In this review, we aimed to inquire whether bladder cancer and BCG immunotherapy to be applied are effective on cancer stem cells, and discuss underlying mechanisms of frequent recurrences.

INTRODUCTION: The prevalence of diabetes mellitus is more common in the geriatric population older than 65 years. Nursing home inhabitants are mostly geriatric people with relatively low functional capability, high chronic disease prevalence and high complication ratios. The aim of this study is to detect prevalence of diabetes mellitus and risk status in state nursing homes in the province of Ankara
METHODS: All individuals in state nursing homes in Ankara were included in the study. Participants were given a questionnaire consisting of 21 questions related with socio-demographic characteristics, chronic diseases and drugs. Diabetes Risk Questionnaire (FİNRISK) was applied to participants who have not a diagnosis of Diabetes Mellitus. Fasting plasma glucose levels were measured. Fasting glucose level equals to 126mg/dl and above was accepted as diabetes mellitus. 75 g oral glucose tolerance test was performed to patients with impaired fasting glucose levels. Datas were analyzed with 95% confidence intervals using SPSS (Statistical Program for Social Sciences) version. Shapiro-Wilks test, median, quarters inter width – QIW, interquartile range - IQR, the Mann-Whitney U test and Spearman's rho correlation coefficient was used fort he evaluation of variables.
RESULTS: 852 people were included in the study. Diabetes Mellitus prevalence was found as 25.5% (n= 217). 12.8% of participants had impaired fasting glucose, 1.6% of them had impaired glucose tolerance. HbA1c values obtained from 62 individuals median was found 7.0 (QIW = 2.1). When the risk scores obtained from the individuals were grouped, it was seen that 31 (6.3%) of them had lower risk, 241 (49.7%) of them had slight risk and 125 (25.8%) of them had medium-risk. 78 (16.1%) of the individuals had high risk of developing diabetes, 10 (2.1%) of them had a very high risk of developing diabetes.
DISCUSSION AND CONCLUSION: The prevalence of diabetes is increasing with age. So it should be given enough attention and precautions should be taken. Health checks of elderly people should be done regularly by the employee working in nursing homes and health care workers should follow up and treat elderly patients by taking risk factors into account.

INTRODUCTION: Chronic renal failure (CRF) is an irreversible condition that has many otorhinolaryngological manifestations. We examined the effects of CRF and haemodialysis treatment on nasal mucociliary clearance (MCC) and aimed to explain the possible pathophysiological mechanisms.
METHODS: This study included 27 patients with end-stage CRF who were not undergoing haemodialysis (pre-dialysis group), 36 patients with CRF on haemodialysis (dialysis group), and 36 heathy individuals. MCC was measured using the saccharin clearance test (SCT) and the results were statistically compared among the three groups.
RESULTS: The mean SCT times in the control, pre-dialysis, and dialysis groups were 11.7 ± 5.7, 30.16 ± 11.66, and 27.33 ± 9.4 min, respectively. The results for both the pre-dialysis and dialysis groups were significantly higher than for the control group (both p < 0.001). There was no significant difference between the pre-dialysis and dialysis groups (p = 0.22).
DISCUSSION AND CONCLUSION: Both CRF and haemodialysis treatment cause severe prolongation of MCC time. Patients with CRF should be monitored closely for middle ear, sinonasal, and respiratory tract infections and informed about possible infection risks.

INTRODUCTION: Sexual dysfunction in women is defined as inability to reach or enjoy orgasm. Some studies have suggested that sexual health may be altered by delivery method. This study aimed to investigate whether delivery method affects sexual function in the postpartum period in a female population.
METHODS: In this prospective study we aimed to compare sexual functions at postpartum 6 to 24 months in primipara patients who gave birth by vaginal delivery (NVD) (n=40) or Caesarean section (CS) (n=40) at Şifa Hospital between 2012 and 2014. We used Female Sexual Function Index (FSFI) form as the sexual dysfunction assessment method. The groups were matched with regard to demographic characteristics, medical history, obstetric details, and body mass index values.
RESULTS: Apart from body mass index (BMI), the study groups showed no significant differences with regard to age, educational status, sexual activity frequency, the number of marital years, occupational status, and socioeconomic level. The two groups did not show any significant differences with respect to sexual desire, sexual stimulation, lubrication, pain, orgasm, and sexual achievement.
DISCUSSION AND CONCLUSION: Our study demonstrated that vaginal delivery did not adversely affect postnatal sexual function in women.

INTRODUCTION: The primary aim of this study was to determine the incidence of chronic postoperative pain after the types of breast surgery. The secondary aim was to examine the factors associated with chronic postoperative pain.
METHODS: The prospective study included 240 female patients. Data were collected on: visual analogue scale (VAS) pain scores in the Post Anesthesia Care Unit (PACU) at 1st month and at 3rd-6th months postoperative; and age, BMI, preoperative pain, radiotherapy, chemotherapy, postoperative acute pain, length of hospital stay were the measures taken into account.
RESULTS: Chronic postoperative pain was experienced by 39,2% of patients at 3rd month and 18.3% of patients at 6th month. Chronic pain was detected in 41.8% of patients who had severe acute postoperative pain. BMI, age, preoperative and severe acute postoperative pain, the type of surgery, the length of hospital stay, development of complications, chemotherapy and radiotherapy treatment have been shown to be the risk factors in chronic postoperative pain after breast surgery. The incidence of postmastectomy pain syndrome (PMPS) was 29.5% in mastectomy cases, and 64% in those having mastectomy and axillary dissection.
DISCUSSION AND CONCLUSION: As they are considered a complication of surgery according to some authors, chronic postoperative pain and post mastectomy pain syndrome are commonly discussed and studied clinical problems in recent years. More comprehensive studies about its etiology, risk factors and pathogenesis to prevent or treat the chronic postoperative pain and post mastectomy pain syndrome are warranted as it both reduces life comfort and causes workforce loss following surgery.

INTRODUCTION: to compare the pregnancy results in adolescent age group with pregnancy results of the pregnant women in reproductive age.
METHODS: In 2010 and 2015, among patients who applied to Erzincan University Faculty of Medicine, Mengücek Gazi Education and Research Hospital, results regarding 222 pregnant adoles¬cents between ages of 14-19 and the 97 pregnant women bet¬ween ages of 19-34 were retrospectively evaluated.
RESULTS: Average age of adolescent pregnant women were found to be 17,3±0,9 years (14-19 year-olds), whereas average age of the pregnant women at reproductive phase were deter¬mined as 26,6±3,9 years (19-34 year-olds). In adolescent group, 4.5 % smoking cases were revealed, whereas the number was 24.74 % for reproductive age group. Regular prenatal care rate of adolescent pregnancy was detected in 73.4%, it was found to be 79.38% in the 20-34 age group. The rate of preterm birth was observed to be significantly higher in the adolescent group; besides the rate of cesarean delivery was higher in between the ages of 20-34 control group. There was no difference between the groups in terms of perinatal parameters.
DISCUSSION AND CONCLUSION: Our study does not demonstrate any increase in perinatal problems with adolescent pregnant women compared to reproductive age group; nevertheless, more extensive studi¬es are needed in order to reduce the number of such pregnan¬cies and minimise perinatal complications.

INTRODUCTION: Urinary tract infection is a common infectional disease in children and it is still located in the first row to causing chronic kidney disease in our country. The inflammatory cytokine interleukin interleukin-8 play an important role in response to bacterial infection. The aim of this study was to evaluate the effects of urine interleukin-8 level on diagnosis and localization of urinary tract infection.
METHODS: A total of 82 children aged 1 month to 15 years old with urinary tract infection and 49 healty children were included. The patients were divided into the acute pyelonephritis group (n = 39) and cystitis group (n = 43) according to the Jodal’s UTI criteria. Fever; C-reactive protein; white blood cells count; erythrocyte sedimentation rate and interleukin-8 were evaluated.
RESULTS: There was a significant difference between two study groups related with fever, C-reactive protein and erythrocyte sedimentation rate levels (p < 0.05). Significantly, higher initial urine interleukin-8 level were found in children with acute pyelonephritis (median 499 pg/ml) than in those with cystitis (252.1 pg/ml) (p < 0.001). And also, urine interleukin-8 in children were positively correlated with urine leucocyte counts (r=0.5, p<0.005).
DISCUSSION AND CONCLUSION: hese results indicate that urine interleukin-8 level is a useful diagnostic marker for early recognition of acute pyelonephritis in febrile children.

INTRODUCTION: Determine the characteristics of patients with ısolated Acinetobacter baumannii in respiratory samples in State Hospital intensive care unit between April 2009 - December 2012
METHODS: We retrospectively evaluated patients with ısolated Acinetobacter baumannii in respiratory samples in State Hospital intensive care unit between April 2009 - December 2012
RESULTS: During this period, Acinetobacter baumannii isolated in 38 patients of respiratory samples(female = 16, male n = 22). The average age of patients was 68,6 ± 18,1, mean duration of hospitalisation was 25,4 ± 18,3, mean isolation time of Acinetobacter baumannii was 13,4 ± 9,4 day 29 cases (76.3%) were established exitus. Evaluation of the underlying disease most common cause of hypertension, stroke, heart failure, diabetes and COPD established respectively. Prior antibiotic use, urinary catheter, mechanical ventilation, nasogastric tube, total parenteral nutrition, central venous catheter were observed. as the most common cause of a risk factor APACHE 2 score of the patients acceptance to the the intensive care unit was 23.3 ± 5.7. The susceptibility to antibiotics for colistin polymyxin, tobramycin, gentamicin, imipenem, ciprofloxacin, was determined.on culture antibiogram.
DISCUSSION AND CONCLUSION: As a result, intensive care unit mortality rate is high due to Acinetobacter baumannii

INTRODUCTION: Effects of upper airway obstruction findings on obstructive sleep apnea syndrome (OSAS) are well known. The nose forms a big part of upper airway resistance and its effects on OSAS is controversial. This study aimed to investigate the effects of obstructive nasal examination findings on OSAS.
METHODS: One hundred and nine patients presented to our hospital with complaints of sleep disorders, had night polysomnography performed and diagnosed with OSAS. Detailed ENT examination of each patient was performed and obstructive inferior turbinate hypertrophy, obstructive nasal septal deviation and internal nasal valve stenosis was identified. In addition to this Mallampati score, tonsillar size (Brodsky scale), body mass index (BMI), neck and waist measurements were recorded. OSA patients with and without nasal obstruction were compared.
RESULTS: Patients with nasal obstruction (n: 61) and those without nasal obstruction (n = 48) were compared. Apnea-hypopnea index (AHI), the lowest O2 saturation, oxygen desaturation index (ODI) and Epwort sleepiness scales showed no significant difference between these two groups. (Mann Whitney U test, P> 0.05). Furthermore there was no correlation between age, Mallampati scores and AHI (p> 0.05) but Brodski scale, BMI, waist and neck measurements were found to be correlated with AHI (p <0.05).
DISCUSSION AND CONCLUSION: The presence of nasal obstruction as assessed by objective polysomnographic findings showed no significant effect on patients with OSAS.

INTRODUCTION: Several biomarkers are used to detect infections, evaluate prognosis and assess treatment response. In this study we evaluated biomarkers commonly used in the diagnosis and prognosis of bacterial infections among geriatric patients in palliative care.
METHODS: This descriptive, cross-sectional study included inpatients treated in the palliative care unit of our hospital for a period of more than two days between November 2015 and February 2016.
RESULTS: A total of 63 palliative care patients with a mean age of 80 years were included; 55.6% of the patients were male. Eighty-one percent of the patients developed an infection and were treated with an antibiotic. Biomarkers measured on the first day of hospitalization were evaluated in two groups, patients with and without infections. ROC analysis revealed the diagnostic powers of C-reactive protein (CRP) and albumin were 76.2% and 73.9%, respectively (p<0.05). The diagnostic power of the CRP/albumin ratio was 81.3% (p<0.001). In ROC analysis to predict prognosis in patients with infection, CRP had a predictive power of 83.9% and albumin of 78.0% (p<0.05). With a cut-off value of 8.23 mg/dl, CRP showed 75.8% specificity and 88.9% sensitivity in detecting infection; for albumin, these values were 44.4% and 93.9% with a cut-off value of 2.27 mg/dl. The CRP/albumin ratio had a prognostic predictive power of 84.3% (p<0.001) and showed 72.4% specificity and 94.4% sensitivity in detecting infection at a cut-off value of 2.89.
DISCUSSION AND CONCLUSION: CRP and albumin are indicators of inflammation and nutritional status, and we believe their evaluation within 24 hours of hospitalization is beneficial in determining prognosis.

Hydatid cyst disease, which is caused by Echinococcus granulosus and Echinococcus multilocularis, is a frequent zoonotic enfestation worldwide. The most often affected organs are liver (%65) and lungs (%25) in human beings. Thyroid gland involvement is very rare even in regions where the disease is endemic. In this study, two rare cases, at the ages of 70 and 15, who were admitted to the hospital with swelling in the neck and diagnosed as thyroid cyst hydatid was presented.

Mastitis and breast abscess are very rare infectious conditions in the neonatal period. Although the etiology has not been clarified yet, breast massages applied to the newborns that have physiologic breast hypertrophy disrupt dermal integrity, facilitate dissemination of microorganisms and lead to manifestations of neonatal mastitis. Herein, a newborn case with the diagnosis of neonatal mastitis after breast massage was presented to attract attention to the development of neonatal mastitis with serious complications, if early diagnosis and therapy cannot be accomplished.

Introduction: Penetrating injuries to the vertebral column and the spinal cord are rare. Cauda equina injury due to glass breakage is even rarer than expected.
Case Presentation: In this study, a case of spinal column injury was reported in a 25-year-old female patient with stabbed glass in to her back, after falling back to the top on table made of glass. A piece of stabbed glass was removed and the wound was sutured at another hospital before she presented to our ED. At the time of presentation, the patient had 2 of 5 muscle strength on her right leg and hypoesthesia below the L4 level. After emergency surgical intervention, the sensory deficit and the muscle strength has completely improved, and patient was discharged after 6 days.
Conclusions: In penetrating trauma to the lumbar region, emergency physician must take into account possible spinal column injury.

Extracranial carotid artery aneurysms, although seen rarely, must be paid attention as it may cause potential fatal complications such as thromboemboli and rupturation. 44 year-old female admitted to our clinic with a progressive bulging mass since 5 years on left side of her neck. No neurologic symptom like stroke, transient ischemic attack or cranial nerve dysfunction was detected. Initial investigation with duplex ultrasound demonstrated saccular aneurysm of the internal carotid artery on the left. On MRI a 16x25 mm sacculer aneurysm was revealed on 3cm distal part of common carotid bifurcation. Internal carotid artery was anastomosed with end-to-end technique following resection of aneurismatic segment.