Amaç: Bu çalışma, peptik ülser perforasyonu (PUP) olgularında laparoskopik ve açık cerrahi onarım yöntemlerinin perioperatif ve postoperatif sonuçlarını karşılaştırarak minimal invaziv cerrahinin etkinliğini ve güvenilirliğini değerlendirmeyi amaçlamaktadır.Yöntemler: Temmuz 2020–2025 tarihlerinde PUP nedeniyle opere edilen 80 hasta retrospektif olarak değerlendirildi. Laparoskopik cerrahi uygulanan Grup A (n = 35) ile açık cerrahi uygulanan Grup B (n = 45), klinik ve cerrahi sonuçlar açısından karşılaştırıldı. Analizlerde p
Giriş: Travmalar, ekstremitelerde kırık ve çıkıklara sebebiyet vererek ömür boyu kalabilen anatomik ve fonksiyonel kayıplara yol açabilmektedir. Bu kayıplar; yaş, cinsiyet, çıkık-kırığın özellikleri, sayısı, eşlik eden diğer sistemlere ait travmalar ve tedavi şekline göre değişmektedir. Çocukluk çağında ciddi ve potansiyel ölümcül multipl travmalar nadir görülmektedir. Ancak birçok çocuk minör travmaya maruz kalmaktadır. Bu çalışmanın amacı 18 yaş altı çocuklarda üst ekstremite travmalarını, oluş mekanizmalarını, tedavi türünü ve yaş aralıklarını incelemektir.Yöntemler: Çalışma tanımlayıcı niteliktedir. Çalışma evrenini Sağlık Bilimleri Üniversitesi Gazi Yaşargil Eğitim ve Araştırma Hastanesi acil servisine başvuran 18 yaş altı üst ekstremite travması tanılı çocuklar oluşturmaktadır. Verilerin analizinde tanımlayıcı istatistiksel yöntemlerin yanında, bağımsız örneklem T-testi ve Tek yönlü varyans analizleri ANOVA kullanılmıştır.Bulgular: İncelenen 2695 vakanın %69,4’ü erkek olup, yaş ortalaması 13,18± 3,78’dir. Vakların %84’ünde (2252 kişi) yumuşak doku travması mevcuttur, geriye kalan hastaların tamamında üst ekstremite bölgesinde en az bir kırık ya da çıkık tanısı konulmuştur. En fazla üst ekstremite travması el bölgesinde görülmüştür. Tespit edilen 443 kırık ve çıkık tanılı hastada en çok tespit edilen patoloji radius distal uç kırığıdır. Kırık vakalarının bölgelere göre Q-Dash skoru incelendiğinde kol ve omuz bölgesi kırıkları diğer üst ekstremite bölgelerine göre daha yüksek düzeydeydi(p
Objective: Cardiovascular disease (CVD) is closely associated with traditional risk factors; however, the role of socioeconomic status (SES), as an important social determinant of health, has not been fully clarified. Understanding how SES contributes to cardiovascular risk may help identify and address health inequalities. In this study, we aimed to evaluate factors associated with failure to achieve target low-density lipoprotein (LDL) levels, with particular attention to socioeconomic status alongside conventional risk factors.Methods: Patients presenting to the outpatient clinic with acute coronary syndrome (ACS) were prospectively included. Data were collected through structured, face-to-face interviews. The relationship between LDL target attainment and clinical variables—including body mass index (BMI), age, sex, diabetes mellitus (DM), hypertension (HT), smoking status, family history, chronic kidney disease (CKD), chronic obstructive pulmonary disease (COPD), socioeconomic status, and place of residence—was analyzed.Results: Factors associated with failure to achieve target LDL levels were evaluated. Statistically significant associations were found for chronic kidney disease (CKD) (p
Amaç: Antinükleer antikorlar (ANA), sistemik otoimmün romatizmal hastalıkların (AARD) tanısında başlıca serolojik belirteçlerden biridir. HEp-2 hücrelerinde indirekt immünofloresan (IIFA) yöntemi, farklı nükleer ve sitoplazmik paternlerin saptanmasına olanak sağlayarak ANA tespitinde altın standart kabul edilmektedir. Bu çalışmada, Türkiye’nin doğu bölgesinde geniş bir hasta kohortunda ANA pozitifliği, patern dağılımları ve klinik tanılarla ilişkisi değerlendirilmiştir.Yöntemler: Ocak–Aralık 2024 tarihleri arasında ANA testi yapılan 3.744 erişkin hasta retrospektif olarak incelenmiştir. Hastalar klinik tanılarına göre üç gruba ayrılmıştır: ANA ile ilişkili romatizmal hastalıklar (AARD), ANA ile ilişkili olmayan otoimmün hastalıklar (non-ANA-AID) ve klinik tanısı olmayan ANA pozitif olgular (ANA-NC).Bulgular: ANA pozitifliği genel olarak %14,8 (n=553) oranında saptanmıştır ve kadınlarda (%16,4) erkeklere (%10,0) göre anlamlı derecede yüksektir (p
Objective: Diabetes mellitus (DM) is a metabolic condition characterized by chronically high blood glucose concentrations. DM affects many organs, including the liver, kidneys, and brain, and its association with lung damage, as manifested by pulmonary fibrosis, has been established. Chronic high blood sugar can also cause structural damage to the lungs, a condition known as diabetic lung fibrosis. Berberine (BBR) and N-acetylcysteine (NAC) exert a wide range of biological activities, including antioxidant, anti-inflammatory, and antifibrotic actions. The primary purpose of this research is to investigate the therapeutic potential of Berberine (BBR) and N-acetylcysteine (NAC) in the progression of lung fibrosis in rats with induced diabetes.Methods: Thirty rats were included in the experiment and allocated into five groups (n = 6): a control; a diabetes (D) receiving streptozotocin (STZ, 45 mg/kg); a D+BBR group treated with STZ (45 mg/kg) and berberine (50 mg/kg/day); a D+NAC group administered STZ (45 mg/kg) and N-acetylcysteine (50 mg/kg/day); and a combined treatment group (D+NAC+BBR) given STZ (45 mg/kg) followed by NAC (50 mg/kg/day) and BBR (50 mg/kg/day). Lung tissues were evaluated by histopathological and immunohistochemical techniques.Results: TGF-β1 and collagen expression significantly increased in group D (27,66) compared to the control group (2,16) (p
Objectives: To evaluate the role of orexin-A in childhood generalized epilepsy by determining serum orexin-A levels in children with generalized epilepsy syndromes.Methods: This cross-sectional, case-control study included 21 children diagnosed with generalized epilepsy syndromes and 21 age- and sex-matched healthy controls. Serum orexin-A levels were measured using the enzyme-linked immunosorbent assay method. All patients underwent detailed neurological examination, electroencephalography, and neuroimaging as part of routine clinical evaluation.Results: No significant difference was observed in serum orexin-A levels between patients with generalized epilepsy syndromes and healthy control subjects (2745.3±2240.5 pg/mL and 2674.3±1794.5 pg/mL, respectively; p=0.697). The observed between-group effect size was negligible. In addition, serum orexin-A levels were not significantly associated with seizure frequency, seizure type, or electroencephalographic findings (all p>0.05).Conclusions: Serum orexin-A levels were not significantly altered in children with generalized epilepsy syndromes and were not associated with seizure-related clinical features. Despite supportive preclinical evidence, these findings suggest that peripheral orexin-A measurements may have limited utility as a biomarker in pediatric generalized epilepsy, highlighting the need for larger, multimodal studies to clarify the role of orexin signaling in epilepsy.
Objective: Temporomandibular joint disorder (TMD) can affect jaw joint function as well as impair neuromuscular control and postural stability. This study aims to compare balance, kinesiophobia, and spinal function parameters in individuals with TMD with healthy controls.Methods: A total of 71 participants were included in the study, comprising 35 individuals with TMD and 36 healthy controls. Participants’ static and dynamic balance was assessed using the Biodex Balance System, kinesiophobia was evaluated using the Tampa Kinesiophobia Scale, and spinal function was measured with the Spinal Mouse device.Results: When individuals with TMD were compared to the healthy control group, significant differences were found between the groups in favour of the healthy control group in static and dynamic balance (anterior-posterior, medial-lateral, and overall) and spinal assessment parameters (spine check score, posture and mobility) (p
Objective: Previous studies have reported an association between the fibrinogen-to-albumin ratio and diabetic complications; however, its role prior to the development of overt complications remains unclear. This study aimed to evaluate fibrinogen-toalbumin ratio levels in patients with type 2 diabetes mellitus without complications and to compare them with those in patients with established microvascular complications and healthy controls. In addition, the association between the fibrinogen-toalbumin ratio and glycemic parameters was examined.Methods: This retrospective study consisted of 305 patients (244 with type 2 diabetes mellitus and 61 controls), aged 27–77 years, followed at the Internal Medicine Outpatient Clinic of a tertiary hospital between October 1, 2023, and March 31, 2024. Patients with diabetes were categorized into four subgroups with equal sample sizes: those without diabetic complications, those with isolated diabetic neuropathy, those with isolated microalbuminuria, and those with at least two diabetic complications. Fasting blood glucose, HbA1c, fibrinogen, fibrinogen-to-albumin ratio, albumin, and microalbumin levels were compared between the groups. To identify the independent predictors of the burden of complications, a multinomial logistic regression analysis was applied.Results: The fibrinogen-to-albumin ratio did not differ significantly between the controls and patients without complications (p>0.05); however, it was significantly elevated in patients with complications (p
Background: Contrast-induced nephropathy (CIN) is still recognized as a major complication in patients undergoing chronic total occlusion (CTO) interventions. The predictive value of CTO complexity scores for CIN remains unclear. The present study investigated whether the CASTLE (EuroCTO) score is associated with the development of CIN in patients treated with CTO-PCI. Methods: A total of 356 patients undergoing CTO-PCI were retrospectively analyzed and classified according to CIN development. Clinical, angiographic, and procedural characteristics were compared between groups. Missing data were handled using multiple imputation, and independent predictors of CIN were identified through multivariable logistic regression analysis. The predictive performance of CTO scoring systems was evaluated using receiver operating characteristic (ROC) curve analysis. Results: CIN was observed in 34 patients (9.5%). Individuals who developed CIN were generally older, more frequently diabetic, and had lower left ventricular ejection fraction values. Procedural complexity was greater in the CIN group, reflected by higher CASTLE and J-CTO scores, longer lesion length, and higher contrast volume. In multivariable analysis, the CASTLE score remained associated with CIN (OR: 1.838, 95% CI: 1.354–2.494, p<0.001), whereas the association with the J-CTO score was weaker, and the PROGRESS CTO score was not significant. ROC analysis demonstrated that the CASTLE score showed acceptable discriminative performance (AUC: 0.694, 95% CI: 0.643–0.742), with a cut-off >2 providing a reasonable balance between sensitivity (70.6%) and specificity (63.3%). Conclusion: The CASTLE (EuroCTO) score showed an association with CIN occurrence in patients treated with CTO-PCI and demonstrated acceptable predictive capability compared with other CTO scoring models. Although the score may contribute to preprocedural risk assessment, the results should be interpreted carefully.
Objective: Adenosine deaminase (ADA) deficiency is a rare inborn error of immunity caused by defects in purine metabolism and typically presents as severe combined immunodeficiency (ADA-SCID). The disease commonly manifests in early infancy with severe and recurrent infections. This study aimed to evaluate the clinical, immunological, biochemical, and genetic characteristics of patients diagnosed with ADA deficiency.Methods: This retrospective study included patients with confirmed ADA deficiency who were followed in the Pediatric Allergy and Immunology Clinic between 2020 and 2026. Demographic characteristics, clinical findings, laboratory data, immunological parameters, metabolite analyses, genetic test results, treatment approaches, and clinical outcomes were reviewed.Results: A total of six patients, including five males and one female, were included in the study. All patients were diagnosed within the first year of life, with a median age at diagnosis of 3.5 months (range, 1–7). Consanguinity was present in 83.3% of the patients. The most common presenting manifestation was recurrent pneumonia, observed in 66.7% of the patients. Oral candidiasis and chronic diarrhea were also frequently observed. Severe infectious complications occurred in 50% of the patients. Marked lymphopenia was present in all patients, with a median absolute lymphocyte count of 430/mm³ (range, 30–1570). Flow cytometric immunophenotyping demonstrated profound reductions in T-, B-, and NK-cell populations consistent with severe combined immunodeficiency. Biochemical analyses revealed markedly elevated dAXP levels in all patients, while adenosine levels were elevated in the majority of patients. Hematopoietic stem cell transplantation was performed in four patients, and five patients were alive at the last follow-up.Conclusion: ADA deficiency is a life-threatening inborn error of immunity that should be considered in infants presenting with severe recurrent infections and profound lymphopenia. Early recognition of warning signs, including consanguinity and sibling death history, is essential for prompt diagnosis and timely therapeutic intervention to improve outcomes.
Objectives: Psoriasis is a chronic inflammatory skin disorder that substantially affects patients’ quality of life. Oxidative stress arises when there is a disruption in the balance between reactive oxygen species (ROS) and the body's antioxidant defense mechanisms, significantly contributing to its pathophysiology. This study aimed to investigate the effects of various boron compounds—borax, colemanite, boric acid, and ulexite—on oxidative stress markers in an LPS-induced psoriasis-like cell culture model using HaCaT keratinocytes.Methods: HaCaT cells were stimulated with LPS to induce a psoriasis-mimicking inflammatory response. Subsequently, cells were treated with different boron compounds. To evaluate antioxidant activity and lipid peroxidation, oxidative stress markers such as superoxide dismutase (SOD), glutathione peroxidase (GPx), and malondialdehyde (MDA) were examined.Results: Boron compounds modulated oxidative stress parameters by enhancing SOD and GPx activities and reducing lipid peroxidation, as reflected by decreased MDA levels. Among the tested agents, colemanite and ulexite exhibited the strongest antioxidant activities, likely attributable to their distinct mineral compositions.Conclusion: Findings suggest that boron compounds hold therapeutic potential for reducing oxidative stress in psoriasis-like conditions. Further research is needed to clarify the underlying molecular mechanisms and to refine boron-based therapeutic applications.
Objective: To characterize regional aeroallergen sensitization patterns in Eastern Anatolia and assess their association with spirometrically defined airway outcomes among children with asthma from lake-adjacent districts of Van Province and inland districts in other Eastern Anatolian provinces.Methods: In this retrospective cross-sectional study, 235 children aged 6–18 years were stratified by residence (lake-adjacent districts of Van Province vs inland districts in other Eastern Anatolian provinces). Sensitization burden was defined as the number of positive aeroallergen groups. Spirometry was available for 137 children with physician-diagnosed asthma. Multivariable logistic regression was used to identify independent predictors of airway obstruction (FEV₁/FVC < 0.80), adjusting for age, sex, eosinophilia, and log-transformed IgE.Results: Sensitization profiles differed by region: house dust mite sensitization was more prevalent in lake-adjacent districts, whereas sensitization to grass and weed pollen was more frequent in inland districts. Among children who underwent spirometry, 22.6% had airway obstruction. Obstruction prevalence increased across sensitization burden categories (0, 1, and ≥2 aeroallergen groups) (8.5%, 20.0%, and 35.0%; p = 0.033). FEV₁/FVC and FEF₂₅-₇₅ declined with increasing sensitization burden (p = 0.007 and p = 0.012, respectively). In adjusted analysis, sensitization burden was independently associated with airway obstruction (adjusted OR 1.88, 95% CI 1.24–2.85; p = 0.003). Model discrimination was modest (AUC 0.68, 95% CI 0.59–0.77).Conclusion: Regional ecological context was associated with distinct patterns of aeroallergen sensitization and clinically relevant differences in airway function. Cumulative sensitization burden was independently associated with spirometrically defined airway obstruction in this pediatric cohort.
Objective: It is an established medical fact that the reduction of inflammation plays a pivotal role in the development of atherosclerosis. This reduction of inflammation is an accepted treatment strategy for coronary artery disease (CAD). The objective of the present study was to demonstrate the effect of colchicine, a commonly used anti-inflammatory agent, on inflammatory markers. Method: The study comprised a sample of 122 patients diagnosed with CAD, whose medical records were meticulously reviewed. Ratios of neutrophil/lymphocyte, monocyte/lymphocyte, and platelet/lymphocyte were calculated and recorded. Following a period of six months during which colchicine was administered, a recalculation of the values was performed. Results: Prior to the commencement of treatment, the neutrophil/lymphocyte ratio (NLR) (3.99 ± 4.72), monocyte/lymphocyte ratio (MLR) (0.41 ± 0.42), and platelet/lymphocyte ratio (PLR) (129.6 ± 74.1) were observed. Following treatment, a decrease was observed in the neutrophil-to-lymphocyte ratio (NLR) (3.5 ± 3), MLR (0.38 ± 0.28), and PLR (122.6 ± 65). In the post-treatment period, statistically significant decreases were observed NLR, MLR, and PLR compared to pre-treatment levels (p
Amaç: Bu çalışmada, premarital tarama programı kapsamında ileri incelemeye yönlendirilen bireylerde alfa ve beta globin gen varyantları ile yapısal varyant hemoglobinlerin moleküler spektrumunun tanımlanması ve Aydın iline ait bölgesel genetik profilin ortaya konulması amaçlandı.Yöntemler: Ocak 2008 ile Kasım 2019 tarihleri arasında, evlilik öncesi tarama programı kapsamında ileri değerlendirme için yönlendirilen bireyler arasından dahil edilme kriterlerini karşılayan 366 vakanın verileri retrospektif olarak analiz edildi. Hipokromik mikrositik anemi, normal serum demir parametreleri ve hemoglobin elektroforezi/kromatografisinde anormal bulgular gösteren bireyler çalışmaya dahil edildi. Normal HbA2 düzeyine sahip vakalarda StripAssay yöntemiyle belirlenen alfa globin gen varyantları değerlendirilirken, HbA2 düzeyi %3,5 veya daha yüksek olan veya anormal hemoglobin pikleri olan vakalarda Sanger sekanslama ve MLPA analizleriyle saptanan beta globin gen varyantları değerlendirildi.Bulgular: Alfa globin geni varyantları açısından değerlendirilen 124 vakada toplam 148 mutant alel tespit edildi; en yaygın varyant 3,7 kb'lık tek gen delesyonuydu. Beta globin geni analizi yapılan 242 vakada ise beş delesyon varyantı da dahil olmak üzere toplam 36 farklı varyant saptandı ve en sık saptanan varyant c.93-21G>A idi. Ayrıca, çoğunlukla β-globin genini içeren toplam 11 farklı varyant hemoglobin tespit edildi. Varyant dağılımı, Ege Bölgesi’nden bildirilen önceki çalışmalarla genel olarak uyum göstermekte olup, bölgesel genetik yapının sürekliliğini desteklemektedir.Sonuç: Bu çalışma, Aydın ilinde premarital tarama sürecinde ileri incelemeye yönlendirilen bireylerde hemoglobinopatilerin moleküler spektrumunu ortaya koymaktadır. Elde edilen bölgesel moleküler veriler, taşıyıcılık riskinin değerlendirilmesine ve genetik danışmanlık süreçlerinin desteklenmesine katkı sağlayabilecek niteliktedir.
Objective: Nasopharyngeal carcinoma (NPC) is a malignancy originating from the epithelial layer of the nasopharynx. In our study, we aimed to investigate the factors affecting treatment response and survival in patients diagnosed with NPC.Methods: A retrospective study was conducted on 76 patients aged ≥18 years with a pathological diagnosis of NPC who presented to the Oncology Clinic of Dicle University Faculty of Medicine between January 2010 and May 2020. General characteristics of the patients and their effects on overall survival were evaluated.Results: The mean age of the patients was 46. There were 39 patients (51.3%) under 50 years and 37 patients (48.7%) ≥50 years. 18 were female (23.7%) and 58 were male (76.3%). The mean body mass index (BMI) was 24.1±5.2. 39 patients (51.3%) were smokers, and 37 patients (48.7%) were not. At the time of diagnosis, 11 patients (14.5%) were TNM Stage 2, 39 patients (51.3%) were Stage 3, and 26 patients (34.2%) were Stage 4. According to the WHO 2005 histological classification, there were 30 patients (39.5%) in Type 2A and 40 patients (52.6%) in Type 2B. There were no patients with Type 1 or Type 3 tumors. Other tumor types were detected in 6 patients (7.9%). In the survival analysis, 25 patients (32.9%) were deceased and 51 (67.1%) were alive. Kaplan-Meier analysis revealed a mean survival time of 108 months (95% CI = 88-128). Multivariate Cox regression analysis showed that advanced stage of TNM at diagnosis, low BMI, and high serum lactate dehydrogenase (LDH) levels negatively impacted survival (p=0.017, p=0.04, p=0.04, respectively).Conclusion: In NPC, the patient's TNM stage at diagnosis, BMI level, and serum LDH level may be independent prognostic risk factors.
Objective: Cutaneous mastocytosis (CM) is the most common form of mastocytosis in childhood; however, data on its clinical course and associated allergic and immunologic features remain limited. This study aimed to characterize the clinical phenotype of pediatric CM and to evaluate the frequency of concomitant allergic diseases and inborn errors of immunity (IEI).Methods: This retrospective study included 17 pediatric patients diagnosed with CM between 2007 and 2025. Demographic characteristics, clinical findings, laboratory parameters, allergic sensitization, immunologic evaluation, and follow-up outcomes were systematically analyzed.Results: The cohort showed a male predominance (64.7%), with a median age at symptom onset of 14.2 months. Maculopapular cutaneous mastocytosis was the most frequent subtype (82.3%), followed by diffuse CM and solitary mastocytoma. During a median follow-up of 4.5 years, 11.2% of patients achieved complete regression, 47.0% showed partial regression, 35.2% remained stable, and 5.8% exhibited progression. No cases of systemic mastocytosis, anaphylaxis, or mortality were observed.Eosinophilia was present in 23.5% and hepatosplenomegaly in 11.7% of patients, without evidence of organ dysfunction. Serum immunoglobulin levels and vaccine responses were within normal ranges in all evaluated patients, and no IEI was identified. Elevated IgE levels were detected in 17.6%, while allergic sensitization was documented in 29.4%. Allergic comorbidities were observed in 41.1% of patients, most commonly allergic rhinitis.Conclusion: Pediatric CM predominantly presents as an early-onset, skin-limited disease with a favorable and often regressive clinical course. The frequency of allergic diseases and sensitization does not appear to be increased compared to the general population, and humoral immune function remains preserved. These findings support a selective, clinically driven approach to immunologic evaluation rather than routine screening in children with CM.
Legionella pneumophila is an obligate aerobic intracellular bacterium. It stains poorly with Gram staining and appears as a thin, pleomorphic Gram-negative bacillus. The organism grows poorly on routine culture media. It is distributed worldwide and causes both epidemic and sporadic infections. Transmission usually occurs through inhalation of aerosolized water droplets containing the bacteria.Legionella pneumonia is more frequently observed in elderly and immunosuppressed patients and may present as community-acquired or hospital-acquired pneumonia with a severe clinical course. In this report, we present a case of legionellosis diagnosed using a molecular syndromic panel after the lack of response to β-lactam therapy and the presence of extrapulmonary findings raised suspicion of atypical pneumonia. A brief review of the recent literature was also conducted.
Objectives: Hypertensive patients may present with varying degrees of clinical severity and target organ damage (TOD). Bedside ultrasound measurement of optic nerve sheath diameter (ONSD) is a rapid and non-invasive bedside imaging method increasingly used in emergency settings. The primary aim of this study was to evaluate the association between baseline ONSD and clinical severity in hypertensive patients presenting to the emergency department (ED).Methods: This prospective, single-center, observational study included adult patients presenting to the ED with hypertension and suspected acute TOD, consistent with hypertensive emergency (HE). Demographic and clinical data, blood pressure measurements, and pre- and post-treatment ONSD values were recorded. The associations between ONSD, TOD, treatment response, and hospitalization were analyzed, and the discriminative ability of ONSD for clinical outcomes was assessed using receiver operating characteristic (ROC) analysis.Results: A total of 113 hypertensive patients were included in the study. ONSD values were significantly higher in patients with TOD compared to those without (4.88±0.76 mm vs. 4.45±0.46 mm, p=0.007). A significant decrease in ONSD values was observed after antihypertensive treatment (p
Amaç: Bu çalışma, Madde Kullanım Bozukluğu (MKB) tanısıyla tedavi başvurusu yapmış ergenlerde, Kokain Kullanım Bozukluğu (KKB) gelişimiyle ilişkili bireysel, davranışsal ve zamansal belirleyicileri ortaya koymayı amaçlamaktadır.Yöntemler: Kesitsel ve retrospektif tasarımla yürütülen bu çalışmaya, Nisan 2019– Şubat 2024 tarihleri arasında MKB tanısıyla takip edilen ve en az bir kez kokain kullanmış 87 ergen dâhil edilmiştir. DSM-5’e göre KKB tanısı alanlar “KKB grubu” (n = 31), yalnızca kokain deneyimi olanlar ise “KKB olmayan grup” (n = 56) olarak sınıflandırılmıştır. Grup karşılaştırmaları Ki-kare/Fisher’s Exact ve Mann–Whitney U testleriyle yapılmış; ikili analizlerde anlamlı bulunan değişkenler Backward LR yöntemiyle çok değişkenli lojistik regresyona alınmıştır.Bulgular: KKB grubu, kokainle daha erken yaşta tanışmış (medyan = 15) ve ilk madde deneyiminden kokain kullanımına daha kısa sürede geçmiştir (medyan = 2 yıl). Ayrıca, hayat boyu MKB tanı sayısı KKB grubunda belirgin olarak daha yüksektir (p < 0,01). Buna karşın, ilk maddeyle tanışma yaşı ve hayat boyu toplam madde sayısı açısından anlamlı fark saptanmamıştır. Tercih maddeleri incelendiğinde, yalnızca esrar tercihi farklılık göstermiş; esrarı tercih maddesi olarak bildirenlerde KKB olasılığı anlamlı ölçüde daha düşük bulunmuştur (p = 0,002). Lojistik regresyon analizinde, dört değişken KKB ile bağımsız ilişkili kalmıştır: daha yüksek hayat boyu MKB tanı sayısı (OR = 1,81), daha erken kokainle tanışma yaşı (OR = 0,61), daha kısa geçiş süresi (OR = 0,69) ve esrar tercihi (OR = 0,13).Sonuç: Ergenlerde KKB gelişiminin özellikle kokainle karşılaşma zamanlaması, kullanım hızındaki artış ve birikimli bağımlılık yüküyle ilişkili olduğunu; bu göstergelerin erken müdahalede önemli olduğunu ortaya koymaktadır.
Amaç: Uzamış sarılık, yenidoğanların polikliniklere en sık başvuru nedenlerinden biridir. Tüm yenidoğanların %2-15’ini, anne sütü ile beslenenlerin %40 kadarını etkiler. Ciddi bir patolojinin ilk belirtisi olabilmesi ve etiyolojinin belirlenmesi için yapılan tetkikler ve izlem sürecinin aileleri oldukça endişelendirmesi nedeni ile bu yenidoğanların izlemi dikkatle yapılmalıdır. Bu çalışmada, uzamış sarılık ile izlediğimiz yenidoğanlarda etiyolojik nedenler ve takiplerde uzamış sarılık süresi üzerinde etkili olabilecek faktörlerin belirlenmesi amaçlandı.Yöntemler: Çalışmamızda Ocak 2017- Haziran 2019 tarihleri arasında Çocuk Sağlığı ve Hastalıkları Polikliniğine başvurmuş ve yenidoğan uzamış sarılığı tanısı almış 37 hafta ve üzerinde doğan term 112 yenidoğanın dosyaları retrospektif olarak değerlendirildi.Bulgular: Sonuçlar değerlendirildiğinde; etiyolojik nedenlerin oranları sırası ile; geç tip anne sütü sarılığı: 63 (%56,3), ABO uygunsuzluğu: 17 (%15,2), Rh uygunsuzluğu: 6 (%5,4), idrar yolu enfeksiyonu: 11 (%9,8), G6PD enzim eksikliği: 7 (%6,3), konjenital hipotiroidi 5 (%4,5), sepsis: 3 (%2,7) olduğu saptandı. Bu çalışmada anne eğitim düzeyinin yüksek olması ve kilo alımının 30gr/gün üzerinde olmasının uzamış sarılığın daha erken düzelmesinde olumlu etkilerinin olduğu saptandı.Sonuç: Uzamış sarılık çoğu kez iyi seyirlidir; ancak altta yatan ciddi bir hastalığın ilk belirtisi olabileceği için etiyolojinin belirlenmesi önemlidir. Anne sütü sarılığı en sık neden olsa da, anne sütü ile beslenme devam edilmelidir. Iyi kilo alımının uzamış sarılıkta olumlu etkisi olduğu görülmüştür. Sadece anne sütü ile beslenen uzamış sarılıklı bebeklerin yeterli emzirme desteğine ihtiyaçları vardır.
