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Öğe Bacillus Calmette-Guerin is a preventive factor in mortality of childhood tuberculous meningitis(Elsevier Sci Ltd, 2014) Kelekci, Selvi; Karabel, Musemma; Karabel, Duran; Hamidi, Cihat; Hosoglu, Salih; Gurkan, M. Fuat; Tas, M. AliObjectives: Studies have been done that have focused on the efficacy of bacillus Calmette-Guerin (BCG) vaccination in the prevention of cases of childhood tuberculous meningitis (TBM). However the efficacy of the vaccination in the prevention of mortality has not been sufficiently evaluated. This study aimed to determine the main features of TBM cases in childhood and to evaluate the factors related to mortality, proving the protective effect of BCG vaccination in childhood TBM. Methods: In a retrospective approach, all consecutive cases of TBM in children that occurred between 1997 and 2005, at Dicle University Hospital, were studied. The following data were evaluated: demographic aspects, admission symptoms, radiology and laboratory findings, BCG vaccination status, tuberculin skin test (TST) positivity, and mortality rates. Results: In total, 172 cases of childhood TBM were evaluated (mean age 53.3 +/- 55.7 months; 109 boys (63.4%)). The majority of these cases (70.4%) had typical TBM symptoms on admission. BCG vaccination data were available for 152 (88.4%) cases and 29 of them (19.1%) were positive. The TST was performed for 143 patients (83.1%) and 28 (19.6%) were found positive. Hydrocephalus was identified in 118 patients (68.6%) on computed tomography examination. A shunt was placed in 79 cases (45.9%). In total, 24 patients (14.0%) died in the hospital. TST negativity was a significant factor for mortality (p = 0.012). BCG positivity was found to be a preventive factor from mortality (p = 0.05). Conclusions: BCG vaccination is effective in the prevention of TBM-associated mortality in childhood. TST negativity may be a sign of a poor prognosis in TBM cases. (C) 2013 The Authors. Published by Elsevier Ltd on behalf of International Society for Infectious Diseases. All rights reserved.Öğe Comparison of 3.0-T MRI findings in drug resistant and non-resistant adult epileptic patients(2013) Ekici, Faysal; Tekbaş, Güven; Önder, Hakan; Gümüş, Hatice; Çetinçakmak, Mehmet Güli; Balık, Suzan K.; Acar, Abdullah; Hamidi, Cihat; Bilici, Aslan; 0000-0002-4293-1335Epilepsy is a common chronic disease characterized by spontaneous and recurrent seizures. Along with the increases in life expectancy, the prevalence of epilepsy in adults increased in parallel. 3.0-T MRI provides high signal/noise ratio and is an important tool in the determination of epileptic lesion in epilepsy patients. Our aim in this study was to research and compare 3.0-T MRI findings of Turkish epileptic patients that are resistant and non-resistant to medical treatment. 3.0-T MRI images from 264 consecutive patients, of which 150 were males and 114 were females (age range 18-82 years; mean age 31.3 years) were examined, retrospectively. Among those patients, 94 were resistant to medical treatment (DRE+) and 170 were non-resistant (DRE-). Epileptic lesion was determined in 119 of the patients. Epileptic lesion was determined in sixty-three patients who were resistant to medical treatment and in fifty-six patients who were non-resistant. Epileptic lesion was determined in approximately half of the adult epilepsy patients by using 3.0-T MRI. This study demonstrates a high prevalence of brain abnormalities in Turkish epileptic patients with DRE+. The lesion was determined in 67% of patients with medical treatment resistance, while the percentage for the other group was only 32.9%. The ratio of epileptic lesion determination by using 3.0-T MRI was quite higher in the medical treatment resistant group than the non-resistant group.Öğe Ocular blood flow changes in Behçet disease patients with/without thrombotic disease(Informa Healthcare, 2014) Yüksel, Harun; Türkçü, Mehmet Fatih; Hamidi, Cihat; Cingü, Abdullah Kürşat; Şahin, Muhammed; Özkurt, Zeynep; Çaça, İhsanIn this study, the authors aimed to evaluate ocular blood flow changes in Behçet disease (BD) with and without thrombotic disease. Ninety eyes of 90 patients with a diagnosis of BD (30 eyes with active uveitis, 23 eyes with inactive uveitis, 25 eyes without ocular involvement, and 12 eyes without ocular involvement and with a history of thrombosis) and 30 eyes of 30 age- and sex-matched control patients without any systemic disease with a total of 120 eyes were evaluated. In all cases, ophthalmic, central retinal, and ciliary artery flow parameters were measured with colour Doppler ultrasonography (CDU). The ocular blood flow parameters of all vessels in patients with active uveitis were found to be affected. All the flow parameters in the CRAs of the study groups were significantly different from the control group (p < 0.001). Additionally, in non-ocular BD patients with thrombosis, blood flow parameters were affected more than the parameters in non-ocular BD patients without thrombosis and control patients. In conclusion, major haemodynamic changes were observed using CDU in the ophthalmic vessels of ocular Behçet patients. Also, CDU may detect ocular blood flow alterations before initial ocular clinical manifestations appear in BD patients.Öğe A questionnaire study about gonadal shield use of urologists(Dicle Üniversitesi Tıp Fakültesi, 2012) Sancaktutar, Ahmet Ali; Ziypak, Tevfik; Adanur, Şenol; Söylemez, Haluk; Hamidi, Cihat; Bozkurt, Yaşar; Atar, Murat; Bodakçi, Mehmet NuriObjectives: Our aim is to reflect routines, awareness, and consciousness level of urologists about usage of gonadal shield (GS) in Turkey. Materials and methods: Because of this objective a questionnaire which includes 15 questions was prepared. The questionnaire was delivered to urologists in a Turkish Urology congress. Data derived from 271 urologists by face to face interview were evaluated. Results: Participant were urologists (n=271), consisted of professors (n=33), associate professors (n= 36), assistant professors (n= 36), specialists (n=94), and residents (n=81). According to the data obtained from the questionnaires, 22% of the participants acquired their first information about GS as a medical student, 44% during their residency training, and 14% of them had no information about GS at all. Besides 64% of them did not read any medical article about this subject until that time, and 54% them practically hadn’t seen any GS during their urology practice. In 82% of the hospitals where participants were working hadn’t had any GS, and 18% of the urologists had indicated that GS was available in their hospitals, and they used them once in a while. Urologists responded favorably (20%) or unfavorably (80 %) to the question of ‘Do you find yourself or your colleagues adequately sensitive, and mindful about GS use? Conclusions: Sensitivity and awareness about use of gonadal shields among Turkish urologists are not at a desired level and for this reason, it is not used widely. The urologists should be informed in urological academic platforms about gonad protecting devices.Öğe Venous Intravasation as a Complication and Potential Pitfall During Hysterosalpingography: Re-Emerging Study with a Novel Classification(Medknow Publications & Media Pvt Ltd, 2013) Dusak, Abdurrahim; Soydinc, Hatice E.; Onder, Hakan; Ekinci, Faysal; Goruk, Neval Y.; Hamidi, Cihat; Bilici, AslanObjectives: Presently, hysterosalpingography (HSG) is used as a means to evaluate women with infertility and repetitive pregnancy loss. Venous intravasation is a complication and potential pitfall during HSG and analogous procedures including hysteroscopy. The aim of our study was to assess the venous intravasation and to obtain critical information for more secure and more accurate procedures. In particular, the primary goal of the present study was to compare HSG without and with intravasation to identify differences seen on HSG and to assess the predisposing factors of intravasation. The secondary goal was to describe clinical- and imaging-based novel classification of intravasation. Materials and Methods: This study included a patient cohort of 569 patients who underwent HSG between 2008 and 2011 at our center in the absence (control group) or presence (study group) of intravasation. Intravasation classified from level 0 (no intravasation) to level 3 (severe intravasation) was compared with preprocedural (demographic and clinical) and procedural (HSG) data. Data were analyzed using Statistical Package for Social Sciences (SPSS) statistical software. Results: Of the 569 patients undergoing HSG, 528 showed no intravasation and 41 (7.2%) patients showed intravasation when associated with preprocedural (leukocytes, menometrorrhagia, secondary infertility, ectopic pregnancy, abortus, polycystic ovaries, endometriosis, and interventions) and procedural (pain, scheduling, endometrial-uterine nature, and spillage) parameters. Moreover, intravasation was lower in women with smooth endometrium, triangular uterus, and homogeneous peritoneal spillage. No association was found between age, tubal patency, increased pressure, and intravasation. Conclusions: Using a novel classification method, intravasation can be observed in women during HSG and associates with preprocedural and procedural predisposing factors in subsumed conditions. This classification method will be useful for improving the efficiency and accuracy of HSG and related procedures by minimization of severe complications caused by intravasation.