Tıbbi Tekstiller ve Yara Örtüsü

Son yıllarda yaşanan ekonomik ve teknolojik gelişmelere bağlı olarak insan ihtiyaç ve istekleri hızla değişmektedir. Bu gelişmeler insan yaşamına kolaylıklar sağlarken, öte taraftan doğal yaşamı ve çevreyi olumsuz şekilde etkilemektedir. Bu olumsuz gelişmelerin bir neticesi olarak; kanser gibi bazı ciddi rahatsızlıklarda artış gözlemlenmektedir. Afrika ülkeleri başta olmak üzere birçok üçüncü dünya ülkesinde salgın hastalıkların oranında artış görülmektedir. Gelecek nesillere daha güzel ve sağlıklı bir dünya bırakmak için hastalıkların çabuk iyileşmesine yardımcı olan ve salgınları engelleyebilecek tekstil ürünlerinin kullanımına dikkat etmek gerekmektedir. Bu bağlamda, tıbbi tekstillere gereken önemin verilmesi oldukça önemlidir

Hypernatremic dehydration in exclusively breast-fed infants

Yenidoğan yoğun bakım ünitesine şiddetli hipernatremik dehidratasyon nedeni ile yatırılan, tek başına anne sütü ile beslenmiş olguların özellikleri değerlendirildi. Hastalar ve Yöntemler: Son iki yılda sadece anne sütü ile beslenmiş, serum sodyum değeri 150 mEq/L’den daha yüksek ve dehidratasyon bulguları olan 14 yenidoğan (10 kız, 4 erkek; ort. gebelik yaşı 38±1.7; dağılım 34-40 hafta) geriye dönük olarak yatış dosyaları incelenerek değerlendirildi. Bulgular: Olguların %71’i kızdı. Doğum tartıları ortalama 3020±715 gr idi. Olguların %93’ü AGA ve %78.6’s› ailenin ilk bebeğiydi. Anne yaşları ortalama 28±5.4 yıldı. %57 olgu sezaryenle ve %57 olgu çevre hastanelerde doğmuştu. En sık başvuru nedeni emmeme ve ateşti, başvurular ortalama 5.5±4.6 günde yapılmıştı. Başvuru sırasında hesaplanan tartı kayıpları %14.5±9.1, ortalama serum sodyum değeri 158.5±14 mEq/L, serum üre değeri 73±109 mg/dl, serum kreatinin 1.2±2.1 mg/dl, serum osmolaritesi 338±35 mOsmol/L idi. Sonuç: Olguların çoğunun ilk bebek olması ve sezaryen ile doğmaları dikkat çekiciydi. Hipernatremik dehidratasyonun gelişmemesi için anneye mutlaka iyi bir emzirme danışmanlığının verilmesi uygun olacaktır.The characteristic features of exclusively breast-fed infants with hypernatremic dehydration in our neonatal intensive care unit were evaluated. Patients and Methods: Within the last two years, fourteen exclusively breast-fed newborn infants (10 females, 4 males; mean gestational age 38±1.7; range 34 to 40 weeks) whose serum sodium level was equal to or greater than 150 mEq/L with signs of dehydration were evaluated from clinical charts retrospectively. Results: 71% of all cases were girls. Mean birth weight was 3020±715 gr. 93% of the cases were AGA and 78.6% were first child of the family. Mean age of mothers was 28±5.4 years. 57% of the cases were born by cesarean and 57% were referred to our hospital from different hospitals. The most common presenting complaint was fever and refusing sucking; and mean application time was 5.5±4.6 days. On the admission, mean weight loss was 14.5±9.1%, serum sodium level 158.5±14 mEq/L, serum urea level 73±109 mg/dl, serum creatinine level 1.2±2.1 mg/dl, and serum osmolarity 338±35 mOsmol/L. Conclusion: It was remarkable that the cases were mostly first babies and born by cesarean section. A possible solution for hypernatremic dehydration would be to provide breast feeding consultancy to mothers

Teknoloji kullanımında ebeveyn tutum ölçeğinin geliştirilmesi

Teknolojinin yaygınlaşması ve kolay erişebilir bir hale gelmesi yaşamın her alanında etkisini göstermekte, teknoloji hemen her ailenin günlük hayatında yer edinmeye başlamakta ve bu durumun aktif bir şekilde teknoloji kullanımına başlayan çocukların ebeveynleri ile olan iletişimlerini ve ebeveyn tutumlarını etkilediği düşünülmektedir. Bu çalışma okul öncesi dönemde çocuğu bulunan ebeveynlerin, çocuklarının teknolojik araç kullanımlarına yönelik bilgi ve tutumlarının belirlenmesinde geçerli ve güvenilir bir ölçme aracı geliştirmeyi amaçlamıştır. Araştırmanın örnekleminde kartopu ve rassal örnekleme yöntemiyle seçilmiş 243 ebeveyn bulunmaktadır. Araştırmanın amacı teknoloji kullanımında ebeveyn tutumlarının bilgi ve tutum boyutlarını ölçecek bir ölçme aracı geliştirilmesi olduğu için elde edilen veri setiyle öncelikle açımlayıcı faktör analizi (AFA) gerçekleştirilmiştir. Araştırma sonucu Teknoloji Kullanımında Ebeveyn Tutum Ölçeğinin geçerli ve güvenilir bir ölçek olduğunu göstermiştir

COVID-19 infection in pregnancy: A single-center experience in Rize in the Eastern Black Sea Region

Aim: In this study, it was aimed to share the clinical experiences of mothers and their babies (perinatal, natal) who encountered severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during pregnancy. Material and Methods: The study was carried out retrospectively, 62 pregnant individuals were diagnosed with the 2019 coronavirus disease (COVID-19). Demographic characteristics, clinical course, laboratory and radiological findings and clinical results of the baby were evaluated by examining electronic and file records. Results: The average age of the 62 pregnant women included in the study was 29.8 +/- 4.7 (19-42) years, and the average gestational week at the time of admission was 28.5 +/- 10.4 (5-40) weeks. More than half of the patients (80,6%) on admission were in their third trimester. The most common initial symptoms were cough (45.2%), myalgia (43.5%),) fever (21%). In total, 15 of the pregnant women had evidence of COVID-19 pneumonia in lung involvement. The PCR test results of all pregnant women were positive. There were three cases admitted to the intensive care unit, one of whom was due to gestational diabetes. No maternal mortality was recorded. One gestation ended in a miscarriage and two women gave birth prematurely. One stillbirth occurred at the 33h week of gestation. Among 22 neonates, two were admitted to the neonatal intensive care unit. Neonatal mortality, congenital malformation, and mother- to- child transmission were not observed in newborns. Discussion: The results of our study suggest that the clinical course of COVID-19 infection in pregnant women was mostly asymptomatic/mild

A case of diastrophic dysplasia associated with mega cysterna magna

İskelet displazileri boy kısalığı, kemik ve kıkırdak malformasyon ve deformasyonları ile karakterize heterojen bir grup hastalığı kapsar. Diyastrofik displazi (DTD) kulak anomalileri, ayak ve spinal deformiteler, “otostopçu başparmağı” ve kısa boy ile karakterize bir hastalıktır. İç organ tutulumu yoktur. Multipl anomalilerinin olması nedeniyle kliniğimize sevk edilen yenidoğanın fizik muayenede; genel durum kötü, renk siyanotikti, orantısız boy kısalığı, geniş ön fontanel, kısa boyun, düşük kulak, kulak kepçesinde “karnı bahar” deformitesi, yarık damak, otostopçu başparmağı, başparmak dışında diğer el parmaklarında incelik ve uzunluk, proksimal yerleşimli ayak başparmağı, büyük eklemlerde fleksiyon kontraktürleri, iki taraflı talipes ekinovarus ve sol skrotal herni olduğu belirlendi. Kraniyal tomografide, posterior fossada mega sisterna magna tespit edildi. Bu klinik ve radyolojik bulgularla olguya DTD tanısı kondu. On dokuzuncu günde yenidoğan polikliniğinden takip edilmek üzere, aileye genetik danışmanlık verilerek taburcu edildi.Skeletal dysplasias comprise a large group of hereditary disorders characterized by abnormal growth, short stature and malformations and deformations of bone and cartilage. Diastrophic dysplasia is a skeletal disorder characterized by short stature, foot and spinal deformities, hitchhiker's thumb and ear abnormalities. Internal organs develop normally. The physical examination of the newborn referred to our hospital for multiple abnormalities revealed a poor general condition with cyanosis, disproportionate short stature, large front fontanel, short neck, misshapen upper ear and ‘cauliflower' deformity, cleft palate, hitchhiker's thumb, long and slim fingers except the thumb, proximally located toes, flexion contractures in the large joints, bilateral talipes equinovarus and left scrotal hernia. Mega cysterna magna was demonstrated in the posterior fossa in the cranial tomography. With these clinical and radiological findings, the newborn was diagnosed as diastrophic dysplasia. The infant was discharged on day 19 after genetic counseling to the family and was to be followed up by the newborn outpatient clini

Amniotic band sequence: A case report

Amniotik bant sekans (ABS) ekstremite amputasyonları, konstriksiyon bantları, psödosindaktili, multipl kraniofasyal, visseral ve karın duvarı defektleri ile karakterize, sporadik doğuştan anomaliler içerisinde yer alan bir durumdur. Doğum öncesi kontrollerini düzenli olarak yaptırmamış bir anneden 30 haftalık, 1310 gr olarak doğan ve doğumda resüsitasyon gerektiren preterm kız bebek, multipl doğuştan anomalileri olması nedeniyle kliniğimize sevk edildi. Fizik muayenede antimongoloid görünüm, iki taraşı büyük ve düşük kulak vardı. Sağ elde ikinci ve dördüncü parmaklarda distal interfalangeal eklem hizasında boğum vardı, üçüncü parmak proksimal interfalangeal eklemden ampute idi. Sağ ayakta pes kalkaneus, birinci parmak uç kısmında boğum ve diğer parmaklar arasında sindaktili vardı. Sol ayakta pes ekinovarus mevcuttu ve beşinci parmak dışında diğer parmaklar ampute idi. Diğer dış ve iç organ sistemlerinde tutulum yoktu. Plastik cerrahi ile konsülte edildi. Olgu, ailesinin isteği üzerine postnatal yedinci günde taburcu edildi.Amniotic band sequence (ABS) is a sporadic congenital anomaly characterized by amputation of limbs, constriction bands, pseudosyndactylism, multiple craniofacial, visceral and abdominal wall defects. A female preterm infant of 30 weeks, weighing 1310 g and born to a mother who did not receive regular antenatal follow- up, was born with multiple congenital anomalies requiring resuscitation at birth was referred to our clinic. Her physical examination revealed antimongoloid slant, bilateral large and low-set ears, presence of circular constriction bands on second and fourth distal interphalangeal joints and absence of 3rd digit by the amputation of the proximal interphalengeal joint on the right hand, pes calcaneus deformity, constriction band on toe and syndactly of other digits of right foot, equinovarus deformity and amputation of all digits other than 5th digit of left foot. No other external and internal organ involvement was noted. Plastic surgery consultation was made. She was discharged on postnatal day 7 upon the request of her parents

Knowing the ABCs: Teaching the principles of radiology to medical students in Turkey

Background: Radiology education in Turkey is mainly taught during clinical years of medical school and often lacks main principles. Exposure to the fundamentals of radiology at an early stage of medical education may drastically help students generate a better understanding of radiology and expand their interest in the specialty. With the Principles of Radiology Course that we provided, pre- and post-session tests, and assessment survey at the end of the course, we aimed to evaluate the effectiveness of such an online course among Turkish medical students. Methods: A total of nine online sessions on imaging modalities principles was developed by radiology professors. Each session was given through Zoom by radiologists from different U.S.-institutions to Turkish medical students from state (n = 33) and private (n = 8) universities. Pretests and post-tests were given to participants via Qualtrics before and after each session, respectively. Paired two-sample t-tests were conducted to detect the variance and p=-.05 was used as the significance level. An evaluation survey was distributed at the end of the course to collect their feedback through SurveyMonkey. Results: A total of 1,438 predominantly Turkish (99.32%) medical students engaged with this course. An average of 506 students completed both pre-test and post-test. There was a statistically significant (p <.001) increase in the scores in post-test (mean[range]:7.58[5.21–8.53]) relative to pre-test (mean[range]:5.10[3.52–8.53]). Four hundred and thirty-nine participants (F/M:63.33%/35.54%) completed the end-of-course survey. A total of 71% and 69.70% of the participants strongly agreed that the course would be useful in their clinical practice and had increased their understanding of radiology. They also reported that their level of confidence in the subjects had increased 68% and reached a weighted average of 3.09/4. The survey revealed that 396 (90.21%) of the participants strongly or somewhat agree that introductory principles and concepts should be presented in earlier years of medical education. Compared to in-person education, 358 (81.55%) found the course extremely or very convenient. Conclusion: Online lecture series consisting of the principles of the radiological imaging modalities can be offered to Turkish medical students to enhance their grasp of the various imaging modalities and their correct clinical application

Smith-Lemli-Opitz syndrome: A case report

Smith-Lemli-Opitz sendromu otozomal resesif geçen, çok sayıda doğuştan malformasyonun eşlik ettiği nadir görülen bir sendromdur. Smith-Lemli-Opitz sendromlu olgularda kolesterol biyosentezinin son basamağında 7-dehidrokolesterolü kolesterole çeviren ve geni 11q13'de lokalize bir enzim olan 7-dehidrokolesterol redüktazın doğuştan eksikliği mevcuttur. Otuz beş haftalık 1500 gr doğan bebeğin cildi kuru ve parşömen kâğıdı görünümünde, mikrognati, hipertelörizm, düşük kulak, antevert burun delikleri, belirgin filtrum, yarık damak, el parmaklarında ulnar deviasyon ve distal fleksiyon kontraktürü, çomaklaşma, ayaklarda pes ekino varus deformitesi ve çekiç topuk, sağ ayakta sindaktili, ambigius genitalya mevcuttu. İncelemelerde total kolesterol 108 mg/dl LDL kolesterol 48.8 mg/dl bulundu. Yirmi beşinci gün hayatını kaybeden olgunun otopsisinde iki loblu sağ akciğer, atriyal septal defekt, patent duktus arteriyozus, üreterlerde iki taraflı yerleşim anomalisi, sol sürrenalde insitu saptandı.Smith-Lemli-Opitz syndrome is a rare autosomal recessive disorder which is accompanied by many congenital malformations. The syndrome is caused by a congenital deficiency of 7-dehydrocholesterol reductase which is localized on 11q13 gene and it is the final enzyme in the sterol synthetic pathway that converts 7-dehydrocholesterol to cholesterol. The infant was born on the 35. week of gestation and weighed 1500 grams. Anomalies evident on physical examination included dry and thinned skin, micrognathia, hypertelorism, low-set ears, anteverted nares, a long philtrum, cleft palate, ulnar deviation and distal flexion contracture of the fingers, equinovarus deformity and hammer toe, syndactyly of the right toes and ambiguous genitalia. Total cholesterol concentration was 108 mg/dl and LDL-cholesterol was 48.8 mg/dl. The infant died on postnatal day 25 and her autopsy revealed a right lung with two lobes, atrial septal defect, patent ductus arteriosus, bilateral dislocation of the ureter and insitu in the left adrenal gland

Annular pancreas associated with nutcracker syndrome: A case report

The pancreas usually develops from the fusion of thedorsal and ventral pancreatic buds between the first 4-8weeks of embryonic life. Annular pancreas consists of aring of pancreatic tissue, which partially or completely surroundsthe descending portion of the duodenum. Annularpancreas is an uncommon congenital anomaly. The etiologyof this anomaly is still unknown. It has been associatedwith other congenital anomalies and various clinicalsymptoms. The nutcracker phenomenon is definedas compression of the left renal vein between the aortaand superior mesenteric artery. We report the case of a54-year-old patient who presented with a 15-day historyof nausea and vomiting associated with weight loss. Onmagnetic resonance cholangiopancreatography (MRCP)and computer tomography (CT) examination, an annularpancreas and nutcracker syndrome were diagnosed, respectively.In this study, we founded that the radiologicand clinical findings of associated annular pancreas withnutcracker syndrome may be of clinical importance forsurgical procedures.Key words: Annular pancreas, congenital anomaly, nutcrackerphenomenon, MRCP, C

PD-L1 expression in immune cells is a favorable prognostic factor for nasopharyngeal carcinoma

Background: Programmed death-ligand 1 (PD-L1) has been determined as a reliable prognostic factor for various malignancies. In this study, we aimed to determine the prognostic effect of PD-L1 expression in tumor-infiltrating immune cells (TIICs) of nasopharyngeal carcinoma (NPC) patients.Methods: Seventy patients diagnosed with non-metastatic NPC were included in the study. PD-L1 expression on immune cells was analyzed by immunohistochemical method. Patients were categorized into two groups according to the PD-L1 expression level in TIICs (level of PD-L1 staining ≥5% positive vs <5% negative).Results: Median follow-up period was 34 months (range = 1 - 188). 1 and 2 years survival rate were found as 75% and 63% in PD-L1 negative TIICs group (47%), and 85% and 83% in PD-L1 positive TIICs group (53%), respectively. PD-L1 positivity in immune cells (ICs) was detected in 53% of the patients. The survival rate was found better in the PD- L1 positive group compared to the negative group (P = 0.049).Discussion: In conclusion, the survival rate was found significantly better in the PD-L1 positive TIICs group, compared to the negative group