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Öğe Evaluation of clinical and laboratory results of patients diagnosed urinary calculi in emergency department(2023) Atila, Abdullah Ahmet; Sarıhan, Mehmet Ediz; Tunç, Zeynep; Güngör, HasanAim: In this study, we examined the factors affecting the rate of urine culture positivity and the rate of urine culture positivity in patients who were found to have kidney stones in the emergency department and were followed up by the Urology outpatient clinic. We evaluated the examinations and treatments of these patients with the results of the urology outpatient clinic until the urine culture results were obtained. We think that our study will provide useful information to emergency service workers in the evaluation of patients with urinary system stones. Materials and Methods: In this study, patients who applied to Emergency Medicine Department of İnönü University Faculty of Medicine between January 1st, 2016 and November 1st, 2022, who were diagnosed with urinary calculi by imaging and who were followed up in the Urology outpatient clinic, were retrospectively analyzed. The age and gender of the patients, as laboratory tests, complete blood count, urinalysis, serology and urine culture results were examined. Multiple logistic regression analysis was performed with all the parameters obtained from our study and the analysis was statistically significant according to the Hosmer&Lemeshow test. Results: In our study, there were a total of 349 patients, 99 (28.37%) female and 250 (71.63%) male, and a pathogenic microorganism growth was observed in the urine culture of 40 (11.7%) of the patients. The first two microorganisms most frequently encountered in urine culture were Escherichia Coli (24/40) and Klebsiella spp. (5/40). In the logistic regression model, nitrite positivity increased 48.8%, urinary white blood cells increased 0.2%, bacteria presence in urine 3.06%, and increased patient age increased the probability of culture positivity by 2.6%. Each 1 unit increase in hemoglobin value decreased the probability of positive urine culture by 27.8%. Conclusion: The leukocyte count, bacteria presence, nitrite positivity, low blood hemoglobin and advancing advanced age in the complete expulsion examination of a patient with urinary system stone are the prediction of a positive ejection result. These data should be considered in the decision to take the culture of dissemination at the time of death of patients with urinary tract stones or the management of care during the time until they reach the respiratory tract.Öğe Evaluation of effects on periodontal health, halitosis and salivary flow of the occlusal splint use(2012) Güngör, Hasan; Eltas, Abubekir; Tozoğlu, ÜmmühanObjectives: Occlusal splints (OS) are often used for the treatment of temporomandibular disorders (TMDs),bruxism, and occlusal disturbance, although the splint s effect on oral tissue has not been investigated enough. The aim of this study is to evaluate the effects of OS on halitosis, periodontal status and salivary flow rate (SFR)in patients with bruxism.Material and Methods: A total of 43 patients with bruxism participated in this study. Plaque index (PI),bleeding on probing (BoP), probing pocket depth (PPD), SFR and halitosis measurement were performedimmediately before treatment and 3 months following the completion of the baseline treatment protocol.Results: The present study saw that the use of OS for three months did not affected the periodontal status. Therewas significant increase in the level of halitosis and also the level of SFR after the use of OS (p <0.001).Statistically significance relationship between halitosis and SFR with the use of OS was found (p <0.05), whilethere was not a correlation between SFR and halitosis (p >0.05).Conclusions: Although occlusal splints have therapeutic benefits, comprehensive clinical examinations areneeded on this issue.Öğe Mesane tümörlerinde multiparametrik manyetik rezonans görüntülemesinde skorlama sisteminin (VIRADS) klinik tanı ve tedavi üzerine etkileri(İnönü Üniversitesi, 2022) Güngör, Hasan; Çamtosun, AhmetAmaç: Mesane kanseri hastalarında tümörün lokal evrelendirmesi için preoperatif mpMRG (multiparametrik manyetik rezonans görüntüleme) yöntemi ile değerlendirmeyi ve histopatolojik sonuçlarla karşılaştırarak klinik etkinliğini göstermeyi amaçladık. Gereç ve Yöntem: Çalışmaya Kasım 2020 ile Nisan 2022 tarihleri arasında mesane tümörü ön tanısı ile sistoskopi planlanan ve daha önce mesane tümörü tanısı almış rezidü tümörü olan 63 hasta dahil edildi. Bu hastalar preoperatif mpMRG yöntemi ile T2 ağırlıklı (T2A) görüntüleme, difüzyon ağırlıklı görüntüleme (DAG), dinamik kontrastlı görüntüleme (DKG) sekansları birlikte değerlendirildi. Tüm MR görüntüleri 'Vesical Imaging Reporting And Data System' (VIRADS) kriterlerine göre incelendi. Tüm lezyonlar 5 kategoriden oluşan VIRADS skorlarına göre sınıflandırıldı. Daha sonra hastalardan alınan biyopsiler histopatolojik olarak incelendi ve radyolojik bulgularla karşılaştırıldı. Bulgular: Çalışmaya dahil edilen 63 hastanın 60'ı erkek, 3'ü kadın hasta ve yaş ortalaması 64,2±10,55 olarak hesaplandı. Hastaların 41'i primer mesane tümörü ve 22 hasta nüks mesane tümörü, rezidü tümörü olan ve/veya radikal sistektomi planlanan hasta grubunda yer aldı. VIRADS skoru >3 olan tümörler kasa invaze olarak gruplandırıldığında 63 hastanın 53'ü (%84) radyolojik olarak invaziv mesane tümörü olarak değerlendirildi. Fakat histopatolojik olarak 33 (%52,4) hastada invaziv mesane tümörü saptandı. Bu çalışmada duyarlılık %100, özgüllük %33, negatif öngörü değeri %100, pozitif öngörü değeri %62 olarak hesaplandı. Ayrıca bu çalışma sonucunda VIRADS skorunun kas invazyonunu saptamadaki öngörüsü ile tümör hacmi arasındaki korelasyonun anlamlı olmadığı saptandı (p değeri 0,529). Sonuç: Çalışmamızın sonuçlarına göre ameliyat öncesi mesane kanseri evrelemesi klinik tanı ve tedavi yaklaşımı açısından önemlidir. MpMRG kullanılarak elde edilen VIRADS skorlama sisteminin özellikle mesane kas invazyonu olmadığını saptamada başarılı bir yöntemdir. Mesane tümörlerinde kasa invazyonu saptamadaki başarısı daha fazla yapılacak çalışmalar ile tanısal verimliliğin artırılabileceği bir yöntemdir. Anahtar Kelimeler: Mesane kanseri, VIRADS, kas invazyonuÖğe Supine percutaneous nephrolithotomy in a high-volume center: First 60 cases(2023) Topçu, İbrahim; Keskin, Faruk; Güngör, HasanAim: To present the first 60 supine percutaneous nephrolithotomy (PCNL) surgeries performed in our clinic with regard to the results and reliability of this surgery. Materials and Methods: A retrospective study carried out on 60 patients who had undergone PCNL in supine position due to the kidney stone between September 2021 and May 2022. The following parameters were studied: Demographic characteristics, stone size and HU index, operation time and postoperative complications. Results: Patient’s mean age was 48.47, the oldest one was 90 years old, and 20 of them were female. Three of the patients had solitary kidney and 23 of them had previous surgery for kidney stone. 10 patients had this surgery under spinal anesthesia. Mean stone surface area and Hounsfield Unit were 590.55 mm2 and 903.52, respectively. In 3 cases, endoscopic combined intrarenal surgery was performed. Mean operation time was 63,75 minutes and scopy time was 16.5 seconds. 33 patients had totally tubeless procedure and 37 patients had tubeless surgery. None of the patient was required to blood transfusion or any other approach related to bleeding. Only two patients had fever and needed IV antibiotics. Stone free rate was 95 % in one session. Conclusion: Supine PCNL surgery is a feasible surgery with low complication rate and high stone-free rate. It is easier to switch to the supine position in clinics where this surgery is performed intensively in the prone position. It should become more widespread especially in terms of the advantages it offers compared to prone PCNL.
