INTRODUCTION: Feeding tube jejunostomy (FTJ) is performed in cancer patients, especially in those with esophageal and stomach cancers, who have a weight loss of more than 10% until the diagnosis stage before systemic treatment or in cases where they cannot take oral food. In this study, it was aimed to present the management of FTJ implanted by laparoscopic and open surgery methods in our clinic.
METHODS: In the study, oncology patients who had a FTJ in our clinic were retrospectively scanned. The patients were evaluated in terms of clinical features, perioperative period and morbidity
RESULTS: Of the patients, 43.75% (7/16) were females and 56.25% (9/16) were males. Mean age was 62.3±13.2 (39−83) years. Eleven of the patients in the study had gastric cancer, four had esophageal cancer, and one had gastric-invasive pancreatic cancer. In the study, FTJ was inserted in 12 of 16 patients by open method and in 4 by laparoscopic method. There was no statistically significant difference in terms of hospitalization time, enteral feeding time, feeding tube use, transition to normal feeding, parenteral nutrition, reoperation, weight loss and mortality after FTJ (p>0.05) between the two groups. On the other hand, the incidence of minor complications was statistically significantly lower in the laparoscopic surgery group compared to the open surgery group (p=0.027).
DISCUSSION AND CONCLUSION: With controllable complication rates, laparoscopic feeding tube jejunostomy may slow down weight loss and increase the effect of systemic therapy in suitable oncology patients.

INTRODUCTION: Code blue is the universal emergency management in which a professional team effectively intervenes in cases requiring emergency intervention, such as cardiopulmonary arrest in the hospital. This study aimed to contribute to the literature by analyzing code blue calls before and after the pandemic.
METHODS: Code blue calls between 01.03.2019–01.03.2021 were examined retrospectively. Patients' demographic data, the reason for code blue and the place it was given, the time for the team to reach the scene, and all the interventions and their results were recorded.
RESULTS: Two hundred and seventeen code blue calls were included in the study. Mean age of the patients was 60.3±22.2 years, and 52% were females. Of the calls, 54% were reported during the pandemic period. While 50% of the calls were reported during working hours, the time for the team to reach the scene was 2.3±0.9 minutes. While cardiopulmonary resuscitation was performed in 47% of the patients, 23% died.Cardiopulmonary arrest was the most common cause of code blue (39%). The most frequently called places were internal medicine services, with 20% before and pandemic services with 17% after the pandemic. The number of patients who underwent defibrillation was significantly lower in the pandemic group (p=0.04).
DISCUSSION AND CONCLUSION: This study observed an increase in the number of calls and a significant decrease in the number of patients undergoing defibrillation during the pandemic period. We think that the results of the code blue application can be improved with practical training against pandemics that may occur in the future.

INTRODUCTION: In this study, it was aimed to investigate the effects of different concentrations of rose oil on rat tracheal smooth muscle basal tone.
METHODS: Isometric contraction-relaxation responses of rat tracheal rings were recorded using the isolated organ bath model. Tracheal rings were equilibrated at 1.5 g basal tone. In order to determine the cumulative effect, rose oil was applied in increasing concentrations (0.1-100 µL/mL) after pre-contraction with 60 mM KCl. Tracheal rings were incubated separately with 0.1, 1, 10, and 100 µL/mL rose oil concentrations to evaluate the incubation-dependent effects. Statistical significance level was considered as p<0.05.
RESULTS: Cumulatively applied rose oil did not cause a significant change in basal tone at 0.1 and 1 µL/mL. Besides, 10 and 100 µL/mL rose oil caused relaxation and showed a significant bronchoactive effect on basal tone (p=0.037 for 10 µL/mL; p=0.016 for 100 µL/mL). Incubations of 0.1, 1, and 10 µL/mL concentrations of rose oil for 30 min slightly reduced the tone. However, rose oil did not cause a significant change in basal tone at any of these concentrations. Incubation of 100 µL/mL rose oil significantly dilated the tracheal rings at the basal tone level (p=0.029).
DISCUSSION AND CONCLUSION: In conclusion, it is shown for the first time that both cumulatively applied rose oil concentrations and rose oil incubations at different concentrations can significantly induce bronchodilation in rat tracheal rings at the basal tone level. Thus, the first physiological findings regarding the tracheal basal tone reducing effects of rose oil were obtained.

INTRODUCTION: Helicobacter pylori (HP) and related chronic gastric inflammation may result in alteration of appetite and nutritional deterioration besides gastric symptoms. In this study, it was aimed to evaluate the effect of HP on weight loss, clinical symptoms, anthropometric measurements, laboratory, endoscopic and histopathological findings and to test the sensitivity and specificity of HP IgG.
METHODS: Patients aged 5−18 years with chronic gastritis were enrolled between April-October 2018. Besides demographic and clinical data, anthropometric measurements, laboratory and endoscopic findings, histopathological findings defined by Sydney classification were recorded and compared according to the presence of HP.
RESULTS: Of 86 patients, 70.9% (n=61) were females. Weight loss was seen in 37.2% (n=32). Median weight loss rate was 10% (2%−33%). Fifty-six (65.1%) patients had HP positive chronic gastritis. Median duration of symptoms in HP negative patients was significantly longer (p: 0.035). There was no significant difference between HP positive and negative groups in terms of anthropometric measurements and weight loss ratio. However, 68.8% of the patients with weight loss were HP positive. Moderate/severe chronic inflammation as well as inflammation activity were found to be significantly higher in antrum and corpus in the HP positive group (p<0.001, for all). The sensitivity and specifity of HP IgG were calculated as 84.3% and 90%, respectively.
DISCUSSION AND CONCLUSION: Patients with HP positive chronic gastritis showed similar anthropometric measurements, higher weight loss (but not statistically different), higher ratio of severe gastric hyperemia and higher percent of gastric chronic inflammation as well as inflammation activity in histolopathology when compared to HP negative group.

INTRODUCTION: This study aimed to determine the efficacy of first trimester maternal pregnancy associated plasma protein-A (PAPP-A) and free human chorionic gonadotropin (ß-hCG) levels in predicting adverse pregnancy outcomes.
METHODS: A total of 1104 women (mean±SD age: 29.1±5.7 years) with singleton pregnancies who had antenatal first trimester screening test within 11−14th gestational weeks were included in this retrospective study. Data on obstetric and fetal characteristics and adverse pregnancy outcomes were recorded. PAPP-A and ß-hCG, based on multiples-of-median (MoM) values, were categorized as normal (0.5−2.5 MoM) or abnormal (low: ≤0.49 MoM and high: >2.5 MoM) and they were evaluated by Odds ratio according to obstetric and fetal characteristics and adverse pregnancy outcomes
RESULTS: While the rates of intrauterine growth restriction (IUGR), preterm premature rupture of the membranes (PPROM), small for gestational age baby (SGA), neonatal death, gestational diabetes and abruptio placentae were found to be higher in pregnant women with PAPP-A level of 0.49 and below, there was no difference in large for gestational age baby (LGA) rates. While the rates of abortion, preeclampsia, IUGR, SGA, preterm labor, abruptio placentae, and gestational hypertension were found to be significantly higher in pregnant women with ß-hCG level of 0.49 and below, no difference was found in terms of abortion, preeclampsia, preterm delivery, gestational hypertension, and LGA rates.
DISCUSSION AND CONCLUSION: Since first-trimester maternal serum PAPP-A and ß-hCG levels are associated with IUGR, PPROM, SGA, neonatal death, gestational diabetes and abruptio placentae, it may be used to detect pregnant women requiring additional fetal surveillance.

INTRODUCTION: In our study, it was aimed to investigate the compliance of patients diagnosed with non-specific neck pain with home exercise program treatment, the factors affecting compliance, and the effect of compliance on pain and functionality.
METHODS: Ninety-three people aged 18-65 years with nonspecific neck pain lasting longer than 6 months were included in the study. Each patient was given a home exercise program. It was planned to give an exercise program as 2 sets a day for 4 weeks. All patients were evaluated by the same physiatrist with VAS score, Neck Disability Index and The Bournemouth Neck Questionnaire at admission (baseline) and 1 month later.
RESULTS: In the 1st month follow-ups of the patients, there was a statistically significant improvement in VAS and NDI values in all evaluations of the patients who regularly performed their exercises, and in those who partially performed the exercises (p<0.05). No significant improvement was observed in both pain and disability assessments in patients who did not perform the exercises. When the comparison between the groups was made, the patients who exercised regularly showed a significant improvement in tVAS and Bournemouth pain values compared to the individuals who partially performed the exercises and those who did not (p<0.05). When comparing NDI values between the groups, those who regularly performed the exercises showed a significant improvement compared to those who did not (p<0.05).
DISCUSSION AND CONCLUSION: The results of our study showed that compliance with home rehabilitation was associated with relief of neck pain. We observed that as the
commitment to home rehabilitation increases, the pain decreases. We recommend using it as video images to increase compliance with the exercise program.

INTRODUCTION: It was aimed to demonstrate the presence of inflammation in fibromyalgia syndrome(FMS) and healthy subjects by evaluating hematological
indices and ratios associated with inflammation.
METHODS: A total of 187 participants (98 FMS; 89 healthy controls) were included in the retrospective-cross-sectional study, and participants’ neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), mean platelet volume (MPV), erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) which are hematological indices showing inflammation in the last 6 A total of 187 participants (98 FMS; 89 healthy controls) were included in the retrospective-cross-sectional study, and participants’ neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), mean platelet volume (MPV), erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP), which are hematological indices showing inflammation in the last 6 months, were calculatedwere calculated.
RESULTS: Mean age of the participants was 37.3±5.05 years for FMS, and 37.2±5.2 years for healthy controls. There were statistically significant differences between both groups in terms of NLR (p=0.034), MPV (p<0.001), CRP (p=0.001), and ESR (p<0.001). There was no difference in PLR between the two groups (p>0.05).
DISCUSSION AND CONCLUSION: Proinflammatory hematological indices were significantly changed in FMS compared to healthy controls. In addition, the results supported
inflammatory pathogenesis of FMS.

INTRODUCTION: Chronic coccydynia is frequently seen in middle-aged women. Especially depressed and anxious patients may be resistant to medical treatment. This study aimed to evaluate the synergistic effects of steroid injection and psychiatric medical treatment in these patients.


METHODS: Forty-four female patients with chronic coccydynia who scored at or above the threshold for at least one of the Hamilton Depression and Anxiety scales were included in the study. Patients who received only pericoccygeal cortisone injection were recorded as the 1st group, and the patients who received SSRI treatment in addition to the injection were recorded as the 2nd group. VAS scores were evaluated at baseline, 1 month, and 3 months. NCSS (Number Cruncher Statistical System) Statistical Software (Utah, USA) program was used for statistical analysis.
RESULTS: Median value of the pre-treatment VAS score was 7 and 8 in the 1st and 2nd groups, respectively. Median value of the 1st month post-treatment VAS score was 4 and 4 in the 1st and 2nd groups, respectively. Median value of VAS score at the 3rd month after treatment was 4 and 2 in the 1st and 2nd groups, respectively.
DISCUSSION AND CONCLUSION: In depressed and anxious women, chronic coccydynia may become persistent due to anxiety and depression, even if there is an underlying pathoanatomy. In patients presenting with chronic coccydynia, combining local steroid injection and SSRI treatment is a practical and effective treatmen method.

INTRODUCTION: This study aimed to determine the distribution of microorganisms grown in blood cultures of cancer patients hospitalized in the Palliative Clinic and their susceptibility profiles to commonly used antimicrobial agents and to contribute to the clinician's empirical treatment.
METHODS: This study was performed on cancer patients hospitalized in thw Palliative Clinic between 01.01.2016−31.12.2020. All patient data were evaluated retrospectively through patient files and hospital information management system. Microorganisms isolated in patients with positive blood cultures were determined. In the evaluation of the result reports prepared according to The European Committee on Antimicrobial Susceptibility Testing (EUCAST) in patients whose results were accepted as the causative pathogen, their antibiotic/antifungal susceptibility was recorded. SPSS 16 program was used for statistical analysis.
RESULTS: A total of 1859 blood cultures were obtained from 670 patients. Growth was detected in 138 blood cultures of 104 patients (7.4%). Of the isolated microorganisms, 103 (74.7%) were gram-positive bacteria, 25 (21%) were gram-negative bacteria, 8 (4.3%) were fungi with yeast morphology. Coagulase-negative staphylococci were the most frequent isolate in blood culture. Of the staphylococcal strains, 63.6% were resistant to methicillin. Pseudomonas spp. and Klebsiella spp. strains were the most isolated gram-negative bacteria. Acinetobacter spp. strains (100%), Pseudomonas strains (50%), Klebsiella spp. strains (25%) were determined as carbapenem-resistant.
DISCUSSION AND CONCLUSION: Gram-positive bacteria, especially coagulase-negative staphylococci, are the predominant etiological microorganisms in bloodstream infections developed in palliative cancer patients. Local surveillance of pathogens and drug susceptibility is important in the identification and treatment of infection trends.

INTRODUCTION: The aim of this study was to investigate the incidence and antibiotic resistance properties of E. faecalis and E. faecium, two Enterococcus species grown in the blood culture of adult patients treated in the intensive care unit.
METHODS: In this cross-sectional retrospective study, antibiotic resistance properties of enterococci strains grown in the blood cultures of patients treated in the adult intensive care unit of Kanuni Sultan Süleyman Training and Research Hospital between 2016-2019 were investigated. Blood cultures sent to our laboratory were incubated in the BACTEC-FX automatic blood culture (BectonDickinson, USA) device. All strains were identified at the species level, using the VITEK 2 (bioMerieux, France) method. Antimicrobial susceptibility tests of the identified strains were performed according to the recommendations of the European Committee on Antimicrobial Susceptibility Testing (EUCAST).
RESULTS: Of the strains grown in the blood cultures of 246 cases evaluated in the study, 137 (55.6%) were E. faecalis and 109 (44.4%) were E. faecium. Antibiotics to which E. faecalis showed the greatest frequency of resistance were streptomycin (40.9%), gentamicin (39.4%), ampicillin (8%) and amoxicillin/clavulanate (7.3%), respectively. Antibiotics to which E. faecium showed the most resistance were amoxicillin/clavulanate (89%), ampicillin (87.2%), gentamicin (74.3%), and streptomycin (71.6%), respectively. For both E. faecalis and E. faecium, it was determined that linezolid was the antibiotic with the least frequency of resistance development.
DISCUSSION AND CONCLUSION: The present study showed that E. faecalis and E. faecium strains grown in the blood cultures of adult patients treated in the intensive care unit demonstrated a high frequency of resistance against streptomycin, ampicillin and amoxicillin/clavulanate. It was thought that it would be beneficial to apply antibiograms and select antibiotics according to sensitivity, or to initiate treatment according to these data when administering empirical treatments.

INTRODUCTION: Non-melanoma skin cancer (NMSC) is the most common cancer type worldwide. Surgery is the mainstay of treatment. High Dose Rate Brachytherapy (HDR-BT) is an effective alternative method when surgery is contraindicated or when there is cosmetic concern. This study aimed to report our clinical outcomes consisting local control and toxicity rates in patients treated with HDR-BT.
METHODS: Patients with squamous cell cancer (SCC) and basal cell carcinoma (BCC) treated with HDR-BT from May 2021to April 2022 were included in the study. Medical reports including pathologic and radiologic reports and photos were retrospectively reviewed. Radiation toxicity was graded using the Radiation Therapy Oncology Grading (RTOG) acute toxicity scale. Local control and toxicity rates were evaluated for all patients.
RESULTS: All 7 patients, including 3 BCCs and 4 SCCs, with 7 lesions were treated with definitive intent. Prescribed dose was 40 Gray (GY) in 8 fractions in all cases. Local control was 100%. Both overall survival and progression free survival was 100%. Skin toxicity was seen in 4 patients with grade 1 and in 3 patients with grade 2 and resolved in 3 months time.
DISCUSSION AND CONCLUSION: HDR -BT provides excellent cosmetic outcomes without compromising local control both for curative intent. Considering short interval local control rates, long term follow up is necessary.

INTRODUCTION: In this study, it was aimed to determine the professional image perceptions of nurses working in a public hospital in the COVID-19 pandemic and to compare them according to their personal and professional characteristics.
METHODS: The research was carried out in descriptive and cross-sectional type. The population consisted of nurses working in a public hospital in Istanbul between June and July 2020 (n=668). The sample was calculated as a minimum of 244 nurses with a known population sample. Data were collected from 250 nurses who agreed to participate in the study using the "Personal Information Form" and the "Scale of Occupational Image Perception in Nursing".
RESULTS: It was determined that the nurses' professional image perception score was between 165.50±12.17, and they had good image perception. Personal and professional characteristics of the nurses did not affect the total score of the scale of perception of professional image, but in sub-dimension comparisons, the age of the nurses was on the occupational status and education sub-dimension score; sex was on the sex sub-dimension score; education was on appearance and education sub-dimension score; on the sub-dimensions of professional experience, professional competence, professional status and education. It was determined that the unit they worked in made a significant difference on the occupational status and education sub-dimension.
DISCUSSION AND CONCLUSION: As a result of the study, it was determined that the professional image perception of the nurses was at a good level.

Mycoplasma pneumoniae is an important agent causing mainly respiratory infections. Apart from respiratory infections, Mycoplasma pneumoniae also causes some extrapulmonary diseases. Some of the extrapulmonary findings are; skin, musculoskeletal, nervous system, digestive system and hematological findings, usually caused by autoimmune or vascular complications. Skin involvement mainly presents as exanthema, papular, macular, vesiculobullous lesions, Erythema Multiforme or Stevens-Johnson syndrome. Therefore, skin findings in some cases can be confused with collagen tissue diseases. In this article, a case of Mycoplasma, which had presented to our clinic with prolonged fever and had been considered to have a collagen tissue disease after extensive maculopapular eruptions, was presented. Due to its clinical presentations and associated symptoms, it is emphasized that M. pneumoniae infections, which can progress with extrapulmonary findings, should be kept in mind in the differential diagnosis of collagen tissue diseases.