Tiroid nodülleri sýk olup, prevalans palpasyonla %4-7, yüksek çözünürlüklü USG ile %19-68 arasýnda deðiþmektedir. Tiroid nodüllerinin çoðu benignd olup malinite oraný hasta %7-15 arasýnda deðiþmektedir. Tiroid nodülleri klinik muayene veya daha sýklýkla baþka bir nedenle yapýlan görüntüleme yöntemlerinde insidental olarak saptanmaktadýr. Saptanmýþ olan tüm tiroid nodülleri klinik olarak deðerlendirilmelidir. Tiroid fonksiyonunun deðerlendirlmesinde temel test TSH’dýr. Serum TSH düzeyi normal referans aralýðýnýn altýndaysa, nodülün hiperfonksiyonel olup olmadýðýný belirlemek için bir radyonüklid tiroid taramasý yapýlmalýdýr. Serum TSH düzeyi normal veya yüksekse nodüllü deðerlendirmek için ultrasonografi (US) yapýlmalýdýr. US tiroid nodüllerinin deðerlendirilmesinde en sensitif görüntüleme yöntemidir. Bigisayarlý tomografi (BT) ve magnetik rezonans görüntüleme (MRG)’ýn tiroid nodüllerinin ilk deðerlendirmesinde rutin kullanýlmazlar Tiroid nodüllerinin USG özelliklerine göre birçok risk sýnýflama sistemi mevcut olup, klinik pratikte en yaygýn kullanýlan Amerikan Tiroid Birliði (ATA) klavuzu ve Amerikan Radyoloji Koleji Tiroid Görüntüleme Raporlama ve Veri Sistemi (ACR TI-RADS)’dýr. USG risk sýnýfýna göre endikasyonu olan nodüllerin deðerlendirmesinde ince iðne aspirasyon biyopsisi (ÝÝAB) altýn standart yöntemdir. ÝÝAB’nin sitolojik deðerlendirmesinde Bethesda Tiroid Sitopatolojisini Raporlama Sistemi (TBSRTC) en sýk uygulanan sitolojik sýnýflamadýr. TBSRTC basitleþtirilmiþ, 6 kategoriye dayalý bir raporlama sistemi olup, 2023 yýlýnda güncellenmiþtir. Özellikle Bethesda III ve IV tanýlý ÝÝAB örneklerine tanýsal cerrahi giriþim ihtiyacýný azaltmak için moleküler testlerin uygulanmasý giderek artmaktadýr. Özellikle taný koyulamaya Bethesda III ve IV nodüllerde Her kategorinin malinite riskine göre nodüllerin tedavisinde farklý yöntemler uygulanmakta olup, bunlar; takip, cerrahi tedavi, radyoaktif iyot tedavisi, cerrahi dýþý ablasyon yöntemleridir. (SETB-2023-09-176)

Thyroid nodules are common and the prevalence varies between 4 and 7% by palpation and 19–68% by high-resolution USG. Most thyroid nodules are benign, and the malignancy rate varies between 7 and 15% of patients. Thyroid nodules are detected incidentally during clinical examination or, more often, during imaging studies performed for another reason. All detected thyroid nodules should be evaluated clinically. The main test in evaluating thyroid function is thyroid stimulating hormone (TSH). If the serum TSH level is below the normal reference range, a radionuclide thyroid scan should be performed to determine whether the nodule is hyperfunctioning. If the serum TSH level is normal or high, ultrasonography (US) should be performed to evaluate the nodule. US is the most sensitive imaging method in the evaluation of thyroid nodules. Computed tomography (CT) and magnetic resonance imaging are not routinely used in the initial evaluation of thyroid nodules. There are many risk classification systems according to the USG characteristics of thyroid nodules, and the most widely used in clinical practice are the American Thyroid Association guideline and the American College of Radiology Thyroid Imaging Reporting and Data System. Fine needle aspiration biopsy (FNAB) is the gold standard method in the evaluation of nodules with indication according to USG risk class. In the cytological evaluation of FNAB, the Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) is the most frequently applied cytological classification. TBSRTC is a simplified, 6-category reporting system and was updated in 2023. The application of molecular tests to FNAB specimens, especially those diagnosed with Bethesda III and IV, is increasing to reduce the need for diagnostic surgery. Especially in Bethesda III and IV nodules, different methods are applied in the treatment of nodules according to the malignancy risk of each category, these are follow-up, surgical treatment, radioactive iodine treatment, and non-surgical ablation methods.

Amaç: Substernal guatrlý (SG) hastalarda tiroidektomi genellikle servikal insizyonla tamamlanabilse de nadiren sternotomi ihtiyacý doðabilmektedir. Bu çalýþmanýn amacý SG cerrahisinde sternotomi kararýný öngörebilecek bilgisayarlý tomografi (BT) bulgularýný incelemektir.
Yöntemler: 2013-2022 yýllarý arasýnda SG tanýsýyla total tiroidektomi uygulanan hastalarýn boyun-göðüs BT görüntüleri geriye dönük olarak incelendi. Hastalar (n=41); Sternotomi (n=6) ve Servikal (n=35) grup olmak üzere ikiye ayrýldý. Hastalarýn preoperatif patolojik verileri, BT bulgularý ve postoperatif komplikasyonlarý kaydedildi.
Bulgular: Sternotomi grubunun total tiroid hacmi (280.75±127.01 mm3), Servikal gruptan (155.38±74.18 mm3) anlamlý ölçüde daha yüksekti (p=0.015). Retrosternal tiroid hacmi (mm3), kranio-kaudal ve anterior-posterior tiroid uzunluðu (mm) Sternotomi grubunda anlamlý olarak yüksekti (sýrasýyla; (p=0.00, p<0.001 ve p=0.004). Servikal grupta mediastinal uzaným derecesi çoðunlukla derece 1 (%80) iken, Sternotomi grubunda derece 2 (%83) hakimdi (p=0.001).
Sonuç: BT radyolojik bulgularýndan total tiroid hacmi, retrosternal tiroid hacmi, retrosternal tiroid uzunluðu, tiroid anterior-posterior boyutu ve mediastinal uzaným derecesi; substernal guatr cerrahisinde sternotomi uygulanmasý kararýný öngörmede deðerli bulgulardýr. (SETB-2023-03-036)

Objectives: Although thyroidectomy is completed with a cervical incision in most patients with substernal goiter (SG), sternotomies may be required occasionally. The purpose of this study is to examine computed tomography (CT) findings that may predict the need for sternotomy in SG surgery.
Methods: Neck-thoracic CT images of patients who underwent total thyroidectomy with the diagnosis of SG between 2013 and 2022 were retrospectively examined. The patients (n=41) were divided into two groups: sternotomies (n=6) and cervical (n=35). Preoperative pathological data, CT findings, and postoperative complications of the patients were recorded.
Results: The total thyroid volume of the sternotomy group (280.75±127.01 mm3) was significantly greater than that of the cervical group (155.38±74.18 mm3) (p=0.015). The retrosternal thyroid volume (mm3), thyroid craniocaudal, and anterior-posterior dimensions (mm) were significantly greater in the sternotomy group (p=0.001, p<0.001, and p=0.004, respectively). While the majority of mediastinal extension degrees in the cervical group were grade 1 (80%), grade 2 (83%) predominated in the sternotomy group (p=0.001).
Conclusion: The radiological findings of total thyroid volume, retrosternal thyroid tissue volume, retrosternal thyroid length, thyroid anterior-posterior dimension, and mediastinal extension degree on CT are valuable in predicting the decision to perform a sternotomy in SG surgery.

Amaç: Papiller tiroid kanserinde (PTK) lateral lenf nodu metastazý (LLNM), uygulanacak cerrahinin geniþliðini ve hastalýðýn prognozunu belirlemektedir. Biz bu çalýþmada LLNM geliþimi üzerine etkili klinikopatolojik risk faktörlerini deðerlendirmeyi amaçladýk.
Gereç ve Yöntem: Kliniðimizde, Mayýs 2012-Eylül 2020 tarihleri arasýnda opere edilen PTK tanýlý 346 vakaya ait demografik ve klinikopatolojik verileri, univaryans ve multivaryans analiz aracýlýðýyla retrospektif olarak deðerlendirdik. Hastalar, LLNM olan (Grup 1) ve olmayan (Grup 2) olarak 2 gruba ayýrýldý.
Bulgular: 346 PTK’lý hastanýn 36’sýnda (%10.4) LLNM bulunmaktaydý. Grup 1 ile Grup 2 arasýnda; sýrasýyla erkek hasta (E/K: %38.9 vs %21.6; p=0.020), tümör boyutu (2.30 ± 1.99 cm vs 1.31 ± 1.40 cm; p=0.000), lenfovasküler invazyon (%69.4vs %20.6; p=0.000), multisentrisite (%69.4 vs %35.5; p=0.000), multifokalite ( p=0.000), agresif varyant (tall cell, hobnail, solid, diffüz sklerozan alt tipleri) (%22.2 vs %9.4; p=0.000), ekstratiroidal yayýlým (ETE) (%50 vs %16.1 p=0.000), santral lenf nodu metastaz(SLNM) oranlarý (%75 vs %6.5; p=0.000), ve >=3cm lenf nodu metastazý olmasý (%48.5 vs % 0, p=0.000),uzak metastaz olmasý(%2,1 vs % 0, p=0.000 ) açýsýndan istatistiksel olarak anlamlý farklýlýk saptandý. Multivaryans analiz ise SLNM varlýðýný, LLNM geliþimi için baðýmsýz risk faktörü olarak gösterdi.
Sonuç: PTK’lý hastalarda SLNM varlýðý, LLNM geliþimi için baðýmsýz risk faktörü olarak tespit edildi. LLNM’da profilaktik santal boyun diseksiyonu(SBD) ile ilgili tartýþmalar artmasýna raðmen, LLNM olan hastalarda SLNM oraný yüksek olduðundan bu hastalarda profilaktik SBD halen göz önünde bulundurulmalýdýr. SLNM cerrahinin geniþliðini belirleyebilmek açýsýndan cerrahlara referans saðlayabilir.Ayrýca SLNM’ýn varlýðý LLNM nüksünün erken tespiti açýsýndan yakýn takip önemlidir. (SETB-2023-08-157)

Objectives: Lateral lymph node metastasis (LLNM) in papillary thyroid cancer (PTC) determines the extent of surgery to be per- formed and the prognosis of the disease. In this study, we aimed to evaluate the clinicopathological risk factors affecting the development of LLNM.
Methods: We retrospectively evaluated the demographic and clinicopathological data of 346 cases with PTC who were operated in our clinic between May 2012 and September 2020. The patients were divided into 2 groups as patients with LLNM (Group 1) and without LLNM (Group 2).
Results: Thirty-six (10.4%) patients out of 346 patients with PTC had LLNM. A statistically significant difference was found between Group 1 and Group 2 regarding the male gender (M/F: 38.9% vs. 21.6%; p=0.020), tumor size (2.30±1.99 cm vs. 1.31±1.40 cm; p=0.000), lymphovascular invasion (69.4 vs. 20.6%; p=0.000), multicentricity (69.4% vs. 35.5%; p=0.000), multifocality (p=0.000), aggressive variant (22.2% vs. 9.4%; p=0.000), extrathyroidal extension (50% vs. 16.1% p=0.000), central lymph node metastasis (CLNM) rates (75% vs. 6.5%; p=0.000), and ≥3 cm lymph node metastasis (48.5% vs. 0%, p=0.000), distant metastasis (2.1% vs. 0%, p=0.000), respectively. Multivariance analysis determined the presence of CLNM as an independent risk factor for the development of LLNM.
Conclusion: The presence of CLNM in patients with PTC was determined as an independent risk factor for the development of LLNM. Although there has been increasing debate about prophylactic central neck dissection (pCND) in LLNM, pCND should still be considered in these patients as the rate of CLNM is high in patients with LLNM. CLNM might be a reference for surgeons to de- termine the extent of surgery. In addition, the presence of CLNM is important for close follow-up for the early detection of LLNM recurrence.

Amaç: Nekrotizan fasiit cerrahi müdahale gerektiren ve yüksek morbidite ve mortaliteye sahip bir hastalýk olup ayrýca selülit gibi bazý cilt hastalýklarý ile karýþtýrýlabilir. Bu çalýþmamýzda nekrotizan fasiit ve selülit hastalarýnýn ayýrýcý tanýsýnda hastaneye baþvuru anýndaki klinik ve laboratuvar parametrelerin rollerini araþtýrdýk.
Yöntemler: Retrospektif olarak tasarlanan çalýþmamýza Ocak 2018 ile Ocak 2021 tarihleri arasýnda meme baþý ile diz arasýnda yerleþimli selülit ve nekrotizan fasit tanýsý alan hastalar dahil edilmiþtir. Hastalarýn acil servise baþvuru anýndaki ateþ, özgeçmiþ, tam kan sayýmý sonuçlarý, kan biyokimyasý, c-reaktif protein (CRP) ve prokalsitonin deðerleri, hastanede kalýþ süreleri, mortalite oranlarý, nekrotizan fasiit için laboratuvar risk göstergesi (LRINEC) skorlarý kaydedildi ve her iki hasta grubunda fark olup olmadýðý deðerlendirildi.
Bulgular: Çalýþmaya nekrotizan fasiit grubundan 26 hasta ve selülit grubundan 29 hasta olmak üzere toplam 55 hasta dahil edildi. Ýstatistiksel olarak nekrotizan fasiitli hastalarýn hastaneye daha erken baþvurduðu, lökosit, trombosit ve nötrofil düzeylerinin daha yüksek olduðu, hastanede kalýþ sürelerinin daha uzun olduðu ve mortalite sayýlarýnýn daha yüksek olduðu görüldü.
Sonuç: Selülitli hastalarda lökosit, trombosit ve nötrofil düzeylerinin yüksek olmasý durumunda, klinisyen hastanýn klinik seyrini yakýndan takip etmeli ve nekrotizan fasiiti akýlda tutmalýdýr. (SETB-2023-04-057)

Objective: Necrotizing fasciitis (NF) requires surgical intervention and has high morbidity and mortality. Furthermore, it can be confusing with some skin diseases such as cellulitis. We investigated the roles of clinical and laboratory parameters at the time of admission to the hospital in the differential diagnosis of NF and cellulitis patients.
Methods: Patients with cellulitis and NF located between the nipple level and the knee between January 2018 and January 2021 were included in our retrospective study. The fever, history, complete blood count results, blood biochemistry, C-reactive protein and procalcitonin values of the patients at the time of admission to the emergency department, length of hospital stay, mortality rates, and laboratory risk indicator for necrotizing fasciitis (LRINEC) scores were recorded and evaluated whether there was a dif- ference in both patient groups.
Results: A total of 55 patients, including 26 patients in the NF group and 29 patients in the cellulite group, were included in the study. It was observed that patients with NF applied to the hospital statistically earlier, had higher leukocyte, platelet and neutro- phil levels, had longer hospital stays and had higher mortality numbers.
Conclusion: In high leukocyte, platelet, and neutrophil levels in the case of cellulitis patients, the clinician should follow the patient’s clinic course closely and keep NF in mind.

Amaç: Malign, borderline ve benign kitlelerin ayrýmýnda objektif kriterlerin rolünü belirlemek ve yorumlama farklýlýklarýný azaltarak gereksiz cerrahi giriþimleri en aza indirmek için MRG, kan parametreleri ve tümör belirteçlerinin etkinliðini deðerlendirmek
Yöntem: Baþlangýç tanýsý için ameliyat edilen ve over kitleleri doðrulanan hastalarýn histopatolojik ve klinik-laboratuvar sonuçlarý retrospektif olarak incelendi. Gruplar arasýnda yaþ, kanser antijeni 125 (CA-125), ortalama trombosit hacmi (MPV), NLR, PLR, asit varlýðý, ORADS MRG skorlarý, kitle özellikleri ve lenfosit sayýsý karþýlaþtýrýldý.
Bulgular: Çalýþmaya toplam 191 hasta dahil edildi. Bu hastalar benign (n=113), borderline (n=26) ve malign (n=52) olmak üzere üç gruba ayrýldý. Solid, kistik veya mikst kitlelerin uniloküler veya multiloküler doðasý ile NLR, PLR veya MPV oranlarý arasýnda kayda deðer bir korelasyon saptanmadý. Bununla birlikte, NLR ile asit varlýðý arasýnda dikkate deðer bir korelasyon tespit edildi (p=0.003). Over kanserli hastalarda malign epitelyal ve malign seks kord-stromal tipler arasýnda NLR ve MPV açýsýndan anlamlý fark yokken (p>0.05), PLR oranýnda anlamlý fark ortaya çýktý (p=0.013).
Sonuç: Malign potansiyeli olan over kitlelerinde NLR ve PLR gibi laboratuvar parametreleri taný sürecinde yol gösterici olabilir. Gelecekte farklý testlerin, belirteçlerin ve görüntüleme yöntemlerinin geliþtirilmesi, NLR, PLR, MPV gibi kan testlerinin kanser teþhisinde kullanýlmasý gibi çeþitli çalýþmalar mümkün olacaktýr. Bu çalýþmalarýn sonuçlarý yumurtalýk kanseri tanýsý için yeni yöntemlerin geliþtirilmesine ve tedavi protokollerinin iyileþtirilmesine katký saðlayabilir. (SETB-2023-08-143)

Objective: Evaluate the effectiveness of magnetic resonance imaging (MRI), blood parameters, and tumor markers to determine the role of objective criteria in distinguishing malignant, borderline, and benign masses and to minimize unnecessary surgical interventions by reducing interpretation differences.
Methods: The histopathological and clinical–laboratory results of the patients who underwent surgery for the initial diagnosis and whose ovarian masses were confirmed were retrospectively reviewed. Between groups, age, cancer antigen 125, mean platelet vol- ume (MPV), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), the presence of ascites, the ovarian-adnexal reporting and data system MRI scores, mass characteristics, and lymphocyte count were compared.
Results: The study comprised a total of 191 patients. These patients were categorized into three groups: Benign (n=113), border- line (n=26), and malignant (n=52). No noteworthy correlation was detected between the unilocular or multilocular nature of solid, cystic, or mixed masses and the rates of NLR, PLR, or MPV. However, a notable correlation was identified between NLR and the presence of acidity (p=0.003). In ovarian cancer patients, there was no significant difference in NLR and MPV between malignant epithelial and malignant sex cord-stromal types (p>0.05), whereas a significant difference emerged in the PLR ratio (p=0.013). Conclusion: In ovarian masses with malignant potential, laboratory parameters such as NLR and PLR can guide the diagnosis pro- cess. In the future, various studies such as the development of different tests, markers, and imaging methods, the use of blood tests such as NLR, PLR, and MPV in cancer diagnosis will be possible. The results of these studies may contribute to the development of new methods for the diagnosis of ovarian cancer and the improvement of treatment protocols.

Amaç: Hirsutizm üreme çaðýndaki kadýnlarýn %5-15'ini etkileyen bir problemdir. Saðlýkla iliþkili yaþam kalitesi (HQOL), belirli bir hastalýða baðlý fiziksel, sosyal ve duygusal yönleri dikkate alan çok boyutlu bir refah deðerlendirmesidir. Bu çalýþmanýn amacý idiyopatik hirsutizm (ÝH) tanýsý alan hastalarda HQOL'yi deðerlendirmek ve polikistik over sendromu (PKOS) tanýsý alan hastalarla karþýlaþtýrmaktýr.
Yöntem: Bu kesitsel gözlemsel çalýþma, 51 idiyopatik hirsutizm tanýlý hasta, 76 polikistik over sendromu tanýlý hasta ve 56 saðlýklý gönüllüden oluþan 183 kadýnla gerçekleþtirilmiþtir. Nöropsikiyatrik bozukluk öyküsü olan, 18 yaþ altý ve 45 yaþ üstü, gebelik ve emzirme döneminde olan, tanýsal laboratuvar testlerini etkileyebilecek herhangi bir kronik hastalýðý olan ve daha önce ÝH veya PCOS tedavisi görmüþ olanlar çalýþma dýþý býrakýlmýþtýr. Olgularýn demografik, antropometrik, laboratuvar ve klinik verileri kaydedilmiþtir. Kýsa Form-36 (SF-36) anketi, Beck Depresyon Envanteri (BDI) ve Beck Anksiyete Envanteri (BAI), ilgili yazarlar tarafýndan yüz yüze görüþmelerle katýlýmcýlara uygulandý.
Bulgular: Ortalama yaþ, eðitim düzey, yaþam tarzý ve medeni durum her üç grupta benzerdi. Gruplar arasýnda beden kitle indeksi (BMI) veya bel çevresi açýsýndan anlamlý bir fark bulunmamýþtýr. Ortalama modifiye Ferriman-Gallwey (mFG) skorlarý ÝH ve PKOS gruplarýnda benzerdi. ÝH hastalarýnda, SF-36 yaþam kalitesi skorlarýnýn genel saðlýk ve ruh saðlýðý alanlarý kontrol grubuna göre anlamlý derecede düþüktü (sýrasýyla p<0.001 ve p=0.026). SF 36 yaþam kalitesi skorlarý ÝH ve PKOS gruplarý arasýnda karþýlaþtýrýldýðýnda, genel saðlýk ve duygusal rol alanlarý PKOS grubunda anlamlý derecede düþüktü (sýrasýyla p=0.013 ve p<0.001) ve diðer alanlar benzerdi. Tüm SF-36 yaþam kalitesi alanlarý, ÝH hastalarýnda BMI ve bel çevresi ölçümleri ile anlamlý ve negatif korelasyon göstermiþtir. Hem BDI hem de BAI skorlarý, BMI (sýrasýyla r=0.348, p<0.001 ve r=0.162, p=0.012) ve bel çevresi (sýrasýyla r=0.326, p<0.001 ve r=0.344, p<0.001) ile anlamlý ve pozitif korelasyon göstermiþtir. SF-36 yaþam kalitesi skorlarýnýn sekiz alanýndan altýsý mFG skorlarý ile anlamlý ve negatif korelasyon göstermiþtir.
Sonuç: ÝH tanýlý hastalarýn saðlýkla iliþkili yaþam kalite düzeyleri, PKOS tanýlý hastalara benzer þekilde düþüktür. Endokrinoloji ve dermatoloji polikliniklerine baþvurularýn sýk nedenlerinden biri olan hirsutizm için hasta yönetiminde hedeflerden biri de HQOL'yi iyileþtirmek olmalýdýr. (SETB-2023-08-147)

Objective: Hirsutism affects 5–15% of women of reproductive age. Health-related quality of life (HQOL) is a multidimensional assessment of well-being that considers the physical, social, and emotional aspects associated with a specific disease. The aim of this study is to evaluate HQOL in patients diagnosed with idiopathic hirsutism (IH) and compare it with patients diagnosed with polycystic ovary syndrome (PCOS).
Methods: This cross-sectional observational study was performed on 183 female individuals, consisting of 51 patients diagnosed with idiopathic hirsutism, 76 patients diagnosed with PCOS, and 56 healthy volunteers. Participants with a history of neuropsychiatric disorders, under 18 and over 45 years of age, during pregnancy and lactation, with any chronic disease that could interfere with diag- nostic laboratory tests, and who had previously been treated for IH or PCOS were excluded from the study. Demographic, anthropo- metric, laboratory, and clinical data on the cases were recorded. The Short Form-36 (SF-36) questionnaire, the Beck Depression Inven- tory (BDI), and the Beck Anxiety Inventory (BAI) were administered in a face-to-face interview by related authors involved in the study. Results: The mean age, level of education, lifestyle, and marital status of all three groups were similar. There were no significant differ- ences in body mass index (BMI) or waist circumference between the groups. Mean modified Ferriman-Gallwey (mFG) scores were similar in the IH and PCOS groups. In the IH patients, the general health and mental health domains of the SF-36 questionnaire scores were sig- nificantly lower than in the control group (p<0.001 and p=0.026, respectively). When the SF-36 questionnaire scores were compared be- tween the IH and PCOS groups, the general health and role emotional domains were significantly lower in the PCOS group (p=0.013 and p<0.001, respectively), and the other domains were similar. All SF-36 questionnaire domains were significantly and negatively correlated with BMI and waist circumference measurements in IH patients. Both BDI and BAI scores were significantly and positively correlated with BMI (r=0.348, p<0.001, and r=0.162, p=0.012, respectively) and waist circumference (r=0.326, p<0.001, and r=0.344, p<0.001, respective- ly). Six out of eight domains of the SF-36 QOL scores were significantly and negatively correlated with the mFG scores.
Conclusion: Patients diagnosed with IH have impaired HQOL, similar to patients diagnosed with PCOS. Improving HQOL should be a goal when deciding on a management approach for hirsutism, which is one of the most common reasons for referral to endo- crinology and dermatology outpatient clinics.

Amaç: Transrektal yolla verilenlere ilave olarak Transüretral yoldan Anestezik madde verilmesinin etkinliðini araþtýrmak.
Metod: Transrektal ultrason eþliðinde 12 kor prostat biyopsi yapýlmasýna karar verilen 237 hasta çalýþmamýza dahil edildi. Hastalar Randomize olarak iki gruba ayrýldý. Biyopsisinden 10 dakika önce Grup 1’e (n=113) Sadece transrektal 10 ml % 2 lidokainli jel, Grup 2’ye (n=124) Transüretral + Transrectal yoldan 10 ml %2 Lidokainli jel verildi. Biyopsiden hemen sonra hastaya iðnenin giriþi esnasýnda hissettiði aðrý düzeyini 0-10 puan arasýnda puanlamasýný söyleyerek elde edilen VAS scoru ile ölçüm yapýldý. Biyopsiden hemen sonra biyopsiden duyduðu memnuniyet ve yeniden biyopsi gerekirse kabul etme durumu 1-4 arasýnda puanlandý. Ýki grup istatistiksel olarak karþýlaþtýrýldý.
Bulgular: Grup 1 ve Grup 2 nin VAS skoru ortalamasý sýrasýyla 4,88±1,89 ve 3,77±1,83, olarak bulundu. Grup 2 nin aðrý düzeyi Grup 1 in aðrý düzeyinden daha düþüktü. Ýki grup arasýndaki fark istatistiksel olarak anlamlý kabul edildi (p<0,001). Grup 1 ve Grup 2 nin hasta memnuniyet oraný sýrasýyla 2,45±0,71 ve 2,78±0,66, Yeniden biyopsiyi kabul oraný sýrasýyla 2,81±0,69 ve 3,02±0,51 olarak bulundu. Grup 2 nin hasta memnuniyet düzeyi oraný ve Yeniden Biyopsiyi Kabul Oraný Grup 1 den yüksekti. Ýki grup arasýndaki Hasta Memnuniyet Düzeyi Oraný(p<0,001) ve Yeniden Biyopsiyi Kabul Oraný (p=0,014) farký Ýstatistiksel olarak anlamlý bulundu.
Sonuç: Sandviç anestezi, TRUS rehberliðinde yapýlan prostat biyopsilerinde uygulanabilir, ucuz, güvenli, etkili bir yöntemdir. (SETB-2023-09-168)

Objectives: We aimed to evaluate the effectiveness of the additive transurethral anesthetic agent to transrectal anesthetic agent.
Methods: Transrectal ultrasound-guided 12 core prostate biopsy planned, 237 patients included in our study. The patients randomly divided into two groups. Group 1 (n=113): Only transrectal 2% lidocaine, Group 2 (n=124): Transrectal + Transurethral(Sandwiches) lidocaine gel given to the patients 10 min before the procedure as anesthesia. Immediately after the biopsy, the patient questioned about the level of pain he felt during the needle entry. The evaluation measured by the VAS score. Immediately after biopsy satisfaction rate with the procedure and if rebiopsy was required, acceptance was scored between 1 and 4. The two groups compared statistically.
Results: The mean VAS score of Group 1 and Group 2 was 4.88±1.89 and 3.77±1.83, respectively. The pain level of Group 2 was lower than Group 1’ pain level. The difference between the two groups was considered statistically significant (p<0.001). The patient satis- faction rates of Group 1 and Group 2 found to be 2.45±0.71 and 2.78±0.66, and the acceptance rate of rebiopsy was 2.81±0.69 and 3.02±0.51, respectively. The patient satisfaction rate and acceptance rate of the rebiopsy of Group 2 were higher than Group 1. Patient satisfaction level (p<0.001) and rebiopsy acceptance rate (p=0.014) between the two groups found to be statistically significant.
Conclusion: In the TRUS-guided prostate biopsies, sandwich anesthesia is a cheap, convenient, tolerable, and effective method.

Amaç: Perkütan nefrolitotomi (PNL) yapýlan hastalarda tanýdan tedaviye kadar geçen süredeki (TTS) uzamanýn cerrahi sonuçlara etkisini araþtýrdýk.
Materyal ve metod: Kasým 2017 ile kasým 2021 tarihleri arasýnda PNL yapýlan 544 hastanýn demografik, radyolojik ve peroperatif klinik bilgileri kaydedildi. Hastalarýn 3. ay batýn tomografisine göre taþsýzlýk oranlarý ve peroperatif komplikasyonlar ile TTS arasýndaki iliþki istatistiksel yöntemlerle araþtýrýldý.
Bulgular: Hastalarýn median yaþý 48 (38-58), taþ boyutu 405 (250-700) mm2, dansitesi ise 1000 (730-1221) Hounsfield Unit idi. TTS median deðeri 75 (42-133) gün idi. 27 (5,0 %) hastaya peroperatif kan transfüzyonu uygulandý. TTS ile peroperatif kan transfüzyonu oraný arasýnda istatistiksel olarak anlamlý farklýlýk saptandý (p=0,022). TTS ile taþsýzlýk oranlarý ve genel komplikasyon oranlarý arasýnda anlamlý farklýlýk saptanmadý. TTS cut-off deðeri (90,5 gün) kan transfüzyonu yapýlma ihtimalini tahmin etmede 59,3% sensitivite ve 60% spesifite deðerlerine sahipti.
Sonuç: PNL yapýlan hastalarda TTS 90,5 günü geçtiðinde peroperatif kan transfüzyon oraný artmaktadýr. TTS’deki uzamanýn PNL’nin cerrahi sonuçlarý üzerine etkisinin daha net anlaþýlmasý için geniþ çaplý ve yüksek kanýt düzeyinde çalýþmalara ihtiyaç vardýr. (SETB-2023-02-028)

Objectives: We aimed to investigate the effect of prolonged time from diagnosis to treatment (TDT) on surgical outcomes in patients undergoing percutaneous nephrolithotomy (PNL).
Methods: This study included a total of 544 patients who underwent PNL in our clinic between November 2017 and November 2021. Clinicodemographical, radiological, and perioperative data of the patients were recorded. The stone-free rate as assessed by abdominal computed tomography at 3 months was estimated. The possible relation of the stone-free rate and perioperative complications with TDT was examined.
Results: The median age was 48 (range, 38–58) years, the median stone size was 405 (range, 250–700) mm2, and the median stone density was 1,000 (range, 730–1,221) Hounsfield units. The median TDT was 75 (range, 42–133) days. Twenty-seven patients (5.0%) required perioperative blood transfusion (PBT). There was a statistically significant correlation between TDT and the need for PBT (p=0.022). However, there was no significant correlation between TDT and stone-free rate (p>0.05). Using a cutoff value of 90.5 days, TDT could predict the need for PBT with 59.3% sensitivity and 60% specificity.
Conclusion: Our study results suggest that the need for PBT increases in patients undergoing PNL longer than 90.5 days after the diagnosis. However, further large-scale, prospective studies are warranted to elucidate the effect of prolonged TDT on surgical outcomes in this patient population.

Amaç: Bu çalýþmanýn amacý, erken evre kronik böbrek hastalýðý (KBH) olan eriþkin hastalarda böbrek morfolojisi ve somatotip bileþenlerini incelemektir.
Yöntem: Örneklemi erken evre KBH'li 46 birey (26 erkek ve 20 kadýn, ortalama yaþ = 45.92 ± 16.53 yýl) oluþturdu. Patolojik denekler, 46 saðlýklý kiþiden (28 erkek ve 18 kadýn, ortalama yaþ = 41.96 ± 11.48 yýl) oluþan bir kontrol grubu ile karþýlaþtýrýldý. Somatotip bileþenlerini belirlemek için Heath-Carter yöntemi kullanýldý. Evre 2 KBH'li hastalarýn ve saðlýklý gönüllülerin son 3 ay içinde çekilen karýn bilgisayarlý tomografisi (BT) böbrek morfolojisini belirlemek için tarandý. BT'lerde böbrek ölçümleri yapýldý (böbreðin uzunluðu, geniþliði, derinliði ve hacmi).
Bulgular: Böbrek hastalarý (ortalama somatotip: 6.33–5.37–0.6), kontrollere göre (ortalama somatotip: 4.35–4.40–3.02) daha az ektomorfik ve daha fazla endomorfikti. Gruplar arasýnda endomorfi (ES = 0.87; p = 0.035) ve ektomorfide (ES = 1.08; p=0.012) orta düzeyde etki büyüklüðü (ES) bulundu. Böbrek morfolojisinde anlamlý bir fark gözlenmedi (ES = 0.04-0.19; p>0.05).
Sonuç: Erken evre KBH'de böbrek morfolojisi ayýrýcý faktör olmayabilir. Öte yandan, hastalar endomorf bileþenleri açýsýndan önemli ölçüde farklýlýk gösterdi. Aþýrý kilolu olmak da böbrek hastalýðý için olumsuz bulgulardan biri olabilir. Somatotip sýnýflandýrmasý, böbrek hastalýðýnýn izlenmesi için uygun bir araç olabilir. (SETB-2022-11-252)

Objectives: The aim of this study is to examine the kidney morphology and somatotype components of adult patients with early-stage chronic kidney disease (CKD).
Methods: The sample consisted of 46 individuals with early-stage CKD (26 men and 20 women, mean age=45.92±16.53 years). The pathological subjects were compared with a control group consisting of 46 healthy subjects (28 men and 18 women, mean age=41.96±11.48 years). The Heath-Carter method was used to determine somatotype components. Abdominal computed tomography (CT) of patients with Stage 2 CKD and healthy volunteers taken within the past 3 months was scanned to determine kidney morphology. Kidney measurements were performed on CTs (length, width, depth, and volume of kidney).
Results: Kidney patients (mean somatotype: 6.33–5.37–0.6) were less ectomorphic and more endomorphic than the controls (mean somatotype: 4.35–4.40–3.02). Moderate effect size (ES) was found in endomorphy (ES=0.87; p=0.035) and ectomorphy (ES=1.08; p=0.012) between groups. No significant difference was observed in the kidney morphology (ES=0.04–0.19; p>0.05).
Conclusion: In the early-stage CKD, kidney morphology may not be the distinguishing factor. On the other hand, patients differed significantly in terms of endomorph components. Being overweight can also be one of the negative findings for kidney disease. Somatotype classification could be a suitable tool for monitoring kidney disease.

Amaç: Çalýþmada, akut iskemik inmede düþük doz (0,9 mg/kg; maksimum 50 mg/kg) trombolitik tedavi uygulanan hastalarýn klinik verilerinin incelenmesi, sonuçlarýn standart doz trombolitik tedavi uygulanan hastalarla karþýlaþtýrýlmasý amaçlandý.
Yöntem: Ocak 2015 ve Haziran 2018 tarihleri arasýnda semptom baþlangýcýndan sonraki 4,5 içerisinde intravenöz trombolitik tedavi uygulanmýþ hastalar retrospektif olarak incelendi. Uygulanan trombolitik tedavi dozuna göre hastalar düþük doz grubu (0,9 mg/kg; maksimum 50 mg/kg) ve standart doz grubu (0,9 mg / kg; maksimum 90 mg/kg) olarak ayrýlarak demografik veriler ve klinik sonuçlar analiz edildi.
Bulgular: Trombolitik tedavi uygulanan toplam 109 hasta çalýþmaya dahil edildi (düþük doz grubunda 19 hasta ve standart doz grubunda 90 hasta). Her iki grupta da iyi sonuç oraný arasýnda anlamlý bir fark yoktu (%47,4'e karþýlýk %52,2). Semptomatik ve asemptomatik intraserebral kanama oranlarý arasýnda istatistiksel anlamlý fark saptanmadý.
Sonuç: Çalýþmamýz akut iskemik inmeli hastalarda semptom baþlangýcýndan itibaren ilk 4,5 saat içerisinde uygulanan standart doz trombolitik tedaviyle kýyaslandýðýnda düþük doz intravenöz trombolitik tedavinin benzer etkinlik ve güvenilirliðe sahip olduðunu göstermektedir. (SETB-2022-05-133)

Objectives: This study aimed to investigate the clinical data of patients with acute ischemic stroke who received low-dose intravenous (IV) thrombolytic therapy (0.9 mg/kg; maximum 50 mg) for various reasons, compare the obtained results with those of patients who received standard-dose thrombolytic therapy, and discuss them in light of the literature.
Methods: Patients who received IV thrombolytic therapy within 4.5 h of symptom onset between January 2015 and June 2018 were retrospectively reviewed. Patients were divided into the low-dose group (0.9 mg/kg; max. 50 mg) and the standard-dose group (0.9 mg/kg; max 90 mg) according to the thrombolytic therapy dose, after which demographic data and clinical results were analyzed.
Results: A total of 109 patients receiving thrombolytic therapy (19 patients in the low-dose group and 90 patients in the standard-dose group) were included in the study. There was no significant difference between the two groups in terms of good outcome rates (47.4% vs. 52.2%). There was no statistically significant difference in terms of symptomatic and asymptomatic intracerebral hemorrhage rates.
Conclusion: Our study showed similar efficacy and safety for low-dose IV thrombolytic therapy compared with standard-dose IV thrombolytic therapy administered within 4.5 h of symptom onset in patients with acute ischemic stroke.

Amaç: Koronavirüs hastalýðýnýn (COVID-19) hiperinflamasyon yoluyla endotel fonksiyonunda bozulmaya neden olduðu düþünülmektedir. Bu çalýþmada, akut koroner sendromu olan COVID-19 hastalarýnda anjiyografik parametrelerden TIMI frame sayýsý (TFC) ve miyokardiyal boyanma derecesini (MBG) kullanarak mikrovasküler disfonksiyonu araþtýrmayý amaçladýk.
Gereç ve Yöntemler: 1 Mart - 30 Haziran 2020 tarihleri arasýnda akut koroner sendromla (%62,4’ü ST elevasyonlu miyokard enfarktüsü) baþvurarak perkütan koroner giriþim uygulanan yüz altmýþ beþ hasta çalýþmaya dahil edildi. COVID-19’u düþündüren semptomlarý veya tipik bilgisayarlý tomografi bulgularý olmasý durumunda hastalara polimeraz zincir reaksiyonu (PCR) testi yapýldý.
Bulgular: Yirmi altý hastada (%15,7) COVID-19 testi pozitif saptandý. COVID -19 hastalarý anlamlý olarak daha düþük MBG’ye (0 ve 1. derece) sahipken (p<0.001), TFC deðerleriyse anlamlý olarak daha yüksek saptandý (p<0.001). Tepe troponin-I deðeri de COVID-19 grubunda daha yüksek bulundu (27335’e karþý15959 ng/dl, p=0.006). Mortalite riski COVID-19 hastalarýnda daha yüksekti (%38,4’e karþý %7,2, p<0.001). Lojistik regresyon analizi sonuçlarýna göre; TFC ve ejeksiyon fraksiyonu, akut koroner sendromu olan COVID-19 hastalarýnda hastane içi mortaliteyi öngördürebilir. Korelasyon analizinde; TFC’nin, C-reaktif protein (CRP) (r=0.340, p<0.001) ve tepe troponin-I deðeriyle (r=0.369, p<0.001) pozitif korele olduðu saptandý.
Sonuç: COVID-19, akut koroner sendromda koroner yavaþ akým ve mikrovasküler bozulmayla iliþkilidir. (SETB-2022-09-206)

Objective: Coronavirus disease 2019 (COVID-19) is considered to deteriorate endothelial function through hyperinflammation. We aimed to investigate microvascular dysfunction using the angiographic parameters thrombolysis in myocardial infarction frame count (TFC) and myocardial blush grade (MBG), in COVID-19 patients with acute coronary syndrome (ACS).
Methods: One hundred and sixty-five patients presented with ACS (62.4% ST elevated myocardial infarction) and underwent percutaneous coronary intervention between March 1 and June 30, 2020, were enrolled in the study. The polymerase chain reaction test was performed in case of suggestive symptoms or typical computerized tomography findings.
Results: Twenty-six patients (15.7%) were tested positive for COVID-19. Significantly higher values were observed in TFC in patients with COVID-19 (p<0.001), whereas COVID-19 patients had significantly lower MBGs (Grade 0 and 1) (p<0.001). Peak troponin-I value was also higher in the COVID-19 group (27335 vs. 15959 ng/dL, p=0.006). Mortality risk was higher in COVID-19 patients (38.4% vs. 7.2%, p<0.001). TFC and ejection fraction may predict in-hospital mortality among COVID-19 patients with ACS according to logistic regression results. In correlation analysis, TFC correlated positively with C-reactive protein (r=0.340, p<0.001) and peak troponin-I value (r=0.369, p<0.001).
Conclusion: COVID-19 is associated with slow coronary flow and microvascular impairment in ACS.

Amaç: Pulmoner arteriyel hipertansiyon (PAH), artmýþ ortalama pulmoner arter basýncý (oPAP) ile karakterize pulmoner hipertansiyonun spesifik bir formudur. Çeþitli klinik, laboratuvar ve görüntüleme parametreleri kullanýlarak yapýlan risk sýnýflandýrmasý, PAH hastalarýnýn yönetiminde çok önemli bir rol oynar. Ýnflamatuar ve nutrisyonel belirteçleri içeren Naples prognostik skoru (NPS)’nun, diðer týbbi durumlarda prognostik deðeri göstermiþtir ancak PAH'ta çalýþýlmamýþtýr. Bu çalýþmanýn amacý PAH hastalarýnda prognostik bir gösterge olarak NPS'nin önemini deðerlendirmektir.
Yöntemler: Bu retrospektif çalýþmaya 101 PAH hastasý dahil edildi. Ekokardiyografik, laboratuvar ve sað kalp kateterizasyonu (SKK) verileri toplandý. Ýstatistiksel analizler, hayatta kalan ve hayatta kalmayan hastalar arasýndaki deðiþkenleri karþýlaþtýrdý ve çok deðiþkenli lojistik regresyon, mortalite risk faktörlerini belirledi.
Bulgular: 101 hastadan 18'i takip süresi içerisinde öldü. Mortalite grubunda yüksek B tipi natriüretik peptid (BNP) seviyeleri ve anlamlý derecede yüksek ortalama NPS görüldü. Hastalar NPS skoruna göre kategorize edildi ve Grup 2'de daha yüksek mortalite ortaya çýktý. Çok deðiþkenli lojistik regresyon, yaþ ve BNP düzeylerini mortalitenin baðýmsýz belirleyicileri olarak tanýmladý. NPS'nin modele dahil edilmesi, mortaliteyle iliþkisini daha da güçlendirdi.
Sonuç: Çalýþma, NPS'nin PAH hastalarýndaki kötü sonuçlarla baðlantýlý olduðunu göstermektedir. Basit ve kolayca hesaplanabilen bir skor olan NPS, PAH'ýn klinik gidiþatýný tahmin etme potansiyeline sahiptir ve bu popülasyonda risk deðerlendirmesinde avantajlar sunar. (SETB-2023-07-130)

Objectives: Pulmonary arterial hypertension (PAH) is a specific form of pulmonary hypertension characterized by an increased mean pulmonary arterial pressure. Risk stratification is crucial in managing PAH, using various clinical, laboratory, and imaging parameters. The Naples prognostic score (NPS), incorporating nutritional and inflammatory markers, has demonstrated prognostic value in other conditions but not in PAH. The goal of this study was to appraise the importance of NPS as a prognostic indicator for patients with PAH.
Methods: This retrospective study involved 101 PAH patients. Echocardiographic, laboratory, and right heart catheterization data were collected. Statistical analyses compared variables between survivors and non-survivors, and multivariate logistic regression identified mortality risk factors.
Results: Among the 101 patients, 18 died within the follow-up period. The mortality group showed elevated levels of B-type natriuretic peptide (BNP) and significantly higher median NPS. Patients were categorized based on their NPS scores, revealing higher mortality in Group 2. Multivariate logistic regression identified age and BNP levels as independent predictors of mortality. The inclusion of NPS in the model further reinforced its association with mortality.
Conclusion: The study suggests that NPS is linked to poor outcomes in PAH patients. NPS, a straightforward and easily calculated score, holds the potential to predict the clinical trajectory of PAH, offering advantages for risk assessment in this population.

Amaç: Behçet Hastalýðý (BH) vücudun çeþitli organlarýný etkileyebilen sistemik vaskülit olup inflamasyonla seyreder. Diðer sistemik vaskülitlerde farklý olarak bu hastalýkta venöz aðýrlýklý tutulum sözkonusudur.
Çalýþma Planý: Merkezimizde Vasküler Behçet Hastalýðý tanýsý konulan 147 hastanýn demografik ve klinik özellikleri retrospektif olarak incelendi.
Bulgular: Vasküler Behçet Hastalýðý tanýsý alan hastalar, tüm Behçet hastalarýnýn %25'ini (147/589) oluþturmuþtur. Damar tutulumu ile cinsiyet arasýnda istatistiksel olarak anlamlý bir iliþki saptanmýþ olup aðýrlýklý olarak erkeklerde (%76.9) görülmüþtür. 71 hastada Behçet Hastalýðý izleminde vasküler olay geliþti ve 76 hastada (%51.70) vasküler olay sonrasý hastalýk tanýsý koyuldu. En sýk görülen vasküler olay alt ekstremitede derin ven trombozu (%69.4) idi. Arter tutulumu en çok pulmoner arterlerde görüldü (%12.90). Alt ekstremite derin ven trombozu genç hastalarda, pulmoner arter tutulumu ise daha yaþlý hastalarda saptandý. Genel olarak venler, arterlerden 4,5 kat daha fazla etkilenmiþtir.
Sonuç: Derin ven trombozu en sýk alt ekstremitede görülür ve bu hastalýkta trombotik olaylar trombotik faktörlerdeki anormallikler ile açýklanamaz. Behçet Hastalýðýnda trombotik olaylarýn tedavisinde antikoagülan tedavinin etkinliði net deðildir ve temel tedavi immünosupresif tedavidir. Genç erkek hastalar arteriyel veya vasküler bir olay ile baþvurduðunda ve özellikle tekrarlayan bir vasküler olay olduðunda, Behçet Hastalýðý düþünülmelidir. (SETB-2023-07-112)

Objectives: Behcet’s disease (BD) is characterized by systemic vasculitis with inflammation that can affect various body organs. In BD, vasculitis primarily manifests with venous involvement, distinguishing it from other forms of systemic vasculitis.
Methods: We retrospectively analyzed the demographic and clinical characteristics of 147 patients diagnosed with vascular BD in our center.
Results: Vascular BD cases accounted for 25.0% (147 out of 589) of all BD patients. A statistically significant correlation was found between gender and vascular involvement that was seen predominantly in males (76.9%). In 71 patients, a vascular event developed during follow-up for BD, while in 76 patients the disease was diagnosed after the occurrence of a vascular event (51.7%). The most common vascular event was deep vein thrombosis in the lower extremities (69.4%). Arterial involvement was primarily observed in the pulmonary arteries (12.9%). Patients with lower extremity deep vein thrombosis tended to be younger, while those with pulmonary artery involvement were typically older. Overall, veins were affected 4.5 times more frequently than arteries.
Conclusion: The prevalent type of venous involvement was deep vein thrombosis in the lower extremities. Thrombotic events in BD cannot be solely attributed to abnormalities in thrombotic factors. The treatment of thrombotic events in BD remains contentious, with anticoagulant efficacy being debated and immunosuppressive therapy representing the primary treatment approach. Behcet’s disease should be considered when a young male patient presents with an arterial or venous vascular event, especially if it is recurrent.

Amaç: Epikardiyal yað dokusu proinflamatuar özelliklere sahip bir tür viseral yað dokusudur. Covid-19 pnömonisi olan hastalarda hastalýðýn þiddeti ile kontrastsýz toraks bilgisayarlý tomografiden bakýlan epikardiyal yað dokusu hacmi ve atenüasyonu, inflamasyon belirteçlerle arasýndaki iliþkiyi araþtýrmayý amaçladýk.
Method: Hastanemize baþvuran, nazofarengeal sürüntü örneðinde bakýlan Covid-19 polimeraz zincir reaksiyonu(PCR) testi (+) ve çekilen akciðer tomografisinde Covid-19 pnömonisini düþündüren, 18 yaþýndan büyük olan 125 hasta çalýþmaya alýndý. Baþvuru sýrasýnda c-reaktif protein(CRP), prokalsitonin, fibrinojen, lökosit, nötrofil-lenfosit oraný, trombosit-lenfosit oraný, laktat dehidrogenaz(LDH), ferritin, d-dimer deðerlendirildi. Toraks bilgisayarlý tomografide epikardiyal yað dokusu hacmi ve atenüasyonu ölçüldü. Serviste yatýp taburcu olan hastalar Grup 1, yoðun bakým yatýþý gereken ve/veya ex olan hastalar Grup 2 olarak sýnýflandýrýldý. Çalýþmamýzýn birincil sonlaným noktasý ölüm,yoðun bakýma yatýþ ve taburculuk olarak deðerlendirildi. Hastalýðýn ciddiyeti ile epikardiyal yað dokusu ve diðer inflamatuar belirteçler arasýndaki iliþki araþtýrýldý.
Bulgular: Grup 1’de 106 hasta, Grup 2’de 19 hasta var idi. 125 hastanýn 46’sý kadýn, 79’u erkek idi. Ortalama yaþ 58.5±15.9 idi. Grup 2’deki hastalar daha yaþlý idi. Epikardiyal yað doku volümü ve atenüasyon ölçümleri ile ilgili olarak, belirlenen gruplar arasýnda istatistiksel olarak anlamlý fark saptanmadý. Grup 2’deki hastalarda laboratuar deðerlerinden üre, kreatinin, LDH, d-dimer, troponin T, prokalsitonin, CRP, Nötrofil/lenfosit oraný istatistiksel olarak anlamlý düzeyde yüksek saptandý. Grup 1’deki hastalarla karþýlaþtýrýldýðýnda, grup 2’deki hastalarýn albumin deðerleri istatistiksel olarak anlamlý derecede düþüktü (p<0.001). Obez hastalarda, epikardiyal yað doku volümü istatistiksel olarak anlamlý düzeyde daha yüksek, epikardiyal yað doku atenüasyonu daha düþük saptandý.
Sonuç: Çalýþmamýzda kritik Covid-19 hastalýðý ile epikardiyal yað dokusu inflamasyonunun bir göstergesi olan epikardiyal yað dokusu hacmi ve atenüasyonu arasýnda bir iliþki saptanmadý. Kritik Covid-19 hastalýðýný öngördürmede rutin laboratuar testlerinden inflamatuar belirteçleri kullanýlabilir. Obezite ile kritik Covid-19 hastalýðý arasýnda bir iliþki saptanmadý. (SETB-2023-01-08)

Objectives: Epicardial adipose tissue (EAT) is a type of visceral adipose tissue with pro-inflammatory properties. We sought to examine the relationship between the EAT volume and attenuation measured on non-contrast chest computed tomography (CT), inflammation markers, and the severity of COVID-19 pneumonia.
Methods: One hundred and twenty-five patients who are over 18 years old who applied to our hospital and were found to have COVID-19 polymerase chain reaction (+) on nasopharyngeal swab sample and COVID-19 pneumonia on chest CT were included in the study. At admission, C-reactive protein (CRP), procalcitonin, fibrinogen, leukocytes, neutrophil–lymphocyte ratio, platelet-lymphocyte ratio, lactate dehydrogenase (LDH), ferritin, and d-dimer were evaluated. EAT volume and attenuation were measured on chest CT. Patients who were hospitalized and discharged from the ward were categorized as Group 1, whereas patients who required intensive care admission and/or died were classified as Group 2. The primary endpoint of our study was defined as death, hospitalization in the intensive care unit, and discharge. The relationship between disease severity and EAT and other inflammatory markers was investigated.
Results: One hundred and six individuals were in Group 1 and 19 patients were in Group 2. Of the 125 individuals, 46 were women and 79 were men. The mean age was 58.5±15.9 years. Group 2 patients were older. Regarding measurements of the EAT volume and attenuation; there was no statistically significant difference between the groups determined. The patients in Group 2 had statistically substantially higher values for urea, creatinine, LDH, d-dimer, troponin T, procalcitonin, CRP, and neutrophil/lymphocyte ratio in their laboratory tests. When compared to patients in Group 1, patients in Group 2 had statistically significantly lower albumin values (p<0.001). In obese patients, EAT volume was statistically significantly higher and EAT attenuation was found to be lower.
Conclusion: In our study, no relationship was found between critical COVID-19 disease and EAT volume and attenuation, which is an indicator of EAT inflammation. Inflammatory markers from routine laboratory tests can be used to predict critical COVID-19 disease. No relationship was found between obesity and critical COVID-19 disease.

Giriþ: Çocuk kardiyoloji polikinliklerine en sýk baþvuru nedenlerinden birisi çocukluk çaðý göðüs aðrýlarýdýr. Çoðunlukla masum karakterli olmakla birlikte nadiren hayatý tehdit edebilen patolojiler ile birliktelik gösterebilir. Bu çalýþmada göðüs aðrýsý olan çocuklarda etyolojik nedenlerin deðerlendirilmesi amaçlandý.
Metot: Çalýþmamýza Ocak 2019-Haziran 2022 tarihleri arasýnda çocuk kardiyoloji kliniðine göðüs aðrýsý þikayeti ile yönlendirilen 1000 çocuk dahil edildi. Hastalarýn dosya arþivlerinden demografik özellikleri, eþlik eden yakýnmalarý ekokardiografi, elektrokardiografi, 24 saat ritm holter, efor testi, bilgisayarlý tomografi anjiyografi gibi laboratuvar sonuçlarý ile takiplerinde etyolojiye yönelik tespit edilen diðer bulgular retrospektif olarak incelendi.
Bulgular: Çalýþmaya dahil edilen hastalarýn 509’u (%50.9) kýz, 491’i (%49.1) erkekti. Hastalarýn ortalama yaþý 11,3’tü (aralýk: 3-18 yýl). Hastalarýn sadece %6.8’sinde göðüs aðrýsý iliþkili kardiyolojik patolojiler saptandý. Göðüs aðrýsý etyolojileri içerisinde %2.1 oranla mitral kapak prolabsusu (MVP) en sýk kardiyolojik patolojiydi. Göðüs aðrýsýna yönelik kalp dýþý etyolojik deðerlendirmede sýrasýyla %48 sýklýkta idiyopatik nedenler, %22.6 sýklýkta kas-iskelet sistemi patolojileri, %7.9 sýklýkta solunumsal patolojiler, % 7.3 sýklýkta psikiyatrik patolojiler, %4.1 sýklýkta gastrointestinal patolojiler, % 2.4 sýklýkta ailesel akdeniz ateþi, %1.1 diðer nedenler saptandý.
Tartýþma: Çalýþmada çocuk yaþ grubunda göðüs aðrýsý etyolojik nedenleri arasýnda kalp dýþý nedenler daha sýk tespit edildi. Ek olarak, MVP kardiyak göðüs aðrýsýnýn en yaygýn nedeniydi. (SETB-2023-07-121)

Objectives: One of the most common reasons for pediatric cardiology referrals is chest pain in childhood. Although it is mostly innocent in character, it is rarely associated with life-threatening pathologies. In this study, it was aimed to evaluate the etiological causes in children with chest pain.
Methods: Our study included 1000 children who were referred to the pediatric cardiology clinic with the complaint of chest pain between January 2019 and June 2022. Demographic characteristics, accompanying complaints, echocardiographies, electrocardiographies, 24-h rhythm holters, treadmill exercise test, computed tomography angiography, and non-cardiac findings related to etiology were analyzed retrospectively from the file archives of the patients.
Results: Five hundred and nine (50.9%) of the patients were female and 491 (49.1%) were male. The mean age of the patients was 11.3 y (range: 3–18 years). Cardiological pathology associated with chest pain was detected in only 6.8% of the patients. Among the etiologies of chest pain, mitral valve prolapse (MVP) was the most common cardiological pathology with a rate of 2.1%. In the non-cardiac etiological evaluation of chest pain, idiopathic causes with a frequency of 48%, musculoskeletal pathologies with a frequency of 22.6%, respiratory pathologies with a frequency of 7.9%, psychiatric pathologies with a frequency of 7.3%, gastrointestinal pathologies with a frequency of 4.1%, and familial Mediterranean fever with a frequency of 2.4%, miscellaneous with a frequency of 1.1% were found, respectively.
Conclusion: In the study, it was determined that non-cardiac causes were more common among the etiological causes of chest pain in the pediatric age group. In addition, MVP was the most common cause of cardiac chest pain.

Amaç: Bu çalýþmada atopik dermatit (AD) tanýsý olan hastalarda besin duyarlýlýðý ve duyarlýlýk saptanan hastalarda besin alerjisi sýklýðýnýn araþtýrýlmasý amaçlanmýþtýr.
Metod: Çalýþmaya AD tanýsý ile izlenen 0-2 yaþ arasý hastalar dahil edildi. Hastalarýn demografik ve klinik özellikleri ile laboratuvar bulgularý geriye dönük olarak kayýt edildi. Hastalar AD þiddetine göre SCORAD (SCORing Atopic Dermatitis) indeksi kullanýlarak hafif, orta ve aðýr olarak sýnýflandýrýldý. Besin duyarlýlýðý varlýðý deri prik ve serum spesifik (sp)Immunglobulin (Ig) E sonuçlarý ile deðerlendirildi. Besin alerjisi tanýsý oral besin yükleme testi ile konuldu.
Bulgular: Çalýþmaya dahil edilen 72 hastanýn %62,5’i (n=45) erkek, yaþ ortalamasý 9 ± 4,8 ay idi. Hastalýk þiddeti deðerlendirildiðinde 40 hastada (%55,6) hafif; 32 hastada (%44,4) orta/aðýr þiddette AD mevcuttu. Daha küçük yaþta olan (p=0,01), semptomlarý ilk 6 ayda baþlayan (p=0,03), ailesinde alerjik hastalýk öyküsü olan (p=0,001), daha kýsa süre anne sütü alan (p=0,01), ortanca serum total IgE düzeyi ve serum eozinofil yüzdesi daha yüksek saptanan (sýrasý ile p=0,005, p=0,01) hastalarda orta/aðýr þiddette AD sýklýðý daha fazla saptandý. Hastalarýn %45,8’inde besin duyarlýlýðý; %41,7’sinde besin alerjisi saptandý. En sýk duyarlýlýk ve alerji saptanan besinler yumurta beyazý/sarýsý ve inek sütü idi. Erkek cinsiyette olan (p=0,03) ve anne sütü alan hastalarda (p=0,03) besin duyarlýlýðý oraný daha yüksek iken, hafif ve orta/aðýr þiddette AD’li hastalarda benzer oranda idi.
Sonuç: Atopik dermatit tanýlý hastalarda besin duyarlýlýðýnýn araþtýrýlmasýnda hastalýk þiddeti dýþýnda cinsiyet, anne sütü alýmý gibi diðer demografik ve klinik özelliklerin birlikte deðerlendirilmesi önemlidir. Besin duyarlýlýðý saptanan atopik dermatit tanýlý hastalarda besin eliminasyonu önerilmeden önce mutlaka besin yükleme testi yapýlmalýdýr. (SETB-2023-08-133)

Objectives: In this study, it was aimed to examine food sensitivity in patients with atopic dermatitis (AD) and to investigate the frequency of food allergy in patients with food sensitivity.
Methods: Patients aged 0–2 years who were followed up with the diagnosis of AD were included in the study. The characteristics of demographic and clinical and laboratory findings of the patients were recorded retrospectively. Patients were classified as mild, moderate, and severe using the SCORing AD index according to the severity of AD. The presence of food sensitivity was evaluated by skin prick test and serum-specific immunoglobulin (Ig)E results. Food allergy was diagnosed by oral food challenge (OFC) test.
Results: Of the 72 patients included in the study, 62.5% (n=45) were male, and the mean age was 9±4.8 months. When the disease severity was evaluated, it was mild in 40 patients (55.6%); moderate/severe AD was present in 32 patients (44.4%). The frequency of moderate/severe AD was higher in patients who were younger (p=0.01), whose symptoms started in the first 6 months (p=0.03), who had a family history of allergic disease (p=0.001), who breastfed for <6 months (p=0.01), who had a higher median serum total IgE level, and a higher percentage of serum eosinophils (p=0.005 and p=0.01, respectively). Food sensitivity in 45.8% of patients; food allergy was detected in 41.7% of them. The most common sensitivities and allergies were eggs white/yolk and cow’s milk, respectively. The rate of food sensitivity was found to be higher in male gender (p=0.03) and breastfed patients (p=0.03), whereas it was similar in patients with mild and moderate/severe AD.
Conclusion: In the investigation of food sensitivity in patients with AD, it is important to evaluate other demographic and clinical characteristics such as gender and breastfeeding, apart from the severity of disease. The OFC test should be performed to confirm the food allergy in patients with food sensitivity before the recommendation of an elimination diet.

Amaç: Vücut geliþtirme sporcularýnýn omuz sakatlýklarýný sýk geçirdikleri bilinmektedir. Bu nedenle omuz egzersizleri sýrasýnda, hareketin en uygun formunun belirlenmesi önemlidir. Bu nedenle bu çalýþmada, vücut geliþtirme sporcularýnýn deltoid kas aktivasyonunu farklý açýlardan inceleyerek, hareketin en doðru formunun belirlenmesi amacýyla yapýlmýþtýr.
Yöntem: Bu çalýþmada nicel araþtýrma tekniklerinden biri olan tarama modeli kullanýlmýþtýr. Araþtýrmaya düzenli olarak vücut geliþtirme salonlarýna devam eden yaþlarý 25.77±9.13, boylarý 177.07±8.40, vücut aðýrlýklarý 78.06±14.16 ve beden kütle indeksi (BKI) deðerleri 24.78±3.43 olan 53 sporcu (44 erkek, 9 kadýn) dahil edilmiþtir. Glenohumeral eklem 90°'de, kubital eklem 180°, 150° ve 120°'de abduksiyonda iken katýlýmcýlarýn deltoid aktivasyonlarý ölçüldü. Kas aktivasyonlarý, yüzeyel elektromiyografi (yEMG) biofeedback cihazý Neurotrac Myoplus Pro cihazý kullanýlarak belirlendi. Eklem açýlarý gonyometre ile belirlendi. Çalýþmanýn istatistiksel analizleri SPSS 25 paket programý kullanýlarak yapýldý. Verilerin normal daðýldýðý görülmüþ ve karþýlaþtýrmalar için Tekrarlý Ölçüm Anova Testi uygulanmýþtýr.
Bulgular: Ýstatistiksel analiz sonucunda erkek katýlýmcýlarda ortalama deltoid yEMG deðerleri ve maksimum istemli kasýlma (MVC (%) açý boyutu küçüldükçe anlamlý olarak azaldýðý tespi edilmiþtir (p<0.05). Kadýn katýlýmcýlarda ortalama yEMG ve MVC (%) deðerleri farklý açýlarda deðiþmemiþtir (p>0,05).
Sonuç: Araþtýrma sonuçlarýna göre vücut geliþtirme sporcularýnda omuz yEMG aktivasyonlarý açý ile doðru orantýlý olarak azalmaktadýr. Glenohumeral eklem 90° ve kubital eklem 180° olduðunda medial deltoid kasýn aktivasyonu en yüksektir. Vücut geliþtirme sporcularýnýn deltoid kasý hipertrofisi için egzersizler yaparken çalýþmamýzýn sonuçlarýný dikkate almalarý önerilir. (SETB-2022-12-264)

Objectives: It is known that bodybuilders suffer from shoulder injuries frequently. Therefore, it is important to determine the most appropriate form of movement during shoulder exercises. For this reason, this study was carried out to determine the most accurate form of movement by examining the deltoid muscle activation of bodybuilders from different angles.
Methods: The survey model, one of the quantitative research techniques, was used in this study. 53 athletes (44 men, 9 women) with an age of 25.77±9.13 years, height of 177.07±8.40 cm, body weight of 78.06±14.16 kg, and body mass index of 24.78±3.43 kg/m2 who regularly attended bodybuilding gyms were included in the study. The deltoid activations of the participants was measured, while the glenohumeral joint is at 90°, the cubital joint is in abduction at 180°, 150° and 120°. surface electromyography (sEMG) biofeedback was determined using the Neurotrac Myoplus Pro device. Joint angles were determined with a goniometer. Statistical analyses of the study were performed using the SPSS 25 package program. It was found that the data were normally distributed and the Repeated measures Anova test was applied for comparisons.
Results: As a result of statistical analysis, in male participants, mean deltoid sEMG values and maximum voluntary contraction (MVC [%]) significantly decreased with decreasing angle size (p<0.05). In female participants, the average sEMG and MVC (%) values did not change at different angles (p>0.05).
Conclusion: According to the research results, shoulder sEMG activations decrease in direct proportion to the angle in bodybuilders. When the glenohumeral joint is 90° and the cubital joint is 180°, the activation of the medial deltoid muscle is highest. It is suggested that bodybuilders should consider the results of our study when performing exercises to hypertrophy the deltoid muscle.

Amaç: Kan dolaþýmý enfeksiyonlarý, yüksek morbidite ve mortalite ile iliþkilidir. Araþtýrmamýzýn amacý, altta yatan hastalýk, hastanýn týbbi öyküsü veya giriþimsel iþlem uygulamalarý gibi belirli risk faktörleri ile çoklu ilaca dirençli (ÇÝD) bakteriyel enfeksiyon arasýnda bir iliþki olup olmadýðýný belirlemek ve mortalite için risk faktörlerini saptamaktý.
Gereç ve Yöntemler: Altý aylýk bir sure boyunca bakteriyemi saptanan, ayaktan ve/veya yatarak tedavi edilen 222 hasta çalýþmaya dahil edildi. 222 hastadan 232 izolat elde edildi. Bu izolatlar antimikrobiyal duyarlýlýk açýsýndan test edildi. Hastalarýn demografik ve klinik verileri ile ÇÝD bakteri oranlarý arasýndaki iliþki analiz edildi.
Bulgular: En sýk görülen mikroorganizmalar gram negatif bakteriler (%59,4), gram pozitif bakteriler (%36,9), Candida türleri (%2,2) ve anaerobik bakterilerdi (%1,35). En çok elde edilen izolatlar Escherichia coli 53 (%22,8), Staphylococcus aureus 35 (%15,1), Klebsiella pneumoniae 26 (%11,2), Pseudomonas spp. (n=17, %7.3), Acinetobacter spp 17 (%7,3), Enterococcus spp 14 (%6) idi. En çok antimikrobiyal direnç gözlenen mikroorganizmalar Acinetobacter baumannii’de %82,3, koagülaz negatif stafilokoklarda %64,5, Escherichia coli’de %60,3, Klebsiella pneumoniae’de %50 ve Enterobacterales spp.’de %27,2 idi. ÇÝD bakterilerin sebep olduðu kan dolaþýmý enfeksiyonuna sahip hastalarýn çoðu yoðun bakým ünitesindeydi (%64). Sepsis tanýsý, üriner kateter kullanýmý, cerrahi öykü, geniþ spektrumlu antibiyotik kullanýmý, antibiyotiðe dirençli bakteriyemi, koroner arter hastalýðý, uygun olmayan ampirik tedavi, saðlýk hizmeti iliþkili enfeksiyonlar, üriner kateterizasyon ve yoðun bakýmda kalýþ mortalite için risk faktörleri olarak belirlendi.
Sonuç: Çalýþmamýz ÇÝD bakterilerin neden olduðu kan dolaþýmý enfeksiyonlarýnýn risk faktörlerini belirlemiþ ve bu faktörler ile mortalite arasýndaki iliþkinin ortaya çýkarýlmasýna yardýmcý olmuþtur. (SETB-2023-04-056)

Objectives: Bloodstream infections (BSI) are associated with high morbidity and mortality. The aim of our study is to determine whether there is a relationship between certain risk factors such as the underlying disease, patient’s medical history, or interventional procedures and multidrug resistant (MDR) bacterial infection and to determine the risk factors for mortality.
Methods: Two hundred and twenty-two outpatients and inpatients who were diagnosed with bacteremia over a 6-month period were included in the study. 232 agents from 222 patients were isolated and tested for antimicrobial susceptibility. The relationship between patients demographic and clinical data and MDR was analyzed.
Results: The most common microorganisms were Gram-negative bacteria (59.4%), Gram-positive bacteria (36.9%), Candida species (2.2%), and anaerobic bacteria (1.35%). The most common isolates were Escherichia coli 53 (22.8%), Staphylococcus aureus 35 (%15.1), Klebsiella pneumoniae 26 (11.2%), Pseudomonas spp. (n=17, 7.3%), Acinetobacter spp 17 (7.3%), and Enterococcus spp 14 (6%). Microorganisms with the highest antimicrobial resistance observed were 82.3% in Acinetobacter baumannii, 64.5% in coagulase-negative staphylococci, 60.3% in E. coli, 50% in K. pneumoniae, and 27.2% in Enterobacterales spp. Most patients with BSI caused by MDR bacteria were in the intensive care unit (64%). Sepsis diagnosis, urinary catheter use, history of surgery, and use of broad-spectrum
antibiotics as well as risk factors for antibiotic-resistant bacteremia, coronary artery disease, inappropriate empirical therapy, healthcare-associated infections, urinary catheterization, and stay in the ICU were determined as risk factors for mortality.
Conclusion: Our study identified the risk factors of BSI caused by MDR bacteria and helped to reveal the relationship between these factors and mortality.

Amaç: Yüksek çözünürlüklü bilgisayarlý tomografi multiplanar rekonstrüksiyon (MPR) görüntülerinde elde edilen koklea boyut ölçümlerinin, Ýnkomplet partisyon (IP) defekti tanýsýndaki faydasýný deðerlendirmek.
Gereç ve Yöntemler: Bu çalýþmaya inkomplet partisyon defekti tanýsý konmuþ 64 koklea (32 hasta) ve herhangi bir defekti olmayan control grubu olarak kabul edilen 38 koklea dahil edilmiþtir. Bazal dönüþ uzunluðu (BL), Koklear yükseklik (CH), Orta apikal uzunluk (MAL), Orta apikal yükseklik (MAH), Koklear uzunluk (A) ve Koklear geniþlik (B) reformat görüntüler üzerinde ölçülmüþtür.
Bulgular: Hasta grubunda 20 koklea IP tip I, 34’ü IP tip II ve 10'u IP tip III olarak teþhis edilmiþtir. MAL deðerleri IP tip I ve III'te kontrol grubuna göre daha kýsadýr (p<0.001, p<0.001). BL deðerleri IP tip III olgularýnda daha kýsadýr (p<0.001). IP II olgularýnda BL ve MAL deðerleri kontrol grubu ile örtüþmektedir. CH hiçbir IP tipinde kontrol grubundan anlamlý farklýlýk göstermemiþtir. A ve B deðerleri IP I ve III için kontrol grubundan anlamlý derecede düþük bulunmuþtur (p<0.01). Tüm IP tipleri için A ve B deðerleri arasýnda pozitif bir korelasyon saptanmýþtýr (p<0.01).
Sonuç: Ýnkomplet partisyon vakalarýnda kokleanýn boyut ve þeklindeki farklýlýklara iliþkin nicel veriler, bu vakalarýn normal kokleadan ayýrt edilmesine yardýmcý olacaktýr. A ve B deðerleri pozitif bir korelasyon gösterdiðinden, A ve B deðerlerinin IP tipleri için CDL'yi tahmin etmek için kullanýlabileceði önerilmektedir. (SETB-2023-04-051)

Objectives: The purpose of the study was to evaluate cochlea dimensions by the multiplanar reconstruction of high-resolution computed tomography that could be useful in diagnosing incomplete partition (IP) malformations.
Methods: This study included 32 patients with 64 side cochleae diagnosed with IP defect and 38 cochleae as the control without any defect. Basal turn length (BL), cochlear height (CH), Mid-apical length (MAL), Mid-apical height, Cochlear length (A), and Cochlear width (B) were measured on reformat images.
Results: Twenty cochleae of these patients have been diagnosed with IP type I, 34 with IP type II, and 10 with IP type III. The MAL values are shorter than the control group in IP types I and III (p<0.001, p<0.001). BL values are shorter in IP type III cases (p<0.001). In IP II cases, BL and MAL values overlapped with the control group. CH did not differ significantly from the control group in any IP type. A and B values were significantly lower than the control group for IP I and III (p<0.01). There is a positive correlation between A and B values for all IP types (p<0.01).
Conclusion: Quantitative data about differences in the size and shape of the cochlea in IP cases would help differentiate them from the normal cochlea. Since A and B values showed a positive correlation, it is suggested that A and B values can be used to estimate CDL for IP types.

Amaç: Ciddi akut solunum sendromu koronavirüs-2 (SARS-CoV-2) damlacýklar aracýlýðýyla bulaþýrken, bu nedenle aðýz, burun ve konjonktival mukozalarýn korunmasýnýn önemi kiþisel koruyucu ekipmanlarýn (KKE) kullanýlmasýný gerektirmektedir. KKE kullanýmý, saðlýk çalýþanlarý ve hastalar arasýnda iletiþim zorluklarýna neden olabilmektedir. Bu çalýþma, farklý KKE tiplerinin kullanýldýðý durumlarda konuþma seslerinin akustik parametrelerindeki deðiþikliklerini araþtýrmayý amaçlamaktadýr.
Yöntemler: Kesitsel bir çalýþma olarak 18 saðlýklý erkek ve kadýn katýlýmcý dahil edildi. Katýlýmcýlara, ses kalitesini deðerlendirmek için en az 3 saniye boyunca sürekli bir [ɑː] ünlüsünü üretmeleri istendi. Ayrýca, tüm Türkçe ünlülerini en az 200 ms süreyle üretmeleri istendi. Son olarak, bir taþýyýcý cümle içinde farklý ünlü baðlamlarýyla birlikte üç Türkçe sürtünmeli ünsüzü ([f], [s], [ʃ]) üretildi. Kayýtlar, þu koþullarda tekrarlandý: KKE olmadan, cerrahi maske, N99 maske, yüz siperliði, cerrahi maske + yüz siperliði ve N99 maske + yüz siperliði. Tüm kayýtlar analiz edildi.
Sonuçlar: Frekans bozulma parametrelerinde anlamlý farklýlýklar gözlenmedi. Ancak erkeklerde, birinci formant (F1) içinde [u] hariç tüm ünlüler, ikinci formant (F2) içinde [ɔ] ve [u] hariç tüm ünlüler, üçüncü formant (F3) içinde [ɛ] ve [ɔ] hariç tüm ünlüler ve dördüncü formant (F4) içinde sadece [i] anlamlýydý. Kadýnlarda ise, birinci formant (F1) içinde [i] hariç tüm ünlüler, ikinci formant (F2) içinde [u] hariç tüm ünlüler, üçüncü formant (F3) içinde tüm ünlüler ve dördüncü formant (F4) içinde [u] ve [ɯ] hariç tüm ünlüler anlamlýydý. Spektral moment deðerleri her iki grupta da anlamlý bulundu.
Sonuçlar: Farklý KKE tiplerinin kullanýmý konuþma akustik özelliklerinde farklýlýklara yol açmaktadýr. Bu bulgular, KKE'nin belirli frekanslardaki filtreleme etkileri ve yüz önünde potansiyel bir boþluk etkisi ile iliþkilendirilebilir. KKE'nin konuþma akustiðine etkisinin anlaþýlmasý, saðlýk ortamlarýnda iletiþim zorluklarýnýn ele alýnmasýna katký saðlar. (SETB-2023-04-052)

Objectives: The transmission of severe acute respiratory syndrome coronavirus-2 occurs primarily through droplets, which highlights the importance of protecting the oral, nasal, and conjunctival mucosas using personal protective equipment (PPE). The use of PPE can lead to communication difficulties between healthcare workers and patients. This study aimed to investigate changes in the acoustic parameters of speech sounds when different types of PPE are used.
Methods: A cross-sectional study was conducted, enrolling 18 healthy male and female participants. They were instructed to produce a sustained [ɑː] vowel for at least 3 s to estimate voice quality. In addition, all Turkish vowels were produced for a minimum of 200 ms. Finally, three Turkish fricative consonants ([f ], [s], and [ʃ]) were produced in a consonant/vowel/consonant format with different vowel contexts within a carrier sentence. Recordings were repeated under the following conditions: no PPE, surgical mask, N99 mask, face shield, surgical mask + face shield, and N99 mask + face shield. All recordings were subjected to analysis.
Results: Frequency perturbation parameters did not show significant differences. However, in males, all vowels except [u] in the first formant (F1), except [ɔ] and [u] in the second formant (F2), except [ɛ] and [ɔ] in the third formant (F3), and only [i] in the fourth formant (F4) were significant. In females, all vowels except [i] in F1, except [u] in F2, all vowels in F3, and except [u] and [ɯ] in F4 were significant. Spectral moment values exhibited significance in both groups.
Conclusion: The use of different types of PPE resulted in variations in speech acoustic features. These findings may be attributed to the filtering effects of PPE on specific frequencies and the potential chamber effect in front of the face. Understanding the impact of PPE on speech acoustics contributes to addressing communication challenges in healthcare settings.