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A rare paraneoplastic condition in Hodgkin lymphoma: Evans syndrome and literature review. 霍奇金淋巴瘤中一种罕见的副肿瘤性疾病:埃文斯综合征和文献综述。
IF 0.9 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-10-03 eCollection Date: 2024-01-01 DOI: 10.14744/nci.2022.66742
Unal Atas, Kubra Cerci, Sema Tuncer, Volkan Karakus

Evans syndrome (ES) is a spectrum of diseases in which the combination of autoimmune hemolytic anemia and immune thrombocytopenia or sometimes neutropenia. ES has been accepted usually as an idiopathic condition, but it may be secondary. The coexistence of autoimmune cytopenias and Hodgkin lymphoma (HL) is rarely observed and the rate of ES in HL patients is not clear. Here we describe a 56-year-old male patient who presented with ES and was diagnosed with HL. After corticosteroids, intravenous immunoglobulin (IVIG) and ABVD (doxorubicin, bleomycin, vinblastine, dacarbazine) treatment, immune cytopenias were completely resolved. The literature is also reviewed and we found 16 cases in which HL and ES coexist. Although AIHA and immune thrombocytopenia usually develop simultaneously, they rarely occur at different times. Many aspects of the pathogenesis are unknown, but it is thought to be a complex immunological background. Corticosteroids and/or IVIG are the most commonly used first-choice drugs in the initial treatment of ES. Response rates to treatment are variable and response to treatment may be poor, particularly with underlying conditions. If detected, the underlying lymphoma should be treated.

埃文斯综合征(ES)是一种合并自身免疫性溶血性贫血和免疫性血小板减少症(有时为中性粒细胞减少症)的疾病。ES通常被认为是一种特发性疾病,但也可能是继发性的。自身免疫性细胞减少症与霍奇金淋巴瘤(HL)同时存在的情况很少见,而霍奇金淋巴瘤患者的ES发病率也不明确。在此,我们描述了一名 56 岁的男性患者,他出现 ES 并被诊断为 HL。经过皮质类固醇、静脉注射免疫球蛋白(IVIG)和 ABVD(多柔比星、博来霉素、长春新碱、达卡巴嗪)治疗后,免疫性细胞减少症完全消失。我们还查阅了文献,发现有 16 例 HL 和 ES 并存的病例。尽管 AIHA 和免疫性血小板减少症通常同时发生,但它们很少在不同时间出现。发病机制的许多方面尚不清楚,但认为是一种复杂的免疫学背景。皮质类固醇和/或 IVIG 是治疗 ES 最常用的首选药物。对治疗的反应率不尽相同,治疗反应可能较差,尤其是在有基础疾病的情况下。如果发现潜在的淋巴瘤,应进行治疗。
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引用次数: 0
Pachymeningitis in a pediatric case of IgG4-related disease successfully treated with mycophenolate mofetil. 用霉酚酸酯(mycophenolate mofetil)成功治疗一例IgG4相关疾病的小儿脑膜后炎。
IF 0.9 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-08-01 eCollection Date: 2024-01-01 DOI: 10.14744/nci.2022.15246
Betul Sozeri, Sevinc Kalin, Mustafa Cakan
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引用次数: 0
A rare pathology in the neck: Hydatid cyst. 一种罕见的颈部病变:水瘤囊肿。
IF 0.9 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-06-10 eCollection Date: 2024-01-01 DOI: 10.14744/nci.2022.47124
Gulistan Huriye Bozdag Baskaya

Neck cysts can be classified as congenital, infectious-inflammatory, and neoplastic. Hydatid disease is a parasitic infection caused by Echinococcus, is usually seen in the liver and lung and, is rare in the head and neck region even in endemic areas. If not treated, a life-threatening condition may be encountered. In this study, a case of hydatid cyst operated due to a cystic lesion with a diameter of approximately 8 cm in the neck was presented by reviewing the literature.

颈部囊肿可分为先天性、感染-炎症性和肿瘤性。包虫病是由棘球蚴引起的寄生虫感染,通常发生在肝脏和肺部,即使在流行地区也很少发生在头颈部。如果不及时治疗,可能会危及生命。本研究通过查阅文献,介绍了一例因颈部直径约 8 厘米的囊性病变而进行手术的包虫囊肿病例。
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引用次数: 0
The effect of Myrtus communis L. extract on nephrolithiasis model in rats. 香桃木提取物对大鼠肾结石模型的影响
IF 1 Pub Date : 2024-04-24 eCollection Date: 2024-01-01 DOI: 10.14744/nci.2023.09068
Busra Ertas, Dogancan Dorucu, Oznur Gulerturk, Ali Sen, Ozge Cevik, Sule Cetinel, Pinar Eker, Asuman Akgun, Emre Tarik Sener, Goksel Sener

Objective: Nephrolithiasis is a common urological disease that can lead to renal failure. Oxidative stress has been shown to be a contributing factor for nephrolithiasis and many agents have been studied to prevent and treat oxidative stress-related nephrolithiasis and renal damage. Myrtus communis (MC) extract has been shown to be an important antioxidant in different animal models. In this study, MC extract was administered preventively or therapeutically to rats with kidney stones, and its effectiveness was investigated.

Methods: Wistar albino rats were divided into four groups (n=8); control (C), ethylene glycol (EG), EG+preventive MC, and EG+curative MC groups. The nephrolithiasis model was created by adding 0.75% EG to drinking water for 8 weeks. Ultimately, 24-hour urine was collected to measure calcium, citrate, and creatinine levels. After decapitation, kidney tissues were harvested for histological analyses, measurement of osteopontin and 8-hydroxydeoxyguanosine (8-OHdG) levels, and N-acetyl-β-glucosaminidase (NAG), myeloperoxidase (MPO) and caspase-3 activities.

Results: In 24-hour urine samples, calcium, citrate and creatinine levels were decreased in the EG group, while oxalate levels were increased and in treatment groups these parameters returned to control levels. MPO, 8-OHdG, caspase-3 and NAG activity were significantly increased in tissue and these changes were reversed in both MC groups. Histological findings also supported the biochemical parameters.

Conclusion: MC can reduce oxidative stress and histopathological changes in kidney tissues in rat nephrolithiasis model when used as either a preventive or therapeutic agent. If supported with further clinical trials, MC might have clinical implications in preventing oxidative renal cell injury and ultimately kidney stone formation.

目的:肾结石是一种常见的泌尿系统疾病,可导致肾功能衰竭。氧化应激已被证明是导致肾结石的一个因素,人们研究了许多药物来预防和治疗与氧化应激相关的肾结石和肾损伤。在不同的动物模型中,桃金娘(MC)提取物已被证明是一种重要的抗氧化剂。本研究对肾结石大鼠进行了MC提取物的预防或治疗,并对其有效性进行了调查:Wistar白化大鼠分为四组(n=8):对照组(C)、乙二醇组(EG)、EG+预防性MC组和EG+治疗性MC组。通过在饮用水中添加 0.75% 的乙二醇,建立肾炎模型,为期 8 周。最终,收集 24 小时尿液以测量钙、柠檬酸盐和肌酐水平。断头后,采集肾组织进行组织学分析,测量骨化素和 8-羟基脱氧鸟苷(8-OHdG)水平,以及 N-乙酰基-β-氨基葡萄糖苷酶(NAG)、髓过氧化物酶(MPO)和 caspase-3 活性:在 24 小时尿样中,EG 组的钙、柠檬酸盐和肌酐水平降低,而草酸盐水平升高,治疗组的这些参数恢复到控制水平。组织中的 MPO、8-OHdG、caspase-3 和 NAG 活性显著增加,这些变化在 MC 组和 EG 组均得到逆转。组织学研究结果也支持生化指标:结论:在大鼠肾结石模型中,MC 作为一种预防或治疗药物可减少氧化应激和肾组织病理变化。如果得到进一步临床试验的支持,MC 在预防氧化性肾细胞损伤和最终肾结石形成方面可能具有临床意义。
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引用次数: 0
Impact of central sensitization on clinical parameters in patients with rheumatoid arthritis. 中枢敏化对类风湿性关节炎患者临床指标的影响。
IF 1 Pub Date : 2024-04-22 eCollection Date: 2024-01-01 DOI: 10.14744/nci.2023.81231
Nilgun Mesci, Erkan Mesci, Emine Unkun Kandemir, Duygu Geler Kulcu, Talha Celik

Objective: This study aimed to investigate the effects of central sensitization (CS) on pain sensitivity, disease activity, neuropathic symptoms and quality of life (QoL) in patients with rheumatoid arthritis (RA).

Methods: Sixty patients diagnosed with RA according to the American College of Rheumatology and the European League Against Rheumatism (ACR/EULAR) 2010 classification criteria were included in the study. Patient assessment tools included visual analog scale (VAS) for pain, algometer for pain pressure threshold (PPT), disease activity score in 28 joints (DAS-28) for disease activity (DA), central sensitization inventory (CSI) for CS and rheumatoid arthritis QoL questionnaire for QoL.

Results: Central sensitization was identified in 29 (48.3%) patients. Although erythrocyte sedimentation rate (ESR), C-reactive protein and swollen joint count were comparable between patients with or without CS, higher VAS, tender joint count and DAS-28 scores were observed in patients with CS (all p<0.05). Pain pressure thresholds (PPT) at the wrist (PPTW) and the trapezius muscle (PPTT) were lower in patients with CS (p=0.004, p=0.001, respectively). It was found that neuropathic pain components increased and quality of life decreased as CSI scores increased (all p=0.000).

Conclusion: The presence of CS leads to pain sensitivity as well as overestimation of disease activity in RA patients. The presence of CS should not be overlooked in RA patients to avoid overtreatment for inflammation and to determine the treatment need for nociplastic pain.

研究目的本研究旨在探讨中枢敏化(CS)对类风湿关节炎(RA)患者疼痛敏感性、疾病活动性、神经病理性症状和生活质量(QoL)的影响:根据美国风湿病学会和欧洲抗风湿病联盟(ACR/EULAR)2010 年的分类标准确诊为类风湿关节炎的 60 名患者被纳入研究。患者评估工具包括疼痛视觉模拟量表(VAS)、疼痛压力阈值(PPT)、28个关节疾病活动度评分(DAS-28)、中枢敏感性清单(CSI)和类风湿关节炎QoL问卷:结果:29 名患者(48.3%)被确诊为中枢过敏。尽管红细胞沉降率(ESR)、C 反应蛋白和关节肿胀计数在 CS 患者和非 CS 患者之间具有可比性,但在 CS 患者中观察到较高的 VAS、关节触痛计数和 DAS-28 评分(均为 pW),并且 CS 患者的斜方肌(PPTT)较低(分别为 p=0.004 和 p=0.001)。研究发现,随着 CSI 评分的增加,神经性疼痛成分增加,生活质量下降(均为 p=0.000):结论:CSI的存在会导致RA患者对疼痛的敏感性以及对疾病活动性的高估。RA患者不应忽视CS的存在,以避免过度治疗炎症,并确定非痉挛性疼痛的治疗需求。
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引用次数: 0
A rare disease: ZAP70 deficiency. 一种罕见疾病:ZAP70 缺乏症。
IF 1 Pub Date : 2024-04-18 eCollection Date: 2024-01-01 DOI: 10.14744/nci.2022.89646
Seher Erdogan, Selen Ceren Cakmak, Atay Gurkan, Canan Hasbal Akkus, Burcu Karakayali, Ozlem Akgun Dogan, Betul Sozeri

Zeta associated protein (ZAP) 70 deficiency is a rare disease. ZAP70 deficiency results in an autosomal recessive form of severe combined immunodeficiency (SCID) that is characterized by a selective absence of CD8 T cells. The diagnosis should be suspected in patients presenting with a severe combined immunodeficiency phenotype and selective deficiency of CD8 T cells. Sequencing of the ZAP70 gene can confirm the diagnosis. We wanted to emphasize that immunodeficiencies should also be remembered in the differential diagnosis by presenting a 5-month-old patient who applied to our clinic with complaints of skin rash and cough, was given respiratory support with mechanical ventilation for a long time, and was diagnosed with ZAP70 deficiency.

Zeta 相关蛋白(ZAP)70 缺乏症是一种罕见疾病。ZAP70 缺乏症会导致常染色体隐性遗传的重症联合免疫缺陷病(SCID),其特征是 CD8 T 细胞选择性缺乏。如果患者表现为重症联合免疫缺陷表型和 CD8 T 细胞选择性缺乏,则应怀疑该病的诊断。ZAP70 基因测序可以确诊。我们想通过介绍一名 5 个月大的患者,强调在鉴别诊断中也应注意免疫缺陷,该患者以皮疹和咳嗽为主诉来我院就诊,长期使用机械通气进行呼吸支持,并被诊断为 ZAP70 缺乏症。
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引用次数: 0
Drug utilization studies in Turkiye: A systematic review. 土耳其的药物使用研究:系统回顾。
IF 1 Pub Date : 2024-02-01 eCollection Date: 2024-01-01 DOI: 10.14744/nci.2023.60134
Ahmet Akici, Dieudonné Havyarimana, Ertan Direnc, Volkan Aydin

Objective: Drug utilization studies (DUS) provide a framework for drug utilization at the national or targeted population level and important information on unmet medical needs, particularly in assessing the rationality of drug use. We aimed to systematically review DUS conducted in Turkiye.

Methods: We examined 162 DUS with an accessible full-text, published as "research articles" and conducted in Turkiye between 2000 and 2021 using medical records and prescription data. We included English or Turkish papers with English abstracts. We examined the scientific characteristics of the publications, source of the data, place/time of collection, research designs, and studied drug groups.

Results: We found that 79.6% of articles were in English, 45.1% were listed in SCI/SCIE, and 63.0% were on the WOS platform with 3.5 (interquartile range: 1-15) citations. The mean study period and publication time were 2.9±3.1 and 2.9±2.1 years, respectively. The highest number of studies (17.9%) were published in 2021 and (26.5%) were conducted nationwide. We identified that 93.8% of the studies had retrospective design, 67.8% were conducted in secondary/tertiary health-care institutions, and 54.9% used direct hospital data. We detected that 68.5% of the studies were conducted on the general population, 19.1% on adults, 12.4% on children, and 44.4% were antibiotic oriented.

Conclusion: Our study showed that a significant portion of the DUS, the trend of which has gained momentum in recent years, was antibiotic focused and conducted with a retrospective design from hospital-based data collected on the general patient population. This situation points to the necessity of expanding the existing DUS range by effectively using the new advantages provided by medical record databases and conducting more DUS that can provide critical clues for specific patients and drug groups.

目的:药物利用研究(DUS)为全国或目标人群的药物利用提供了一个框架,并提供了有关未满足医疗需求的重要信息,尤其是在评估药物使用的合理性方面。我们旨在对土耳其进行的 DUS 进行系统回顾:我们利用医疗记录和处方数据,对 2000 年至 2021 年期间在土耳其进行的 162 篇可查阅全文的 DUS 进行了研究。我们收录了附有英文摘要的英文或土耳其文论文。我们研究了出版物的科学特征、数据来源、收集地点/时间、研究设计和研究药物组别:结果:我们发现79.6%的文章为英文,45.1%的文章被SCI/SCIE收录,63.0%的文章在WOS平台上发表,引用次数为3.5次(四分位间范围:1-15次)。平均研究时间(2.9±3.1)年,平均发表时间(2.9±2.1)年。发表于 2021 年的研究数量最多(17.9%),在全国范围内开展的研究数量最多(26.5%)。我们发现,93.8%的研究采用回顾性设计,67.8%的研究在二级/三级医疗机构进行,54.9%的研究直接使用医院数据。我们发现,68.5%的研究针对普通人群,19.1%针对成人,12.4%针对儿童,44.4%以抗生素为导向:我们的研究表明,近年来DUS的发展趋势是以抗生素为重点,并根据医院收集的普通患者数据进行回顾性设计。这种情况表明,有必要有效利用病历数据库提供的新优势,扩大现有的 DUS 范围,开展更多的 DUS,为特定患者和药物组提供重要线索。
{"title":"Drug utilization studies in Turkiye: A systematic review.","authors":"Ahmet Akici, Dieudonné Havyarimana, Ertan Direnc, Volkan Aydin","doi":"10.14744/nci.2023.60134","DOIUrl":"10.14744/nci.2023.60134","url":null,"abstract":"<p><strong>Objective: </strong>Drug utilization studies (DUS) provide a framework for drug utilization at the national or targeted population level and important information on unmet medical needs, particularly in assessing the rationality of drug use. We aimed to systematically review DUS conducted in Turkiye.</p><p><strong>Methods: </strong>We examined 162 DUS with an accessible full-text, published as \"research articles\" and conducted in Turkiye between 2000 and 2021 using medical records and prescription data. We included English or Turkish papers with English abstracts. We examined the scientific characteristics of the publications, source of the data, place/time of collection, research designs, and studied drug groups.</p><p><strong>Results: </strong>We found that 79.6% of articles were in English, 45.1% were listed in SCI/SCIE, and 63.0% were on the WOS platform with 3.5 (interquartile range: 1-15) citations. The mean study period and publication time were 2.9±3.1 and 2.9±2.1 years, respectively. The highest number of studies (17.9%) were published in 2021 and (26.5%) were conducted nationwide. We identified that 93.8% of the studies had retrospective design, 67.8% were conducted in secondary/tertiary health-care institutions, and 54.9% used direct hospital data. We detected that 68.5% of the studies were conducted on the general population, 19.1% on adults, 12.4% on children, and 44.4% were antibiotic oriented.</p><p><strong>Conclusion: </strong>Our study showed that a significant portion of the DUS, the trend of which has gained momentum in recent years, was antibiotic focused and conducted with a retrospective design from hospital-based data collected on the general patient population. This situation points to the necessity of expanding the existing DUS range by effectively using the new advantages provided by medical record databases and conducting more DUS that can provide critical clues for specific patients and drug groups.</p>","PeriodicalId":19164,"journal":{"name":"Northern Clinics of Istanbul","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10861429/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82608668","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Investigation of skincare habits and possible rosacea triggers of patients with rosacea: A prospective case-control study. 红斑痤疮患者的护肤习惯和可能的红斑痤疮诱因调查:前瞻性病例对照研究
IF 1 Pub Date : 2024-01-31 eCollection Date: 2024-01-01 DOI: 10.14744/nci.2023.33410
Husna Guder, Semih Guder

Objective: Skincare is a part of rosacea treatment; patients benefit from complementary dermo-cosmetic care as well as medical treatments. Some skincare habits are known to trigger and exacerbate rosacea, but there are very few epidemiological studies on this matter.

Methods: A total of 200 people, including 100 patients with rosacea and 100 controls, were included in the study. We questioned the methods used by the participants in daily facial cleansing. Sun and heat exposure, makeup habits, the history of the use of topical steroids, and outdoor working status were noted. A dermoscopic examination, a non-invasive and valuable method to evaluate the presence and severity of Demodex, was performed.

Results: We evaluated 30% of our rosacea patients as erythematotelangiectatic rosacea, 13% as papulopustular rosacea, and 57% of our patients had mixed type, which could not be distinguished from one of these subtypes. In the case group, the proportion of people who used daily facial cleansers and daily soaps was lower than in the control group, while the proportion of those who cleaned their face with only water and those who used facial cleansers less frequently was higher (p<0.001). In the case group, while the rate of daily make-up and use of make-up products was lower (p=0.001, p<0.001, respectively), the rate of not wearing make-up was higher (p=0.001). The history of hot bath use was higher in the case group than in the control group (p=0.011). We found a significant relationship between the severity of plaque and dry appearance and the increase in Demodex density (p=0.007, p<0.001, respectively).

Conclusion: We recommend that patients with rosacea clean their faces daily with soap or facial cleansers and not take a bath with very hot water. Patients should be evaluated for increased Demodex mites, especially if skin dryness is accompanied.

目的:护肤是红斑痤疮治疗的一部分;患者可从辅助性皮肤美容护理和药物治疗中获益。已知一些护肤习惯会诱发和加重酒糟鼻,但这方面的流行病学研究却很少:研究共涉及 200 人,包括 100 名酒糟鼻患者和 100 名对照组。我们询问了参与者日常面部清洁的方法。我们还记录了日晒和高温暴露、化妆习惯、外用类固醇激素的使用史以及户外工作状况。此外,还进行了皮肤镜检查,这是一种非侵入性的重要方法,可用于评估白癣菌的存在和严重程度:结果:我们将 30% 的红斑痤疮患者评估为红斑扩张型红斑痤疮,13% 的患者为丘疹脓疱型红斑痤疮,57% 的患者为混合型红斑痤疮,无法从这些亚型中区分出来。在病例组中,每天使用洁面乳和香皂的比例低于对照组,而只用清水清洁面部和较少使用洁面乳的比例则高于对照组(P结论:我们建议红斑痤疮患者每天用肥皂或洁面乳清洁面部,不要用很热的水洗澡。应评估患者是否有更多的 Demodex 螨虫,尤其是在皮肤干燥的情况下。
{"title":"Investigation of skincare habits and possible rosacea triggers of patients with rosacea: A prospective case-control study.","authors":"Husna Guder, Semih Guder","doi":"10.14744/nci.2023.33410","DOIUrl":"10.14744/nci.2023.33410","url":null,"abstract":"<p><strong>Objective: </strong>Skincare is a part of rosacea treatment; patients benefit from complementary dermo-cosmetic care as well as medical treatments. Some skincare habits are known to trigger and exacerbate rosacea, but there are very few epidemiological studies on this matter.</p><p><strong>Methods: </strong>A total of 200 people, including 100 patients with rosacea and 100 controls, were included in the study. We questioned the methods used by the participants in daily facial cleansing. Sun and heat exposure, makeup habits, the history of the use of topical steroids, and outdoor working status were noted. A dermoscopic examination, a non-invasive and valuable method to evaluate the presence and severity of Demodex, was performed.</p><p><strong>Results: </strong>We evaluated 30% of our rosacea patients as erythematotelangiectatic rosacea, 13% as papulopustular rosacea, and 57% of our patients had mixed type, which could not be distinguished from one of these subtypes. In the case group, the proportion of people who used daily facial cleansers and daily soaps was lower than in the control group, while the proportion of those who cleaned their face with only water and those who used facial cleansers less frequently was higher (p<0.001). In the case group, while the rate of daily make-up and use of make-up products was lower (p=0.001, p<0.001, respectively), the rate of not wearing make-up was higher (p=0.001). The history of hot bath use was higher in the case group than in the control group (p=0.011). We found a significant relationship between the severity of plaque and dry appearance and the increase in Demodex density (p=0.007, p<0.001, respectively).</p><p><strong>Conclusion: </strong>We recommend that patients with rosacea clean their faces daily with soap or facial cleansers and not take a bath with very hot water. Patients should be evaluated for increased Demodex mites, especially if skin dryness is accompanied.</p>","PeriodicalId":19164,"journal":{"name":"Northern Clinics of Istanbul","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10861432/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76856454","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
An innovative surgical treatment method in persistent rectal prolapse: Ventral abdomino-rectosigmoidopexy through tube sigmoidostomy combined with Ekehorn's rectopexy. 顽固性直肠脱垂的创新手术治疗方法:腹股沟直肠乙状结肠吻合术(通过乙状结肠管造口术)结合 Ekehorn 直肠吻合术。
IF 1 Pub Date : 2024-01-29 eCollection Date: 2024-01-01 DOI: 10.14744/nci.2023.25874
Sabri Cansaran, Cengiz Gul, Olga Devrim Ayvaz, Yusuf Polat, Aysenur Celayir

Objective: Herein, the results of the cases, who underwent surgical repair with or without ventral abdomino-rectosigmoidopexy through tube sigmoidostomy combined with Ekehorn's rectopexy due to recurrent rectal prolapse, were discussed.

Methods: The demographic characteristics, surgical technique, and results of children who were operated in the department of Pediatric Surgery for rectal prolapse between 2004 and 2022 were retrospectively analyzed.

Results: In 18 years, six pediatric cases (2 females [33%] and 4 males [67%]) were operated for persistent rectal prolapse. The mean operative age of the patients was 7.5 years (2.1-17), and all had severe rectal prolapse. Some of these patients were followed up in other centers and their rectal prolapse continued despite diet changes, toilet behavior training, and the treatment of sclerosing agents. Rectal trimming was applied to one of the first two patients who were operated for anal atresia and recurrence did not occur. In the second case who underwent laparoscopic colon pull-through, Ekehorn rectopexy was performed alone and no recurrence was observed also in this case. Considering that rectosigmoid colon adhesions formed on the anterior abdominal wall due to colostomy opening-closing may provide ventral sigmoidopexy, it was decided to offer the option of applying both methods together. Three of the next four cases were diagnosed with cystic fibrosis. All four underwent ventral abdomino-rectosigmoidopexy through tube sigmoidostomy combined with Ekehorn's rectopexy. Ekehorn's butterfly sutures were removed on 15th day and Foley catheters on 21st day. Three cases with cystic fibrosis were uneventful. However, a 14-year-old girl with a history of sexual abuse relapsed 6 months later.

Conclusion: Ventral abdomino-rectosigmoidopexy through tube sigmoidostomy combined with Ekehorn's rectopexy is a successful and unique method in terms of providing intestinal fixation. It may be the primary option for definitive surgical treatment of persistent rectal prolapse.

目的:通过管状乙状结肠造口术联合Ekehorn直肠外翻术,对因复发性直肠脱垂而接受或不接受腹腔腹直乙状结肠外翻术进行手术修复的病例的结果进行讨论:方法:回顾性分析2004年至2022年间在小儿外科接受直肠脱垂手术的儿童的人口统计学特征、手术技术和结果:结果:18年间,共有6例儿童(2例女性[33%],4例男性[67%])因持续性直肠脱垂接受了手术治疗。患者的平均手术年龄为 7.5 岁(2.1-17 岁),均患有严重的直肠脱垂。其中一些患者在其他中心接受了随访,尽管他们改变了饮食习惯、进行了如厕行为训练并使用了硬化剂治疗,但直肠脱垂仍在继续。在前两名因肛门闭锁而接受手术的患者中,有一人接受了直肠修剪术,结果没有复发。在第二例接受腹腔镜结肠拉通术的患者中,只进行了 Ekehorn 直肠切除术,也没有发现复发。考虑到因结肠造口术开腹-闭合而在前腹壁形成的直乙状结肠粘连可能提供腹侧乙状结肠切除术,因此决定提供两种方法同时应用的选择。接下来的四个病例中有三个被诊断为囊性纤维化。这四人都接受了腹侧腹直乙状结肠吻合术,即通过管状乙状结肠造口术结合 Ekehorn 直肠吻合术。第 15 天拆除 Ekehorn 蝶形缝合线,第 21 天拆除 Foley 导管。三例囊性纤维化病例均无大碍。然而,一名有性虐待史的 14 岁女孩在 6 个月后复发:结论:通过管状乙状结肠造口术进行腹股沟直肠吻合术并结合埃克霍恩直肠吻合术是一种成功且独特的肠道固定方法。它可能是顽固性直肠脱垂最终手术治疗的主要选择。
{"title":"An innovative surgical treatment method in persistent rectal prolapse: Ventral abdomino-rectosigmoidopexy through tube sigmoidostomy combined with Ekehorn's rectopexy.","authors":"Sabri Cansaran, Cengiz Gul, Olga Devrim Ayvaz, Yusuf Polat, Aysenur Celayir","doi":"10.14744/nci.2023.25874","DOIUrl":"10.14744/nci.2023.25874","url":null,"abstract":"<p><strong>Objective: </strong>Herein, the results of the cases, who underwent surgical repair with or without ventral abdomino-rectosigmoidopexy through tube sigmoidostomy combined with Ekehorn's rectopexy due to recurrent rectal prolapse, were discussed.</p><p><strong>Methods: </strong>The demographic characteristics, surgical technique, and results of children who were operated in the department of Pediatric Surgery for rectal prolapse between 2004 and 2022 were retrospectively analyzed.</p><p><strong>Results: </strong>In 18 years, six pediatric cases (2 females [33%] and 4 males [67%]) were operated for persistent rectal prolapse. The mean operative age of the patients was 7.5 years (2.1-17), and all had severe rectal prolapse. Some of these patients were followed up in other centers and their rectal prolapse continued despite diet changes, toilet behavior training, and the treatment of sclerosing agents. Rectal trimming was applied to one of the first two patients who were operated for anal atresia and recurrence did not occur. In the second case who underwent laparoscopic colon pull-through, Ekehorn rectopexy was performed alone and no recurrence was observed also in this case. Considering that rectosigmoid colon adhesions formed on the anterior abdominal wall due to colostomy opening-closing may provide ventral sigmoidopexy, it was decided to offer the option of applying both methods together. Three of the next four cases were diagnosed with cystic fibrosis. All four underwent ventral abdomino-rectosigmoidopexy through tube sigmoidostomy combined with Ekehorn's rectopexy. Ekehorn's butterfly sutures were removed on 15<sup>th</sup> day and Foley catheters on 21<sup>st</sup> day. Three cases with cystic fibrosis were uneventful. However, a 14-year-old girl with a history of sexual abuse relapsed 6 months later.</p><p><strong>Conclusion: </strong>Ventral abdomino-rectosigmoidopexy through tube sigmoidostomy combined with Ekehorn's rectopexy is a successful and unique method in terms of providing intestinal fixation. It may be the primary option for definitive surgical treatment of persistent rectal prolapse.</p>","PeriodicalId":19164,"journal":{"name":"Northern Clinics of Istanbul","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10861431/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83254087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Effect of sugammadex, rocuronium and sevoflurane on oxidative stress and apoptosis in cerebral ischemia reperfusion model in rats. 苏麦迪、罗库溴铵和七氟烷对大鼠脑缺血再灌注模型氧化应激和细胞凋亡的影响
IF 1 Pub Date : 2024-01-29 eCollection Date: 2024-01-01 DOI: 10.14744/nci.2023.07888
Hakan Ciftci, Nilay Tas, Zubeyir Cebeci, Sibel Kokturk, Selma Cirrik, Tevfik Noyan

Objective: Cerebral ischemia-reperfusion (I/R) injury causes neurological dysfunction and cell death. Sugammadex, as a large molecule, is normally difficult to pass through the blood-brain barrier (BBB). In ischemia, molecules can pass into the brain tissue. In this study, we aimed to evaluate the effect of sugammadex in the presence of cerebral I/R damage in rats with a general anesthesia model with sevoflurane and rocuronium.

Methods: Rats were divided into 7 groups; Group 1 (Control), Group 2 (Sham), Group 3 (Sevoflurane), Group 4 (Sugammadex), Group 5 (Sevoflurane + Rocuronium), Group 6 (Sevoflurane + Sugammadex), Group 7 (Sevoflurane + Rocuronium + Sugammadex). Brain tissues of rats with cerebral I/R damage with bilateral carotid occlusion were removed. Tissue Malondialdehyde (MDA), Myeloperoxidase (MPO), and Superoxide dismutase (SOD) levels were examined with ELISA and apoptosis was examined by Caspase-3.

Results: The number of caspase-3 positive cells decreased the most in Group 4 compared to the other groups. Group 4's mean MDA and MPO levels were lower than Group 2. There was no significant difference in terms of SOD levels.

Conclusion: The apoptotic effect of sugammadex was lowest compared to other agent groups, and it did not increase oxidative damage as much as the other groups.

目的:脑缺血再灌注(I/R)损伤会导致神经功能紊乱和细胞死亡。舒降之作为一种大分子药物,通常很难通过血脑屏障(BBB)。缺血时,分子可进入脑组织。在这项研究中,我们的目的是评估舒降之在使用七氟醚和罗库溴铵全身麻醉模型的大鼠出现脑I/R损伤时的作用:大鼠分为7组:第1组(对照组)、第2组(Sham组)、第3组(七氟烷组)、第4组(舒甘马定组)、第5组(七氟烷+罗库溴铵)、第6组(七氟烷+舒甘马定组)、第7组(七氟烷+罗库溴铵+舒甘马定组)。切除双侧颈动脉闭塞造成脑缺血再灌注损伤的大鼠脑组织。用 ELISA 检测组织丙二醛(MDA)、髓过氧化物酶(MPO)和超氧化物歧化酶(SOD)水平,用 Caspase-3 检测细胞凋亡:结果:与其他组相比,第 4 组的 Caspase-3 阳性细胞数量减少最多。结果:与其他组相比,第 4 组 caspase-3 阳性细胞数量减少最多;第 4 组的平均 MDA 和 MPO 水平低于第 2 组;SOD 水平无显著差异:结论:与其他药物组相比,舒降之肽的凋亡效应最低,而且与其他药物组相比,舒降之肽不会增加氧化损伤。
{"title":"Effect of sugammadex, rocuronium and sevoflurane on oxidative stress and apoptosis in cerebral ischemia reperfusion model in rats.","authors":"Hakan Ciftci, Nilay Tas, Zubeyir Cebeci, Sibel Kokturk, Selma Cirrik, Tevfik Noyan","doi":"10.14744/nci.2023.07888","DOIUrl":"10.14744/nci.2023.07888","url":null,"abstract":"<p><strong>Objective: </strong>Cerebral ischemia-reperfusion (I/R) injury causes neurological dysfunction and cell death. Sugammadex, as a large molecule, is normally difficult to pass through the blood-brain barrier (BBB). In ischemia, molecules can pass into the brain tissue. In this study, we aimed to evaluate the effect of sugammadex in the presence of cerebral I/R damage in rats with a general anesthesia model with sevoflurane and rocuronium.</p><p><strong>Methods: </strong>Rats were divided into 7 groups; Group 1 (Control), Group 2 (Sham), Group 3 (Sevoflurane), Group 4 (Sugammadex), Group 5 (Sevoflurane + Rocuronium), Group 6 (Sevoflurane + Sugammadex), Group 7 (Sevoflurane + Rocuronium + Sugammadex). Brain tissues of rats with cerebral I/R damage with bilateral carotid occlusion were removed. Tissue Malondialdehyde (MDA), Myeloperoxidase (MPO), and Superoxide dismutase (SOD) levels were examined with ELISA and apoptosis was examined by Caspase-3.</p><p><strong>Results: </strong>The number of caspase-3 positive cells decreased the most in Group 4 compared to the other groups. Group 4's mean MDA and MPO levels were lower than Group 2. There was no significant difference in terms of SOD levels.</p><p><strong>Conclusion: </strong>The apoptotic effect of sugammadex was lowest compared to other agent groups, and it did not increase oxidative damage as much as the other groups.</p>","PeriodicalId":19164,"journal":{"name":"Northern Clinics of Istanbul","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10861428/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87245395","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
Northern Clinics of Istanbul
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