Kantar, Y.; Hayme, S.

Background:Although analgesic management is a critical priority in the guidelines for trauma patients, paramedics' prehospital administration practices vary.Objectives:This study evaluated the paramedics' practices regarding prehospital analgesia administration in trauma patients.Methods:The study was conducted in two phases. In the first phase, the records of patients 18 years and above who were brought to our hospital via ambulance were retrospectively reviewed. A total of 506 patients with trauma were included in this phase of the study. In the second phase, paramedics' practices regarding pre-hospital analgesic administration to trauma patients, such as drugs, and frequency. Data were analyzed using descriptive statistics, and are presented as mean +/- standard deviation for numerical variables and as frequency and percentage for nominal variables. Nominal variables were evaluated using the Pearson Chi-Square test.Results:According to data collected retrospectively in the first phase of the study, prehospital analgesia was administered to only 1% of the 506 patients. In the second phase of the study, when asked about the reasons for not administering prehospital analgesia, it was found that 77.5% of paramedics believed that doing so would interfere with the hospital physician's examination.Conclusion:High rates of interventions such as spinal board immobilization, cervical collar application, and appropriate splinting or dressing have been observed in trauma patients. Paramedics were also found to be quite successful in establishing intravenous access. However, the rates of fluid administration and analgesia were considerably lower compared to the literature.

Daltaban, F.; Sayar, I.; Tayfur, M.; Gürbüzel, M.; Balcı, M.

Background: Thyroid papillary carcinoma (PTC) is the most common carcinoma of thyroid carcinomas and endocrine carcinomas. The diagnosis of thyroid PTC is made mainly by the presence of nuclear features such as nuclear clearing, groove, and nuclear inclusions. Some benign lesions of the thyroid may have nuclear features and growth patterns of papillary thyroid carcinomas, which can make the differential diagnosis difficult. Different immunohistochemical markers have always been needed to reduce diagnostic errors and detect malignancies in routine practice. As in all tumor cases, studies continue to understand carcinogenesis in thyroid carcinomas. One of the ways that can help understand this involves the use of new and effective immunohistochemical markers. Aim: This study aimed to examine the expression of epithelial cell adhesion molecule (EpCAM), Galectin-3 (Gal-3), and proliferative cell nuclear antigen (PCNA), which are immunohistochemical markers that may contribute to the diagnosis and prognosis of thyroid PTCs and lymph node (LN) metastases. Materials and Methods: EpCAM, Gal-3, and PCNA immunohistochemical markers were applied to 26 unifocal (UF) thyroid PTC cases and 25 thyroid PTC cases with LN metastasis or multifocal (MF) tumor field. Results: It was observed that the Gal-3 staining score decreased significantly in the LN metastasis focus compared to the UF tumor. With EpCAM significant loss of membranous expression was observed in the MF tumor compared to the UF tumor. There was no statistically significant difference between the case groups in terms of PCNA staining score. Conclusions: These results may be important in terms of obtaining new immunohistochemical clues for diagnosis and carcinogenesis in thyroid PTCs and their metastases. The number of cases in our study is limited, and we think that supporting the results with a large series of studies may contribute to the diagnosis and prognosis of the patients.

Cobden, S. B.; Ozcan, I; Altiparmak, S.; Kuru, A.; Senel, F.; Kantekin, Y.; Kaya, A.

Background and Aim:Tongue base reduction surgery is the only minimally invasive technique that can be performed under local anesthesia as an outpatient procedure, especially to treat obstructive sleep apnea caused by hypopharyngeal obstruction. Studies reported that various devices could be used for tongue base reduction, but comparisons of these methods are limited in the literature. Our study aimed to compare the histological effects of tongue base reduction methods performed with the Celon radiofrequency, monopolar cautery, Coblator, and Sutter devices on the tissue.Methods:This study included 23 female rats (aged 4-8 months). Rats were divided into five groups. Tongue base reduction was performed with monopolar cautery in the first group (5 rats), then Celon radiofrequency in the second group (5 rats), the Coblator in the third group (5 rats), and the Sutter in the fourth group (5 rats). The fifth group was the control group, which comprised three rats. The rats' tongues were resected for histological examination 1 week after procedures.Results:While the highest amount of fibrosis was seen in the Sutter group, fibrosis was also relatively high in the Coblator group. A significant difference was observed in all groups when compared with the control group regarding tissue thickness. While the average tissue thicknesses of the monopolar, celon rf, and Coblator groups were almost the same, tissue reduction was more marked in the Sutter group.Conclusion:Although we observed that all the methods used were safe, the method that produced the most fibrosis and tissue reduction was the Sutter method.

Yanmiş, S.; Molllaoğlu, M.

Background: Hemodialysis is one of the treatment methods for chronic kidney disease, which is a common disease around the world. The problems that occur during the hemodialysis process may cause discomfort in patients. Therefore, it is important to regularly evaluate the concept of comfort in hemodialysis patients. Aim: To determine the comfort level of patients undergoing hemodialysis and the associated factors. Methods: This study was a descriptive cross-sectional study conducted among 95 patients who had been undergoing hemodialysis for at least 6 months. Data were collected using the sociodemographic characteristics form and the Hemodialysis Comfort Scale (HDCS). Results: The mean age of the participants was 58.37 ± 16.62 years. The median duration of hemodialysis was 5 (1–25) years. A total of 51% of the patients were male, 54.7% were married, 34.7% had completed primary school, and 85.3% had a comorbid chronic disease. The mean hemodialysis comfort score was 23.85 ± 6.93. The mean score was significantly higher in male patients (P = 0.041) and those without comorbid chronic disease (P = 0.013). There was a significant negative correlation between the age of hemodialysis patients and the mean hemodialysis comfort score (r = -0.260, P = 0.011). Conclusion: The comfort level was significantly better in hemodialysis patients who were male, those without comorbid disease, and those who were younger. There is a need to periodically assess the comfort level of hemodialysis patients and intervene when necessary in order to improve their quality of life.

Aǧcayazi, S.; Salcan, İ.; Erşahan, A.A.; Seçkin, E.

Background: The nasal cavity and paranasal sinuses are one of the most frequently anatomically varied regions. Their size and shape vary from person to person, and ethnic origin may have a role in this variety. Recognizing this variations is so important for ear nose throat (ENT) specialists because they predispose to sinonasal pathologies and affect the complication rate and success of endoscopic sinus surgery. Aim: This study aimed to determine the frequency of sinonasal anatomic variations on paranasal sinus computed tomography (CT) in the Turkish population. Methods: Patients who had undergone paranasal sinus CT with any complaints between 2013 and 2020 and aged over 18 years were included in the study. A total of 1209 patients who had undergone paranasal sinus CT were examined for coronal, axial, and sagittal plans retrospectively by two ENT professionals, and anatomical variations were evaluated. To assign the frequency of anatomic variations in a healthy population, patients who had previously undergone paranasal sinus and nasal surgery, who had nasal polyposis, and for whom CT evaluation was not possible due to intense sinusitis were excluded from the study. Results: Among 1209 patients, 644 were male and 565 were female. The mean age of the patients was 33.7 years. The most common sinonasal anatomical variations were nasal septal deviation and agger nasi cells, while the least common variation is the supreme turbinate. No variation was found in 48 (3.9%) CTs. Conclusion: Almost all patients had at least one sinonasal anatomical variation. These variations should be known by the professionals who have interest in sinonasal disease and surgery.

Sayar, I.; Gürbüzel, M.

Background: Thyroid carcinomas are the most common malignant endocrine tumors, and various immunohistochemical markers are tested in routine practice to reduce diagnostic differences, as well as to elucidate carcinogenesis and detect malignancy. Disruption of basement membranes and the extracellular matrix is an important step in tumor carcinogenesis and progression. The claudin and matrix metalloproteinase families are also thought to be effective in this process. Aim: In this retrospective study, the comparative expression of claudin-1 and MMP-7 immunomarkers in normal tissues and thyroid neoplasia were investigated. Materials and Methods: Immunohistochemical staining was performed for claudin-1 and matrix metalloproteinase 7 (MMP-7) in 112 sections, including 24 follicular adenomas, 22 follicular carcinomas, 24 medullary carcinomas, 24 papillary carcinomas, and 18 single dominant nodules from thyroid lesions. Results: A significant staining difference for claudin-1 was observed in follicular carcinoma and medullary carcinoma, papillary carcinoma, and single dominant nodules compared to normal thyroid tissue. A statistically significant staining difference was observed for MMP-7 in follicular adenoma, medullary carcinoma, and papillary carcinoma compared to normal thyroid tissue. Conclusions: These results indicate that claudin-1 and MMP-7 are important in the diagnosis, differential diagnosis, and carcinogenesis of follicular adenoma, follicular carcinoma, medullary carcinoma, papillary carcinoma, and single dominant nodules.

Ayerden, D.; Tayfur, M.; Balci, M.G.

Background: Cancer is one of the biggest health problems in the world. Colon adenocarcinoma is the third most common cancer and is the fourth most common cause of cancer deaths. The majority of colon adenocarcinomas originate from a previous adenoma. Cyclin D1 expression and Ki-67 proliferation index increase as the risk of malignancy transformation increases in adenomas. Aims: This study aims to share the results of the Cyclin D1 and Ki-67 studies we performed in colon adenoma and colon adenocarcinoma cases in our hospital with the literature and contribute to the diagnosis and treatment of patients. Materials and Methods: Surgical materials of 40 colon adenocarcinomas and 40 colon adenomas were histopathologically re-evaluated. Cyclin D1 and Ki-67 immunohistochemical staining were applied to these materials. Cyclin D1 and Ki-67 staining rates were compared in colon adenocarcinomas and adenomas. Results: Cyclin D1 and Ki-67 staining rates were increased in colon adenocarcinoma cases compared to colon adenoma. There was a significant difference between the colon adenocarcinoma and colon adenoma case groups in terms of Cyclin D1 and Ki-67 staining scores. Conclusion: In conclusion, immunohistochemical markers such as Cyclin D1 and Ki-67 will be helpful in differential diagnosis when there is difficulty in evaluating routine Hematoxylin-Eosin stained preparations between adenocarcinomas and adenomas.

Inan, H.C.; Issin, G.

Epithelial myoepithelial carcinoma (EMC), a very rarely seen, low-grade, malignant, salivary gland tumor is most commonly located in the parotid gland followed by the submandibular gland. It is more often observed in females and in the 6th decade of life. Although primary treatment of the tumor is surgical resection, adjuvant radiotherapy may be applied to the adjacent area or close follow-up can be done if the surgical margin is closed. Patients must be followed up closely for recurrence and metastasis. Physical and radiological examinations (USG and MRI) should be performed to see for any recurrence in the operated area during the first year for every 2-3 months. This study presents the clinical, radiological, and pathological characteristics of a 59-year-old female patient with low-grade, oncocytic variant of EMC located in the left parotid gland.

Tayfur, M.; Balci, M.

Background: Parasitic infestation of the appendix is uncommon. Parasitic infections can cause inflammation in the appendix and can imitate acute appendicitis clinically. Enterobius vermicularis and Taenia species are among the most common parasitic agents causing acute appendicitis. Objective: We have studied the ratio of parasites causing acute appendicitis in appendectomy specimens and whether there is any relationship between the type of the parasite, histopathological type of acute appendicitis, age of the patient, and gender of the patient in the appendectomy cases. Materials and Methods: We retrospectively analyzed the data of 2400 patients who underwent appendectomy with the prediagnosis of acute appendicitis between 1 st January 2004 and 31 st March 2018 at Erzincan University. The age of the patient, gender of the patient, histopathologic type of acute appendicitis, and the type of parasite were retrospectively analyzed. Positive appendectomy specimens for histopathological features of acute appendicitis were classified into four groups: Catarrhal appendicitis, suppurative appendicitis, gangrenous appendicitis, and perforated appendicitis. Results: In all, 1451 were males and 949 were females. The mean age was 25.51 years. No acute inflammation was found in 36 appendectomy specimens. The distribution of 2364 cases involving acute appendicitis was as follows: Catarrhal appendicitis: 438, suppurative appendicitis: 300, gangrenous appendicitis: 1082, and perforated appendicitis: 544. Parasites were identified in 32 cases. The ratio of appendices to parasites was 1.3%. The number of appendectomy cases with Enterobius vermicularis was 22, and the number with Taenia species was 10. Conclusion: Although they are a rare cause of acute appendicitis, parasitic infestations must always be considered. Accurate identification of acute appendicitis and appropriate therapy will improve the quality of life as much as the prevention of acute appendicitis sourced from parasites.

Sagsoz, O.; Yildiz, M.; Hojjat Ghahramanzadeh, A.S.L.; Alsaran, A.

Objective: The purpose of this study was to examine the fracture strength and surface microhardness of computer-aided design/computer-aided manufacturing (CAD/CAM) materials in vitro. Materials and Methods: Mesial-occlusal-distal inlays were made from five different CAD/CAM materials (feldspathic ceramic, CEREC blocs; leucite-reinforced ceramic, IPS Empress CAD; resin nano ceramic, 3M ESPE Lava Ultimate; hybrid ceramic, VITA Enamic; and lithium disilicate ceramic, IPS e.max CAD) using CEREC 4 CAD/CAM system. Samples were adhesively cemented to metal analogs with a resin cement (3M ESPE, U200). The fracture tests were carried out with a universal testing machine. Furthermore, five samples were prepared from each CAD/CAM material for micro-Vickers hardness test. Data were analyzed with statistics software SPSS 20 (IBM Corp., New York, USA). Results: Fracture strength of lithium disilicate inlays (3949 N) was found to be higher than other ceramic inlays (P < 0.05). There was no difference between other inlays statistically (P > 0.05). The highest micro-Vickers hardness was measured in lithium disilicate samples, and the lowest was in resin nano ceramic samples. Conclusion: Fracture strength results demonstrate that inlays can withstand the forces in the mouth. Statistical results showed that fracture strength and micro-Vickers hardness of feldspathic ceramic, leucite-reinforced ceramic, and lithium disilicate ceramic materials had a positive correlation.