ISSN :2822-5872
ANKARA CITY HOSPITAL MEDICAL JOURNAL - ACH Medical Journal: 2 (5)
Volume: 2  Issue: 5 - Aralık 2023
1.Full Issue

Pages I - II

RESEARCH ARTICLE
2.Radiotherapy/Chemoradiotherapy for Geriatric Head and Neck Cancer Patients
Hüseyin Furkan Öztürk, Çağkan Ergiden
doi: 10.5505/achmedj.2023.66375  Pages 266 - 274
INTRODUCTION: In our study, it was aimed to analyze radiotherapy (RT) compliance, acute toxicity results, and survival in geriatric patients with head and neck cancers.
METHODS: In our study, 77 geriatric patients (≥ 70 years) underwent curative RT diagnosed with head and neck cancer between 04.05.2010 and 24.03.2022 in the Radiation Oncology Clinic of Ankara Bilkent City Hospital and Ankara Atatürk Training and Research Hospital were analyzed. The study’s primary outcome was RT completion, interruption, and acute adverse events. The study’s secondary endpoint was evaluating overall survival (OS) and progression-free survival (PFS).
RESULTS: The median follow-up period of the study was 10 (range 1-130) months. The median age of the patients at the time of RT was 75 years. (Range 70-86). Most patients were diagnosed with laryngeal cancer (n=35, 45.5%). Of the 77 patients in our study, 71 (92.2%) completed their treatment, and 6 (7.8%) could not complete the radiotherapy course. Patients who could not complete the planned radiotherapy scheme were mostly diagnosed with laryngeal and hypopharyngeal cancer. (p=0.036; OR 1.94 95%CI 0.33-11.30). 71 patients completed treatment, and 67 (94.4%) did not interrupt treatment. In contrast, the treatment had to be interrupted for the last 4 (5.6%) patients. Grade 3 side effects were observed in 6 patients (7.8%). No grade 4 side effects were observed. During the follow-up period, 16 (20.8%) patients died; 61 (79.2%) were alive. Median OS was 9.8 (range 1 to 130) months. There was a significant relationship between OS and primary (p=0.035). Hypopharyngeal patients were significantly lower; nasopharyngeal and nasal cavity tumors have higher OS values. Local recurrence was observed in 6 (7.3%) of the patients and the median PFS was 8.9 (range 1-130) months.
DISCUSSION AND CONCLUSION: In patients over 70 with head and neck cancer, definitive chemoradiotherapy (CRT) is a feasible treatment with acceptable toxicity.

3.The Relationship Between Endometrial Biopsy Results and Covid-19 in Postmenopausal Women
Elçin İşlek Seçen, Gonca Türker Ergün, Işılay Karadag, Raziye Desdicioglu
doi: 10.5505/achmedj.2023.69885  Pages 275 - 279
INTRODUCTION: To investigate the impact of Covid-19 infection on postmenopausal bleeding and endometrial sampling results in postmenopausal women.
METHODS: Our study is a retrospective study, and it compares the demographic data, transvaginal ultrasound findings, and histopathological results of endometrial biopsies in postmenopausal women who had postmenopausal bleeding or underwent endometrial sampling due to asymptomatic endometrial thickness increase of the groups of those who had and had not experienced Covid-19 at Ankara City Hospital between October and December 2020.
RESULTS: Among the 274 patients included in our study, it was observed that biopsies were taken from 173 (63.13%) due to postmenopausal bleeding (PMB), and from 101 (31.86%) asymptomatic women due to increased endometrial thickness. It was determined that 60 (21.89%) of the women had experienced Covid-19 infection. The mean endometrial thickness in patients who underwent biopsy was 8.93±6.42mm, and no significant difference was observed between the measured endometrial thickness in the groups who had and had not experienced Covid-19 (7.98±4.80 vs 9.20±6.79; p=0.17). It was observed that 37 of the 173 patients (21.39%) who had samples taken due to PMB had experienced Covid-19. In both groups of patients who had and had not experienced Covid-19, no significant difference was observed in the rates of postmenopausal bleeding and in the benign and malignant pathology results from the histopathological examination (p > 0.05).
DISCUSSION AND CONCLUSION: In terms of our study in postmenopausal women, it was observed that Covid-19 infection did not affect the rates of postmenopausal bleeding and endometrial biopsy results.

4.Exploring Emergency Department Workers’ Attitudes Towards Individuals with Suicide Attempts: A Cross Sectional Study
Selvi Ceran, Habibe Selmin Özensoy, Miray Tümer
doi: 10.5505/achmedj.2023.29392  Pages 280 - 285
INTRODUCTION: This study aims to determine the attitudes of emergency service workers toward patients attempting suicide (PAS) and the factors influencing these attitudes.
METHODS: A total of 122 voluntary emergency service workers employed in a city hospital participated in the research. Data were collected using the “Attitude scale towards attemnpted suicide cases for evaluating emergency medical teams (ASETSA).” The data were analyzed using ANOVA and Student t-test.
RESULTS: The average age of the participants was 29 ± 6.7, with the majority being male (60%) and in the first five years of their profession (58%). The mean score on the ASETSA was 98.3 ± 8.6. It was determined that variables such as age, gender, education level, marital status, years of service, and weekly working hours did not affect the participants’ attitudes towards PAS. A small percentage of workers (7%) reported receiving training on suicide prevention.
DISCUSSION AND CONCLUSION: The overall attitudes of emergency health workers towards individuals with suicide attempts were positive and not associated with sociodemographic and professional characteristics. It was identified that emergency health workers need more psychiatric training to feel adequately prepared when intervening in cases of suicide attempts.

5.Surgical Results Of Chordee Without Hipospadias
Süleyman Tağcı, Gökhan Demirtaş, Bilge Karabulut, Hüseyin Tuğrul Tiryaki
doi: 10.5505/achmedj.2023.30592  Pages 286 - 289
INTRODUCTION: Congenital penile curvature is an anomaly that often accompanies hypospadias. It is the abnormal curvature of the erected penis without any abnormality in penile chord meatal position without hypospadias and it is a rare condition. We aimed to review our experiences in the light of the literature by presenting our cases of congenital chordee without hypospadias that we operated on in pediatric patients.
METHODS: The data of the patients who were operated in our clinic between January 2020 and June 2022 for congenital chord without hypospadias were analyzed retrospectively. Patients who had previous surgical procedures were excluded from the study.
RESULTS: Seventeen patients were included in the study. The ages of the patients were determined as 23-176 months (median 91.8 months).It was observed that the chordee degree of the patients was between 30-90 degrees.Seven of the 17 patients had chordee after degloving of the penis, that is, they had skin chordee. Heineke-Mikulicz plication was performed in 5 of the remaining ten patients and tunical plication was performed in 3 patients. Two patients with ventral cords underwent corporotomy and ventral grafting in their follow-up.
DISCUSSION AND CONCLUSION: The vast majority of penile cords without hypospadias can be corrected with simple degloving or plication techniques. No matter what technique we use, the protection of neurovascular structures and the urethral plate should be our main goal. Although penile cordis without hypospadias is rare, we argue that it can be performed in experienced centers with low complication rates and successful results.

6.Evaluation of thorax computed tomography findings of patients with COVID-19 associated myocarditis
Murathan Koksal, Muhammet Batuhan Gökhan, Halil Tekdemir
doi: 10.5505/achmedj.2023.73792  Pages 290 - 297
INTRODUCTION: It is known that human coronaviruses cause myocarditis, and during the pandemic, a series of coronavirus disease (COVID-19) related myocarditis cases have been reported. It is stated that cardiac magnetic resonance (CMR) has a specificity of up to 91% and a sensitivity of 67% for the diagnosis of myocarditis. The present study aims to determine whether patients at risk for myocarditis might be recognized on thoracic CT, comparing thoracic computed tomography (CT) and laboratory findings of patients with COVID-19-associated myocarditis that can be a significant consequence for COVID-19 patients and controls.
METHODS: The study included 51 patients with elevated troponin levels, CMR, and suspected myocarditis to meet this aim. As a result of the evaluation, while myocarditis findings such as a signal change in myocardial contrast involvement on T1 and T2 weighted images and contrast involvement in myocarditis in post-contrast series were detected in 31 patients, no abnormality was detected in the CMRs of 20 patients.
RESULTS: When the thoracic CT findings of the groups were compared, no significant difference was detected in the volumetric evaluations of infiltration frequency, distribution, lateralization, lobar involvement, and lung involvement. No infiltration related to COVID-19 was observed in most of the patients in both groups. Pleural and pericardial effusion were more frequently observed in the group with myocarditis.
DISCUSSION AND CONCLUSION: The present study revealed that myocardial involvement can occur without COVID-19-related distinct lung involvement and that pleural-pericardial effusion can be an alert for myocarditis diagnosis.

LETTER TO THE EDITOR
7.Chronic myelomonocytic leukemia complicated by telangiectasia and small bowel bleeding
Sakarie Mustafe Hidig, Fidele Kakule Kitaghenda
doi: 10.5505/achmedj.2023.35220  Pages 298 - 299
Abstract |Full Text PDF