GİRİŞ ve AMAÇ: Çocukluk çağı solid tümörlerinin akciğer metastazlarında, kliniğimizin cerrahi yaklaşım sonuçlarının değerlendirilmesidir.
YÖNTEM ve GEREÇLER: Akciğer metastazı nedeniyle 1978-2016 arasında başvuran ve cerrahi girişim yapılan olgular geriye
dönük olarak incelendi. Primer tümörü kontrol altına alınan, başka uzak organ metastazı olmayan ve akciğer metastazı için
cerrahi tedavi uygulanan olgular çalışmaya dahil edildi. Yaş, cinsiyet, primer tanı, akciğer metastazının ortaya çıkış zamanı, cerrahi tedavi yöntemi, patolojik tanı ve takip açısından değerlendirme yapıldı.
BULGULAR: Kliniğimizde 38 yıllık sürede akciğer metaztazı tanısı alan onsekiz olgunun (K/E: 11/7) yaş ortalaması 8,1 yıl (1,5-14
yaş) idi. Primer tümörler; Wilms tümörü (n: 9, %50), Ewing sarkomu (n: 3, %17), osteosarkom (n: 2, %11), hepatoblastom (n: 1, %5,5), fibrosarkom (n: 1, %5,5), rabdomyosarkom (n: 1, %5,5) ve endodermal sinüs tümörü (n: 1,%5,5) idi. Olguların 4’ünde
(%22), ilk başvuru anında akciğer metastazı mevcuttu. Onaltısında (%89), metastazın ortaya çıkış zamanı ortalama 16,5 ay (7
ay-4 yıl) idi. Radyolojik değerlendirme tüm olgularda preoperatif dönemde akciğer grafisi ve bilgisayarlı tomografi (BT) ile yapıldı. Onsekiz olguya toplam 23 torakotomi yapıldı. Yirmibir wedge rezeksiyon, 1 lobektomi, 1 lobektomi ve kot rezeksiyonu uygulandı. Patolojik incelemede çıkarılan lezyonların 3’ü (%16,5) inflamatuar reaksiyon olarak değerlendirildi. Toraks dreni alınma süresi
ortalama 5,2 gün (3-8), hastanede kalış süresi 7,3 gün (5-10 gün) idi. Cerrahi girişime bağlı komplikasyon görülmedi. Ortalama 3,7 yıllık (1-7 yıl) takip süresinde 6 olgu ilerleyici primer hastalık nedeniyle kaybedildi.
TARTIŞMA ve SONUÇ: Çocukluk çağı tümörlerinde akciğer metastazları başvuru sırasında ve/veya takipte görülebilir. Cerrahi tedavisinde sınırlı rezeksiyon yeterli görünmektedir. Torakotomi bu olgularda tüm lezyonların değerlendirilmesini sağlamaktadır ve güvenle uygulanmaktadır. Radyolojik incelemeler tümör metastazını desteklese de kesin tanı patolojik inceleme ile konulmaktadır.

INTRODUCTION: To evaluate our surgical approach to lung metastasis of childhood tumors.
METHODS: Cases with solid tumor lung metastasis that underwent surgical intervention between years 1978-2016were investigated retrospectively. Patients were evaluated regardingage, gender, primary diagnosis, time of lung metastasisoccurence, surgical treatment method, pathological diagnosisand follow-up.
RESULTS: Of the 18 cases which were operated due to lung metastasis11 were female, 7 were male. Median age was 8,1 years
(range 1,5-14 years). The most common pulmonary metastasis were related to Wilms’ tumor (n: 9). Lung metastasis were present
at the initial diagnosis in 4 patients. In the remaining 14 patients, the average time of occurence of metastasis was 16,5
months (range 7mo-4yr). In all cases the CT imaging demonstrated findings compatible with lung metastasis. Twenty-three
thoracotomies were performed in eighteen cases. Surgical procedures were; wedge resection in 21, lobectomy in 1 and
lobectomy with costal bone resection in another. Pathological diagnosis was negative for tumor metastasis in 3 patients who
had CT imaging indicative of the disease. Average time of chest tube removal was 5,2 days (range 3-8 ) while average length of
hospital stay was 7,3 days (range 5-10 days). During follow-up, 6 cases died due to progressive primary disease.
DISCUSSION AND CONCLUSION: In patients with childhood tumors, lung metastasis can be encountered at initial diagnosis and/or during
follow-up. From the surgical point of view, limited resection is considered to be adequate. Although radiological imaging supports tumor metastasis, definitive diagnosis should be made via pathological evaluation.

INTRODUCTION: This study was descriptively designed to detect the common physical complaints of the woman experienced during pregnancy.
METHODS: The study was carried out between April 2014 and December 2014 in State Research Hospital pregnancy policlinic in İstanbul. The universe of the study consists of all the pregnant women applying to State Researh Hospital pregnancy policlinic and the sampling group consists of 330 pregnant women randomly chosen from the universe of the study. In order to collect data in the study, a questionnaire developed by the researcher in line with the literature was used. The data were collected by means of face to face interview technique. In the analysis of the data, pearson Chi-square, mean, standart deviation, values and percent were used.
RESULTS: The means age of women who attend to research 27.90 ± 5.36 years, weeks of pregnancy 30.32 ± 8.45 weeks, undergraduate
and master degree education level (29.1%), the first pregnany (55%) and planned pregnancy (89.1%) was determined.
While heartburn (30.9%), backache (41.5%), weakness and fatigue (30.9%), frequent urining (62.4%), leucorrhoea (37.3%), and pyrosis (28.5%) were the most frequent complaints, hot flush (27.9%), increased appetite (28.8%) and leg cramps (31.2%) were sometimes experienced by pregnant women. It has been found that the rate of never experiencing of complaints such as hemorrhoids (76.7%), appetite reduction (50.6%) and vomiting (60.6%) was very high among pregnant.
DISCUSSION AND CONCLUSION: It is recommended that health workers, especially nurses and midwiferies, should inform of the pregnant women about the common complaints during the antenatal checkups, teach them complaints which experienced by the pregnat are part of the normal process of pregnancy, and coping strategy.

INTRODUCTION: Interest in the relationship between asthma and vitamin D has been increasing in recent years. Studies have shown that there is a relationship between vitamin D deficiency and asthma. Interest in research on vitamin D supplementation in asthmatic patients has been increasing in recent years. In this study, the effect of vitamin D supplementation on asthma was investigated in addition to the treatment they were receiving asthmatic patients.
METHODS: Forty patients were included in the study. The patients were randomly divided into two groups. In the first group, the patient was given steroids and the other group was inhaled steroids and D vitamins. The effects of these two treatments were compared with clinical and laboratory methods.
RESULTS: There was no difference in FEV1 change, ACQ, ACT, and exacerbation numbers between before and after treatment between the two groups. Compared with the placebo group, salbutamol response was higher after treatment with vitamin D (p = 0.042).
DISCUSSION AND CONCLUSION: As a result of our study, the use of vitamin D; We think that the response to treatment in asthma affects the positive direction. In patients with high blood vitamin D levels, salbutamol response is higher than in those with low blood vitamin D levels. These results suggest that the addition of vitamin D in addition to asthma therapy may provide positive contributions to the success of treatment. However, more extensive studies are needed in this regard.

INTRODUCTION: Different approaches have been proposed for the diagnosis and treatment of empyema secondary due to pulmonary infections. The aim of this study was to present our experience of diagnostic and therapeutic procedures in children with empyema.
METHODS: Clinical data of children with empyema that were treated with chest drainage in a public hospital pediatric surgery clinic between 1993 and 2016 were reviewed retrospectively. Patients were evaluated in terms of intercostal chest tube drainage with physical examination, erect anteroposterior and/or lateral decubitus chest radiograph, serum laboratory tests, diagnostic thoracentesis and pleural fluid studies.
RESULTS: In a total of 70 patients; 39 males and 31 females with a mean age of 6.9 years (5 days-17 years) were treated. 55 (78.5%) patients were monitored with chest ultrasonography (US). Most common isolated bacteria were Staphylococcus aureus and Streptococcus pneumoniae. 8 patients underwent re-intubation due to the loculation of fluid or technical reasons. A total of 81 chest tubes were inserted in 70 patients. The tubes were removed within 3-41 days (mean 11 days). 21 patients had varying degrees of pleural thickening, pneumothorax developed due to pneumatoceles in 6 patients. Because of the risks and limited facilities, fibrinolytic agents and decortication were not applied. Families were informed about it. Pleural thickenings decreased mostly following the clinical improvement in 10-90 days (mean 20 days) and lungs re-expanded completely.
DISCUSSION AND CONCLUSION: X-ray, laboratory tests and US were sufficient for the diagnosis and follow-up of postpneumonic empyema. Treatment was successfully done by combining systemic antibiotics, closed intercostal chest tube drainage and chest physiotherapy. Although there is a long recovery time, this essential treatment should be considered as a primary choice.

INTRODUCTION: To determine the prevalence and impact of premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD) in Turkish employee women, with a focus on their disruption of work performance.
METHODS: In this cross-sectional study, Premenstrual Symptoms Questionnaire (PSQ) results of the 232 working women who applied to Acıbadem Kozyatagı Hospital Gynecology Clinic between 2013-2015 with the diagnosis of PMS/ PMDD were analyzed.
RESULTS: The prevalence of each premenstrual symptom was high. The prevalence of moderate to severe PMS and PMDD was 8.6% and 2.9%, respectively. The 44.3% of working women was found to suffer from reduced work performance. ‘Working as a director’ (OR8.63,95%CI: 1.22-120.0), ‘difficulty concentrating’ (OR3.15,95%CI: 1.05-10.6), and ‘fatigue or lack of energy’(OR5.92,95%CI: 1.32-34.5) increased the risk of poor work performance.
DISCUSSION AND CONCLUSION: This study showed that premenstrual symptoms affect not only the daily activities but also the work performance of employee women.

INTRODUCTION: The relative prevalence of placental attachment abnormalities (PAA) has been increased lately. They may cause severe complications in respect to their types, and determining presence and the type of the invasion before delivery is important for the obstetrician.
The objective of this prospective, cross – sectional and descriptive study was to investigate PAA preoperatively using gray scale and Doppler ultrasonography (USG) in patients who had a Caesarian section (C/S) at least once before and scheduled for C/S again, and to compare the results with histopathological diagnosis.
METHODS: A total of 104 pregnant women who admitted to Yıldırım Beyazıt University Medical Faculty, Atatürk Education and Research Hospital Obstetrics and Gynecology Department between January and July 2013, and scheduled for C/S were included in the
study. All of the included patients had had C/S before, at least once. Gray scale and Doppler USG was performed in all patients to determine PAA, and the findings were compared with the histopathologic results of placental bed biopsy obtained during C/S.
RESULTS: The indications for C/S were previous C/S once in 74%, previous C/S twice in 25.5%, and previous C/S more than twice in 1% of the patients. None of the patients had any suspicion for PAA intraoperatively, postoperative complications, or PAA in the histopathological
diagnosis. There were no findings on Doppler USG in 77.9% of the patients, 20.2% of them had increased vascularity alone, 1.0% had increased vascularity and lacunar flow, and 1.0% had lacunar flow alone in the subplasental region. There were no findings on gray scale USG in 90.4% of the patients. There were placental lacunae and obliteration of the retroplacental clear zone in 2.0% of the patients, and the thinnest myometrial wall was <1 mm in the placental region in 7.6% of them.
DISCUSSION AND CONCLUSION: Absence of PAA in our series may be due to factors such as our surgical technique, and individual wound healing processes. The mechanisms causing abnormal placentation are not still clear.

INTRODUCTION: This research aims to reveal the influence of sleep hygiene interventions on premenstrual syndrome.
METHODS: In the study was used a pre-test post-test non-randomized, control group desing. This study, which was included a total of 88 (intervention group n=47; control group n=41) women with PMS. The intervention group participants were used sleep hygiene
intervention. In the first step, the participants in the intervention group received sleep hygiene education. In the second step, the participants of the intervention group used the sleep hygiene intervention for two menstrual cycles. Data were obtained by using premenstrual syndrome scale (PMS scale) and Pittsburgh Sleep Quality Index (PSQI) in pre-intervention and post-intervention (1th
menstruation and 2nd menstruation period).
RESULTS: The results obtained from the study showed that there was no significant difference between two groups, both the 1st menstruation and 2nd menstruation PSQI scores (p>0.05) and PMS scale score (p>0.05). Nevertheless, when the differences in the 1th menstruation and
2nd menstruation PMS scale scores of the two groups were compared, a statistically significant improvement was detected (p<0.001).
DISCUSSION AND CONCLUSION: Sleep hygiene intervention may be useful to reduce premenstrual symptoms in women.

Gastrointestinal Stromal Tumors (GISTs) are mesenchymal tumors that are arises from the wall of the gastrointestinal tract and is throught to originate from the Interstitial Cells of Cajal (ICC), which regulate the motility of the gastrointestinal tract. More rarely neoplasms with histology and immunohistochemistry similar to gastrointestinal stromal tumors may ocur outside the gastrointestinal tract and are
so-called Extra-gastrointestinal Stromal Tumors (EGISTs). Surgical removal is the gold standard treatment for non-metastatic Extragastrointestinal stromal tumors. We reported a very rare case of ekstragastrointestinal stromal tumor arising from the vulva in this article.

Datura stramonium, also known as pipe flower or angel’s trumpet, is a toxic plant member of the belladonna family containing
several alkaloids. All parts of Datura plants contain tropane alkaloids at dangerous levels, such as atropine, hyaline and scopolamine,
classified as deliriums or anticholinergics. High amounts of datura stramonium ingestion may result in painful photophobia, which
can lead to poisoning, usually lasting several days, resulting in delirium (as opposed to hallucinations), hyperthermia, tachycardia,
strange behavior and severe mydriasis. The onset of symptoms is usually about 30 to 60 minutes after taking the plant. These symptoms
usually end between 24 and 48 hours, but have been reported to last up to two weeks in some cases. In this article, we report the poisoning of 6 to 8 year old siblings with datura stramonium, who were brought to the emergency service with dry mouth, euphoric symptoms, visual hallucinations and disorientation.

A 19-year-old female presented with abdominal pain, nausea and vomiting. Diagnostic procedures with abdominal
computed-tomography and pelvic ultrasonography suggested 110x58mm and 74x64x38 mm left-adnexial cysts, respectively.
Due to inconclusive radiologic diagnosis and suspicious physical abdominal examination, an emergency diagnostic laparotomy
was performed. Exploratory surgery revealed a necrosed and torsioned left paratubal cyst and torsioned but intact fallopian tube were
found. Early surgical intervention with paratubal cyst excision and detorsion of fallopian tube ensured the preservation of fallopian tubes.

Placenta percreta is a life-threatening obstetric emergency characterized by the abnormal invasion of chorionic villi into the uterine wall. Although various conservative treatment modalities have been described, hysterectomy is still a common option as life
saving procedure. In this case, surrounding resection technique with hypogastric artery ligation is described as an option in
selected cases who desire fertility. In selected cases with focal placenta percreta surrounding resection technique can be used by an experienced surgical team.

Puerperium or the postpartum period includes the period of psychological and physical changes in pregnancy and the childbirth process. This process begins immediately after the birth of the placenta and membranes, until the mother’s body returns to its condition prior to the pregnancy, or until around 6-8 weeks (42 days). Until the end of this period, the mother and the family should act in accordance with the requirements of the nursing care process, which is very important for the healthy management of the postpartum condition. The purpose of
end-natal care, monitoring closely the consideration of factors that impact on the health of new mothers who have been postpartum,
breastfeeding and parenting skills trainers and assuming the role of supporter is to protect both mother and baby’s health. This care involves wide areas like community and social care as well as special areas such as newborn care. In this context postpartum nursing care practices constitute an important part of the care given by the women’s health nurses.

Parasitic infections influence ten of millions of pregnant worldwide. While the rate varies according to the regions in our country they are reported to be around 20%. In recent years in our country, this rate is increasing by the migrants who escaped from the chaos in the Middle
East countries. Parasitic infections show their effect at maternal, fetal and placental levels. Ancylostoma duodenale, Necator americanus, Ascaris lumbricoides, Echinoccoccus granulosus cause maternal infection, while Schistosoma mansoni, Schistosoma haematobium, Schistosoma japanicum, Plasmodium falciparum, Plasmodium vivax prefer to infect placenta and Leishmania chagasi, Leishmania donovani, Trypanosoma gambiense, Trypanosoma rhodesiense, Trypanosoma cruzi, Wuchereria bancrofti infect the fetus. The diagnostic methods are serologic testing, polymerase chain reaction and microscopic examination of parasites in the stool, urine, blood or tissues
depending on the species. Some antihelmintic drugs can pass into breast milk. In addition to antihelmintic drugs oral iron supplements therapy or surgery may be required. Specific methods of insect body protector to prevent parasitic infections, you grant to pay attention to hygiene and water, chemoprophylaxis is used. To prevent parasitic infections, specific body insect protectors, hygienic food and water and chemoprophylaxis can be utilized. Possible poor pregnancy outcomes can be avoided with the early diagnosis and appropriate treatment of parasitic diseases.