2ö$=ødø 7,3 `(5*ø6ø - İstanbul Anadolu Kuzey Kamu Hastaneleri
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Infertility is obserYHGLQRIFRXSOHVRIUHSURGXFWLYHDJH 7KH IUHTXHQF\ DQG FDXVHV RI LQIHUWLOLW\ YDULHV IURP RQH VRFLHW\ WR DQRWKHU$PRQJ FRXSOHV PHQ DUH UHVSRQVLEOH IRU LQIHUWLOLW\ LQ RIWKHFDVHVZKLOHZRPHQDUHUHVSRQVLEOHIRU WKHLQIHUWLOLW\LQRIWKHFDVH7KHUHIRUHWKHUHLVDPDOHIDFWRULQYROYHGLQQHDUO\ KDOI RI DOO FRXSOHV ZLWK LQIHUWLOLW\ ,Q FDVHV ZKHUHWKHLQIHUWLOLW\LVDVVRFLDWHGZLWKDPDOH SUREOHPWKHSUREOHPRIWHQVWHPVIURPDQLPSDLUPHQW RI VSHUP SDUDPHWHUV $OWKRXJK WKH underlying cause of male infertility is known LQQHDUO\RIFDVHVWKHUHDUHVWLOOPDQ\ FDVHVLQZKLFKWKHFDXVDWLYHIDFWRUVFDQQRWEH LGHQWL¿HG7KHDLPRIWKHFXUUHQWVWXG\ZDVWR UHWURVSHFWLYHO\DQDO\]HWKHGDWDRISDWLHQWVZKR KDGVSHUPLRJUDPVSHUIRUPHGIRUSULPDU\DQG VHFRQGDU\LQIHUWLOLW\DQGWRHYDOXDWHWKHVHUHVXOWVLQOLJKWRIWKHGDWDIURPWKHOLWHUDWXU 67$7,67,&$/$1$/<6,6 7KH6366SDFNDJHSURJUDPZDVXVHG IRUWKHVWDWLVWLFDODQDO\VLVRIWKHGDWD&DWHJRULcal measurements were summarized as number DQG SHUFHQWDJHV ZKLOH TXDQWLWDWLYH PHDVXUHments were summarized as mean and standard GHYLDWLRQV,QFDVHWKHDVVXPSWLRQVZHUHVDWLV¿HGGXULQJWKHFRPSDULVRQRITXDQWLWDWLYHPHDVXUHPHQWV EHWZHHQ JURXSV WKH LQGHSHQGHQW JURXSWWHVWZDVXVHGLQFDVHWKHDVVXPSWLRQV ZHUHQRWVDWLV¿HGWKH0DQQ:KLWQH\WHVWZDV XVHGLQVWHDG,QDOOWHVWVWKHOHYHORIVWDWLVWLFDO VLJQL¿FDQFHZDVDFFHSWHGDV 5(68/76 $OORIWKHSDWLHQWVZHUHPDUULHG7KHPHDQ DJH RI WKH SDWLHQWV ZDV GHWHUPLQHG DV \HDUV7KH QXPEHU RI SULPDU\ LQIHUWLOLW\ FDVHV LQFOXGHG LQ WKH VWXG\ ZDV ZKLOH WKH QXPEHU RI VHFRQGDU\ LQIHUWLOLW\ FDVHVLQFOXGHGLQWRWKHVWXG\ZDV7KH DYHUDJHSHULRGRIVH[XDODEVWLQHQFHIRUWKHSDWLHQWVLQFOXGHGLQWRWKHVWXG\ZDVGD\V ZKLOH WKHLU PHDQ VSHUP YDOXH ZDV POPHDQVSHUPFRQFHQWUDWLRQZDV PO DQG7306& ZDV ; $Q HYDOXDWLRQ RI WKH SDWLHQWV¶ PRUSKRORJLFDO DQRPDOLHVUHYHDOHGWKDWKDGKHDG DQRPDOLHV KDG QHFN DQRPDOLHV DQGKDGWDLODQRPDOLHV(YDOXDWLRQ of primary and secondary infertility in cases diDJQRVHGZLWKYDULFRFHOHUHYHDOHGWKDWSULPDU\ LQIHUWLOLW\ZDVSUHVHQWLQRIWKHVH FDVHVZKLOHVHFRQGDU\LQIHUWLOLW\ZDVSUHVHQWLQ RIWKHVHFDVHV%DVHGRQWKHFRPSDrison of infertility among patients included in WKHVWXG\DIXUWKHUFRPSDULVRQEHWZHHQFDVHV of primary and secondary infertility is provided in 7DEOH%DVHGRQWKHFRPSDULVRQWKDWZDV SHUIRUPHG DFFRUGLQJ WR WKH W\SH RI LQIHUWLOLW\ VWDWLVWLFDOO\VLJQL¿FDQWGLIIHUHQFHVZHUHLGHQWL¿HGZLWKUHJDUGVWRDJH\HDUVVSHUPFRQFHQWUDWLRQ PO WRWDO PRWLOLW\ $%& PRWLOLW\$PRWLOLW\%PRWLOLW\& PRWLOLW\'WKH7306&DQGPRUSKRORJ\QRUPDOYDOXHV7KHFKDUDFWHULVWLFV RIYDULFRFHOHSDWLHQWVZLWKSULPDU\DQGVHFRQGDU\LQIHUWLOLW\DUHVKRZQLQ7DEOH%DVHGRQ WKH FRPSDULVRQV WKDW ZHUH SHUIRUPHG QR VWD- 0$7(5,$/6$1'0(7+2'6 )ROORZLQJWKHDSSURYDORIWKHHWKLFVFRPPLWWHH WKLV VWXG\ ZDV FRQGXFWHG E\ UHWURVSHFWLYHO\ DQDO\]LQJ WKH GDWD RI SDWLHQWV ZKR KDGVSHUPLRJUDPVSHUIRUPHGIRUSULPDU\DQG VHFRQGDU\ LQIHUWLOLW\ DW RXU KRVSLWDO¶V DQGURlogy laboratory between November 2008 and 'HFHPEHU$WWRWDORIPDOHSDWLHQWV ZKRVH VSHUPLRJUDPV ZHUH UHTXHVWHG IRU WKH assessment of male fertility were included in WKH VWXG\ 7KHVH DVVHVVPHQWV ZHUH UHTXHVWHG ZLWKLQWKHFRQWH[WRIHYDOXDWLRQVSHUIRUPHGRQ LQIHUWLOHFRXSOHVDGPLWWHGWRWKHREVWHWULFVDQG gynecology polyclinic. 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A total of 500 sperm were FRXQWHGLQHDFKVHPHQVDPSOH7KHPRWLOLW\RI HDFKVSHUPZDVVFRUHGDFFRUGLQJWRIRXUFDWHJRULHVZKLFKZHUHUDSLGIRUZDUGPRWLOLW\D VORZIRUZDUGPRWLOLW\EQRQSURJUHVVLYHPRWLOLW\FDQGLPPRWLOHG6SHUPWKDWPRYHG RXWVLGHRIWKHPLFURVFRSHDUHDE\OLQHDUPRWLlity were considered as displaying forward moWLOLW\7KHWRWDOSHUFHQWDJHRIVSHUPZLWKOLQHDU PRWLOLW\ZLWKQRQOLQHDUPRWLOLW\DQGZLWKQRQ SURJUHVVLYHPRWLOLW\ZDVFRQVLGHUHGDVWKHWRWDOPRWLOLW\6SHUPVDPSOHVZLWKRUPRUH -6- CiLT:1 SAYI:1 YIL:2014 %2ö$=ødø7,3'(5*ø6ø WLVWLFDOO\ VLJQL¿FDQW GLIIHUHQFHV ZHUH LGHQWL¿HGZLWKUHJDUGVWRWKHSDUDPHWHUVRQWKLVWDEOH 3! 7DEOH provides a general evaluation of paWLHQWVGLDJQRVHGZLWKYDULFRFHOH%DVHGRQWKH FRPSDULVRQ SHUIRUPHG EHWZHHQ SDWLHQWV ZLWK DQGZLWKRXWYDULFRFHOHVWDWLVWLFDOO\VLJQL¿FDQW GLIIHUHQFHVZHUHLGHQWL¿HGZLWKUHJDUGVWRDJH \HDUV VSHUP FRQFHQWUDWLRQ PO WRWDO PRWLOLW\$%&PRWLOLW\$PRWLOLW\ %PRWLOLW\'WKH7306&DQG WKHPRUSKRORJ\QRUPDOKHDGDQG QHFNYDOXHV3IJKGIJ 7DEOH&RPSDULVRQDFFRUGLQJWRLQIHUWLOLW\W\SH 3ULPDU\ ,QIHUWLOLW\ Q 6HFRQGDU\LQIHUWLO\ Q 3 $JH\HDUV 9ROXPHPO 6SHUPFRQFHQWUDWLRQPO 0RWLOLW\7RWDO $%& 7DEOH&RPSDULVRQRISDWLHQWVZLWKRUZLWKRXWYDULFRFHOH 3DWLHQWV ZLWK YDULFRFHOH Q 3DWLHQWV ZLWKRXW YDULFRFHOH Q 3 $JH<HDUV 0RUSKRORJ\ QRUPDO 9ROXPHFF 0RWLOLW\$ 0RWLOLW\% 0RWLOLW\& 0RWLOLW\' 7RWDO3URJUHVVLYH 0RWLOH6SHUP &RXQW 6SHUPFRQFHQWUDWLRQPO 0RUSKRORJ\ QRUPDO 0RWLOLW\7RWDO $%& +HDG$QRPDO\ 0RWLOLW\$ 0RWLOLW\% 1HFN$QRPDO\ 0RWLOLW\& 0RWLOLW\' 7RWDOSURJUHVVLYHPRWLOHVSHUP FRXQW 7DLO$QRPDO\ 7DEOH&RPSDULVRQRIYDULFRFHOHVWDWXVDFFRUGLQJWR LQIHUWLOLW\ 3ULPDU\ LQIHUWLOLW\ Q 6HFRQGDU\LQIHU WLOLW\Q 3 +HDGDQRPDO\ $JH\HDUV 1HFNDQRPDO\ 0RUSKRORJ\ QRUPDO 7DLODQRPDO\ 9ROXPHFF ',6&866,21 6SHUPFRQFHQWUDWLRQ PO 0RWLOLW\7RWDO $%& 0RWLOLW\$ 0RWLOLW\% 0RWLOLW\& 0RWLOLW\' 7RWDO3UJUHVVLYH0RWLOH 6SHUP&RXQW +HDG$QRPDO\ 1HFN$QRPDO\ 7DLO$QRPDO\ ,QIHUWLOLW\ LV GH¿QHG DV WKH LQDELOLW\ RI FRXSOHVWRFRQFHLYHGHVSLWHUHJXODUVH[XDOLQWHUFRXUVHWZRGD\VDZHHNZLWKRXWSURWHFWLRQ for a period of one year. 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In a meta-analysis performed RQ SDWLHQWV IURP FHQWHUV DFURVV FRXQWULHV LQFUHDVHG DJH ZDV LGHQWL¿HG DV D risk factor for low semen volume.18 In a study FRQGXFWHGZLWKSDWLHQWVWKHPHDQDJHRI WKH SDWLHQWV ZDV LGHQWL¿HG DV \HDUV DQG increased severity of varicocele was associated ZLWK D GHFUHDVH LQ VSHUP FRQFHQWUDWLRQV In D VWXG\ FRPSDULQJ WKH FOLQLFDO FKDUDFWHULVWLFV RI PHQ ZLWK SULPDU\ DQG VHFRQGDU\ LQIHUWLOLW\RIWKHFDVHVZHUHGHVFULEHGDVKDYLQJ SULPDU\LQIHUWLOLW\ZKLOHZHUHGHVFULEHGDV KDYLQJVHFRQGDU\LQIHUWLOLW\7KHPHDQDJHIRU PHQZLWKVHFRQGDU\LQIHUWLOLW\ZDVGHWHUPLQHG DV\HDUVZKLOHWKHPHDQDJHIRUPHQZLWK SULPDU\ LQIHUWLOLW\ ZDV GHWHUPLQHG DV years. Sperm concentration was determined DV PLOOLRQPO IRU FDVHV ZLWK VHFRQGDU\ LQIHUWLOLW\ DQG PLOOLRQPO IRU FDVHV ZLWK SULPDU\LQIHUWLOLW\1RUPDOVSHUPPRUSKRORJ\ ZDVLGHQWL¿HGDVIRUFDVHVZLWKVHFRQGDU\LQIHUWLOLW\DQGIRUFDVHVZLWKSULPDU\ LQIHUWLOLW\ZKLOHWRWDOPRWLOHVSHUPFRXQWZDV IRUFDVHVZLWKVHFRQGDU\LQIHUWLOLW\DQG $FFRUGLQJWRWKH.UXJHUVWULFWWHVWWKHIHUWLOL]DWLRQUDWHSHURRF\WHLVLQFDVHVZKHUH QRUPDOPRUSKRORJ\LVOHVVWKDQZKLOHWKH IHUWLOL]DWLRQUDWHUHDFKHVLQFDVHVZKHUH QRUPDOPRUSKRORJ\LVDERYH110RUSKRORJLcal evaluation of sperm is a sensitive indicator of spermatogenesis quality and fertility. )RU FRXSOHV ZLWK XQH[SODLQHG LQIHUWLOLW\ VSHUPPRUSKRORJ\ZDVUHSRUWHGDVEHLQJVLJQL¿FDQWO\ ZRUVH LQ FRPSDULVRQ WR IHUWLOH FRXSOHV LQ WKH FRQWURO JURXS In a prospective VWXG\FRQGXFWHGE\:LFKPDQQHWDORQSDWLHQWVE\XVLQJWKH:+2FULWHULDVSHUP PRUSKRORJ\ ZDV VKRZQ WR EH DQ LQGHSHQGHQW IDFWRU ZLWK UHJDUGV WR IHUWLOL]DWLRQ RXWFRPH ,PSDLUHG VSHUP PRUSKRORJ\ JHQHUDOO\ GHFUHDVHV WKH SUREDELOLW\ RI DFKLHYLQJ SUHJQDQ-8- CiLT:1 SAYI:1 YIL:2014 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CiLT:1 SAYI:1 YIL:2014 %2ö$=ødø7,3'(5*ø6ø .ÕVD5DSRU A Rare Cause Of Acute Renal Failure: Leriche Syndrome Akut Böbrek Yetmezliginin Nadir Bir Sebebi: Leriche Sendromu 6H\GDKPHW$.,16LQDQ.$=$1%LOJH.$/.$10HKPHW$/ø867$2ö/8 'U/W¿.ÕUGDU.DUWDO(÷LWLPYH$UDúWÕUPD+DVWDQHVLøo+DVWDOÕNODUÕ.OLQL÷L,VWDQEXO7XUNH\ 'U/W¿.ÕUGDU.DUWDO(÷LWLPYH$UDúWÕUPD+DVWDQHVL$LOH+HNLPOL÷L.OLQL÷L,VWDQEXO7XUNH\ g=(7 /HULFKH6HQGURPXLOLDNDUWHUOHUGHWÕNDQÕNOÕ÷DVHEHSRODQDRUWLNELIXUNDV\RQGDRNO]LIDWHURPSODNODUÕ LOHNDUDNWHUL]HGLU5HQDODUWHUOHUVDGHFHKDVWDGDWXWXODELOLU5HQDODUWHUWXWXOXPXDNXWE|EUHN\HWPH]OL÷LQLQQDGLUELUVHEHELGLU$NXWE|EUHN\HWPH]OL÷LLOHEDúYXUDQELU/HULFKHVHQGURPXROJXVXQXELOGLUL\RUX] $QDKWDUNHOLPHOHUDWHURVNOHUR]/HULFKHVHQGURPX5HQDO\HWPH]OLN $%675$&7 /HULFKH6\QGURPHLVFKDUDFWHUL]HGZLWKRFFOXVLYHDWKHURPSODTXHVDWDRUWLFELIXUFDWLRQREVWUXFWLQJ LOLDFDUWHULHV5HQDODUWHULHVDUHLQYROYHGLQRQO\RISDWLHQWV5HQDODUWHU\LQYROYHPHQWPD\EHDUDUH FDXVHRIUHQDOLPSDLUPHQW:HUHSRUWD/HULFKHV\GURPHFDVHSUHVHQWLQJZLWKDFXWHUHQDOIDLOXUH 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Palyatif Bakım Derneği Bülteni, 2016
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