Objective: Cardiovascular diseases are the leading causes of death in our country and in the world. In our study, we aimed to show the approach of physicians at different academic stages in family medicine discipline to the treatment of dyslipidemia, which is one of the most important risk factors of cardiovascular diseases. Methods: Our study was conducted between 01.01.2019 - 01.03.2019 in 189 (73%) of 259 family physicians actively working in the city of Kadikoy and its district, with face-to-face interviews and online survey filling. Opinions of the physicians participating in the study about their dyslipidemia and statin treatment were obtained with a questionnaire consisting of 32 questions about the demographic data, diagnosis and follow-up of dyslipidemia patients, their knowledge and experience about statin treatment. Results: It was observed that resident family physicians followed more chronic diseases than both specialist and general practitioners. Specialist family physicians think that they have more information about the diagnosis and treatment of dyslipidemia than general practitioner family physicians and general practitioner family physicians. It has been observed that assistant and specialist family physicians follow drug efficacy, duration of treatment and side effects more than general practitioners. 29.8% (n=25) of practitioner family physicians, 50.8% of assistant family physicians (n=31) and 68.3% (n=28) of specialist family physicians stated that they follow the latest guidelines. It has been observed that specialist family physicians follow more guidelines than assistant family physicians and assistant family physicians follow general practitioners. Conclusion: The diagnosis, treatment and follow-up of dyslipidemia by family physicians according to current guidelines will reduce the accumulation in 2nd and 3rd level healthcare facilities. In our study, it was concluded that residents and specialist family physicians diagnosed and treated more dyslipidemia than general practitioners.

Introduction: It was aimed to determine the information about application complaints, type of enuresis, comorbid diagnoses, family history, recommended treatment methods of patients diagnosed with enuresis. Method: 86 cases who applied to our outpatient clinic between January 2014 and January 2019 and were diagnosed with enuresis are evaluated. Results: Of the 86 patients included in the study, 34 (39.5%) were female and 52 (60.5%) were male. Primary enuresis was diagnosed in 52 (60.5%) of the cases diagnosed with enuresis and secondary enuresis in 34 (39.5%). After evaluation, 64 (74.4%) of the cases were diagnosed with enuresis only, enuresis and encopresis in 6 (7%). Apart from enuresis and encopresis, the most common psychiatric diagnosis was the diagnosis of Attention Deficit Hyperactivity Disorder. Keeping a calendar (sun-cloud), fluid restriction, sleep hygiene rules were described in 69 (81.2%) of the cases under the title of “behavioral recommendations”, and [medical treatment was started in addition to behavioral recommendations in 13 cases (15.3%)]. It was determined that 18 (20.9%) of the cases had a family history of enuresis. Conclusion: Consistent with the literature, our cases were found to be predominantly male and the comorbidity rate was high. Outpatient follow-up rates, compliance with treatment and treatment rates were also found to be low. Since enuresis is a disorder that negatively affects self-esteem and can cause secondary psychological problems, it is important to apply treatment algorithms suitable for early diagnosis and etiological factor.

Intoduction: Metastatic lymph node ratio (mLNR) has been shown to be an important prognostic factor in some solid tumours. The aim of this study was to investigate the prognostic value of mLNR in patients with colorectal carcinoma (CRC). Methods: The records of 246 CRC patients who had not distant metastasis and treated with curative surgery were retrospectively evaluated between January 2008 and April 2014. The effects of age, gender, the number of total lymph nodes removed, the number of metastatic lymph nodes, pathological T stage, TNM staging, mLNR and lymphovascular invasion on disease free survival and overall survival were analyzed with univariate and multivariate Cox-regression tests. Survival curves were calculated using Kaplan-Meier method and survival differences were assessed by log-rank test. Optimal cut-off value for mLNR is determined with ROC analysis. Results: Median age was 61 (23-86) and median follow-up period was 38 (11-78) months. Optimal cut-off value for mLNR was found as 0.08 in ROC analysis. In the multivariate analysis, the number of total lymph nodes removed (p<0.007) and mLNR (HR, 2.1; 95% CI, 1.2-4.2; p<0.003) were found to be independent risk factors on disease-free survival (DFS). For overall survival (OS), mLNR only was the independent risk factor on OS (HR,7.5; 95% CI, 2.6-21.2; p<0.0001). Conclusion: mLNR value more than 0.08 was found to be an independent risk factor on both OS and DFS in patients with nonmetastatic CRC. Larger prospective studies are needed to support the significance of mLNR for TNM classification of CRC.

Objective: Relapse is not common in patients with acute leukemia in childhood, however it is a serious complication with high mortality rate. We aimed to predict relapse among pediatric acute leukemia patients in remission by using complete blood parameters which are used routinely in clinical practice. Materials and Methods: The data of 279 children diagnosed with acute leukemia in our clinic over a 20-year period were retrospectively reviewed. Fourty two children relapsed and 37 children non-relapsed acute leukemia cases, all of whose data were available, were included in the study. Blood count parameters and physical examination findings at the time of diagnosis and during the follow-up were evaluated retrospectively in all patients. Mann-Whitney U and T-test were used for comparison of numerical variables. Chi-square test was used to compare categorical variables. Results: In the relapse group; twenty-four children were diagnosed with B-cell ALL, 10 children with T-cell ALL, and eight children with AML. In non- relapse group; 26 children had B-cell ALL, 10 children were diagnosed with T-cell and one child had AML. Thrombocytopenia was observed in 24 patients for the relapse group, compared to nine children in non- relapse group. After remission, the risk of relapse was significantly higher in patients with thrombocytopenia than in patients without thrombocytopenia among both groups. During the remission period, relapse was observed in all patients with thrombocytopenia lasting for an average of 3.86 weeks. Conclusion: Thrombocytopenia during the remission period of pediatric acute leukemia patients can be explained primarily by the effect of chemotherapeutic drugs used in treatment and possible infections on the bone marrow. We demonstrated that the presence of thrombocytopenia which develops after the remission period and lasts longer than three weeks can be used as an easy-to-access blood parameter in the prediction of relapse.

Objective: Non-Dipper hypertension is associated with increased cardiovascular morbidity and mortality. The neutrophil-lymphocyte ratio (NLR) has been associated with poor outcomes in patients with cardiovascular disease. This study aimed to investigate the relationship between dipper and non-dipper patterns and NLR in resistant hypertension (RHT) patients. Material and method: 164 RHT patients were included in this study. RHT patients were divided into two groups as dipper (n:76) and non-dipper (n:88) according to ambulatory blood pressure measurement. NLR was calculated by dividing the number of neutrophils by the number of lymphocytes. Results: 76% of the patients included in the study were female and the average age was 57±7. Statistically, a significant increase in neutrophil count, red blood cell distribution width (RDW), body mass index and triglyceride values were found in the nondipper resistant hypertension group compared to the dipper RHT group. Also, the neutrophil-lymphocyte ratio was significantly higher in the non-dipper resistant hypertension group compared to the dipper resistant hypertension group. In the multiple logistic regression analysis, neutrophil-lymphocyte ratio a significant relationship was found between non-dipper resistant hypertension. Conclusion: Our study has shown that the presence of a nondipper pattern in resistant hypertension patients is associated with inflammation caused by hypertension, and inflammatory indicators such as NLR and RDW were higher in this group of patients.

Introduction: There is controversy about the treatment of proximal humeral fracture (PHF) in elderly patients. Surgery should be considered especially for comminuted and advanced displacement fractures. Due to factors such as osteoporosis caused by advanced age, locked proximal humeral plates (LPHP) with good bone involvement are preferred. We examined the results of the LPHP that we applied for PHF over 60 years of age. Materials and Methods: Patients with PHF over the age of 60 were included in the study. Patients underwent open reduction with a deltopectoral incision and osteosynthesis with a LPHP. Patients are followed up for at least 1 year radiologically and clinically. After the first year, our patients were evaluated according to the Constant-Murley shoulder score (CMSS) and complications were followed up. Results: 31 patients with PHF who were operated on by us were included in our study (25 females, 6 males). The mean age is 71.22 (62-87). Our patients; According to the Neer classification, 1 has 1-part, 13 has 2-part, 12 has 3-part, 5 has 4- part and 3 has fracture-dislocations. Mean follow-up time: 13.9 (12-18) months. Average union time: 13.55 weeks (12-20). The mean CMSS was found to be 49.74 (23-98). There was no significant difference between the CMSS of patients aged above and below 70 years. No significant difference was found between the CMSS of Neer type 1,2 and type 3,4 patients. Conclusion: Since locked humeral plate application in patients with PCC over 60 years of age is prone to complications and poor functional results, we think that it would be appropriate to plan the surgeries accordingly by considering alternative treatment options for these patients.

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Objective: Cardiovascular diseases are the leading causes of death in our country and in the world. In our study, we aimed to show the approach of physicians at different academic stages in family medicine discipline to the treatment of dyslipidemia, which is one of the most important risk factors of cardiovascular diseases. Methods: Our study was conducted between 01.01.2019 - 01.03.2019 in 189 (73%) of 259 family physicians actively working in the city of Kadikoy and its district, with face-to-face interviews and online survey filling. Opinions of the physicians participating in the study about their dyslipidemia and statin treatment were obtained with a questionnaire consisting of 32 questions about the demographic data, diagnosis and follow-up of dyslipidemia patients, their knowledge and experience about statin treatment. Results: It was observed that resident family physicians followed more chronic diseases than both specialist and general practitioners. Specialist family physicians think that they have more information about the diagnosis and treatment of dyslipidemia than general practitioner family physicians and general practitioner family physicians. It has been observed that assistant and specialist family physicians follow drug efficacy, duration of treatment and side effects more than general practitioners. 29.8% (n=25) of practitioner family physicians, 50.8% of assistant family physicians (n=31) and 68.3% (n=28) of specialist family physicians stated that they follow the latest guidelines. It has been observed that specialist family physicians follow more guidelines than assistant family physicians and assistant family physicians follow general practitioners. Conclusion: The diagnosis, treatment and follow-up of dyslipidemia by family physicians according to current guidelines will reduce the accumulation in 2nd and 3rd level healthcare facilities. In our study, it was concluded that residents and specialist family physicians diagnosed and treated more dyslipidemia than general practitioners.