O. Karaköse, Hüseyin Pülat, Kazım Çağlar Özçelik, İsmail Zihni, Kemal Kürşat Bozkurt, S. Şenol, Fatma Nihan Cankara, Hasan Erol Eroğlu
The most frequent postoperative complication after breast surgery is seroma formation. Seroma occurs due to lymphatic and vascular fluid leakage into the dead space created by surgical dissection. The objective of the research was to evaluate the effects of local fibrin glue, tetracycline, talc applications, and flap fixation technique on reducing seroma formation after mastectomy and axillary dissection. In addition, we aimed to determine the level of efficacy for these applications, as well as to identify the most appropriate method to be used in operations with high risk of seroma formation. Materials and Methods. This experimental study was conducted using a total of 60 female Wistar albino rats. They were allocated into six groups and each comprised ten rats. Unilateral mastectomy and axillary dissection were performed on all the rats. Local applications of fibrin glue, tetracycline, talc, and alcoholic iodine were performed in four separate groups. Flap fixation technique was applied in one group and those rats that did not receive any intervention constituted the control group. On the 10th postoperative day, seroma was aspirated under anesthesia, and the amount of seroma fluid was recorded. Seroma fluid was analyzed for interleukin 1-β , vascular endothelial growth factor, and C-reactive protein levels. Tissue samples were obtained from the skin overlaying the dissection area, the axilla, and the thoracic wall. Wound healing was evaluated with histopathological examination. Results. Seroma volume was lower and the wound healing scores were the highest in the flap fixation group and the tetracycline group as compared to the control group. However, the alcoholic iodine group and the talc group had a greater amount of seroma (p < 0.05). There was no difference between the fibrin glue group and the control group. Conclusions. In our mastectomy model, local application of alcoholic iodine and talc substances caused more wound site problems and postoperative seroma formation. While fibrin glue did not cause wound site problems, it did increase seroma formation. These three substances were determined to be inefficacious in postoperative seroma formation. Local tetracycline application and flap fixation technique were found to reduce postoperative seroma and benefit wound healing.
{"title":"Effects of Different Applications on Postoperative Seroma Formation and Wound Healing Following Mastectomy and Axillary Dissection in Rats","authors":"O. Karaköse, Hüseyin Pülat, Kazım Çağlar Özçelik, İsmail Zihni, Kemal Kürşat Bozkurt, S. Şenol, Fatma Nihan Cankara, Hasan Erol Eroğlu","doi":"10.21802/GMJ.2021.1.5","DOIUrl":"https://doi.org/10.21802/GMJ.2021.1.5","url":null,"abstract":"The most frequent postoperative complication after breast surgery is seroma formation. Seroma occurs due to lymphatic and vascular fluid leakage into the dead space created by surgical dissection. The objective of the research was to evaluate the effects of local fibrin glue, tetracycline, talc applications, and flap fixation technique on reducing seroma formation after mastectomy and axillary dissection. In addition, we aimed to determine the level of efficacy for these applications, as well as to identify the most appropriate method to be used in operations with high risk of seroma formation. Materials and Methods. This experimental study was conducted using a total of 60 female Wistar albino rats. They were allocated into six groups and each comprised ten rats. Unilateral mastectomy and axillary dissection were performed on all the rats. Local applications of fibrin glue, tetracycline, talc, and alcoholic iodine were performed in four separate groups. Flap fixation technique was applied in one group and those rats that did not receive any intervention constituted the control group. On the 10th postoperative day, seroma was aspirated under anesthesia, and the amount of seroma fluid was recorded. Seroma fluid was analyzed for interleukin 1-β , vascular endothelial growth factor, and C-reactive protein levels. Tissue samples were obtained from the skin overlaying the dissection area, the axilla, and the thoracic wall. Wound healing was evaluated with histopathological examination. Results. Seroma volume was lower and the wound healing scores were the highest in the flap fixation group and the tetracycline group as compared to the control group. However, the alcoholic iodine group and the talc group had a greater amount of seroma (p < 0.05). There was no difference between the fibrin glue group and the control group. Conclusions. In our mastectomy model, local application of alcoholic iodine and talc substances caused more wound site problems and postoperative seroma formation. While fibrin glue did not cause wound site problems, it did increase seroma formation. These three substances were determined to be inefficacious in postoperative seroma formation. Local tetracycline application and flap fixation technique were found to reduce postoperative seroma and benefit wound healing.","PeriodicalId":12537,"journal":{"name":"Galician Medical Journal","volume":"28 1","pages":""},"PeriodicalIF":0.1,"publicationDate":"2021-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41552741","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Y. Tyravska, O. Savchenko, V. Lizogub, N. Raksha, O. Savchuk
Aim: To investigate the serotonin and von Willebrand factor (vWF) concentrations among unstable angina (UA) patients without and with progression toward myocardial infarction (outcome) and to assess the utility of both as prognostic markers of UA complications. Materials and methods: In observational cohort study, we recruited 103 patients with ischemic heart disease (the median age 65.0 (59.0-69.0) years, 45 females (43.7%)). After full set of investigations including high sensitive Troponin I test and 28-day follow-up period, we defined three groups: Group 1 – stable angina patients (n=22) as control, Group 2 – UA patients without outcome (n=71), Group 3 – UA patients with outcome (n=10). We analyzed the blood plasma serotonin content by the ion-exchange chromatography with measurement of serotonin on fluorescence spectrophotometer. VWF concentration was determined by ELISA. We compared the concentrations of observed parameters among the groups with the Kruskal-Wallis test (with post-hoc Mann-Whitney test with Bonferroni-Holm correction). We assessed binary logistic models, receiver operating characteristic curves, calculated sensitivity (Se), specificity (Sp), and positive likelihood ratio (LR+) for each indicator. Results: We registered elevation in serotonin concentration and decline in vWF concentration in Group 3 in comparison with Group 2 (22.670 (20.687-24.927) μg/ml vs 11.980 (8.120-15.000) μg/ml, p < 0.001, and 0.117 (0.109-0.120) rel.units/ml vs 0.134 (0.127-0.143) rel.units/ml, p < 0.001) and Group 1 (12.340 (10.05213.619) μg/ml, p < 0.001, and 0.137 (0.127-0.156) rel.units/ml, p < 0.001), respectively. No significant differences in serotonin and vWF concentrations between Group 1 and Group 2 were detected (p=0.81 and p=0.36, respectively). The probability of outcome increased significantly (by 60.7% and 59.7%, LR+ 19.0 [6.0, 60.0] and 18.0 [3.9, 80.0]) if serotonin concentration was above 21.575 μg/ml (Se=80.0%, Sp=95.8%, AUC=0.975) and vWF concentration was below 0.114 rel.units/ml (Se=50.0%, Sp=97.2%, AUC=0.973), respectively. Conclusions: Serotonin and vWF as biomarkers are demonstrated promising results for rule-in the patients with risk of short-term UA progression toward myocardial infarction.
目的：研究无心肌梗死和有心肌梗死进展的不稳定型心绞痛（UA）患者的5-羟色胺和血管性血友病因子（vWF）浓度（结果），并评估两者作为UA并发症预后标志物的效用。材料和方法：在观察性队列研究中，我们招募了103名缺血性心脏病患者（中位年龄65.0（59.0-69.0）岁，45名女性（43.7%）。经过包括高敏肌钙蛋白I测试和28天随访期在内的全套研究，我们确定了三组：第1组-稳定型心绞痛患者（n=22）作为对照，第2组-无结果的UA患者（n=71），第3组-UA患者有结果（n=10）。我们用离子交换色谱法和荧光分光光度计测量5-羟色胺来分析血浆5-羟色胺含量。采用ELISA法测定VWF浓度。我们用Kruskal-Wallis检验（用Bonferroni-Holm校正的事后Mann-Whitney检验）比较了各组间观察到的参数浓度。我们评估了每个指标的二元逻辑模型、受试者操作特征曲线、计算的敏感性（Se）、特异性（Sp）和阳性似然比（LR+）。结果：与第2组（22.670（20.687-24.927）μg/ml vs 11.980（8.120-15.000）μg/ml，p<0.001，0.117（0.109-0120）rel.units/ml vs 0.134（0.127-0.143）rel.units/ml，p<001）和第1组（12.340（10.05213.619）μg/ml和0.137（0.127-0.156）rel.unit/ml，p>0.001）相比，第3组的血清素浓度升高，vWF浓度下降，分别地第1组和第2组之间的血清素和vWF浓度没有显著差异（分别为p=0.81和p=0.36）。如果血清素浓度高于21.575μg/ml（Se=80.0%，Sp=95.8%，AUC=0.975），vWF浓度低于0.114 rel.units/ml（Se=50.0%，Sp=97.2%，AUC=0.973），则结果的概率分别显著增加（分别增加60.7%和59.7%，LR+19.0[6.0]和18.0[3.9,0.0]）。结论：血清素和vWF作为生物标志物在有短期UA进展为心肌梗死风险的患者中被证明是有希望的规则结果。
{"title":"Blood Plasma Serotonin and von Willebrand Factor as Biomarkers of Unstable Angina Progression Toward Myocardial Infarction","authors":"Y. Tyravska, O. Savchenko, V. Lizogub, N. Raksha, O. Savchuk","doi":"10.21802/GMJ.2021.1.2","DOIUrl":"https://doi.org/10.21802/GMJ.2021.1.2","url":null,"abstract":"Aim: To investigate the serotonin and von Willebrand factor (vWF) concentrations among unstable angina (UA) patients without and with progression toward myocardial infarction (outcome) and to assess the utility of both as prognostic markers of UA complications. Materials and methods: In observational cohort study, we recruited 103 patients with ischemic heart disease (the median age 65.0 (59.0-69.0) years, 45 females (43.7%)). After full set of investigations including high sensitive Troponin I test and 28-day follow-up period, we defined three groups: Group 1 – stable angina patients (n=22) as control, Group 2 – UA patients without outcome (n=71), Group 3 – UA patients with outcome (n=10). We analyzed the blood plasma serotonin content by the ion-exchange chromatography with measurement of serotonin on fluorescence spectrophotometer. VWF concentration was determined by ELISA. We compared the concentrations of observed parameters among the groups with the Kruskal-Wallis test (with post-hoc Mann-Whitney test with Bonferroni-Holm correction). We assessed binary logistic models, receiver operating characteristic curves, calculated sensitivity (Se), specificity (Sp), and positive likelihood ratio (LR+) for each indicator. Results: We registered elevation in serotonin concentration and decline in vWF concentration in Group 3 in comparison with Group 2 (22.670 (20.687-24.927) μg/ml vs 11.980 (8.120-15.000) μg/ml, p < 0.001, and 0.117 (0.109-0.120) rel.units/ml vs 0.134 (0.127-0.143) rel.units/ml, p < 0.001) and Group 1 (12.340 (10.05213.619) μg/ml, p < 0.001, and 0.137 (0.127-0.156) rel.units/ml, p < 0.001), respectively. No significant differences in serotonin and vWF concentrations between Group 1 and Group 2 were detected (p=0.81 and p=0.36, respectively). The probability of outcome increased significantly (by 60.7% and 59.7%, LR+ 19.0 [6.0, 60.0] and 18.0 [3.9, 80.0]) if serotonin concentration was above 21.575 μg/ml (Se=80.0%, Sp=95.8%, AUC=0.975) and vWF concentration was below 0.114 rel.units/ml (Se=50.0%, Sp=97.2%, AUC=0.973), respectively. Conclusions: Serotonin and vWF as biomarkers are demonstrated promising results for rule-in the patients with risk of short-term UA progression toward myocardial infarction.","PeriodicalId":12537,"journal":{"name":"Galician Medical Journal","volume":" ","pages":""},"PeriodicalIF":0.1,"publicationDate":"2021-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44358471","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Omair Shah, F. Shera, N. Choh, T. Gojwari, Fahad Shafi, J. Suhail, Musadiq Rafiq
The length of the styloid process varies greatly in different populations and depends on ethnicity and geographical background. The elongated styloid process may be associated with Eagle’s syndrome. Therefore, the mean normal length of the styloid process in different population groups needs to be calculated and the upper cutoff limit for elongated styloid process should be found. The objective of the research was to evaluate the styloid process length in the Kashmiri population using multidetector computed tomography. Materials and Methods. We retrospectively evaluated 304 patients who underwent computed tomography of the head and paranasal sinuses, and the mean styloid process length was calculated on both sides. The mean of three measurements of styloid process length was taken. The study population was grouped as follows: Group I included patients at the age of 21-30 years; Group II comprised patients at the age of 31-40 years; Group III included 68 patients at the age of 41-50 years; Group IV comprised patients > 50 years old. Results. The mean length of the styloid process in the studied population varied from 20 to 51 mm (mean 31.3 ± 4.5 mm). There was no significant difference in the length on both sides (p=0.835). The mean length of the styloid process was 30.1 ± 4.2 mm in females and 32.3 ± 4.8 mm in males (p < 0.034). The lengths of the styloid process in different age groups were as follows: in Group I – 30.9 ± 4.4 mm; in Group II – 31.2 ± 4.8 mm; in Group III – 31.6 ± 4.3 mm; in Group IV – 31.5 ± 4.5 mm. Conclusions. The mean length of the styloid process in our population was higher as compared to many other ethnic groups. The styloid process in males was longer. The elongated styloid process on computed tomography scan should not be labeled as Eagle’s syndrome unless clinical symptoms are present.
{"title":"Styloid Process: What Length Is Abnormal?","authors":"Omair Shah, F. Shera, N. Choh, T. Gojwari, Fahad Shafi, J. Suhail, Musadiq Rafiq","doi":"10.21802/GMJ.2021.1.4","DOIUrl":"https://doi.org/10.21802/GMJ.2021.1.4","url":null,"abstract":"The length of the styloid process varies greatly in different populations and depends on ethnicity and geographical background. The elongated styloid process may be associated with Eagle’s syndrome. Therefore, the mean normal length of the styloid process in different population groups needs to be calculated and the upper cutoff limit for elongated styloid process should be found. The objective of the research was to evaluate the styloid process length in the Kashmiri population using multidetector computed tomography. Materials and Methods. We retrospectively evaluated 304 patients who underwent computed tomography of the head and paranasal sinuses, and the mean styloid process length was calculated on both sides. The mean of three measurements of styloid process length was taken. The study population was grouped as follows: Group I included patients at the age of 21-30 years; Group II comprised patients at the age of 31-40 years; Group III included 68 patients at the age of 41-50 years; Group IV comprised patients > 50 years old. Results. The mean length of the styloid process in the studied population varied from 20 to 51 mm (mean 31.3 ± 4.5 mm). There was no significant difference in the length on both sides (p=0.835). The mean length of the styloid process was 30.1 ± 4.2 mm in females and 32.3 ± 4.8 mm in males (p < 0.034). The lengths of the styloid process in different age groups were as follows: in Group I – 30.9 ± 4.4 mm; in Group II – 31.2 ± 4.8 mm; in Group III – 31.6 ± 4.3 mm; in Group IV – 31.5 ± 4.5 mm. Conclusions. The mean length of the styloid process in our population was higher as compared to many other ethnic groups. The styloid process in males was longer. The elongated styloid process on computed tomography scan should not be labeled as Eagle’s syndrome unless clinical symptoms are present.","PeriodicalId":12537,"journal":{"name":"Galician Medical Journal","volume":"14 1","pages":""},"PeriodicalIF":0.1,"publicationDate":"2021-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68361011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Aamir Hussain Hela, Haseeb Mohammad Khandwaw, Rahul Kumar, Mir Adnan Samad
Introduction: Laparoscopic cholecystectomy is the most commonly performed surgical procedure of digestive tract. It has replaced open cholecystectomy as gold standard treatment for cholelithiasis and inflammation of gallbladder. It is estimated that approximately 90% of cholecystectomies in the United States are performed using a laparoscopic approach. The aim of this study was to evaluate the outcome of Laparoscopic cholecystectomy in context to its complications, morbidity and mortality in a tertiary care hospital. Methods: This retrospective study was conducted on 1200 patients, who underwent laparoscopic cholecystectomies, during the period from January 2019 to December 2019, at Government Medical College Jammu J & K, India and necessary data was collected and reviewed. Results: In our study, a total of 1200 patients were studied including 216 males (18%) and 984 females (82%). The mean age of the patients was 43.35±8.61. The mean operative time in our study was 55.5±10.60 minutes with range of 45 – 90 minutes. Conversion rate was 2.6%. 2 patients were re-explored. Bile duct injury was found in 6 patients (0.5%). Conclusions: Gallstone disease is a global health problem. Laparoscopic cholecystectomy has now replaced open cholecystectomy as the first choice of treatment for gallstones. Gall stone diseases is most frequently encountered in female population. The risk factors for conversion to open cholecystectomy include male gender, previous abdominal surgery, acute cholecystitis, dense adhesions and fibrosis in Calot’ s triangle, anatomical variations, advanced age, comorbidity, obesity, suspicion of common bile duct stones, jaundice, and decreased surgeon experience. The incidence of surgical site infection has significantly decreased in laparoscopic cholecystectomy compared to open cholecystectomy. In our study we could not find any case of surgical site infection.
{"title":"Experience of Laparoscopic Cholecystectomies in a Tertiary Care Hospital: a Retrospective Study","authors":"Aamir Hussain Hela, Haseeb Mohammad Khandwaw, Rahul Kumar, Mir Adnan Samad","doi":"10.21802/gmj.2020.4.3","DOIUrl":"https://doi.org/10.21802/gmj.2020.4.3","url":null,"abstract":"Introduction: Laparoscopic cholecystectomy is the most commonly performed surgical procedure of digestive tract. It has replaced open cholecystectomy as gold standard treatment for cholelithiasis and inflammation of gallbladder. It is estimated that approximately 90% of cholecystectomies in the United States are performed using a laparoscopic approach. The aim of this study was to evaluate the outcome of Laparoscopic cholecystectomy in context to its complications, morbidity and mortality in a tertiary care hospital. \u0000Methods: This retrospective study was conducted on 1200 patients, who underwent laparoscopic cholecystectomies, during the period from January 2019 to December 2019, at Government Medical College Jammu J & K, India and necessary data was collected and reviewed. \u0000Results: In our study, a total of 1200 patients were studied including 216 males (18%) and 984 females (82%). The mean age of the patients was 43.35±8.61. The mean operative time in our study was 55.5±10.60 minutes with range of 45 – 90 minutes. Conversion rate was 2.6%. 2 patients were re-explored. Bile duct injury was found in 6 patients (0.5%). \u0000Conclusions: Gallstone disease is a global health problem. Laparoscopic cholecystectomy has now replaced open cholecystectomy as the first choice of treatment for gallstones. Gall stone diseases is most frequently encountered in female population. The risk factors for conversion to open cholecystectomy include male gender, previous abdominal surgery, acute cholecystitis, dense adhesions and fibrosis in Calot’ s triangle, anatomical variations, advanced age, comorbidity, obesity, suspicion of common bile duct stones, jaundice, and decreased surgeon experience. The incidence of surgical site infection has significantly decreased in laparoscopic cholecystectomy compared to open cholecystectomy. In our study we could not find any case of surgical site infection.","PeriodicalId":12537,"journal":{"name":"Galician Medical Journal","volume":"1 1","pages":""},"PeriodicalIF":0.1,"publicationDate":"2020-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41613884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The objective of the research was to determine the morphological features of the duodenal wall of animals within 14-56 days of developing streptozotocin-induced diabetes mellitus using light optical microscopy. Materials and Methods. The research was carried out on 40 white nonlinear adult male rats. Diabetes mellitus was simulated by a single intraperitoneal injection of streptozotocin (Sigma, USA) at a dose of 60 mg/kg body weight. The material was taken from the duodenum on the 14th, 28th and the 56th days after the onset of experimental diabetes mellitus. For histological study, the preparations were made using the conventional method, which included the staining of sections with hematoxylin and eosin. Results. Streptozotocin-induced diabetes mellitus was experimentally found to lead to dystrophic changes in the epithelial components of the duodenal mucosa from the 14th day of developing. There were observed a shortening of the villi of the mucous membrane and a lack of distinctness of striated border contours on the apical surface of epitheliocytes. Between the connective-tissue fibers of the lamina propria of the mucosa and thin-walled vessels, the cellular elements, including mainly macrophages, lymphocytes, were found. There was a shortening of the villi, edema and histiolymphocytic infiltration of the villous stroma 28 days after developing experimental diabetes mellitus. The epithelium covering was discontinuous; numerous areas of desquamation were found at the apex of the villi. Fifty-six days after developing experimental diabetes mellitus, the destruction and desquamation of the epithelium of the villi and crypts were observed. The surface of the duodenal mucosa smoothed down due to the shortening and flattening of the villi (indicating their atrophy), while the crypts elongated and their depth increased. Conclusions. Histological study of the duodenal wall of diabetic animals showed pronounced desquamation at the apex of the villi, destructive and dystrophic changes in the surface epithelium, edema and increased cellular infiltration of the lamina propria of the mucosa. Thus, in diabetes mellitus, structural changes in the duodenal wall of rats are characterized by the dystrophic processes, which can be considered as the morphological reflection of enteropathy.
{"title":"Morphological Characteristics of Changes in the Duodenal Wall Within 14-56 Days of the Development of Streptozotocin-Induced Experimental Diabetes Mellitus","authors":"I. Bilinskyi","doi":"10.21802/gmj.2020.4.13","DOIUrl":"https://doi.org/10.21802/gmj.2020.4.13","url":null,"abstract":"The objective of the research was to determine the morphological features of the duodenal wall of animals within 14-56 days of developing streptozotocin-induced diabetes mellitus using light optical microscopy. \u0000Materials and Methods. The research was carried out on 40 white nonlinear adult male rats. Diabetes mellitus was simulated by a single intraperitoneal injection of streptozotocin (Sigma, USA) at a dose of 60 mg/kg body weight. The material was taken from the duodenum on the 14th, 28th and the 56th days after the onset of experimental diabetes mellitus. For histological study, the preparations were made using the conventional method, which included the staining of sections with hematoxylin and eosin. \u0000Results. Streptozotocin-induced diabetes mellitus was experimentally found to lead to dystrophic changes in the epithelial components of the duodenal mucosa from the 14th day of developing. There were observed a shortening of the villi of the mucous membrane and a lack of distinctness of striated border contours on the apical surface of epitheliocytes. Between the connective-tissue fibers of the lamina propria of the mucosa and thin-walled vessels, the cellular elements, including mainly macrophages, lymphocytes, were found. There was a shortening of the villi, edema and histiolymphocytic infiltration of the villous stroma 28 days after developing experimental diabetes mellitus. The epithelium covering was discontinuous; numerous areas of desquamation were found at the apex of the villi. Fifty-six days after developing experimental diabetes mellitus, the destruction and desquamation of the epithelium of the villi and crypts were observed. The surface of the duodenal mucosa smoothed down due to the shortening and flattening of the villi (indicating their atrophy), while the crypts elongated and their depth increased. \u0000Conclusions. Histological study of the duodenal wall of diabetic animals showed pronounced desquamation at the apex of the villi, destructive and dystrophic changes in the surface epithelium, edema and increased cellular infiltration of the lamina propria of the mucosa. Thus, in diabetes mellitus, structural changes in the duodenal wall of rats are characterized by the dystrophic processes, which can be considered as the morphological reflection of enteropathy.","PeriodicalId":12537,"journal":{"name":"Galician Medical Journal","volume":" ","pages":""},"PeriodicalIF":0.1,"publicationDate":"2020-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42123973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
There is no available treatment or vaccine for HIV/AIDS, and health education has, therefore, become a top priority in the prevention of disease. It is of great importance to have sufficient information about HIV/AIDS and how to control infection. This study was conducted to determine the effect of the Infectious Disease Nursing course on nursing students’ knowledge and attitudes towards AIDS. Materials and Methods. This quasi-experimental study was carried out between February 12 - May 28, 2019 and included 50 nursing students who were taking the Infectious Disease Nursing course for the first time and attended the pre-test and post-test. The data were collected using a Personal Information Form and the AIDS Knowledge and Attitude Scale. Descriptive statistics, the paired sample t-test and Pearson correlation analysis were used in the evaluation of the data. Results. Among the students who participated in the study, 94.0% of students were at the age of 18-21 years; 80.0% of students were females; 54.0% of students stated that they had adequate knowledge of AIDS; 78.0% of students stated that they did not want to provide care to individuals with HIV/AIDS. There was found a significant strong positive correlation between the mean pre- and post-education scores for the AIDS Knowledge and Attitude Scale (p<0.05, r=0.34; p<0.01, r=0.72). There was a significant, weak negative correlation between the mean post-education AIDS total Attitude mean score and the status of having contact with a patient with HIV/AIDS and wanting to provide care for a patient with HIV/AIDS (p<0.05, r=-0.31), and a significant weak positive correlation between the status of wanting to provide care for a patient with HIV/AIDS and seeing people with HIV/AIDS as a threat (p<0.01; r=-0.50). Conclusions. All the students benefited from the information on AIDS and became informed due to attending the Infectious Diseases Nursing course and their attitudes towards AIDS improved.
{"title":"The Effect of the Infectious Disease Nursing Course on Turkish Students’ Knowledge and Attitudes Towards AIDS: A Quasi-Experimental Study","authors":"Sibel Şentürk, alev yıldırım keskin","doi":"10.21802/gmj.2020.4.5","DOIUrl":"https://doi.org/10.21802/gmj.2020.4.5","url":null,"abstract":"There is no available treatment or vaccine for HIV/AIDS, and health education has, therefore, become a top priority in the prevention of disease. It is of great importance to have sufficient information about HIV/AIDS and how to control infection. This study was conducted to determine the effect of the Infectious Disease Nursing course on nursing students’ knowledge and attitudes towards AIDS. \u0000 Materials and Methods. This quasi-experimental study was carried out between February 12 - May 28, 2019 and included 50 nursing students who were taking the Infectious Disease Nursing course for the first time and attended the pre-test and post-test. The data were collected using a Personal Information Form and the AIDS Knowledge and Attitude Scale. Descriptive statistics, the paired sample t-test and Pearson correlation analysis were used in the evaluation of the data. \u0000 Results. Among the students who participated in the study, 94.0% of students were at the age of 18-21 years; 80.0% of students were females; 54.0% of students stated that they had adequate knowledge of AIDS; 78.0% of students stated that they did not want to provide care to individuals with HIV/AIDS. There was found a significant strong positive correlation between the mean pre- and post-education scores for the AIDS Knowledge and Attitude Scale (p<0.05, r=0.34; p<0.01, r=0.72). There was a significant, weak negative correlation between the mean post-education AIDS total Attitude mean score and the status of having contact with a patient with HIV/AIDS and wanting to provide care for a patient with HIV/AIDS (p<0.05, r=-0.31), and a significant weak positive correlation between the status of wanting to provide care for a patient with HIV/AIDS and seeing people with HIV/AIDS as a threat (p<0.01; r=-0.50). \u0000 Conclusions. All the students benefited from the information on AIDS and became informed due to attending the Infectious Diseases Nursing course and their attitudes towards AIDS improved.","PeriodicalId":12537,"journal":{"name":"Galician Medical Journal","volume":" ","pages":""},"PeriodicalIF":0.1,"publicationDate":"2020-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46671383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
N. Seredyuk, A. Matlakh, Y. Vandzhura, M. Bielinskyi, O. Skakun, R. Denina
Multi-vessel coronary artery disease is quite a common state, which is often diagnosed by coronary angiography in patients with both stable coronary artery disease and acute coronary syndromes. Major difficulties in percutaneous coronary intervention include stent thrombosis and the need for antiplatelet therapy (aspirin and a P2Y12 inhibitor). Stent thrombosis leads to the recurrence of myocardial infarction and may occur within the first few hours after percutaneous coronary intervention. The use of dual antiplatelet therapy, especially that combined with low-molecular-weight heparin in the first days after myocardial infarction, poses a risk of bleeding, which often occurs in real clinical practice. Among P2Y12 inhibitors, ticagrelor causes bleeding somewhat more frequently than clopidogrel. A case of multi-vessel coronary artery disease is described in this paper. Coronary angiography revealed right-dominant circulation; occlusion of the proximal and medial segments of the right coronary artery, thrombolysis in myocardial infarction flow grade 0; stenosis of the left main coronary artery (50-60%), thrombolysis in myocardial infarction flow grade 2; diffuse stenosis of the medial and distal segments of the left anterior descending artery, thrombolysis in myocardial infarction flow grade 1; stenosis of the proximal segment of the left circumflex artery (> 75%), thrombolysis in myocardial infarction flow grade 1. The patient underwent percutaneous coronary intervention; the stents were implanted in the infarct-dependent right coronary artery. The clinical course was complicated by early stent thrombosis with subsequent thrombus extraction; a day later melena developed. Bleeding was stopped, the intensity of antithrombotic therapy was reduced: the combination of aspirin and ticagrelor was replaced by the combination of aspirin and clopidogrel. Six weeks after stenting of the infarct-dependent coronary artery, complete myocardial revascularization (hybrid intervention) was performed: coronary artery bypass grafting [the left internal mammary artery → the left anterior descending artery], coronary autogenous bypass grafting [the aorta → the right coronary artery and the aorta → the left circumflex artery]. The role of fractional flow reserve or instantaneous wave-free ratio-controlled complete myocardial revascularization techniques is discussed. The following algorithm for myocardial revascularization was used: percutaneous coronary intervention for the right coronary artery + coronary artery bypass grafting-3: the left internal mammary artery → the left anterior descending artery, the aorta → the left circumflex artery, the aorta → the right coronary artery.
{"title":"Multi-Vessel Coronary Artery Disease: Choice of Myocardial Revascularization Strategy","authors":"N. Seredyuk, A. Matlakh, Y. Vandzhura, M. Bielinskyi, O. Skakun, R. Denina","doi":"10.21802/gmj.2020.4.1","DOIUrl":"https://doi.org/10.21802/gmj.2020.4.1","url":null,"abstract":"Multi-vessel coronary artery disease is quite a common state, which is often diagnosed by coronary angiography in patients with both stable coronary artery disease and acute coronary syndromes. Major difficulties in percutaneous coronary intervention include stent thrombosis and the need for antiplatelet therapy (aspirin and a P2Y12 inhibitor). Stent thrombosis leads to the recurrence of myocardial infarction and may occur within the first few hours after percutaneous coronary intervention. The use of dual antiplatelet therapy, especially that combined with low-molecular-weight heparin in the first days after myocardial infarction, poses a risk of bleeding, which often occurs in real clinical practice. Among P2Y12 inhibitors, ticagrelor causes bleeding somewhat more frequently than clopidogrel. A case of multi-vessel coronary artery disease is described in this paper. Coronary angiography revealed right-dominant circulation; occlusion of the proximal and medial segments of the right coronary artery, thrombolysis in myocardial infarction flow grade 0; stenosis of the left main coronary artery (50-60%), thrombolysis in myocardial infarction flow grade 2; diffuse stenosis of the medial and distal segments of the left anterior descending artery, thrombolysis in myocardial infarction flow grade 1; stenosis of the proximal segment of the left circumflex artery (> 75%), thrombolysis in myocardial infarction flow grade 1. The patient underwent percutaneous coronary intervention; the stents were implanted in the infarct-dependent right coronary artery. The clinical course was complicated by early stent thrombosis with subsequent thrombus extraction; a day later melena developed. Bleeding was stopped, the intensity of antithrombotic therapy was reduced: the combination of aspirin and ticagrelor was replaced by the combination of aspirin and clopidogrel. Six weeks after stenting of the infarct-dependent coronary artery, complete myocardial revascularization (hybrid intervention) was performed: coronary artery bypass grafting [the left internal mammary artery → the left anterior descending artery], coronary autogenous bypass grafting [the aorta → the right coronary artery and the aorta → the left circumflex artery]. The role of fractional flow reserve or instantaneous wave-free ratio-controlled complete myocardial revascularization techniques is discussed. The following algorithm for myocardial revascularization was used: percutaneous coronary intervention for the right coronary artery + coronary artery bypass grafting-3: the left internal mammary artery → the left anterior descending artery, the aorta → the left circumflex artery, the aorta → the right coronary artery.","PeriodicalId":12537,"journal":{"name":"Galician Medical Journal","volume":" ","pages":""},"PeriodicalIF":0.1,"publicationDate":"2020-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43645989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mycotic infections of the nasal cavity and paranasal sinuses represent a wide spectrum of disorders that vary in clinical presentation, histopathologic appearances, and biological significance. The second most common form is a fungal ball. The objective of the research was to describe the cases of paranasal sinus fungal ball found in the files of patients with chronic rhinosinusitis. Materials and Methods. There were demonstrated clinical and histopathological data of two patients. Results. A 42-year-old woman and a 40-year-old man with chronic hypertrophic sinusitis had a large amount of friable cheesy mass in the maxillary sinus. The female patient previously underwent upper dental arch sanation. Histology revealed dense laminated masses of matted fungal hyphae that were separate from the mucosa. Sinonasal mucosa showed mild chronic inflammation (male) and severe non-specific chronic active inflammation (female). No evidence of fungal invasion in the mucosa was found. Conclusions. Fungal ball represents a non-invasive form of mycotic rhinosinusitis with favourable prognosis. Biopsy examination plays an important role in the diagnostic process. Although the diagnosis can also be achieved by polymerase chain reaction assays, biopsy is the only way to explore the status of an inflammatory damage to adjacent tissue and, thus, to rule out potential invasive mycotic sinus disease with much worse clinical outcome.
{"title":"Mycotic Infection (Fungal Ball) of the Paranasal Sinuses: A Clinicopathological Observation","authors":"V. Bartoš, V. Bartošová","doi":"10.21802/gmj.2020.4.6","DOIUrl":"https://doi.org/10.21802/gmj.2020.4.6","url":null,"abstract":"Mycotic infections of the nasal cavity and paranasal sinuses represent a wide spectrum of disorders that vary in clinical presentation, histopathologic appearances, and biological significance. The second most common form is a fungal ball. \u0000The objective of the research was to describe the cases of paranasal sinus fungal ball found in the files of patients with chronic rhinosinusitis. \u0000Materials and Methods. There were demonstrated clinical and histopathological data of two patients. \u0000Results. A 42-year-old woman and a 40-year-old man with chronic hypertrophic sinusitis had a large amount of friable cheesy mass in the maxillary sinus. The female patient previously underwent upper dental arch sanation. Histology revealed dense laminated masses of matted fungal hyphae that were separate from the mucosa. Sinonasal mucosa showed mild chronic inflammation (male) and severe non-specific chronic active inflammation (female). No evidence of fungal invasion in the mucosa was found. \u0000Conclusions. Fungal ball represents a non-invasive form of mycotic rhinosinusitis with favourable prognosis. Biopsy examination plays an important role in the diagnostic process. Although the diagnosis can also be achieved by polymerase chain reaction assays, biopsy is the only way to explore the status of an inflammatory damage to adjacent tissue and, thus, to rule out potential invasive mycotic sinus disease with much worse clinical outcome.","PeriodicalId":12537,"journal":{"name":"Galician Medical Journal","volume":" ","pages":""},"PeriodicalIF":0.1,"publicationDate":"2020-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48647623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Papatya Karakurt, Sevinç Köse Tuncer, Nadire Yildiz Çiltaş, M. Doğan
Providing care to someone with a chronic disease requires being physically, emotionally, and mentally energetic. In particular, the presence of a patient with a disease that requires palliative care changes daily activities and routines, increases responsibilities of those who take the responsibility for patient’s care and changes the roles in the family. The objective of this study was to determine the care burden and social support levels among the caregivers providing care for patients hospitalized in palliative care clinics. Materials and Methods: The population of this descriptive and correlational study consisted of caregivers taking care of patients treated at the Palliative Care Clinic of Training and Research Hospital between May and October 2018; the sample consisted of 73 caregivers who volunteered to join the study and were open to communication. Data were collected by questioning patients and their caregivers about their sociodemographic characteristics, using the Caregiver Burden Scale and the Multidimensional Scale of Perceived Social Support. Data analysis included percentages, the Kruskal-Wallis test, the Mann-Whitney U test, and the Spearman’s Correlation Coefficient. Results: The average caregivers’ age was 45.44±13.76 years; 75.3% of caregivers were females, 30.1% of caregivers were literate or had primary school degrees. Caregiver’s gender and educational levels were found not to affect caregiving and social support levels; however, the economic status affected caregiving and social support levels. There was a reverse correlation between the caregiver burden and their social support levels. Conclusions: With increased caregiver burden, their social support level decreased. Nurses caring for patients in palliative care clinics will benefit from educating and supporting caregivers about clinic and home care; it will result in a positive level of social support for both caregivers and patients receiving care.
{"title":"Determination of Caregiver Burden and Social Support Levels among Caregivers Providing Care for Patients Hospitalized in Palliative Care Clinics","authors":"Papatya Karakurt, Sevinç Köse Tuncer, Nadire Yildiz Çiltaş, M. Doğan","doi":"10.21802/gmj.2020.4.14","DOIUrl":"https://doi.org/10.21802/gmj.2020.4.14","url":null,"abstract":"Providing care to someone with a chronic disease requires being physically, emotionally, and mentally energetic. In particular, the presence of a patient with a disease that requires palliative care changes daily activities and routines, increases responsibilities of those who take the responsibility for patient’s care and changes the roles in the family. \u0000The objective of this study was to determine the care burden and social support levels among the caregivers providing care for patients hospitalized in palliative care clinics. \u0000Materials and Methods: The population of this descriptive and correlational study consisted of caregivers taking care of patients treated at the Palliative Care Clinic of Training and Research Hospital between May and October 2018; the sample consisted of 73 caregivers who volunteered to join the study and were open to communication. Data were collected by questioning patients and their caregivers about their sociodemographic characteristics, using the Caregiver Burden Scale and the Multidimensional Scale of Perceived Social Support. Data analysis included percentages, the Kruskal-Wallis test, the Mann-Whitney U test, and the Spearman’s Correlation Coefficient. \u0000Results: The average caregivers’ age was 45.44±13.76 years; 75.3% of caregivers were females, 30.1% of caregivers were literate or had primary school degrees. Caregiver’s gender and educational levels were found not to affect caregiving and social support levels; however, the economic status affected caregiving and social support levels. There was a reverse correlation between the caregiver burden and their social support levels. \u0000Conclusions: With increased caregiver burden, their social support level decreased. Nurses caring for patients in palliative care clinics will benefit from educating and supporting caregivers about clinic and home care; it will result in a positive level of social support for both caregivers and patients receiving care.","PeriodicalId":12537,"journal":{"name":"Galician Medical Journal","volume":" ","pages":""},"PeriodicalIF":0.1,"publicationDate":"2020-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44751091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
B. Badak, Ercüment Paşaoğlu, H. Caga, E. Ihtiyar, A. Şahin, S. Erkasap, E. Ateş, N. Yaşar
Crohn’s disease is an inflammatory bowel disease of unknown etiology, progressing with frequent exacerbation periods that can involve any part of the gastrointestinal tract. Although, it can manifest itself with complaints from the entire gastrointestinal tract; abdominal pain, diarrhea, nausea, weight loss and fever are the most important clinical symptoms. In this presentation, a 41-year-old male patient with known Crohn’s disease was presented to our hospital with the help of operation images.
{"title":"Fistulized Crohn’ Disease Mimicking Sigmoid Cancer: A Case Report","authors":"B. Badak, Ercüment Paşaoğlu, H. Caga, E. Ihtiyar, A. Şahin, S. Erkasap, E. Ateş, N. Yaşar","doi":"10.21802/gmj.2020.4.2","DOIUrl":"https://doi.org/10.21802/gmj.2020.4.2","url":null,"abstract":"Crohn’s disease is an inflammatory bowel disease of unknown etiology, progressing with frequent exacerbation periods that can involve any part of the gastrointestinal tract. Although, it can manifest itself with complaints from the entire gastrointestinal tract; abdominal pain, diarrhea, nausea, weight loss and fever are the most important clinical symptoms. In this presentation, a 41-year-old male patient with known Crohn’s disease was presented to our hospital with the help of operation images.","PeriodicalId":12537,"journal":{"name":"Galician Medical Journal","volume":" ","pages":""},"PeriodicalIF":0.1,"publicationDate":"2020-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46931759","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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