocervical malignancy case presenting with massive pleural effusion and mimicking urinothorax: diagnostic challenge

47 yaşında kadın hasta, sol hemitoraksta plevral efüzyonla başvurdu. Plevral sıvı aspirasyonu ürinotoraks için tanısal değildi. Ancak endoservikal biyopsi sonucu servikal adenokarsinom lehine saptandı. Kadınlarda hiçbir vaginal semptom olmadan plevral efüzyon, metastatik endoservikal adenokarsinomun ilk başvuru semptomu olabilir. Aynı zamanda herhangi bir anormal lezyon, primer bir maligniteye sekonder matastaz olabileceğinden hastanın bütünsel değerlendirilmesi önemlidir.We report the case of a 47-year-old woman presenting left-sided pleural effusion as her initial symptom. Pleural aspirate was not diagnostic for urinothorax. However, cervical punch biopsy revealed cervical adenocarcinoma. A pleural symptom such as massive pleural effusion, not vaginal symptoms, in a woman may be a first manifestation of metastatic cervical cancer. Furthermore, any abnormal lesion should not be ignored because of the possibility of metastasis from the primary malignancy, especially in the current case of cervical adenocarcinoma, so a complete evaluation is always mandatory

Metastatik Böbrek Tümöründe Güncel Tedavi Yöntemleri: Literatürün Gözden Geçirilmesi

Renal hücreli karsinomun (RHK) patogenezinde rol oynayan biyolojik mekanizmaların daha iyi anlaşılmasıyla, yeni immünoterapi ve hedefe yönelik tedavi yöntemleri geliştirilmektedir. Bu ajanlar Faz III çalışmalar ile desteklenmekte, dolayısıyla sürekli olarak uluslararası RHK tedavi kılavuzlarında değişiklikler olmaktadır. Yüksek doz interlökin-2, immün kontrol noktası inhibitörleri "anti-programmed cell death-1 (PD-1) antibody (nivolumab)", vasküler endotelyal büyüme faktörü ve rapamisinin memeli hedefi yolak inhibitörlerinin seçimi hastanın prognostik durumu ve daha önce almış olduğu tedaviler göz önüne alınarak, en son yayımlanan çalışmalar ışığında değerlendirilmelidir. Bu çalışmada, metastatik RHK tedavisinde güncel tedavi seçeneklerinin ve klinik uygulamalarının literatür gözden geçirilerek ortaya konulması amaçlanmıştır.Anahtar Kelimeler: Renal hücreli karsinom; immünoterapi; moleküler hedefe yönelik tedaviUnderstanding the biological mechanisms of renal cell carcinoma (RCC) has led to the development of newly immunotherapy, anti-angiogenic and molecularly targeted agents and effective combinations of these agents. Internationally accepted clinical practice guidelines for metastatic RCC have undergone several revisions because these treatment regimes are supported by Phase III trials. The choice of the treatment regimes (high-dose interleukin-2, checkpoint inhibitors "anti-programmed cell death-1 antibody (nivolumab)", inhibitors of the vascular endothelial growth factor ve mammalian target of Rapamycin pathways should be assessed in the light of the latest published studies, the treatments previously received and the prognostic status of the patient. In this review, the data supporting the roles of novel therapeutic agents and current treatment options of metastatic RCC, are presented in accordance with the literature.Keywords: Renal cell carcinoma; immunotherapy; molecular targeted therapy</p

Mauriac Sendromu: Olgu Sunumu ve Literatürün Gözden Geçirilmesi

Diyabetik ketoasidozun klinik bulgularıyla prezente olan kötü kontrollü tip 1 diabetes mellitus tanılı genç bir erkek hastayı sunuyoruz. Hasta stabilize edildikten sonra, hepatomegali ve artmış karaciğer enzimleri açısından incelendi. Diğer klinik bulgular eşliğinde, hastaya Mau- riac sendromu tanısı koyuldu. Mauriac sendromu ilk olarak 1930'da Mauriac tarafından tanımlanmıştır ve kötü kontrollü diyabetik hasta- lardaki hepatomegali ve karaciğer enzim yüksekliği sebeplerinden biridir. Hepatomegali, büyüme geriliği ve sendromun diğer klinik bulgularının insulin tedavisinin optimizasyonu ile geri dönebildiği bilinmektedir. Kötü kontrollü diyabet hastalarında, hastalar cinsel matü- rasyon ve büyüme gelişme açısından yakından izlenmelidir. Optimal tedavi verildikten sonra, klinik bulguların regresyonunu izlemek açı- sından yakın takip elzemdirThis is a case report of a young male with poorly controlled type 1 diabetes mellitus who presented with the clinical features of diabetic ke- toacidosis. Once the patient was stabilized, he was examined for hepatomegaly and elevated liver enzymes. Along with the other clinical features, the patient was diagnosed as a case of Mauriac Syndrome. Mauriac Syndrome, initially described by Mauriac in 1930, is one of the causes of hepatomegaly and elevated liver enzymes in poorly controlled diabetic patients. However, hepatomegaly, growth retarda- tion and other clinical features of the syndrome have been found to be reversible with optimization of insulin therapy. In patients with po- orly controlled diabetes, Type 1 diabetic patients must be closely observed for sexual maturation and growth. After optimal therapy has been given, close follow-up is essential to observe the regression of clinical feature