P-ISSN 2587-2400 | E-ISSN 2587-196X

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EJMO: 2 (1)

Volume: 2  Issue: 1 - 2018

SYSTEMATIC META-ANALYSIS
1.Does Sex Predict the Development of Mediastinitis?
Selen Ozturk, Ibrahim Ozturk
doi: 10.14744/ejmo.2017.33042  Pages 1 - 7 (412 accesses)
Objectives: We aimed to analyze whether sex was a risk factor for the development of mediastinitis after cardiac surgery.
Methods: Literature screening was performed using PubMed database without date limitation. Trial results were evaluated with random or fixed-effect model according to the heterogeneity. Statistical evaluation was performed.
Results: In total, 4044 articles were obtained after database searching. Of all these articles, 32 articles containing 1.11.303 patients, which satisfied the inclusion criteria, were included in the meta-analysis. The rate of mediastinitis was 2.19%. The effect size was observed as heterogeneous (Q: 89.09, df(Q): 31, p: 0.00, I2: 65.20%). Analysis results according to the random effect model were as follows: OR (odds ratio), 1.09; 95% CI, 0.90–1.32; and p=0.34 (p>0.05).
Conclusion: The results of the quantitative analysis showed that a patient’s sex does not predict the development of mediastinitis after cardiac surgery for children and/or adults.

RESEARCH ARTICLE
2.Retrospective Evaluation of the Effect of NT Thickness and Septation on Karyotype Anomalies in Cystic Hygroma Patients
Ugurkan Erkayiran, Bulent Kostu, Salih Serin, Alev Ozer
doi: 10.14744/ejmo.2017.83803  Pages 8 - 12 (364 accesses)
Objectives: This study was planned to observe the effect of septation and nuchal translucency (NT) on the outcomes of karyotype analysis in cystic hygroma (CH) patients.
Methods: Between 2010 and 2014, 84 patients who were suspected to have elevated NT thickness (>3 mm) or CH were included in this study and were retrospectively investigated. Patients were evaluated in two different categories that were divided into four groups: 1) those with NT thickness between 3 and 5 mm (n=47), 2) those with NT thickness >5 mm (n=37), 3) those with cystic septation (n=43), and 4) those without septation (n=41).
Results: The rate of aneuploidy was found to be 36.1% in CH patients with NT thickness of 3–5 mm, whereas this rate was found to be 56% in CH patients with NT thickness >5 mm. In the statistical comparison of these two groups, NT thickness >5 mm increased the aneuploidy risk, but it was not statistically significant (P=0.232). The aneuploidy rate was found to be 79% in CH patients with septation, whereas it was 9.7% in CH patients without septation. On statistical comparison of CH groups with and without septation, it was observed that CH septation was statistically significant in terms of karyotype anomaly (P=0.021).
Conclusion: As a result of aneuploidy in the absence of NT thickness ≥5 mm are not found to be statistically significant increased risk, the risk of aneuploidy septal cysts were found to be statistically increase. Further studies are required to explain this.

3.Sexual Dysfunction in Female Patients with Migraine
Gokhan Ozer
doi: 10.14744/ejmo.2017.70883  Pages 13 - 15 (384 accesses)
Objectives: To investigate sexual dysfunction in married, literate females diagnosed with migraine.
Methods: Twenty-two literate, married female patients with migraine presenting to our outpatient clinic (Ankara) were asked to complete the Female Sexual Function Index (FSFI) questionnaire. Age, body mass index (BMI), employment status, and responses to FSFI questionnaire were analyzed using the Chi-square test to check whether they were correlated with total FSFI scores.
Results: The mean age of females was 30.9±5.7 years, and their mean FSFI score was 27.5±7.5. FSFI scores were significantly associated with employment status and BMI (p<0.05).
Conclusion: Based on FSFI, there was no significant difference in the severity of sexual dysfunction among female patients with migraine compared with healthy subjects in previous population-based studies.

4.A Cross-sectional Study; 2015 Evaluation of Lung Graphs
Ender Alkan, Selma Pekgor, Ismet Tolu, Zeynep Ozturk Inal, Hasan Kucukkendirci
doi: 10.14744/ejmo.2017.07108  Pages 16 - 21 (350 accesses)
Objectives: This study was an evaluation of posteroanterior chest radiographs taken of residents of Konya determined by the cluster sampling method.
Methods: This study was a descriptive cross-sectional study, conducted in cooperation with the Konya Education and Research Hospital, the provincial health directorate, and the metropolitan municipality. The sociodemographic characteristics of 2015 individuals participating in the study were recorded. The standard chest radiographs, which were taken with a traditional analog system during inspiration in the standing position, were evaluated by 2 radiologists. The most obvious pathological finding was recorded.
Results: Of the participants, 1075 (53.40%) were female and 940 (46.60%) were male. The mean age was 45.89±0.45 years for the women and 46.20±0.54 years for the men. In the group, 340 (16.90%) were retired, 492 (24.40%) were farmers and/or laborers, 144 (7.10%) were white-collar employees, and 1039 (51.60%) were housewives or unemployed. In all, 580 (28.80%) were cigarette smokers. While 249 (12.36%) had pathological findings on the chest radiograph, 1766 (87.64%) had normal results. The pathological findings were hilar fullness (n=50, 2.48%), emphysematous appearance (n=48, 2.38%), nodule (n=29, 1.44%), increased reticulonodular density (n=26, 1.29%), increased bronchovascular branching (n=9, 0.44%), bronchiectasis (n=4, 0.20%), and other changes (n=83, 4.12%). The incidence of emphysematous appearance was 2.77 times greater in the smokers than in the non-smokers (p<0.05; odds ratio [OR]: 2.77, confidence interval [CI]: 1.56-4.91). While the chest X-ray was normal in 93.50% of the individuals under the age of 40 years, the rate decreased to 84.60% in the individuals over the age of 40 years. The incidence of a pathological chest radiograph was also 2.62 times higher in individuals over the age of 40 years (p<0.001; OR: 2.62, CI: 1.90-3.61).
Conclusion: The incidence of pathological lung findings was greater in individuals over the age of 40 years, and in workers and retirees.

5.Elevated Expression of Glucocorticoid-Induced Leucine Zipper in Placental Endothelial Cells and Trophoblasts in Preeclampsia
Sefa Arlier
doi: 10.14744/ejmo.2017.02486  Pages 22 - 26 (442 accesses)
Objectives: The objective of this study was to investigate the association between normal and preeclamptic glucocorticoid-induced leucine zipper (GILZ) levels in the placenta.
Methods: Placental paraffin sections (5 μm) were obtained from gestational age-matched normal (n=9) and (PE) (n=9) pregnancies. Tissue sections were immunostained with rabbit monoclonal anti-human GILZ antibodies. Staining intensity of GILZ was evaluated with a histologic scoring (HSCORE) system. Parametric (t-test) and non-parametric tests (Mann–Whitney U) were used for statistical analysis, and a p value of <0.05 was considered significant.
Results: Trophoblasts and endothelial cells were shown to be the source of GILZ release. Compared with the control, PE placental samples displayed significantly increased GILZ immunostaining HSCOREs in trophoblast cell nucleus (mean±SEM, 106.8±12.1 vs 167.9±14.9; p=0.006) and endothelial cells (95.0±8.1 vs 147.2±12.3; p=0.003).
Conclusion: This study suggests that GILZ release by placental trophoblasts and endothelial cells may contribute to PE pathogenesis.

6.Influence of Hospitalization-Requiring Gastroenteritis in Pregnancy on Perinatal Outcome
Zeynep Ozturk Inal, Hakan Timur, Hasan Ali Inal, Burak Ersak, Burcu Timur, Dilek Uygur
doi: 10.14744/ejmo.2017.03522  Pages 27 - 31 (318 accesses)
Objectives: To evaluate the clinical and perinatal outcomes of pregnant women who require hospitalization due to acute gastroenteritis.
Methods: Clinical and perinatal outcomes of 108 pregnant women who required hospitalization due to acute gastroenteritis in Maternal and Fetal Medicine Unit and 110 healthy pregnant women who were admitted to Dr. Zekai Tahir Burak Woman’s Health Education and Research Hospital between January 2014 and March 2015 were evaluated.
Results: No statistically significant difference was observed between the groups with respect to the age, educational status, body mass index, gravida, parity, number of abortions, smoking status, history of preterm delivery, consumption of dairy products and coffee, systolic and diastolic blood pressures, white blood cell count, type of delivery, and sex (p>0.05). Although higher fast food consumption (31.8% vs 45.4%, p=0.040), well and tap water consumption (0.9% vs 7.4% and 12.7% vs 37.0% p=0.001), preterm labor (8.2% vs 24.1%, p=0.003), preterm premature rupture of membranes (5.5% vs 14.8%, p=0.025), elevated serum C-reactive protein values (4.20+0.89 mg/L vs 11.73+9.64 mg/L, p=0.001), and admission to newborn intensive care unit (9.2% vs 24.5%, p=0.005) were observed in the gastroenteritis group, lower gestational week (38.29+1.22 vs 37.33+2.81, p=0.001) and birth weight (3475.82+320.34 g vs 3285.65+588.44 g, p=0.004) were observed.
Conclusion: Gastroenteritis, which requires hospitalization during pregnancy, may lead to preterm delivery and low birth weight. Prospective studies are needed to confirm our results.

7.Vitamin D Seasonal Variation in the Elderly in Residantial Care in Turkey
Ahmet Kaya, Elif Turan
doi: 10.14744/ejmo.2017.95867  Pages 32 - 34 (270 accesses)
Objectives: Many factors influence the intensity and duration of ultraviolet exposure, including geographic location, seasons, dietary intake, atmospheric conditions, and daily sunlight exposure. Our objective was to characterize the effect of diet and the seasonal variation of hypovitaminosis D in housebound elderly people in Konya Nursing Home (NH).
Methods: In total, 41 old-aged participants (22 males, 19 females) who lived in Konya NH were included in the present study. Serum vitamin D3 (VD3) levels were measured and compared in the winter and summer for each group. The results were evaluated between each other and with 20 old-aged participants (10 women, 10 men) who had similar demographic conditions, were healthy, and living outside the NH.
Results: The mean ages of the NH and control groups (CGs) were 74.75±3.90 (65–93) and 73.72±2.90 (68–83), respectively. The mean VD3 levels were 20.36±6.54 ng/mL in summer and 19.29±6.00 ng/mL in winter for men in the NH group. The mean VD3 levels were 19.58±6.93 ng/mL in summer and 18.29±4.69 ng/mL in winter for women in the NH group. The mean VD3 levels were 24.79±6.59 ng/mL in summer and 20.94±5.29 ng/mL in winter for men in the CG. For women in the CG, the mean levels were 25.30±6.77 ng/mL in summer and 20.73±6.50 ng/mL in winter. There were no differences in the mean levels between the NH group and CG in the summer and winter periods.
Conclusion: VD is not required only for bone development and growth of children, it is also required bone strength in adults and prevent osteoporosis and fracture risk in the elderly. All of the seasons VD deficiency was found in older aged people in housebound and living outside. We must fortify the dietary products with VD and increase sunlight exposure in older aged people.

8.Utility of the Therapeutic Intervention Scoring System-28 to Predict Mortality in Intensive Care Units
Yasemin Tekdos Seker, Oya Hergunsel, Ipek Bostanci, Ayten Zeydan
doi: 10.14744/ejmo.2017.00719  Pages 35 - 39 (335 accesses)
Objectives: We compared the commonly used Acute Physiology and Chronic Health Evaluation (APACHE) II score and Sequential Organ Failure Assessment (SOFA) score with the quicker and easier Therapeutic Intervention Scoring System (TISS)-28) to examine mortality in intensive care units (ICUs).
Methods: Patients treated in the ICU at Bakirköy Dr. Sadi Konuk Research and Training Hospital between May 2012 and January 2017 were included in the present study. Patients who made a full recovery and were discharged were defined as group 1, whereas those who died were defined as group 2. TISS-28 scores recorded twice in the first 24 h and APACHE II and SOFA scores recorded at the end of 24 h were evaluated. The groups were compared based on demographic data; duration of nursing (h/day); and TISS-28, APACHE II, and SOFA scores.
Results: Of 2191 patients in this 5-year study, 1405 (64%; group 1) were discharged from the ICU and 786 (36%; group 2) died. There was no significant difference in age between the two groups. The median TISS-28 score was 17 in group 1 and 25 in group 2. The median APACHE II score was 18 in group 1 and 29 in group 2. The median SOFA score was 6 in group 1 and 8 in group 2. All three scores were significantly higher in group 2.
Conclusion: TISS-28 scores correlated with APACHE II and SOFA scores, predicting mortality.

9.Prevalence of Pericentric Inversion of Chromosome 9 in Eastern Anatolia Region and Relationship to Reproductive Efficiency
Sengul Yuksel, Serap Savaci, Cemal Ekici, Elcin Latife Kurtoglu, Selcen Korkmaz, Elif Yesilada
doi: 10.14744/ejmo.2017.06978  Pages 40 - 42 (360 accesses)
Objectives: One of the most common, structurally balanced chromosome rearrangements is the pericentric inversion of chromosome (inv[9]). It is considered to be a variant of the normal karyotype, and has been found in both normal populations and patients with various abnormal phenotypes. The aim of this study was to determine the frequency of chromosome 9 rearrangement in the Malatya Province and check whether it is correlated with certain diseases.
Methods: In this study, we investigated the karyotype analysis of 4168 patients admitted in the Turgut Özal Medical Center and Research Hospital, Genetic Disease Diagnosis Center Laboratory, between 2014 and 2016 and retrospectively reviewed their clinical data. Chromosomes from cultured peripheral blood lymphocytes were analyzed using Giemsa Trypsin-Giemsa (GTG) banding.
Results: Pericentric inversion was detected in 71 (1.7 %) of 4168 cases, including 32 (45.1%) cases with inv(9) causing infertilty, 21 (29.6%) causing growth retardation, four (5.6%) causing multiple spontaneous abortion, and 14 (19.7%) causing other abnormalities, all of which were referred to our laboratory.
Conclusion: In this study, the distribution of inv (9) in the Malatya Province was shown, and it is believed that these results would contribute to the knowledge regarding the incidence of inv (9) in the Eastern Anatolia Region and Turkey.

CASE REPORT
10.Proliferating Trichilemmal Tumor of the Scalp
Fatih Yakar, Pinar Imre, Gunes Deniz, Emrah Celtikci
doi: 10.14744/ejmo.2017.42714  Pages 43 - 45 (299 accesses)
A proliferating trichilemmal tumor is an uncommon, benign, and well-circumscribed hair follicle tumor. It is also called proliferating pilar cyst of the scalp. The tumor has an unclear pathogenesis, but it is often derived from a pre-existing trichilemmal or pilar cyst and is more common in women. The tumor has a slow-growing nature and capacity to be malignant. A 55-year-old female was admitted to Kars Harakani Hospital Neurosurgery Department with a scalp lesion that was growing for 1 month and was infected. Although scalp lesions are frequently encountered in daily neurosurgical practice, proliferating trichilemmal cysts are quite a rare entity, and neurosurgeons should be aware of trichilemmal tumors during differential diagnosis.

11.Anomalous High Origin of the Right Coronary Artery Above the Sinotubular Junction
Veysel Tosun, Necmettin Korucuk, Unal Guntekin
doi: 10.14744/ejmo.2017.13008  Pages 46 - 48 (253 accesses)
Abnormal origin of the right coronary artery (RCA) from the left side of ascending aorta and continuing between the aorta and the truncus pulmonalis is a very rare congenital anomaly. Systolic expansion of the aorta and pulmonary trunk may lead to compression of the coronary artery and result in myocardial ischemia, particularly with exertion. A 59-year-old man admitted to cardiology department with prolonged chest pain during exercise. Abnormal origin of RCA with an interarterial course between the aorta and pulmonary artery was observed on coronary angiography and multi-detector computed tomography coronary angiography (MCTCA). In addition, RCA output compression was reported on MCTCA.

12.A Case of Mature Cystic Teratoma Mimicking a Pericardial Cyst
Elcin Ersoz Kose, Mustafa Vayvada, Mustafa Akyil, Deniz Gurer, Yelda Tezel, Cagatay Tezel
doi: 10.14744/ejmo.2017.35229  Pages 49 - 51 (230 accesses)
The majority of mediastinal germ cell tumors are teratomas. Placement in the anterior mediastinum of the thorax is common, and placement in other compartments of the mediastinum and parenchyma can be observed as well. The main aim of treatment of mature and immature teratomas is complete removal of the mass without complications. Excision provides cure and its prognosis is very good. In this case, we aimed to disscuss the case of a 22-year-old patient with anterior mediastinal involvement, which was first thought to be an anterior cystic pericardial cyst and was determined to be a mature cystic teratoma during resection.

13.A Rare Cause of Acute Abdomen: Thrombosis in the Ileocolic Branch of the Superior Mesenteric Vein
Ozgur Sirkeci, Emel Erkus Sirkeci, Hikmet Nese Ergun
doi: 10.14744/ejmo.2017.36844  Pages 52 - 54 (233 accesses)
Superior mesenteric vein thrombosis is a rare cause of acute abdomen. Patients usually complain of non-specific abdominal pain, which may show progress with secondary complaints, such as nausea, vomiting, and hematochezia. Mesenteric vein thrombosis has a mortality rate of 15% to 40%; early diagnosis plays an important role in treatment. An 80-year-old male patient presented at the Near East Universiry emergency department with complaints of fever and abdominal pain, underwent contrast-enhanced abdominal computed tomography, and was diagnosed with thrombosis in the ileocolic branch of the superior mesenteric vein. The complaints were treated with low molecular weight heparine (LMWH), and surgical intervention was not necessary.

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