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Reproductive outcomes of office hysteroscopic metroplasty in women with unexplained infertility with dysmorphic uterus
No full textObjective: The correlation between dysmorphic uterus and infertility still remains enigmatic. We evaluated the reproductive outcomes of metroplasty via office hysteroscopy in unexplained infertile women with dysmorphic uteri.
Materials and Methods: In this retrospective cohort study, metroplasty via office hysteroscopy using a bipolar system was performed to 272 women with unexplained infertility with dysmorphic uteri from January 2013 to January 2016. Of all the patients, 162 had primary infertility, and 110 had secondary infertility.
Results: In the primary infertility group, the clinical pregnancy rate was 45.68% (74/162) and the live birth rate was 38.9% (63/162), and in the secondary infertility group, the clinical pregnancy rate was 55.45% (61/110) and the live birth rate was 49% (54/110) after metroplasty. In the secondary infertility group, the miscarriage rate and especially the ectopic pregnancy rate declined dramatically [from 84.5% (93/110) to 9.8% (6/61) and from 15.5% (17/110) to 1.6% (1/61), respectively] (p<0.01).
Conclusion: Reproductive outcome can be impaired by Mullerian anomalies, hence, infertile women with dysmorphic uteri should undergo hysteroscopy to improve reproductive outcomes. Our study demonstrated that office hysteroscopic metroplasty of a dysmorphic uterus might improve fertility, particularly in patients with unexplained infertility with dysmorphic uteri, which was an ignored factor previously. Office hysteroscopy is an alternative option in terms of non-invasive procedure
Development of Antibiotic Resistance Against Ureaplasma urealyticum Strains Isolated from Urogenital Samples
No full textObjective: To assess any change in the antibiotic sensitivity of Ureaplasma urealyticum strains isolated from urogenital samples in the course of time.
Materials and Methods: Hospital records were retrospectively examined and cases with growth of U. urealyticum in urogenital samples in the years 2008 and 2013 were identified. Furthermore, the change in the course of time was examined by taking into consideration the cases we reported in 2001.
Results: Higher rates of sensitivity against tetracycline and doxycycline were observed in 60 patients with isolated U. urealyticum. Higher rates of resistance against ofloxacin and ciprofloxacin were observed. A significant difference was found in resistance against antibiotics when the records of 2008 and 2013 were compared. A statistically significant increase was found in resistance against ofloxacin and ciprofloxacin when the records of 2001 were compared with the records of 2008 and 2013 (p< 0.0005).
Conclusion: U. urealyticum strains demonstrated high levels of resistance to quinolones. Resistance development is increasing in the course of time. Sensitivity against tetracycline and doxycycline has continued at high rates. It would be beneficial to consider these results during empirical treatment to be applied in cases ineligible for culturing
Turkish Standardization of Movement Disorders Society Unified Parkinson's Disease Rating Scale and Unified Dyskinesia Rating Scale
No full textBackground: Movement Disorders Society Unified Parkinson's Disease Rating Scale (MDS-UPDRS) and Unified Dyskinesia Rating Scale (UDysRS) were developed as standard tools to rate Parkinson's disease (PD) and drug-induced dyskinesias of PD. As these scales have become widely used, there is a need for translation to non-English languages. Here we present the standardization for the Turkish translations.
Methods: The scales were translated into Turkish and then back-translated to English. These back-translations were reviewed by the MDS team. After cognitive pretesting, movement disorder specialists from nine centers tested 352 patients for MDS-UPDRS, and 250 patients for UDysRS. Confirmatory factor analyses (CFAs) were used to determine if the factor structures for the reference standards could be confirmed in the Turkish data. The comparative fit indexes (CFIs) for the scales were required to be 0.90 or higher. Exploratory factor analyses (EFAs) were conducted to explore the underlying factor structure without the constraint of a pre-specified factor structure.
Results: For both scales, the CFIs were 0.94 or greater as compared to the reference standard factor structures. The factor structures were consistent with that of reference standards, although there were some differences in some areas as compared to the EFA of the reference standard dataset. This may be due to the inclusion of patients with different stages of PD and different cultural properties of raters and patients.
Conclusions: These results demonstrate that the Turkish translations of MDS-UPDRS and UDysRS have adequate clinimetric properties. They are established as the official translations and can be reliably used in Turkish speaking populations
The relationship between internalized stigma and treatment motivation, perceived social support, depression and anxiety levels in opioid use disorder
No full textOBJECTIVE: This study aims to examine how internalized stigma differs in opioid use disorder (OUD) based on sociodemographic and clinical variables, and to what extent internalized stigma is related to treatment motivation, perceived social support, depression, and anxiety levels.
METHODS: One hundred forty-five individuals with OUD included. Sociodemographic and clinical data form, the Internalized Stigma of Mental Illness Scale (ISMI), Treatment Motivation Questionnaire (TMQ), Multidimensional Scale of Perceived Social Support, the Beck Depression Inventory, and the Beck Anxiety Inventory were utilized in the study to collect data. Bivariate and partial correlation coefficients between variables were computed. ISMI and TMQ scores were compared between patients with depressive symptoms and patients without depressive symptoms by using t-test and Mann Whitney U test.
RESULTS: Internalized stigma was high among male patients with heroin use disorder. There was a positive correlation between internalized stigma score and treatment motivation, depression, and anxiety levels. On the other hand, there was a negative correlation between internalized stigma score and multidimensional perceived social support.
CONCLUSION: Internalized stigma occupies an important place in the treatment of OUD, which occurs with frequent relapses and which is hard to treat. Not only application for treatment but also adherence to treatment and treatment motivation at maintenance phase bestow a complicated relationship with depression and anxiety. In the struggle against internalized stigma, it plays a vital role to mobilize people's social support systems, to educate families on the issue and to get in touch with support units exclusive to heroin users
A New PC-Based Text Entry System Based on EOG Coding
No full textome disadvantages of optical eye tracking systems have increased the interest to EOG (Electrooculography) based Human Computer Interaction (HCI). However, text entry attempts using EOG have been slower than expected because the eyes should move several times for entering a character. In order to improve the writing speed and accuracy of EOG based text entry, a new method based on the coding of eye movements has been suggested in this study. In addition, a real time EOG based HCI system has developed to implement the method. In our method all characters have been encoded by single saccades in 8 directions and different dwell time. In order to standardize dwell times and facilitate the coding process, computer assisted voice guidance was used. A number of experiments have been conducted to examine the effectiveness of the proposed method and system. At the end of the fifth trials, an experienced user was able to write at average 13.2 wpm (5 letters = 1 word) with 100% accuracy using the developed system. The results of our experiments have shown that text entry with the eye can be done quickly and efficiently with the proposed method and system
The Rare Benign Lesion That Mimics a Malignant Tumor in Breast Parenchyma: Nodular Fasciitis of the Breast
No full textWe herein report the clinical and pathological findings of a rare case of nodular fasciitis in the breast parenchyma of a 48-year-old female. Because of potentially malignant findings on ultrasonography and during clinical examination, the patient underwent an excisional biopsy. Histologically, the lesion was composed of spindle to round shaped cells arranged in short bundles in a storiform pattern. Immunohistochemically, the cells were positive for vimentin and SMA and negative for desmin, S100, and CD34. Based on these morphological and immunohistochemical features, a diagnosis of nodular fasciitis was made. We emphasize that nodular fasciitis of the breast may showclinical features and imaging findings similar to those of breast cancer. The histopathologic diagnosis of nodular fasciitis can also be challenging. The purpose of this case report is to highlight the characteristics and the differential diagnosis of this rare neoplasm
Laparoscopic gastrostomy under awake thoracic epidural anesthesia: A successful experience
No full textGeneral anesthesia is the first choice as an anesthesia method particularly for abdominal operations. However, because neuromuscular blockade induced during general anesthesia will increase atelectasis in a patient with pulmonary disease, it will also increase postoperative ventilator dependence, which will be even more apparent in cases of chronic obstructive pulmonary disease (COPD) that pose a risk, particularly for postoperative complications. Herein, thoracic epidural anesthesia (TEA) was found to be a better option for our patient with severe COPD and stage IV lung cancer, as it provided sufficient anesthesia and better postoperative care for laparoscopic gastrostomy
Perivascular epithelioid cell tumor outgrowth from the liver
No full textINTRODUCTION: Perivascular epithelioid celltumor (PEComa) is a rare mesenchymal neoplasia and can be found in various body sites. On the other hand, hepatic PEComa is very rare, with only a few studies having reported hepatic malignant PEComa. There is no gold standard regarding the use of diagnostic imaging studies. The diagnosis of hepatic PEComa is made by a positive immunohistochemical staining for HMB45 and Melan A. Herein, we discussed the therapeutic and follow-up process of a symptomatic hepatic PEComa case.
PRESENTATION OF CASE: A 22-year-old woman presented with a palpable mass in abdomen. A computerized tomographic examination showed a giant hepatic mass of left lobe origin, which was excised surgically. The pathology result was reported as a PEComa.
DISCUSSION: The diagnostic approach, treatment modalities, and follow-up procedures are not standard. The main treatment modality for PEComa is surgical excision with adequate surgical margin.
CONCLUSION: A longer follow-up is required for patients with hepatic PEComa because the nature of the disease is not entirely clear. (C) 2018 The Author(s). Published by Elsevier Ltd on behalf of IJS Publishing Group Ltd
Long-term outcomes in patients who underwent surgical correction for atrioventricular septal defect
No full textObjective: The follow-up results of patients operated for atrioventricular septal defect (AVSD) during 1996-2016 at Baskent University are presented.
Methods: Data obtained from hospital records consists of preoperative echocardiographic and angiographic details, age and weight at surgery, operative details, Down syndrome presence, postoperative care details, early postoperative and latest echocardiographic findings and hospitalization for reintervention.
Results: A total of 496 patient-files were reviewed including 314 patients (63.4%) with complete and 181 (36.6%) with partial AVSD (48.4% of all patients had Down syndrome). Atrioventricular (AV) valve morphology was Rastelli type A in 92.2%, B in 6.5%, and C in 1.3% of patients. The operative technique used was single-patch in 21.6% (108), double-patch in 25.8% (128), and modified single-patch (Wilcox) in 52.5% (260) of patients. The follow-up time was 37.79 +/- 46.70 (range, 0-198) months. A total of 64 patients (12.9%) had a rrhythmias while in the intensive care unit; pacemaker was implanted in 12 patients. A total of 78 patients (15.7%) were treated for pulmonary hypertensive crisis. The early morbidity and mortality in the postoperative first month were calculated as 38% and 10%, and the late morbidity and mortality (>1 month) were calculated as 13.1% and 1.9%, respectively. The rate of reoperation in our cohort was 8.9%.
Conclusion: Although the early morbidity and mortality are low in AVSD operations, the rate of reoperations for left AV valve insufficiency are still high. Although Down syndrome is not a risk factor for early mortality, the co-morbid factors, such as longer postoperative mechanical ventilator or inotropic support, lead to higher risk for morbidity. The frequency of pulmonary hypertension and consequent complications are also high
The Mediating Role of Self-Concept and Coping Strategies on the Relationship Between Attachment Styles and Perceived Stress
No full textThe aim of this study was to examine the role of attachment style, self-concept, and coping strategies, in order to explain the differences in perceived stress factors and stress symptoms, in a mediation model. Participants were 515 university students (302 female and 213 male) aged 17-28 years. The assessment instruments were: Social Comparison Scale, Ways of Coping Scale, Experiences in Close Relationships Scale-II, Brief Symptom Inventory and University Students Stress Factors Scale. The results indicated that the effect of anxious attachment on perceived stress factors and stress symptoms was partially mediated by self-concept and coping styles. Our findings revealed that the level of anxious attachment is an important factor to explain perceived stress and stress-related variables