ISSN : 1302-7123 | E-ISSN : 1308-5123
The Medical Bulletin of Sisli Etfal Hospital - Med Bull Sisli Etfal Hosp: 40 (1)
Volume: 40  Issue: 1 - 2006
ORIGINAL RESEARCH
1. Ethical Comittee of Sisli Etfal Teaching and Research Hospital
Ünal Kuzgun
Pages 7 - 21
Abstract |Full Text PDF

2. Prevalance and severity of symptoms in patients with laryngopharyngeal reflux disease
Ibrahim Ercan, Burak Ömür Çakır, Müge Özçelik, Canan Alkım, Suat Turgut
Pages 21 - 25
Objective: The aim of this study was to investigate the severity and frequency of complaints related to the ear, nose and throat in patients proven to have LPR or patients presenting with symtomps related to LPR.
Study Design: Patients who applied to the ear, nose and throat clinic of Şişli Etfal Hospital with symptomps of LPR and 36 patients proven to have LPR were included in the study. A questionnare of 20 questions regardy the presence, severity and frequency of symptomps were asked to be completed by patients later answers were processed to ases the frequency or patients symptoms due to reflux and the mean severity valve when these symptoms were present.
Results: According to our study the most frequent symptomps patients in our study complained about were “hoarseness” (%86) and the urge to continously clear the throat (%80) when mean severity of symtomps was assessed; on a scale of 0-4. The most severe complaints were a lump in the throat (3.57) and loss of taste sensation (3.00).
Conclusion: As depicted in our study smptomps of LPR may be completely independent of complaints regerding the stomach. This indicates that patients with LPR may present with a wide range of symptoms implying that when such symptoms are present LPR should come to mind and a concise examination should be performed for the diagnosis of LPR.

3. Dermatological problems in professional sportsmen
Aslı Küçükünal, Gonca Gökdemir, Adem Köşlü
Pages 26 - 32
Objective: Different dermatological problems can be seen in the people who arc regularly playing sports. The objective of this study was to investigate the frequency of dermatological problems in professional sportsmen.
Study Design: This study was carried out during the period between October 2003 and May 2004. Five hundred and two professional sportsmen who have completed questionnaire were examined and positive findings were reported.
Results: A total of 502 subjects (214 female and 2
Conclusions: Early diagnoses for the sports-related dermatoses allow quick and appropriate treatment of sportsmen. For this reason, health check-up programmes have to be used for these individuals periodically. For the prevention of these dermatoses, educating the sportmen about the dermatological problems will rise the quality of the sportsmen’s lives and help them to perform better performance in their professional lives.

4. The incidence and the distribution of the dermatoses of male genitalia
Özgür Yürüker, Tuğba Rezan Ekmekçi, Adem Köşlü
Pages 33 - 36
Objective: To determine the incidence and the distribution of dermatoses of male genitalia in men above 18 years old. Study design: The genital regions of 514 men attending dermatology outpatient clinic were examined. The dermatoses were classified as primary and secondary.
Results: 180 dermatoses of the genitalia were found in 171 patients (33.26%). 72,77% of these was primary, 27,22 % was secondary. 93 of 171 patients presented because of the complaint of dermatoses of the genitalia, 78 of those presented because of the other dermatological complaint. 100 dermatoses of the genitalia were found in 93 patients. 57% of these was primary, 43% was secondary. While benign lesions, secondary dermatoses, infections were the most seen in patients with complaint of dermatoses of the genitalia, secondary dermatoses, infections and eczema were the most seen in patients with complaint ofthe other dermatological problems. 53,21% of the patients were involved the penis, 22,8% of them were involved the scrotum, 23,97% of them were involved both the penis and the scrotum.
Conclusions: The dermatoses of male genitalia are rather seen. Most of them constitues benign lesions.

5. Musculoskeletal pain among healthcare personnel working in the hospital
Füsun Şahin, Figen Yılmaz, Tülay Şahin, Raikan Soydemir, Özlem Yılmaz, Sinem Yamaç, Banu Kuran
Pages 37 - 43
Objective: To investigate the frequency of musculoskeletal pain (MSA), sick reports, medical visits, and job satisfaction among hospital workers.
Material and Method: MSA complaints, duration of sick leaves, and the number of referrals to a physician among healthcare personnel of our hospital were interrogated using questionnaires. For job satisfaction “Work Stress Questionnaires" (WSQ) were used.
Results: The forms of questionnaires were distributed to 214 individuals (100 physicians, 42 nurses, 32 auxiliary personnel, 22 technicians, 18 secretaries/officials). Sixty eight percent (n=147) of them were female, while 32% (n=67) were male personnel. Mean age was 31,6±7,2 years (20-51 years), and mean duration of the study was 8,3±7,7 years. Eighteen percent of the healthcare workers were not satisfied with their work, while 67,3% of them expressed their satisfaction. Hundred and seventy three (42,2%) personnel worked while experiencing pain, however 41 (19%) of the workers were painless. Painful regions in order of decreasing frequency were back (26.4%), low back (24,1%), neck (21,6%), hand-wrist (8,8%), and elbow (4,3%). Seventy three personnel (42,2%) referred to a physician, and totally 91 visits to physicians were realized. The established diagnoses were lumbar disk hernia, cervical disk hernia, fibromyalgia, myalgia, tendinitis, carpal tunnel syndrome, and mechanical low back pain. In 21 (23%) of 91 physician referrals, sick reports were taken with mean duration of sick leave being 3,5 ±18,9 days. According to WSQ, some workers (84%) stated that their tasks required higher levels of skill, 69,2% of them mentioned that they decided by themselves about the job, while exposure, to psychological (51%) and physical (69%) stresses were also reported. Half of the personnel (50%) specified that they had received social support.
Conclusion: In a survey performed in our hospital on 214 healthcare personnel with mean age of 32 years, 81% of the workers complained of MSA. The most painful regions were back, low back, neck, and shoulders. Forty two percent of the personnel suffered from pain referred to a physician. Twenty percent of physician referrals resulted in sick leaves with a mean duration of 3,5 days. Nearly 50 percent of workers felt psychological strains. 69 percent of workers felt physical strains, while 67% of them were satisfied with their work.

6. Papillary thyroid microcarcinomas in nodular goiter
Mehmet Uludağ, Gürkan Yetkin, Bülent Çitgez, Banu Yılmaz, Adnan Işgör, Abut Kebudi
Pages 41 - 49
Objective: To evaluate the papillay microcarcinoma incidence and the treatment options in the patients that we operated for nodular goiter.

Study design: The datas for 215 patients who has been examined with the diagnosis of nodular goiter and has been operated in our clinic in the period of 2002-2004 were rewiewed retrospectively
Results: In the 215 patients a total of 15 papillary thyroid micro- carcinoma was detected and the incidence was %6.98. The mean age of the patients who has a tumor was 46.5 and 13 of them were women (%86.7). The mean diameter of the tumors was 0.41cm (0.1 -lcm). Extrathyroidal and capsular invasion was observed in the %13.3 of the patients. %6.6 of the tumors were multifocal and in %6.6 of them cervical lenf node metastase was found. The surgical procedures that were administered to these patients were I lobectomy, 6 total thyroidectomy,I near total thyroidectomy and in 7 cases total lobectomy plus subtotal lobectomy was made. In 3 of these patients completion thyroidectomy was necessary because of risk factors. In the mean fallow up of 22,6 months recurrence or mortality was not encountered.
br> Conclusions: Since the papillary thyroid microcarcinomas have a good prognose in the incidental cases which were found in subtotal thyroidectomy patients we recommend fallow up without additional treatment.In the cases who has risk factors related to the tumor our opinion is to perform a total thyroidectomy in order to achieve a safe oncological fallow up.

CASE REPORT
7. A case of homocyctinuria presented with severe anemia
Kutluhan Yılmaz, Osman Başpınar, Ercan Sivaslı, Ramazan Parakazan, Metin Kılınç
Pages 50 - 51
Cases with inborn errors of metabolism have been encountered frequently in our country because of high rate of consanguinity in marriages. an example, homocyctinuria may manifest in various clinical forms. In this report, we emphasize on homocyctinuria as a cause of anemia which is a frequently encountered finding, presenting a case that was presented with, severe anemia and then diagnosed as homocyctinuria.

8. Bilateral giant adrenal metastases accompanying to non-small cell lung carcinoma
Ahmet Mesrur Halefoğlu, Abdullah Soydan Mahmutoğlu, Nuran Yılmaz, Ayşe Deniz Kahraman, Zeki Karpat
Pages 53 - 56
The adrenal gland is one of the common sites of metastasis from primary lung cancer. Adrenal metastases are usually unilateral, however bilateral adrenal metastases are seen in 10% of all lung cancer patients; of these 2-3% occurs at the initial presentation of non-small cell lung cancer. Secondary tumors can disrupt the structure and function of the adrenal. This can lead to adrenal hemorrhage, which constitutes a life threatening hazard for the patient. A 54 year-old male presented with back pain and cough. His initial work-up revealed significant anemia, a speculated mass in the hiler region of the left lung and large masses of heterogeneous texture which presumably composed of hemorrhagic and necrotic elements in both adrenal glands. A biopsy confirmed the malign nature of the mass in the lung to be an adenocarcinoma of the lungs. The patient died suddenly one week after the administration of chemotherapy, due to adrenal failure. Intratumoral hemorrhage is a rare but life threatening complication of adrenal metastases and should be treated as soon as it has been diagnosed. If adrenalectomy is not feasible, combination chemotherapy should be applied as in metastatic disease. In order to choose the appropriate chemotherapeutic regimen it is important to accurately establish the diagnosis.

9. Metastatic overian carcinoma
Atıf Akyol, Inci Davas, Ahmet Varolan, Eser Ağar, Ali Yazgan, Başak Baksu, Ayşiın Özağar, Can Çalışkan
Pages 57 - 60
Background: Our aim in this case was a patient who was preoperatively diagnosed as primary ovarian carcinoma although the diagnosis of the patient was verified postoperatively, depending on our surgical exploration, our demand for further pathological research showed that it was indeed metastatic breast carcinoma.
Case: Patient, virgin and 41 years of age was interned with the complaint of abdominal distention. After the observations, bilateral cystic mass with solid components, localised in the whole abdominal cavity was found. Patient was operated with the diagnosis of primary ovarian carcinoma: During the exploration we thought that the case wasn’t primary, but could be considered as metastatic. We ordered superior research from the pathology department. As a result of all examinations, it was found out that the case was the metastasis of breast carcinoma to the ovary.
Conclusion: Although the metastatic ovarian carcinoma is rarely seen than the primary ovarian carcinoma, our request for further pathological research, has yielded once more the importance of surgical exploration and clinical experience while diagnosing the case as metastatic ovarian carcinoma.

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