OBJECTIVE: Turkey is one of the latest countries that COVID-19 disease was reported, with the first case on March 11, 2020, and since then, Istanbul became the epicenter of the pandemic in Turkey. Here, we reveal sequences of the virus isolated from three different patients with various clinical presentations.
METHODS: Nasopharyngeal swab specimens of the patients were tested positive for the COVID-19 by qRT-PCR. Viral RNA extraction was performed from the same swab samples. Amplicon based libraries were prepared and sequenced using the Illumina NextSeq platform. Raw sequencing data were processed for variant calling and generating near-complete genome sequences. All three genomes were evaluated and compared with other worldwide isolates.
RESULTS: The patients showed various clinics (an asymptomatic patient, patient with mild disease, and with severe pulmonary infiltration). Amplicon-based next-generation sequencing approach successfully applied to generate near-complete genomes with an average depth of 2.616. All three viral genomes carried the D614G variant (G clade according to GISAID classification) with implications for the origin of a spread first through China to Europe then to Istanbul.
CONCLUSION: Here, we report the viral genomes circulating in Istanbul for the first time. Further sequencing of the virus isolates may enable us to understand variations in disease presentation and association with viral factors if there is any. In addition, the sequencing of more viral genomes will delineate the spread of disease and will guide and ease the necessary measures taken to stem the spread of the novel coronavirus.

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OBJECTIVE: Coronavirus Disease 2019 (COVID-19), named the etiological agent of Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) has recently emerged in Wuhan City, Hubei Province, China, in December 2019. Kazakhstan’s border proximity to China has led to preventive measures in the country since January. This study aims to evaluate the epidemiologic characters of the first recorded cases in Kazakhstan.
METHODS: Here, we reviewed the preparedness of the infection control and prevention procedures in Kazakhstan and evaluated the epidemiological characters of confirmed cases in Kazakhstan. The data for COVID-19 cases recorded from March 13 to April 6, 2020, were obtained from the Sanitary Epidemiological Service. Age, gender and their living place were recorded. The severity of infection, geographical distribution, gender and age group of cases were analyzed.
RESULTS: Four phases of preventive measures used in respiratory infections have been implemented in Kazakhstan since January 6, 2020. The first case was recorded on March 13. During the period of March 13 and April 06, 629 cases with COVID-19 were recorded in Kazakhstan. Of these, 45 patients recovered, six had resulted in death; 535 (85%) of cases were mild and/or asymptomatic, 72 (11.5%) - moderate, 22 (3.5%) - severe. Of these, 7.5% of the cases were registered as children and course was mild.
CONCLUSION: The cases are increasing in Kazakhstan as seen in other countries. Currently, the strict implication of respiratory infection control measurement in public and health care services are still very important.

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Amaç: Obezite dünya genelinde prevalansý artan metabolik bir hastalýktýr. Bununla birlikte, obeziteye sahip hastalarda Cushing hastalýðý (CD), ACTH baðýmsýz Cushing sendromu (CS) ve otonom kortizol sekresyonu (ACS) sýklýðý iyi bilinmemektedir. Bu nedenle, bu çalýþmada obezite hastalarýnda CD, CS ve ACS sýklýðýný deðerlendirmeyi amaçladýk.

Gereç ve yöntem: Çalýþmaya 813 hasta dahil edildi (683 kadýn, yaþ ortalamasý 46,47 ± 14,23; ortalama vücut kitle indeksi 37.31±6.50 kg/m2). Obezitesi olan hastalar beden kitle indeksine (BKÝ) göre stage 1, 2. ve 3 þeklinde sýnýflandýrýldý. Tüm hastalara düþük doz deksametazon supresyon testi (LDDST) yapýldý. CD, CS ve ACS'li hastalar ve basit obeziteye sahip olanlar cinsiyet, yaþ, diabetes mellitus, hipertansiyon (HT) ve hiperlipidemi (HL) açýsýndan karþýlaþtýrýldý.

Bulgular: 813 hastanýn 44’ü (%5.4) CD, CS veya ACS tanýsý aldý. CD, CS ve ACS sýrasýyla 4 (% 0,4), 2 (% 0,2) ve 33 (% 4) hastada tespit edildi. CD, CS ve ACS hastalarý basit obezite ile karþýlaþtýrýldýðýnda, taný anýndaki ileri yaþ, stage 1 obezite varlýðý, HT ve kontrolsüz diabetes mellitus, CD, CS ve ACS hastalarýnda daha sýk olduðu saptandý (sýrasýyla P = 0.001, P = 0.007, P = 0.004 and P = 0.0026).
Sonuç: Obezite hastalarýnda CD, CS ve ACS sýklýðý artmaktadýr. Özellikle, kontrolsüz tip-2 diabet ve HT’a sahip 50 yaþýndan büyük stage-I obeziteli hastalarda CD, CS ve ACS taramasý uygun bir yaklaþým olabilir. (NCI-2019-0222.R1)

OBJECTIVE: The frequency of Cushing’s disease (CD), ACTH-independent Cushing’s syndrome (CS) and autonomous cortisol secretion (ACS) in patients with obesity is not well known. Therefore, in the present study, we aimed to assess the frequency of CD, CS and ACS among the patients with obesity.
METHODS: This study included 813 patients (683 female, mean age 46.47±14.23 yr; mean body mass index (BMI) 37.31±6.50 kg/m2). Patients with obesity were classified further to stages 1, 2, and 3, according to BMI. All patients underwent a low dose dexamethasone suppression test (LDDST). The patients with CD, CS, and ACS and patients with simple obesity were compared concerning gender, age, type-2 diabetes, hypertension (HT) and hyperlipidemia (HL).
RESULTS: Forty-four (5.4%) out of 813 patients were diagnosed as CD, CS or ACS. CD, CS, and ACS were diagnosed in four (0.4%), two (0.2%), and 33 (4%) patients, respectively. When patients with CD, CS and ACS were compared to the patients with simple obesity, older age at diagnosis, the presence of stage-1 obesity, the presence of HT, and uncontrolled type-2 diabetes were more frequent in patients with CD, CS and ACS (p=0.001, p=0.007, p=0.004, and p=0.0026, respectively).
CONCLUSION: The frequency of CD, CS, and ACS is high among patients with obesity. Screening for CD, CS, and ACS in patients with stage-I obesity who are older than 50 years of age with uncontrolled type-2 diabetes and HT may be a reasonable approach.

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GÝRÝÞ ve AMAÇ: Ýnvaziv mantar enfeksiyonlarý (IFI), özellikle remisyon indüksiyonu sýrasýnda akut lösemili hastalarda önemli ve eðilimli bir mortalite nedenidir.
YÖNTEM ve GEREÇLER: Akut miyeloid lösemi (AML) tanýsý almýþ ve remisyon indüksiyonu için yoðun tedavi gören 225 hasta retrospektif olarak çalýþmaya alýndý.
BULGULAR: Toplam 225 hastadan oluþan grubun tamamýnda 90 hastaya profilaktik antifungal tedavi (PAT) (% 40), 135 hasta (% 60) almadý. Ortalama hastanede yatýþ maliyeti 9.151,6 (2.872,6-20.483,3) ABD dolarý idi. Cinsiyet daðýlýmý ve ortalama yaþ gruplarý benzerdi. PAT'de olmayan 114 hasta (% 84.4) ve PAT'li 5 hasta (% 5,5) intravenöz antifungal tedavi aldý. PAT'de olmayan hastalarýn 32'si (% 23,7) ve PAT'li hastalarýn 11'i remisyon indüksiyonu sýrasýnda (% 12,22) öldü. Ortalama hastanede yatýþ günleri PAT hastalarý için 22,61 gün, PAT olmayan hastalar için 33,89 gün idi. PAT hastalarýnda ortalama transfüzyon yapýlan trombosit ünitesi sayýsý 6 (0-9) iken, PAT olmayan hastalar için 12,51 (4-43) ünite idi.
TARTIÞMA ve SONUÇ: Çalýþmamýzda, IFI'yi önlemek için remisyon indüksiyon tedavisi sýrasýnda mortalitede belirgin bir azalma olduðunu gösteren posakonazolün oral süspansiyon formunun maliyet açýsýndan etkili olduðu görülmüþtür.

OBJECTIVE: Invasive fungal infections (IFI) are important and trending causes of mortality in patients with acute leukemia, especially during the remission induction.
METHODS: In this study, 225 patients who were diagnosed with acute myeloid leukemia (AML) and undergoing intensive treatment for remission induction were enrolled in a retrospective manner.
RESULTS: Within the whole group, which consisted of 225 patients, 90 patients received prophylactic antifungal treatment (PAT) (40%), while 135 patients did not (60%) receive. The mean cost of hospitalization was 9.151,6 (2.872,6–20.483,3) US dollars. Gender distribution and mean ages of groups were similar. One hundred fourteen patients not on PAT (84.4%) and five patients on PAT (5.5%) received intravenous antifungal treatment. Thirty-two of the patients who were not on PAT (23.7%) and 11 of the patients on PAT died during remission induction (12.22%). The mean day of the hospitalization was 22.61 days for the patients on PAT and 33.89 days for the patients who were not on PAT. In patients on PAT, the mean number of transfused platelet units was six (0–9), while 12.51 (4–43) units for patients who were not on PAT.
CONCLUSION: In our study, the oral suspension form of posaconazole was observed to be cost-effective to prevent IFI with a significant decrease in mortality during remission induction treatment.

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GÝRÝÞ ve AMAÇ: Deðiþken klinik özellikleri nedeni ile Turner Sendromu (TS)’nun erken teþhisi genellikle zordur. Çalýþmada, TS'lu bir grup hastanýn klinik özellikleri ve iliþkili patolojik bulgularýnýn deðerlendirilmesi amaçlanmýþtýr.
YÖNTEM ve GEREÇLER: TS’lu 37 hastanýn klinik verileri hasta dosyalarýndan geriye dönük tarandý. Tüm hastalar iliþkili patolojik bulgular açýsýndan incelendi.
BULGULAR: Taný anýnda yaþ ortalamasý 9,3 ± 4,1 yýl idi. Hastaneye baþvurunun iki ana nedeni boy kýsalýðý ve ergenlik gecikmesi idi. Tüm hastalarda (çalýþma grubunun % 100'ü) en az bir dismorfik bulgu saptandý. En sýk iskelet sistemi anormallikleri (%57) tespit edildi, bunu gastrointestinal sistem anormallikleri (%40) izlemekteydi. Kardiyak defektler % 32, üriner sistem anormallikleri % 27 oranýnda idi. Hastalarýn % 32'sinde dermatolojik sorunlar saptandý. Ýþitme patolojisi % 19 olarak bulundu. Otoimmün tiroid hastalýðý % 24, çölyak hastalýðý ise % 5,4 olarak saptandý.
TARTIÞMA ve SONUÇ: Deðiþken fenotip TS tanýsýnda genellikle gecikmeye neden olmaktadýr. TS’lu hastalarda erken taný ile etkili bir tedavi baþlatabilir. (NCI-2018-0194.R1)

OBJECTIVE: The early diagnosis of Turner syndrome (TS) is often difficult because of the various clinical features. This study aimed to investigate clinical features and identify associated abnormalities in a group of patients with TS.
METHODS: Retrospective data of presenting clinical features collected from the medical records of the 37 patients with TS. All patients were examined for associated clinical abnormalities.
RESULTS: Mean age at diagnosis was 9.3±4.1 years. The main reason for referral was short stature and/or delayed puberty. All of the patients had at least one dysmorphic sign. Skeletal system abnormalities (57%) were the most common associated abnormality, which was followed by gastrointestinal system problems (40%). Cardiac defects occurred in 32%. Urinary system abnormalities occurred in 27%. Dermatological problems were detected in 32% of the patients. The pathology of the hearing was found in 19%. Autoimmune thyroid disease was detected in 24% of the patients, and celiac disease was detected in 5.4% of the patients.
CONCLUSION: Phenotypic variability often leads to a delay in the diagnosis of TS. Early diagnosis can initiate effective management in patients with TS.

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GÝRÝÞ ve AMAÇ: Sol ventrikül hipertrofisini öngörmek için elektrokardiyografiye (EKG) dayalý çok sayýda kriter geliþtirilmiþtir. Öte yandan hepsinin ortak kýsýtlýlýðý ise duyarlýlýklarýnýn düþük olmasýdýr. Buradan yola çýkarak yakýn zaman önce özgüllükten ödün vermeden duyarlýlýðý daha yüksek yeni bir kriter ortaya atýlmýþtýr. Çalýþmamýzda bu yeni EKG kriterini genel kardiyoloji hastalarýndan oluþan büyük bir hasta grubu üzerinde test etmek istedik.
YÖNTEM ve GEREÇLER: Çeþitli etyolojiler nedeniyle ekokardiyografi çekimine gelen hastalar prospektif olarak çalýþmaya alýndý. Mevcut EKG kriterlerine ilave olarak yeni geliþtirilen Peguero-Lo Presti kriteri tüm hastalarda deðerlendirildi. Sol ventrikül kütle endeksi ekokardiyografi ile ölçüldü. Her kriterin performaný ayrý ayrý hesaplandý.
BULGULAR: Çalýþmaya toplam 767 hasta alýndý. Peguero-Lo Presti kriterinin duyarlýlýk ve özgüllüðü sýrasýyla %17,5 ve %94.5 idi. Her ne kadar en yüksek duyarlýlýk Peguero-Lo Presti kriterinde görülse de, ROC analizi sonuçlarýna göre halen kullanýlmakta olan Cornell voltaj kriterine benzer þekilde orta düzeyde bir prediktif deðere sahip olduðu görüldü (AUC=0.64 [0.56-0.68 95% GA], p<0.01).
TARTIÞMA ve SONUÇ: Her ne kadar bu yeni kriterin duyarlýlýðý daha yüksek olsa da genel prediktif performansý kullanýlmakta olan mevcut kriterlere üstün bulunmadý. Yaþ ve vücut kitle indeksi göz önüne alýnarak yapýlacak deðiþiklikler ile daha iyi sonuçlar elde edilebilir. (NCI-2019-0094.R1)

OBJECTIVE: Many criteria have been developed to predict left ventricular hypertrophy using an electrocardiogram (ECG). However, one major common limitation of all has been their low sensitivity. Based on that, recently, a novel criterion has been proposed, which is believed to have higher sensitivity without a compromise in specificity. Therefore, in our study, we aimed to test this novel ECG criterion prospectively in large, unselected cardiac patients.
METHODS: Patients who were referred to our echocardiography laboratory due to various etiologies were prospectively enrolled. The novel Peguero-Lo Presti criterion was assessed along with other established ECG criteria. The left ventricular mass index was calculated using echocardiography. The performance of each index was evaluated.
RESULTS: Overall, 767 patients were enrolled in this study. The sensitivity and specificity of the Peguero-Lo Presti criterion were 17.5% and 94.5%, respectively. Although the highest sensitivity belonged to the Peguero-Lo Presti criterion, in ROC analysis, it showed modest predictive capability, which was similar to the established Cornell voltage criterion (AUC=0.64 [0.56–0.68 95% CI], p<0.01).
CONCLUSION: Although this novel criterion had higher sensitivity, the overall performance was similar to the current indices. Further adjustments, particularly based on age and body mass index, may yield better results.

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Amaç: Senkop, ani ve kýsa süreli bilinç kaybý ve postural ton kaybý ile karakterizedir. Vazovagal senkop (VVS) atak genellikle kendi kendini sýnýrlar ve hastalarýn yaþam kalitesini etkileyebilir. VVS tanýlý hastalarýn klinik özellikleri ile yaþam kalitesi, Beck-depresyon ve Beck-anksiyete ölçekleri arasýndaki iliþkiyi araþtýrmayý amaçladýk.
Yöntem: Çalýþma VVS tanýlý 88 hasta dahil edildi. Tilt masa testi tüm hastalara ugulandý. Hastalar yaþam kalitesi, Beck-depresyon ve Beck-anksiyete ölçeði formlarýný doldurdular. Demografik bilgiler, týbbi öykü, ekokardiyografi, kan basýncý, elektrokardiyografi ve fizik muayene bulgularý kaydedildi.
Bulgular: Toplam senkop epizotlarý (TSE) ile EQ-5D indeksi ve EQ-5D-VAS endeksi arasýnda anlamlý ve negatif bir iliþki vardý (p <0.001, r: -0.649; p <0.001, r: -0.587). TSE, Beck-anksiyete ölçeði ve Beck-depresyon ölçeði ile anlamlý ve pozitif olarak korele idi. EQ-5D indeksi, EQ-5D-VAS indeksi, Beck-depresyon ölçeði ve Beck-anksiyete ölçeði VVS hastalarýnda TSE'nin baðýmsýz bir belirleyicisi olarak tanýmlandý.
Sonuç: VVS tanýlý hastalarda psikolojik faktörler önemli bir rol oynamaktadýr. EQ-5D indeksi, EQ-5D-VAS indeksi, Beck-depresyon ölçeði ve Beck-anksiyete ölçeði VVS hastalarýnda TSE'nin baðýmsýz bir belirleyicisidir. (NCI-2019-0194.R1)

OBJECTIVE: Syncope is characterized by sudden and short-term loss of postural tone and consciousness. Vasovagal syncope (VVS) episode is usually self-limiting, and it may affect patients’ quality of life. In this study, we aimed to investigate the relationship between quality of life, Beck-depression and Beck-anxiety scales and clinical characteristics of the VVS patients.
METHODS: The present study included 88 patients with VVS. Tilt table test was performed to all the patients. Patients filled out the Quality of life, Beck-depression, and Beck-anxiety scale forms. Demographics, medical history, echocardiography, blood pressures, electrocardiography and physical examination findings were recorded.
RESULTS: There was a significant and negative correlation between the total syncope episodes (TSE) and EQ-5D index and EQ-5D-VAS index, respectively (p<0.001, r: -0.649; p<0.001, r: -0.587). TSE was significantly and positively correlated with the Beck-anxiety scale and Beck-depression scale. EQ-5D index, EQ-5D-VAS index, Beck-depression scale, and Beck-anxiety scales were defined as an independent predictor of TSE in VVS patients.
CONCLUSION: Psychological factors play an essential role in VVS patients. EQ-5D index, EQ-5D-VAS index, Beck-depression, and Beck-anxiety scales were an independent predictor of the TSE in patients with VVS.

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Amaç: Yapýlan çalýþmalarda, hiperventilasyonun nöbet süresini uzattýðý bildirilmiþtir. Bununla birlikte, Elektrokonvülsif Tedavi (EKT) sýrasýnda hiperventilasyonun nasýl yapýlacaðýna dair klinik kýlavuzlarda net bir fikir birliði yoktur. Bu çalýþmanýn amacý, hiperventilasyonun nöbet uzunluðu ve serebral oksijenasyon üzerine etkisini araþtýrmaktýr.
Gereç ve Yöntem: Çalýþmaya ilk kez EKT yapýlacak olan 18-65 yaþlarý arasýndaki ve ASA I-II olarak sýnýflandýrýlan 40 hasta dahil edildi. Etik kurul onayý alýndý ve tüm hastalarýn onamý alýndý. Ardýþýk hastalar Grup H (20 hasta; hedef etCO2: 25-30 mmHg) ve Grup N (20 hasta; hedef etCO2 35-40 mmHg) olmak üzere iki gruba randomize edildi. Tüm hastalar 2 dakika boyunca yüz maskesi ile havalandýrýldý ve daha sonra 1 dakika boyunca laringeal maske (LMA) ile havalandýrýldý. Vital bulgular, periferik oksijen satürasyonu (SpO2) ve bölgesel oksijen satürasyonu (rSO2), genel anestezi indüksiyonundan önce, LMA (LMA3) ile ventilasyonun 3. dakikasýnda, postiktal 1. dakikada (PI1), 5. dakikada (PI5) ve 10. (PI10) dakikada kaydedildi. Motor nöbet süresi, Richmond ajitasyon-sedasyon skoru (RASS) ve Aldrete Skoru 9'a ulaþmak için gereken zaman da kaydedildi.
Bulgular: Gruplar arasýnda nöbet uzunluðu ve derlenme süresi açýsýndan karþýlaþtýrýldýðýnda anlamlý bir fark vardý. Bununla birlikte, Grup H'de farklý zamanlarda ölçülen rSO2 deðerlerini karþýlaþtýrdýðýmýzda, ölçümler arasýndaki fark istatistiksel olarak anlamlýydý. Grup H'deki rSO2 deðerleri çiftler halinde karþýlaþtýrýldýðýnda, bazal ve LMA3, bazal ve PI1 ile bazal ve PI5 arasýndaki ölçümler arasýnda anlamlý farklar vardý. Her iki gruptaki Richmond ajitasyon skorlarý karþýlaþtýrýldýðýnda, gruplar arasýnda anlamlý fark yoktu.
Tartýþma ve Sonuç: Çalýþma sonucunda, Grup H’de nöbet süresinin daha uzun olduðu ve derlenme süresinin daha kýsa olduðu bulundu. Ayný kiþide farklý zamanlarda ölçülen serebral oksijenasyona hiperventilasyonun katkýsý vardý, ancak serebral oksijenasyon normoventile olan hastalardan istatistiksel olarak farklý deðildi. EKT'de hiperventilasyonun nasýl uygulandýðýna dair bir fikir birliði oluþturmak için daha fazla çalýþmaya ihtiyaç vardýr. (NCI-2019-0013.R4)

OBJECTIVE: Previous studies have reported that hyperventilation prolongs seizure length. However, there is no clear consensus in clinical guidelines on how to perform hyperventilation during Electroconvulsive Therapy (ECT). The present study aims to investigate the effects of hyperventilation on seizure length and cerebral oxygenation.
METHODS: Forty patients aged 18–65 and classified as ASA I-II, who would have their first ECT course were included in the study. Ethics committee approval was obtained and all patients’ consent was taken. The consecutive patients were randomized into two groups as follows: group H (20 patients; target etCO2: 25–30 mmHg) and group N (20 patients; target etCO2 35–40 mmHg). All patients were ventilated with a facial mask for two minutes and later were ventilated by a laryngeal mask (LMA) for one minute. Vital signs, peripheric oxygen saturation (SpO2), and regional oxygen saturation (rSO2) were measured before general anesthesia induction, on the 3rd minute of ventilation with an LMA (LMA3), on the 1st minute postictal (PI1), on the 5th (PI5), and 10th (PI10) minutes. The motor seizure duration, Richmond sedation-agitation scale, and the time needed to reach Aldrete Score 9 were also recorded.
RESULTS: There was a significant difference between the groups when they were compared concerning seizure length and recovery time. However, when we compared the rSO2 values that were measured at different times in group H, the difference between the measurements was statistically significant. When rSO2 values in group H were compared in doubles, there were significant differences between measurements between the basal and LMA3, basal and PI1, and the basal and PI5. When Richmond agitation scores in both groups are compared, there were no significant differences between the groups.
CONCLUSION: This study found that seizure length was longer, and the recovery time was shorter in group H. There was a contribution of hyperventilation on cerebral oxygenation that was measured on the same person at different times, but cerebral oxygenation was not statistically different from patients that were normoventilated. More studies are required to form a consensus regarding how hyperventilation applies to ECT.

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GÝRÝÞ ve AMAÇ: Vena cava superior sendromu, vena cava superiorun çeþitli kompresyon belirtilerini içerir. Vücudun üst kýsmýnda artmýþ basýncýn sonucunda siyanozla beraber baþ ve boyunda ödem, plethore ve yüzeyel damarlarda belirginleþmeye sebep olabilir. Vena cava superior sendromunun çocuklarda nadir olmasý nedeniyle bu çalýþmayý planladýk.
YÖNTEM ve GEREÇLER: Retrospektif çalýþma, Erciyes Üniversitesi Týp Fakültesi Pediatrik Hematoloji-Onkoloji Anabilim Dalý'nda Ocak 2010-Aralýk 2017 tarihleri arasýnda mediastinal tümörü olan çocuklarda yapýldý. Taný yöntemleri arasýnda hematolojik incelemeler, göðüs radyografisi, göðüs tomografisi, ekokardiyografi ve lenf nodu veya mediastinal biyopsi sayýlabilir.
BULGULAR: Mediastinal tümör tanýsý alan 41 hastadan 19’ unda (% 46.3) Vena cava superior sendromu bulgularýnýn olduðu saptandý. Geriye dönük tanýlara bakýldýðýnda 7’ si (% 37) Hodgkin Lenfoma, 6’sý (% 32) Non-Hodgkin Lenfoma, 4’ü (%21) T hücreli Akut Lenfoblastik Lösemi, 1’i (%5) nöroblastom, 1’i (%5) anaplastik round cell sarkom idi. 19 hastanýn tümünde yüzde þiþlik, venöz geniþleme, mediastinal geniþleme görüldü. Tüm hastalar intravenöz kortikosteroid tedavisi aldý (0.6 mg/kg deksametazon). Ayrýca anaplastik round cell sarkom tanýsý alan bir hasta radyoterapi aldý. Vena cava superior sendromu nedeniyle ölen hastamýz olmadý.
TARTIÞMA ve SONUÇ: Vena cava superior sendromu acil tedavi gerektiren bir týbbi acil durumudur. Çocukluk yaþ gurubu Vena cava superior sendromu çalýþmalarý nadirdir. Bu retrospektif çalýþmada, Vena cava superior sendromunun en sýk nedeni literatürden farklý olarak Hodgkin Lenfoma olarak saptanmýþtýr. (NCI-2019-0004.R1)

OBJECTIVE: Vena cava superior syndrome comprises various symptoms of compression of vena cava superior. The results of increased venous pressure in the upper body may cause edema of the head and neck associated with cyanosis, plethora and distended subcutaneous vessels. Vena cava superior syndrome is rare in childhood. Therefore, we planned this retrospective study.
METHODS: The retrospective study was carried out on the children with mediastinal tumors in the Department of Pediatric Hematology-oncology, Erciyes University Faculty of Medicine, Kayseri,Turkey, from January 2010 to December 2017. Diagnostic procedures included hematological investigations, chestradiography, thoracic computed tomography, echocardiography and lymph node or mediastinal biopsy.
RESULTS: In this study, 19 (five were female) of 41 patients with mediastinal tumors had Vena cava superior syndrome. Diagnosis included Hodgkin’s lymphoma in seven (37%), non-Hodgkin’s lymphoma in six (32%), acute T- lymphoblastic leukemia in four (21%), neuroblastoma and anaplastic round cell sarcoma in one each respectively. All of the 19 patients’ facial swelling, venous distention and mediastinal widening. All patients received intravenous corticosteroids (0.6 mg/kg dexamethasone). Furthermore, the patient with anaplastic round cell sarcoma received emergency radiotherapy. No patients died because of Vena cava superior syndrome.
CONCLUSION: Vena cava superior syndrome is a medical emergency that requiresurgent treatment. Vena cava superior syndrome studies in children are rare. In this retrospective study,we found that the most common cause of Vena cava superior syndrome was Hodgkin’s lymphoma different from literature.

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GÝRÝÞ ve AMAÇ: Türk toplumunda yaþayan yaþlý bireylerde düþmeler ve psikoaktif ilaç kullanýmý arasýndaki iliþkiye dair veriler yetersizdir. Bu çalýþma, Türk toplumunda yaþayan yaþlýlarda düþme sýklýðýný ve psikoaktif ilaç kullanýmý ile düþme arasýndaki iliþkiyi belirlemeyi amaçlamaktadýr.
YÖNTEM ve GEREÇLER: Bu tek merkezli çalýþma, bir geriatri bakým ünitesine baþvuran 65 yaþ üstü bireylerin týbbi kayýtlarý kullanýlarak yapýldý. Ayrýntýlý geriatrik deðerlendirme ile edilen sosyo-demografik özellikler, hastalýklar, kullanýlan ilaçlar, ruh hali, biliþsel durum ve fonksiyonel performans hakkýndaki veriler kayýtlardan alýndý. Son 12 aydaki düþme öyküsüne dayanarak, bireyler düþenler ve düþmeyenler olarak gruplandýrýldý. Psikoaktif ilaçla tedavi edilen bireyler belirlendi.
BULGULAR: Toplam 429 olgunun, 184’ünde (%42,9) düþme öyküsü var iken, 254’inde (%57.1) yoktu. Tüm olgularýn %33,3’ü psikoaktif ilaç tedavisi alýyordu. Düþme öyküsü olan grupta düþme olmayan gruba göre psikoaktif ilaç kullanan birey oraný daha fazlaydý (%45,1 ve %24,5, p<0,001). Çok deðiþkenli regresyon analizinde yaþ ≥ 75 yýl (Olasýlýk Oraný=1,83; Güven Aralýðý: 1,09-3,09; p=0,023), kadýn cinsiyet (Olasýlýk Oraný=2,70; Güven Aralýðý: 1,6-4,50; p<0,001), ve psikoaktif ilaç kullanýmýnýn (Olasýlýk Oraný=2,14; Güven Aralýðý: 1,32-3,48; p=0,002) düþme durumunun baðýmsýz göstergeleri olduðu bulunmuþtur.
TARTIÞMA ve SONUÇ: Türkiye'de bir geriatri polikliniðine baþvuran hastalarýn yaklaþýk üçte birinin, düþme riski ile baðýmsýz olarak iliþkili olan psikoaktif ilaç tedavisi aldýklarýný bulduk. (NCI-2019-0047.R1)

OBJECTIVE: Data on the relationship between fall and psychoactive drug use among Turkish older people are limited. This study aims to investigate the prevalence of falls and the associations between psychoactive drug use and falls in community-dwelling Turkish older people.
METHODS: This single center study was performed using the medical records of subjects aged over 65 years admitted to the geriatric care unit. Demographic and lifestyle factors, clinical characteristics, medications, and data on mood, cognitive status, and functional performance were obtained from the comprehensive geriatric assessment records. Based on a fall history in the last 12 months, subjects were grouped as fallers and non-fallers. Subjects treated with a psychoactive drug were identified.
RESULTS: Among the total of 429 subjects, there were 184 (42.9%) fallers and 245 (57.1%) non-fallers. Of those, 33.3% were on psychoactive drug treatment. The proportion of psychoactive drug users was higher in the fallers group compared to non-fallers (45.1% vs. 24.5%, p<0.001). Multivariable logistic regression analysis showed age ≥75 years (OR=1.83; CI: 1.09–3.09; p=0.023), female gender (OR=2.70; CI: 1.6–4.50; p<0.001), and psychoactive drug use (OR=2.14; CI: 1.32–3.48; p=0.002) as independent predictors of falls.
CONCLUSION: We found that about one-third of geriatric outpatients were on psychoactive drug treatment in Turkey that was independently associated with the risk of falls.

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Amaç: Skuamöz hücreli Özefagus kanseri (SHÖK) son derece ölümcül malignitedir. Bu çalýþmada metastatik olan ve olmayan SHÖK hastalarýnda saðkalýmý etkileyen faktörlerin retrospektif olarak incelenmesi amaçlandý.
Method: Çalýþmaya 2008-2016 yýllarý arasýnda SHÖK nedeni ile takipli hastalar olarak alýndý. Hastalar klinik evre II-III ve evre IV olarak guruplandýrýldý.
Bulgular: Çalýþmaya 55 (55.1%) erkek ve 52 (48.6%) kadýn olmak üzere 107 hasta alýndý. Hastalarýn ortalama yaþý 60.8 idi. 28 (26.2%) hasta klinik evre II, 33 (30.8%) hasta klinik evre III, 46 (%43.0) hasta evre IV tü. Non-metastatik 29 (27.1%) hasta Neoadjuvan kemoradyoterapi (KRT) sonrasý opere olmuþtu, 29 (27.1%) hastaya definitif KRT verilmiþti. Metastatik evre olan hastalarýn 26 (56.5%) sine Kemoterapi (KT) verilmiþti. Neoadjuvan KRT sonrasý opere olanlarda ortanca saðkalýma (mGSK), ulaþýlamazken, Definitif KRT verilenlerde mGSK, 22.0 ay, sadece cerrahi ile tedavi edilenlerde 24.0 aydý (p=0.008)). Metastatik evrede ise ilk seride KT verilenlerde mGSK, 8.0 ay iken en iyi destek tedavi verilenlerde 3.0 ay dý (p<0.001). Çok deðiþkenli analizde non-metastik evrede ECOG PS 3-4 (Tehlike oraný [TO], 6.13) operasyon varlýðý(TO,0.22), Klinik evre III (TO, 3.19) ve rekürrens varlýðý (TO, 24.12), Metastatik evrede ise, ECOG PS 3-4 (TO, 3.31), grad3 (TO, 3.39), karaciðer metastazý(TO, 2.53) ve KT verilmesi (TO, 0.15) saðkalýmý etkileyen en anlamlý faktörler olarak saptandý.
Sonuç: Çalýþmamýzda non-metastatik SHÖK’de cerrahi yapýlmasý, klinik erken evre olmasý saðkalýmý arttýrýrken rekürrens geliþmesi saðkalýmý olumsuz etkiliyordu. Metastatik evrede ise ECOG PS 3-4, grad 3 tümör ve karaciðer metastazý varlýðý saðkalýmý olumsuz etkilerken, KT verilmesi saðkalýmý anlamlý þekilde arttýrýyordu. (NCI-2019-0243.R1)

OBJECTIVE: Squamous cell esophageal cancer (ESCC) is a highly fatal malignancy. This study aims to investigate the factors affecting survival in patients with metastatic and non-metastatic ESCC.
METHODS: Between 2008 and 2016, 107 patients with ESCC who were followed up in an oncology clinic were included in the analysis. Patients were grouped based on the stage of disease as clinical-stage II to IV.
RESULTS: Of the 107 patients, 55 (55.1%) of them were male and 52 (48.6%) of them were female. The mean age was 60.8 years. Based on the clinical-stage, 28 (26.2%) patients had stage II disease, 33 (30.8%) had stage III disease, and 46 (43.0%) had stage IV disease. Twenty-nine (27.1%) patients with the non-metastatic disease underwent surgery following neoadjuvant chemoradiotherapy (CRT), while 29 (27.1%) patients received definitive CRT. Twenty-six (56.5%) patients with metastatic disease received chemotherapy (CT). While median overall survival (mOS) could not be reached in patients who underwent surgery following neoadjuvant CRT, mOS for patients receiving definitive CRT versus patients treated with surgery alone–was 22.0 months and 24.0 months, respectively (p=0.008). In the metastatic stage, mOS was 8.0 months for the patients treated with a first-line CT and 3.0 months for patients receiving best supportive care (p<0.001). In multivariate analysis, factors predicting survival in patients with the non-metastatic disease were ECOG PS 3-4 (Hazard ratio [HR], 6.13), undergoing surgery (HR, 0.22), clinical-stage III disease (HR, 3.19), and presence of recurrence (HR, 24.12). For patients with metastatic disease, ECOG PS 3-4 (HR, 3.31), grade-III histology (HR, 3.39), liver metastasis (HR, 2.53), and receiving CT (HR, 0.15) were the factors associated with survival in multivariate analysis.
CONCLUSION: In our study, surgery and early clinical-stage increased survival, whereas experiencing recurrence adversely affected survival in non-metastatic ESCC. In the metastatic stage, ECOG PS 3-4, grade-3 histology and liver metastasis adversely affected survival, while receiving CT significantly improved survival.

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Amaç: Bu çalýþmanýn amacý yeni, düþük maliyetli bir transkonjontival pars plana vitrektomi (PPV) aydýnlatma yaklaþýmýný tanýmlamak ve cerrahi sonuçlarýný deðerlendirmektir.
Yöntemler: Yukarýda tarif edilen teknik ile pars plana vitrektomi operasyonu uygulanan 36 hastanýn 36 gözü çalýþmaya dahil edildi. Süperotemporal, inferotemporal, inferonazal ve süperonazal kadranlardan 4 trokar yerleþtirildi. 30G intravenöz kanül uç kýsmýndan 23mm uzunluðunda bir parça kesildi ve bu kýlýf içerisine 30mm uzunluðundaki bir endoilluminasyon probu yerleþtirildi. Bu dizayn sayesinde endoilluminasyon probunun vitreus boþluðundaki haraketi 7mm ile sýnýrlandýrýldý ve retinal dokulara hasar verme tehlikesi olmadan bu prob cerrahi asistaný tarafýndan yönlendirilebildi.
Bulgular: Otuzaltý hastanýn 36 gözü çalýþmaya dahil edildi (24 erkek, 12 kadýn, ortalama yaþ: 58.4 ±14.3 yýl). Otuz hastada regmatojen retina dekolmaný (6 hastada eþlik eden koroid dekolmaný), 4 hastada diyabetik traksiyonel retina dekolmaný, 1 hastada nükleus drop ve 1 hastada intraoküler yabancý cisim vardý. PPV sonrasýnda ortalama takip süresi 5.05 ±4.4 aydý. LogMAR en iyi düzeltilmiþ görme keskinliði PPV sonrasýnda anlamlý olarak arttý (p<0.001). Postoperatif komplikasyon olarak; 2 hastada nüks retina dekolmaný, 1 gözde hipotoni ve 1 gözde endoftalmi izlendi. Ondokuz hastada postoperatif erken dönemde geçici göz içi basýncý yükselmesi izlendi, ancak uzun dönem takiplerde preoperatif ve postoperatif ortalama göz içi basýncý deðerleri arasýnda anlamlý fark izlenmedi.
Sonuç: Bu bimanüel vitrektomi sistemi ile standart PPV maliyetinde artýþa neden olmadan olumlu sonuçlar elde edilmiþtir. Bu sistemin avize aydýnlatma sistemlerine üstünlüðü; ýþýk kamaþmasýnda azalma, cerrahi bölgeyi daha iyi aydýnlatabilmek için cerrahi sýrasýnda ýþýðýn yönünün deðiþtirilebilmesi ve düþük maliyetidir. Bu yaklaþým IV kanül boyutunu deðiþtirerek bütün mevcut vitrektomi sistemleri (20G, 23G, 25G ve 27G) ile birlikte kullanýlabilir. (NCI-2019-0230.R1)

OBJECTIVE: The present study aims to describe a novel, low-cost, transconjunctival sutureless bimanual vitrectomy illumination approach and evaluate its surgical outcome.
METHODS: Thirty-six eyes of 36 patients who underwent pars plana vitrectomy with the above-mentioned technique were included in this study. Four trocars were placed in superotemporal, inferotemporal, inferonasal and superonasal quadrants. A piece (23 mm) was cut from 30G intravenous cannula and a 30 mm endoillumination probe was placed inside this sleeve. This design limited the entry of the light probe into the vitreous cavity to 7 mm and provided a safe illumination by the assistant without the risk of damaging the retinal tissue.
RESULTS: Thirty-six eyes of 36 patients were included (24 male, 12 female, mean age: 58.4±14.3 years) in this study. Thirty patients had rhegmatogenous retinal detachment (six of these patients with coexisting choroidal detachment), four patients had diabetic tractional retinal detachment, one patient had a nucleus drop and one patient had an intraocular foreign body. The mean follow-up time after pars plana vitrectomy (PPV) was 5.05±4.4 months. LogMAR best-corrected visual acuity improved significantly after PPV (p<0.001). Postoperative complications included recurrent detachment in two eyes, hypotony in one eye and endophthalmitis in one eye. The transient rise in intraocular pressure was observed in 19 patients, but there was no significant difference between the preoperative and postoperative mean IOP in the long term follow-up.
CONCLUSION: This bimanual vitrectomy system provided favorable outcomes without increasing the cost of standard PPV. The advantage of this system over the chandelier illumination include the reduction in glare, the possibility to change the direction of the light during the surgery to better illuminate the surgical site and the lower cost. This approach can be used in any vitrectomy system (20G, 23G, 25G, and 27G) by changing the size of the IV cannula.

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GÝRÝÞ ve AMAÇ: Bu çalýþmada patella volümü ve patellar kartilaj kalýnlýðý ile kondromalazi geliþimi arasýndaki iliþkiyi deðerlendirdik.
YÖNTEM ve GEREÇLER: Çalýþmaya 01.01.2017 ile 31.05.2017 tarihleri arasýnda kliniðimizde diz aðrýsý nedeniyle diz manyetik rezonans (MR) çekimi yapýlan ve inceleme sonucu kondromalazi saptanan 111 olgu ile diz MR incelemesi normal olan 51 olgu dahil edildi. Tüm olgularýn patella volümleri iþ istasyonunda yarý otomatik yazýlým kullanarak analiz edildi. Kondromalazi saptanan olgularda evreleme Outerbridge klasifikasyonuna göre evre 1-4 arasýnda gruplandýrýldý. Patella volümü ile kondromalazi varlýðý ve derecesi, kartilaj kalýnlýðý, yaþ ve cinsiyet arasýndaki iliþki istatistiksel olarak analiz edildi.
BULGULAR: Çalýþmaya dahil 162 olgunun 67’si (%41,4) erkek, 95’i (%58,6) kadýndý. Patellar kondromalazi saptanan olgularýn 23’ünde (%20,7) grade I, 52’sinde (%46,8) grade II, 32’sinde (%28,8) grade III, 4’ünde (%3,6) ise grade 4 kondromalazi mevcuttu. Çalýþmaya dahil edilen olgularýn ortanca yaþý 44’tü. Patella volümü minimum 12,24, maksimum 39,44, ortanca patella volümü ise 21,4 cm3’tü. Patellar kondromalazi bulunan olgularda patella volümü daha yüksekti(p=0,026). Ayrýca patellar kondromalazi bulunan olgularda patellar kondromalazi bulunmayan olgulara göre medial fasetteki kýkýrdak kalýnlýðý açýsýndan istatistiksel olarak farklý olup, daha düþüktü. Patellar kondromalazi bulunan olgularda kondromalazi evresi ile patella volümü arasýnda istatistiksel olarak anlamlý, zayýf, pozitif korelasyon mevcuttu (p = 0.031, r = 0.204).
TARTIÞMA ve SONUÇ: Çalýþmamýzda kronik ön taraf diz aðrýsýnýn önemli nedenleri arasýnda yer alan patellar kondromalazi ile patella volümü arasýndaki anlamlý iliþki ve patella medial yüz kartilaj kalýnlýðýnýn kondromalazili olgularda lateral yüze göre daha ince olduðu gösterilmiþtir. Ýleri yaþtaki olgularda kondromalazi geliþimi daha sýk olmakla beraber kadýn ve erkek arasýnda anlamlý bir fark gözlenmemiþtir. (NCI-2018-0179.R2)

OBJECTIVE: In this study, we evaluated the relationship between patellar volume and chondromalacia patellae.
METHODS: A total of 162 patients who underwent knee magnetic resonance imaging (MR) due to knee pain at our department between January 2017 and May 2017 were included in this study. Of the cases, 111 were chondromalacia patellae, and 51 were healthy individuals. The patella volumes of all cases were analyzed using semi-automated software. Staging in cases with chondromalacia was graded according to the Outerbridge classification (stages 1–4). The relationship between patellar volume, presence of chondromalacia, cartilage thickness, age, and sex was analyzed statistically.
RESULTS: Of the 162 cases, 67 (41.4%) were male, and 95 (58.6%) were female. The median age of the cases was 44. Patellar volume was a minimum of 12.24, a maximum of 39.44, and a median 21.4 cm3, and it was higher in cases with chondromalacia (p=0.026). In patients with chondromalacia patellae, the thickness of cartilage in the medial facet was lower. There was a statistically significant weak positive correlation between chondromalacia grade and patellar volume (p=0.031, r=0.204).
CONCLUSION: This study showed that chondromalacia patellae, one of the important causes of chronic frontal knee pain, has a statistically significant relationship with patellar volume. The medial facial cartilage of the patella was thinner than in cases with chondromalacia patellae. Although the mean age of the cases with chondromalacia was higher than the cases without chondromalacia, there was no significant difference between male and female individuals.

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OBJECTIVE: To study the clinical, laboratory, and radiological characteristics of the pediatric patients infected with the new emerging 2019 coronavirus virus (SARS-CoV-2) in Hamadan and Sanandaj, west of Iran.
METHODS: A descriptive study was conducted in Hamadan and Kurdistan province between March 1 to April 15, 2020. Medical records of the children diagnosed as probable or confirmed cases of COVID-19 disease were extracted and analyzed in this study. We followed the WHO Guideline for the case definition of the patients.
RESULTS: Thirty patients admitted to the wards specified for COVID-19 diseases. Nineteen (63%) patients categorized as confirmed by Real-Time Reverse-Transcriptase Polymerase Chain Reaction (RT-PCR) and 11 (37%) patients as probable according to Computed Tomography (CT) findings of the chest. Sixteen (53.3%) cases were female, the youngest patient was one day old, and the oldest patient was 15 years old. 11 (36.7%) cases had a definite history of close contact. The most common symptoms were fever, cough, and dyspnea, and the most common sign was tachypnea. None of our patients presented with a runny nose. Lymphopenia and marked elevation of the C-reactive Protein observed in four (13.3%) and 12 (40%) cases, respectively. There were 10 (33.3%) cases with normal chest X-rays. Ground-Glass Opacities (GGOs) were the most common CT findings (19, 73.1%). All but one of the patients discharged without sequala. An 11-yrs-old girl expired with a fulminant pneumonia.
CONCLUSION: COVID-19 is not uncommon in children and could have different presentations. Concomitant use of RT-PCR and chest CT scans in symptomatic cases recommended as a modality of choice to diagnose the disease. Routine laboratory tests, like many other viral infections, may not show significant or specific changes. The superimposed bacterial infection seems not the determinant of clinical outcomes as most patients had a negative evaluation by specific laboratory tests for bacterial infections; got improved dramatically with a short or no antibiotic therapy.

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NCI-2019-0309.R2

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Adenoid kistik karsinom (AKK), primer bölgeden baðýmsýz, tipik olarak yüksek oranda uzak metastaz ile birliktelik gösterebilen uzun bir klinik seyir ile karakterizedir. AKK’ un intrakraniyal metastazý uluslararasý literatürde bildirilen nadir vakalarla sýnýrlýdýr. AKK’ un durada nadir bir ekstraaksiyal intrakraniyal metastazýný bildiriyoruz. Primer parotis tümörü 15 sene önce rezeke edilmiþtir. Ekstraaksiyal metastaz ortaya çýkana kadar herhangi bir nüks saptanmamýþtýr. Cerrahi dekompresyon sonrasý, palyatif radyoterapi uygulanmýþtýr. Bildiðimiz kadarýyla, bu vaka, parotis AKK eksizyonunu takiben metastaz görülmesinin en uzun olduðu intervaldir. Bu vaka, ilgili branþlarda, AKK tedavisi sonrasýnda çok uzun yýllar sonra bile uzak metastaz geliþebilme ihtimali ile ilgili farkýndalýk yaratmaktadýr. (NCI-2018-0116.R2)

Adenoid cystic carcinoma (ACC), regardless of the primary site, is typically characterized by a long clinical course associated with a high rate of distant metastases. Intracranial metastasis of ACC is a very rare entity with only few reported cases in the literature. In this study, we report an unusual case of extra-axial intracranial metastasis of ACC in the dura. The primary parotid gland tumour was resected 15 y back. No recurrence had been detected before the occurrence of extra-axial metastasis. After surgical decompression, palliative radiotherapy was administered. To our knowledge, this is the longest interval for the development of metastases following excision of a parotid adenoid cystic carcinoma. This case can raise awareness across specialties that patients with adenoid cystic carcinoma are still at risk of developing metastases even following specialist discharge.

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Tubercular appendicitis is the appendicular infection with tubercular bacillus, which develops as an extension of ileocecal infection. Tuberculosis is either primary or secondary. Primary tuberculosis of the appendix is uncommon. Diagnosis is made by histopathological examination of the resected appendix. We report a rare case of tubercular appendicitis diagnosed on histopathology. Primary Tuberculosis of the appendix is a clinical rarity. Hence, it is being reported. The case report in this study emphasizes the importance of submitting all appendectomy specimens for histopathological examination and the occurrence of primary tuberculosis at a rare site, such as the appendix.(NCI-2019-0069.R2)

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Aþý sonrasý ciddi yan etkiler nadiren de olsa görülebilmektedir. Özellikle nörolojik yan etkilerden tam hücre boðmaca aþýsý sorumlu tutulmaktaydý ve aþýlamadaki en büyük sorundu. Aþý teknolojilerinin geliþmesi ile birlikte tam hücre boðmaca aþýsýndan aselüler boðmaca aþýnýna geçilmiþ ve nörolojik yan etkiler oldukça azalmýþtýr. Bu yazýda BCG, DaBT-IPA-Hib, KPA aþýlarý sonrasý, muhtemelen aselüler boðmaca fraksiyonuna baðlý çok sayýda jeneralize tonik klonik nöbet geçiren 2 aylýk bir süt çocuðu sunulmuþtur. (NCI-2018-0132.R2)

Although rare, serious adverse effects may be seen after vaccination. Especially, the whole-cell pertussis vaccine has been held responsible for neurological side effects, as the most important problem in vaccination. With the advancement in vaccination technologies, whole-cell pertussis vaccine has been replaced by acellular pertussis vaccine, and neurological side effects have been significantly reduced. Herein, we present a 2-month-old male infant who suffered from generalized tonic-clonic seizures many times, possibly due to acellular pertussis after pentavalent vaccination, including diphtheria, acellular pertussis, tetanus, inactive polio, Haemophilus influenzae type B, and conjugate pneumococcal vaccine (BCG, DaBT-IPA-Hib, CPV).

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Kardiyak troponin, akut koroner sendromun (AKS) tanýsý için tercih edilen biyobelirteçtir, ancak AKS yokluðunda troponin seviyelerinin yükselmesiyle birçok baþka hastalýk tanýmlanabilir. Yüksek duyarlý kardiyak troponin T (hs-cTnT) testinin geliþtirilmesi, çok düþük cTnT seviyelerinin tespitine izin verir. Hs-cTnT testinin kullanýmý, birincil önleyici tedavi için yüksek riskli bireylerin belirlenmesinde bir araç olarak ortaya çýkmýþtýr ve asemptomatik hastalarda subklinik hasarý tespit edebilmektedir. Hs-cTnT analizleri ile ilgili olarak literatürde genelde iskemi ile ilgili makaleler olup bu nedenle literatüre katký saðlayabilecek non-koroner hastalarda hs-cTnT analizi ile ilgili bir deðerlendirme yaptýk. (NCI-2019-0195.R1)

Cardiac troponin is the preferred biomarker for the diagnosis of the acute coronary syndrome (ACS), but many other diseases can be identified with elevated troponin levels in the absence of ACS. The recent development of a high-sensitive cardiac troponin T (hs-cTnT) assay permits the detection of very low levels of cTnT. The use of hs-cTnT assay has emerged as a tool for identifying high-risk individuals for primary preventive treatment and can detect subclinical injury in asymptomatic patients. Hs-cTnT analyses are generally related to ischemia in the literature. Thus, we made an evaluation of hs-cTnT analysis in non-coronary patients, which may contribute to the literature.

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NCI-2020-0130

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