INTRODUCTION: Blood culture (BC) is the gold standard test in diagnosis of bacteremia. Also, it is a frequently used test in pediatric patients. The objective of this study was to observe the changes in contamination rates after educations about obtaining BC.
METHODS: Rates of contaminations and true positive results and contaminant agents were analyzed retrospectively at 2007 in a pediatrics hospital. At 2008, periodic educations about sample obtaining techniques of BC were given to medical personnels who were the sample collectors in this hospital and same parameters were analyzed prospectively.
RESULTS: After educations, rate of true positive results was increased from 3.9% to 6.9%. Contamination rate was decreased from 8.73% to 6.94%. Members of skin flora were the major contaminant agents both before and after educations.
DISCUSSION AND CONCLUSION: Periodic educations about sample obtaining technique of BC should be useful in decreasing the contamination rates in pediatric patients.

INTRODUCTION: Skin prick test is an easy, cheap, safe, fast, and frequently used test to identify allergic diseases. Several factors such as genetic tendency, climate, humidity, vegetation, and altitude effect development of allergies.
Aim: Our goal was to determine the allergic susceptibility of allergic patients in Sirnak City.

METHODS: Medical files of 240 patients who referred to our Chest Disease policlinics in Sirnak State Hospital between February 2011 and June 2011 with respiratory complaints suggestive of allergic diseases such as asthma and allergic rhinitis, were retrospectively reviewed. Skin prick test results were evaluated according to age and gender.
RESULTS: Of 240 patients included in the study, 127 (52.9%) were male and 113 (47.1%) were female. The most common allergic reaction was against grasses, observed in 41 patients (17.1%). The other common allergic reactions were against grains, in 28 patients (11.6%); D. Farinea in 17 patients (7.1%); D Pteronyssinus in 11 patients (4.6%); grass mix in 9 patients (3.7%).
DISCUSSION AND CONCLUSION: Reactions were most commonly observed in the age group of 10-19 years. Atopic patients in Sirnak province should particularly be careful against grasses, grains, and house dust mites.

INTRODUCTION: The aim of this study is determining the intensive care unit nurses' opinions on physical restraint application.
METHODS: This descriptive research has been performed with 90 nurses working at the Intensive Care Units of a private University Hospital in Ankara. The data has been obtained with data collection form. Percentage and chi-square test have been used for data evaluation.
RESULTS: 73.3% of nurses are female, 26.7% male. 54.4% works at internal medicine intensive care unit, 45.6% works at medical surgical intensive care unit. The majority have been working at intensive care unit for more than a year. 41.1% of nurses have been trained previously on physical restraint. The nurses think that purpose of physical restraint is to protect patient from harming himself and his surroundings (82.2%) What nurses think about who should give the decision for starting and ending of the physical restraint application; doctors (22.2%), the nurse (21.3%), the nurse and doctor together (43.3%) should decide. According to nurses, the advantages of physical restraint application are: to provide the continuity of the treatment (24.4.%), to protect patient from harming himself and his surroundings (65.6%) and to decrease the work load of the nurses (6.7%).
DISCUSSION AND CONCLUSION: Nurses consider physical restraint as an application that needs to be done in terms of patient safety. It has been determined that the physician's directive isn't paid enough attention to the initiation and termination of physical detection. Therefore; It's recommended that the knowledge about nurses' responsibilities related to physical detection and implementation should be reinforced and updated

INTRODUCTION: Malignant tumors of liver are examined in two groups as primary (originating from liver tissue) and secondary (metastatic). Metastatic tumors of the liver are 20 times more common than primary liver cancers. We aimed to reveal the histopathologic diagnosis of malignant liver masses and the distribution of the organs from which metastases originated in our clinic.
METHODS: We retrospectively evaluated 127 cases who were admitted to our clinic with liver mass between January 2014 and March 2016 and biopsied and diagnosed as malign tumor in pathology reports.
RESULTS: A single mass was detected in 32.3% of the cases and multiple mass was detected in 67.7% of the cases. Primary liver malignancy was detected in 51 (40.2%) cases and metastasis was detected in 76 (59.8%) cases. Adenocarcinoma was the most common (51.2%) and hepatocellular carcinoma (HCC) was the second most common. Primary focus was detected in 71.8% of metastatic cases. The most common primary cancers as HCC, the most common secondary cancer has been identified as unknown primary tumor.
DISCUSSION AND CONCLUSION: Metastatic tumors of the liver are detected more often than primary tumors. The most common primary tumor is HCC. The primary unknown cancers are the most common metastatic lesions of the liver. Despite efforts to prevent etiologic causes of cancer and to make the scans more conscious for early detection, liver primary and metastatic cancers continue to be a problem.

INTRODUCTION: To evaluate whether or not obtaining low-dose and high quality images in the paranasal sinus CT imaging using 320-row multidetector CT technique on phantom study.
METHODS: Twenty phantom examinations were conducted with different settings of the tube voltage (135, 120, 100, 80 kV) and current. Dose measurements were derived from the study protocol as volume CT dose index (CTDIvol) and dose-length product (DLP). Image qualities of all the phantom images were assessed using a five-point scale (1: non-diagnostic to 5: excellent image quality) by observer 1 and 2.
RESULTS: We obtained the lowest radiation dose in using 80 kVp and 2.5 mAs (CTDIvol: 0.2 mGy, DLP: 2.5 mGy x cm) phantom CT protocol and the highest radiation dose in using 120 kVp and 75 mAs (CTDIvol: 13.7 mGy, DLP: 191.2 mGy x cm) phantom CT protocol(p<0.001). We revealed the lowest radiation dose in using 135 kVp and 5 mAs (CTDIvol: 1.2 mGy, DLP: 16.9 mGy x cm) with high imaging quality for observer 1 and 2 (p<0.001).
DISCUSSION AND CONCLUSION: We suggest that you can perform the 135 kVp and 5 mAs paranasal sinus CT protocol with high image quality in routine daily practice.

INTRODUCTION: To evaluate the effectiveness of intravitreal triamcinolone acetonide injection (IVTA) in chronic diabetic macular edema (DME) and to assess complications of treatment.
METHODS: 4 mg/0.1ml triamcinolone acetonide was injected into the intravitreal cavity of 34 eyes of 20 patients. 7 male and 13 female patients; with diabetic retinopathy that unresponsive to laser photocoagulation were enrolled. The visual acuity, intraocular pressure (IOP) and macular edema were compared in pretreatment and posttreatment 1st week, 1st, 3rd, and 5th months.
RESULTS: Median duration of follow-up was 5.05±0.76 months (4-6 months). The macular edema was significantly improved (27/34 eyes (79.4%); 30/34 eyes (88.2%), and 27/34 eyes (79.4%) at the 1st, 3rd, and 5th months; respectively). Visual acuity improved 13/34 eyes (38.2 %) at the 1st week, 23/34 eyes (67.6%) in the 1st month, 23/34 (67.6%) in the 3rd month, and 24/34 (70.5%) in the 5th month. Except cataract formation in 2 eyes, none of other patient experienced a complication related to IVTA injection. In addition, none of the patients had IOP above 21 mmHg.
DISCUSSION AND CONCLUSION: IVTA is a safe and effective therapeutic method for chronic diabetic macular edema unresponsive to prior laser photocoagulation. However, further studies with longer follow-up and larger number of patients are required to assess the long-term efficacy and to determine the criterias for retreatment.

INTRODUCTION: The aim of this study was to determine the rate of proliferative and malignant breast lesions in patients who underwent excisional biopsy.
METHODS: Non-palpable benign breast lesions in 112 female patients that were diagnosed by mammography and ultrasonography (USG) were analysed using the Breast Imaging Reporting and Data System (BI-RADS) radiological classification system. Patients with a BI-RADS score of 3–5 for mammograms and breast mass excised later were compared according to radiological and pathologic findings.
RESULTS: : For non-palpable breast lesions, a BI-RADS type 4 radiological image was most frequently obtained (62.5%, 70 cases). Most lesions (52.7%, n=59) were benign, 36.6% (n=41) were proliferative and 10.7% (n=12) were malignant. The most frequently seen benign lesion was either a simple cystic disease or a proliferative disease that was classified with or without atypia. A few patients (16.1%, n=18) had proliferative lesions with atypical ductal hyperplasia and 20.5% (n=23) of the patients had proliferative lesions without atypia; no significant difference in proliferative lesions was observed between these two groups (p=.466). Six patients were diagnosed with invasive ductal carcinoma and six patients were diagnosed with ductal carcinoma in situ. In patients with atypical ductal hyperplasia, atypical columnar epithelial cell changes (61.1%) were more common than without atypia (43.5%), but these values were not significantly different.
DISCUSSION AND CONCLUSION: The marking of non-palpable breast lesions followed by excisional biopsy is a valuable method for detecting and staging suspicious lesions. Additionally, the BI-RADS scoring system is a reliable method for ruling out malignancy in non-palpable breast lesions during follow-up.

INTRODUCTION: To investigate the effect of tracheostomy on weaning and prognosis in patients undergoing long-term invasive mechanical ventilation (IMV) due to acute respiratory insufficiency.
METHODS: The study was prospectively conducted on 24 tracheostomized T(+) and 26 non-tracheostomized T(-) patients who undergo long-term IMV due to acute respiratory insufficiency, between 2007-2009.
RESULTS: The mean age of patients was 50±18 in T(+) group and was 61±18 years in T(-) group (p=0.04). The mean values of the APACHE II score on the first day were 22.25±6 in the T(+) group and 27±7 in the T(-) group, respectively (p=0.01). In T(+) group, the duration of intensive care and mechanical ventilation was longer than T(-) group, and the mean age and APACHE II score was lower (p<0.05). The mortality rate was 50% (n: 12) in T(+) group and 73% in T(-) group (p>0.05). In T(+) group, one patient developed transient tracheal stenosis and another one developed pneumothorax. The presence of acute renal failure (ARF) was associated with mortality, regardless of tracheostomy (P <0.05). In all patients, ≥23.5, the APACHE II score was related to mortality with 71% sensitivity and 68% specificity.
DISCUSSION AND CONCLUSION: In conclusion, our study suggests that there is no a significant effect of tracheostomy on weaning and prognosis in patients undergoing of the long-term IMV. In patients with tracheostomy, intensive care and duration of mechanical ventilation are higher than those of patients without tracheostomy. Additionaly, ≥23.5 APACHE II scores and presence of ARF is associated with mortality regardless of tracheostomy.

INTRODUCTION: We aimed to investigate the contribution of strain elastosonography to the differentiation of benign and malignant thyroid nodules.
METHODS: The retrospective study included 135 patients who were detected with thyroid nodules on ultrasonography and then underwent fine-needle aspiration biopsy (FNAB). Semi-quantitative strain elastographic evaluation was performed and mean strain ratio was calculated for each nodule. The elastograms were classified using the Tsukuba five-pattern visual scoring system. Accordingly, the lesions with scores 1 and 2 were accepted as soft nodules (benign), score 3 as moderately hard nodules, and scores 4 and 5 as hard nodules (malignant). The nodules were divided as benign and malignant depending on the histopathological results. The FNAB results were compared with elasticity scores.
RESULTS: The patients included 18 (13.3%) men and 117 (86.7%) women. Of the 135 lesions, 113 (83.7%) were benign and 22 (16.3%) were malignant. Strain ratio value was statistically higher in malignant lesions compared to benign lesions (p<0.01). When compared with the histopathological results, elastosonography scoring had a sensitivity of 81.8%, specificity of 89.4%, positive predictive value (PPV) of 96.2%, and negative predictive value (NPV) of 64.7%. However, compared with the strain ratio values, elastosonography scoring had a sensitivity of 77.3%, specificity of 87.6%, PPV of 95.2%, and NPV of 54.8% at a cutoff point of 4.850.
DISCUSSION AND CONCLUSION: Elastosonography is highly effective in the differentiation of benign and malignant lesions.

INTRODUCTION: Consultation can be undertaken either to improve any complaint of the patient or to provide additional information for the diagnosis. The aim of this study is to evaluate the consultations those undertaken from obstetrics and gynecology to dermatology and to assess the effect of consultation on the diagnosis and treatment of the diseases.
METHODS: Patient data those consulted from obstetrics and gynecology to dermatology between 2011 and 2017 retrospectively obtained. Patients whose did not have any missing data were included in the study.
RESULTS: A total of 50 women aged between 18 and 86 were enrolled in the study. The mean age of the patients was 40.88±18.29, and 11 (22%) were single and 39 (78%) were married. Twenty-eight (56%) of the patients had a complaint on vulva, five (10%) on inguinal, and 17 (34%) on other body parts. Infection was the reason for consultation in 13 (26%) patients. Since 11 infections were at vulvar localization, two at inguinal region. Nine patients was consulted for genital ulcer. Four of those, diagnosed as Behcets disease for the first time. One of the two patients whose consulted before biopsy for vulvar mass diagnosed as lymphedema tarda secondary vulvar lymphangiectasia; the other one was basal cell carcinoma. Four patients with policystic ovary syndrome were consulted for acne; one with hirsutism for additional suggestions.
DISCUSSION AND CONCLUSION: Besides the treatment of the symtoms and findings of the disase, consultation is beneficial to prevent the complications by providing early diagnosis and treatment of multisystemic diseases.

Polycystic kidney disease is an otosomal dominant hereditary disorder which can progress to end stage kidney failure. In this disease, the cysts in distinct sizes and distinct number are seen in kidneys and in liver. Nowadays, there is a great diffence in the number of donors and the patients waiting for transplantation. Because of that, using marginal donors may be necessary. In this article, we aimed to discuss whether a 55 years old braindead polycystic kidney disease patient can be used for transplantation or not.

One of the rare causes of peroneal neuropathy is the loss of 15% of the body weight. In the present study, unilateral foot drop following extreme weight loss has been reported. Case 7 months ago had under gone bariatric surgery and gave 35 kilos in about 7 months within. careful clinical interrogation, neurological examination as well as electrophysiological examination are important for diagnosis and treatment.

Dissection is a term often used to describe the separation of the arterial intima layer from the media layer, and more rarely the separation of the media layer from the adventitia layer. Despite the rare occurrence of this condition, the fact that mortality rate is between 19-43% makes the early diagnosis and treatment important. The hanging-related carotid artery dissections are rarely seen. In this article, a case with cerebral ischemia resulting from hanging carotid artery dissection is presented and the clinical findings,diagnostic procedures, and choice of treatment are discussed in the light of the literature.

Varicella zoster virus (VZV) is a virus belonging to the family of herpes virus that can remain latent in trigeminal nerve and dorsal root ganglia. Some neurological complications; encephalitis, myelitis, meningitis and central nervous system angiitis may occur with virus reactivation. These complications are very rare in people with normal immune response. A 70-year-old male patient presented with complaints of lower extremity weakness and incontinence for 2 days. Vesiculobullous lesions were observed in the area of the left lower extremity L5 dermatome and sacrum. Magnetic resonance imaging showed involvement of between T9 and T12 as transverse myelitis. Lymphocytic pleocytosis and protein elevation was detected in sample of the cerebrospinal fluid. VZV-DNA positivity determined in polymerase chain reaction (PCR). Patients with dermatomal lesions and myelitis findings should be considered transverse myelitis associated with VZV even if they have not immunodeficient. Rapid recognition and treatment are important for the prognosis.

Hip fractures are the leading cause of admission to the hospital in the elderly population.
The most important cause of hip fractures in the elderly population is simple falls and leading causes of mortality and morbidity. The most common cause of femur neck fractures in young populations is traffic accidents and high-energy sports.
Due to the low blood supply, avascular necrosis and nonunion are common in femur neck fractures. There are many options in the treatment of these fractures. The main methods are closed reduction internal fixation and arthroplasty. Treatment options depend on the age of the patient, type of fracture, fracture etiology, timing of the surgeon, presence of rheumatologic disease, presence of neurological disease, psychosis, neglected femoral neck fracture.

Dentin hypersensitivity is a common problem caused by the exposure of dentin surface due to the loss off enamel or gum recession. The open dentine surface evolves as a response to stimuli (thermal, physical and chemical). It is described by the patients as short and sharp pain. The purpose of dentin hypersensitivity treatment; reduce fluid flow in dentin tubules and block the nerve response in the pulp. Today, topical agents with various mechanisms are used for this purpose. Furthermore, in recent years, lasers has been used effectively in the treatment of dentin hypersensitivity. Although there are many studies about dentin hypersensitivity diagnosis and treatment, there is still insufficient data on definite diagnosis and treatment and a controversial issue. The aim of this paper is to summarize existing information etiology, mechanism, laser types and mechanisms of dentin hypersensitivity and clinical studies related to them.