Tuberculosis (TB) is the most common granulomatous disease, but laryngeal involvement is rare. The risk of developing this clinical form is higher in immunocompromised patients due to primary infection or reactivation of latent TB. Laryngeal TB can be misdiagnosed as laryngeal cancer since they have similar macroscopic lesions, and both cause dysphonia. We present a case of laryngeal TB in a 37-week pregnant patient who complained of dysphonia, odynophagia, and dysphagia. A mass with supraglottic carcinoma findings was discovered during a laryngoscopic examination. The reason for presenting this case is to emphasize the necessity for a high degree of suspicion for laryngeal TB involvement in patients with upper respiratory tract lesions in regions with high TB prevalence, to achieve early diagnosis and treatment.
{"title":"A case of laryngeal tuberculosis mimicking supraglottic carcinoma in a pregnant patient and literature review","authors":"Deniz Baklacı, Anil Cakir Turhan, Müge Harma","doi":"10.28982/josam.7372","DOIUrl":"https://doi.org/10.28982/josam.7372","url":null,"abstract":"Tuberculosis (TB) is the most common granulomatous disease, but laryngeal involvement is rare. The risk of developing this clinical form is higher in immunocompromised patients due to primary infection or reactivation of latent TB. Laryngeal TB can be misdiagnosed as laryngeal cancer since they have similar macroscopic lesions, and both cause dysphonia. We present a case of laryngeal TB in a 37-week pregnant patient who complained of dysphonia, odynophagia, and dysphagia. A mass with supraglottic carcinoma findings was discovered during a laryngoscopic examination. The reason for presenting this case is to emphasize the necessity for a high degree of suspicion for laryngeal TB involvement in patients with upper respiratory tract lesions in regions with high TB prevalence, to achieve early diagnosis and treatment.","PeriodicalId":30878,"journal":{"name":"International Journal of Surgery and Medicine","volume":"16 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136359258","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}
Background/Aim: The inflammatory disorder rheumatoid arthritis (RA) affects quality of life and worsens with symptoms in the extra-articular tissues and systemic joints. The most significant member of the Cytochrome P450 enzyme family, Cytochrome P450 2C9 (CYP2C9), plays an essential role in the alkylation, demethylation, and hydroxylation of a variety of substances. Insufficient studies as to whether the susceptibility to rheumatoid arthritis is genetic exists. Therefore, our study presents new information on whether CYPC9 is a genetic risk factor. In this study, we sought to determine whether rheumatoid arthritis and the CYP2C9 gene polymorphism are related. Methods: This study was conducted as a prospective case-control study. Fifty patients with RA and 50 healthy individuals were included in our study group. Blood from the controls and patients was drawn into ethylenediaminetetraacetic acid (EDTA)-containing tubes, and using a DNA isolation kit, DNA was isolated from leukocytes. Reverse transcriptase polymerase chain reaction (RT-PCR) was used to assess the genotypes of CYPC9*2 and CYP2C9*3 with the LightCycler-CYP2C9 mutation detection kit. Results: The heterozygous CYP2C9*2 genotype was found to carry a 2.85-fold risk when compared with the controls (odds ratio [OR]=2.85, 95% confidence interval [CI]: 0.52–15.50; P=0.22); however, this risk was not statistically significant. It was found that people with the CYP2C9*3 heterozygous genotype had a statistically significant 2.79-fold higher risk compared to the controls (OR=2.79, 95% CI: 1.13–7.00 P=0.04). Conclusion: The heterozygous genotype of CYP2C9*3 may contribute to the onset of RA.
{"title":"The role of CYP2C9 gene polymorphism in rheumatoid arthritis","authors":"Hatice Yıldırım Yaroğlu, Ali Biçer","doi":"10.28982/josam.7991","DOIUrl":"https://doi.org/10.28982/josam.7991","url":null,"abstract":"Background/Aim: The inflammatory disorder rheumatoid arthritis (RA) affects quality of life and worsens with symptoms in the extra-articular tissues and systemic joints. The most significant member of the Cytochrome P450 enzyme family, Cytochrome P450 2C9 (CYP2C9), plays an essential role in the alkylation, demethylation, and hydroxylation of a variety of substances. Insufficient studies as to whether the susceptibility to rheumatoid arthritis is genetic exists. Therefore, our study presents new information on whether CYPC9 is a genetic risk factor. In this study, we sought to determine whether rheumatoid arthritis and the CYP2C9 gene polymorphism are related. Methods: This study was conducted as a prospective case-control study. Fifty patients with RA and 50 healthy individuals were included in our study group. Blood from the controls and patients was drawn into ethylenediaminetetraacetic acid (EDTA)-containing tubes, and using a DNA isolation kit, DNA was isolated from leukocytes. Reverse transcriptase polymerase chain reaction (RT-PCR) was used to assess the genotypes of CYPC9*2 and CYP2C9*3 with the LightCycler-CYP2C9 mutation detection kit. Results: The heterozygous CYP2C9*2 genotype was found to carry a 2.85-fold risk when compared with the controls (odds ratio [OR]=2.85, 95% confidence interval [CI]: 0.52–15.50; P=0.22); however, this risk was not statistically significant. It was found that people with the CYP2C9*3 heterozygous genotype had a statistically significant 2.79-fold higher risk compared to the controls (OR=2.79, 95% CI: 1.13–7.00 P=0.04). Conclusion: The heterozygous genotype of CYP2C9*3 may contribute to the onset of RA.","PeriodicalId":30878,"journal":{"name":"International Journal of Surgery and Medicine","volume":"20 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136294101","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}
Background/Aim: The inferior mesenteric vein (IMV) plays a crucial role in the venous system as it joins the superior mesenteric vein (SMV) and splenic vein to form the portal vein. The widespread adoption of multidetector computed tomography (MDCT) has greatly enhanced our ability to assess abdominal vascular structures. This study aimed to investigate the IMV drainage patterns in a Turkish population using MDCT. Methods: This descriptive, single-center, retrospective study included patients who had undergone abdominal computed tomography (CT) in the portal phase at our hospital for various clinical indications. Excluded from the study were patients who did not undergo imaging in the portal venous phase, those with incomplete evaluation of all IMV segments, and individuals who had undergone pancreaticoduodenal or intestinal surgery for any reason. We retrospectively analyzed a total of 877 contrast-enhanced MDCT examinations performed at our hospital between March 2022 and March 2023. Patients were classified based on their IMV drainage patterns into the following categories: type 1 (drainage into the splenic vein), type 2 (drainage into the SMV), type 3 (drainage at the junction level), type 4 (drainage into the branches of the SMV), and type 5 (patients in whom IMV assessment was not possible). Results: The mean age of the patients was 48.7 years (range: 24–92 years), with 449 (51.2%) being male and 428 (48.8%) female. The distribution of patients according to IMV drainage patterns was as follows: type 1, n=379 (43.2%); type 2, n=398 (45.4%); type 3, n=71 (8.1%); type 4, n=15 (1.7%); and type 5, n=14 (1.6%). Conclusion: Our study findings indicate that in the Turkish population, the IMV predominantly drains into the SMV before joining the splenic vein. This disparity from certain studies in the literature underscores the variability in IMV drainage patterns, emphasizing the importance of individualized patient evaluation in this regard.
{"title":"Evaluation of inferior mesenteric vein drainage patterns in the Turkish population: A multidetector computed tomography study","authors":"Hakan Yilmaz","doi":"10.28982/josam.7980","DOIUrl":"https://doi.org/10.28982/josam.7980","url":null,"abstract":"Background/Aim: The inferior mesenteric vein (IMV) plays a crucial role in the venous system as it joins the superior mesenteric vein (SMV) and splenic vein to form the portal vein. The widespread adoption of multidetector computed tomography (MDCT) has greatly enhanced our ability to assess abdominal vascular structures. This study aimed to investigate the IMV drainage patterns in a Turkish population using MDCT. Methods: This descriptive, single-center, retrospective study included patients who had undergone abdominal computed tomography (CT) in the portal phase at our hospital for various clinical indications. Excluded from the study were patients who did not undergo imaging in the portal venous phase, those with incomplete evaluation of all IMV segments, and individuals who had undergone pancreaticoduodenal or intestinal surgery for any reason. We retrospectively analyzed a total of 877 contrast-enhanced MDCT examinations performed at our hospital between March 2022 and March 2023. Patients were classified based on their IMV drainage patterns into the following categories: type 1 (drainage into the splenic vein), type 2 (drainage into the SMV), type 3 (drainage at the junction level), type 4 (drainage into the branches of the SMV), and type 5 (patients in whom IMV assessment was not possible). Results: The mean age of the patients was 48.7 years (range: 24–92 years), with 449 (51.2%) being male and 428 (48.8%) female. The distribution of patients according to IMV drainage patterns was as follows: type 1, n=379 (43.2%); type 2, n=398 (45.4%); type 3, n=71 (8.1%); type 4, n=15 (1.7%); and type 5, n=14 (1.6%). Conclusion: Our study findings indicate that in the Turkish population, the IMV predominantly drains into the SMV before joining the splenic vein. This disparity from certain studies in the literature underscores the variability in IMV drainage patterns, emphasizing the importance of individualized patient evaluation in this regard.","PeriodicalId":30878,"journal":{"name":"International Journal of Surgery and Medicine","volume":"300 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134944000","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}
Background/Aim: Surgical procedures during pregnancy incur great difficulties for both the surgeon and the anesthesiologist. Changing maternal and fetal physiology changes both the pharmacodynamics and pharmacodynamics of the anesthetic drugs administered. In this study, the researcher aimed to determine the risk factors of non-obstetric surgery or anesthesia that cause preterm labor and/or low birth weight. Methods: Our study was planned as a single-center retrospective study and was carried out by scanning the data of 52 pregnant patients between 2015 and 2020. Preterm labor and low birth weight were defined as adverse events. The patients were divided into two groups: those who developed adverse events and those who did not. The effects of age, parity, type of surgery and anesthesia, duration of surgery, gestational age, mode of delivery, and birth weight on mortality have been investigated. Results: Comparing the patient groups with and without adverse events, no statistically significant difference was found between their general characteristics, anesthesia, and surgical characteristics (P>0.05). Conclusion: In the study, the researcher analyzed the surgical and anesthesia factors of non-obstetric surgery. It was concluded that neither surgical nor anesthetic factors independently increased the risk of preterm labor or low birth weight.
{"title":"Non-obstetric surgery and anesthesia during pregnancy. Five-year single-center retrospective analysis","authors":"Mustafa Altınay, Ayşe Surhan Çınar","doi":"10.28982/josam.7952","DOIUrl":"https://doi.org/10.28982/josam.7952","url":null,"abstract":"Background/Aim: Surgical procedures during pregnancy incur great difficulties for both the surgeon and the anesthesiologist. Changing maternal and fetal physiology changes both the pharmacodynamics and pharmacodynamics of the anesthetic drugs administered. In this study, the researcher aimed to determine the risk factors of non-obstetric surgery or anesthesia that cause preterm labor and/or low birth weight. Methods: Our study was planned as a single-center retrospective study and was carried out by scanning the data of 52 pregnant patients between 2015 and 2020. Preterm labor and low birth weight were defined as adverse events. The patients were divided into two groups: those who developed adverse events and those who did not. The effects of age, parity, type of surgery and anesthesia, duration of surgery, gestational age, mode of delivery, and birth weight on mortality have been investigated. Results: Comparing the patient groups with and without adverse events, no statistically significant difference was found between their general characteristics, anesthesia, and surgical characteristics (P>0.05). Conclusion: In the study, the researcher analyzed the surgical and anesthesia factors of non-obstetric surgery. It was concluded that neither surgical nor anesthetic factors independently increased the risk of preterm labor or low birth weight.","PeriodicalId":30878,"journal":{"name":"International Journal of Surgery and Medicine","volume":"468 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135546308","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}
Background/Aim: Advancements in medical technologies and prolonged life expectancy have increased the number of surgical interventions for elderly patients. Despite this however, emergency surgical interventions remain associated with a high mortality rate. Managing an emergency abdominal surgery in elderly patients poses great challenges for both the surgeon and the anesthesiologist. However, knowing the risk factors that increase mortality may offer advantages to the clinician managing the treatment process. There are studies in the literature examining the mortality of emergency surgeries in elderly patients. However, there are very few studies that work with a specific patient group such as abdominal surgery and then analyze laboratory test results. Here, we aimed to identify the risk factors that can be used to predict mortality in elderly patients undergoing emergency abdominal surgery. Methods: The study was designed retrospectively in a single center; 100 patients over the age of 80 who underwent emergency abdominal surgery were included in the study. The patients were divided into two groups as survivor and non-survivor. Demographic, surgical, and anesthetic characteristics, laboratory tests, American Society of Anesthesiologists (ASA) physical status scores, postoperative intensive care needs, and treatments of the groups were compared using the chi-squared and Mann Whitney U-test. Determining factors were investigated with logistic regression analysis. Results: In multivariate analysis, ASA 3 and major surgery significantly increased mortality (P=0.041, P=0.011). Receiver operating characteristic (ROC) curve analysis showed that C-reactive protein with a cut-off value of >84 mg/L had a sensitivity of 58.8% and a specificity of 71.2% (AUC=0.636, P=0.004), while lactate with a cut-off value of >3.6 mmol/L had a sensitivity of 50% and a specificity of 95.5% in predicting mortality (AUC=0.776, P<0.001). Conclusion: The magnitude of surgery and the ASA score were the best predictors of mortality in elderly patients undergoing emergency abdominal surgery.
{"title":"Predictors of mortality in elderly patients in emergency abdominal surgery: A retrospective single-center study","authors":"Mustafa Altınay, Sibel Oba","doi":"10.28982/josam.7972","DOIUrl":"https://doi.org/10.28982/josam.7972","url":null,"abstract":"Background/Aim: Advancements in medical technologies and prolonged life expectancy have increased the number of surgical interventions for elderly patients. Despite this however, emergency surgical interventions remain associated with a high mortality rate. Managing an emergency abdominal surgery in elderly patients poses great challenges for both the surgeon and the anesthesiologist. However, knowing the risk factors that increase mortality may offer advantages to the clinician managing the treatment process. There are studies in the literature examining the mortality of emergency surgeries in elderly patients. However, there are very few studies that work with a specific patient group such as abdominal surgery and then analyze laboratory test results. Here, we aimed to identify the risk factors that can be used to predict mortality in elderly patients undergoing emergency abdominal surgery. Methods: The study was designed retrospectively in a single center; 100 patients over the age of 80 who underwent emergency abdominal surgery were included in the study. The patients were divided into two groups as survivor and non-survivor. Demographic, surgical, and anesthetic characteristics, laboratory tests, American Society of Anesthesiologists (ASA) physical status scores, postoperative intensive care needs, and treatments of the groups were compared using the chi-squared and Mann Whitney U-test. Determining factors were investigated with logistic regression analysis. Results: In multivariate analysis, ASA 3 and major surgery significantly increased mortality (P=0.041, P=0.011). Receiver operating characteristic (ROC) curve analysis showed that C-reactive protein with a cut-off value of >84 mg/L had a sensitivity of 58.8% and a specificity of 71.2% (AUC=0.636, P=0.004), while lactate with a cut-off value of >3.6 mmol/L had a sensitivity of 50% and a specificity of 95.5% in predicting mortality (AUC=0.776, P<0.001). Conclusion: The magnitude of surgery and the ASA score were the best predictors of mortality in elderly patients undergoing emergency abdominal surgery.","PeriodicalId":30878,"journal":{"name":"International Journal of Surgery and Medicine","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135646732","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}
Background/Aim: Women with rheumatic and musculoskeletal disorders often discontinue using their medications prior to conception or during the few early weeks of pregnancy because drug use during pregnancy frequently results in anxiety. Pregnant women have reported seeking out health-related information from a variety of sources, particularly the Internet, in an attempt to ease their concerns about the use of such medications during pregnancy. The objective of this study was to evaluate the accuracy and completeness of health-related information concerning the use of anti-rheumatic medications during pregnancy as provided by Open Artificial Intelligence (AI's) Chat Generative Pre-trained Transformer (ChatGPT) versions 3.5 and 4, which are widely known AI tools. Methods: In this prospective cross-sectional study, the performances of OpenAI's ChatGPT versions 3.5 and 4 were assessed regarding health information concerning anti-rheumatic drugs during pregnancy using the 2016 European Union of Associations for Rheumatology (EULAR) guidelines as a reference. Fourteen queries from the guidelines were entered into both AI models. Responses were evaluated independently and rated by two evaluators using a predefined 6-point Likert-like scale (1 – completely incorrect to 6 – completely correct) and for completeness using a 3-point Likert-like scale (1 – incomplete to 3 – complete). Inter-rater reliability was evaluated using Cohen’s kappa statistic, and the differences in scores across ChatGPT versions were compared using the Mann–Whitney U test. Results: No statistically significant difference between the mean accuracy scores of GPT versions 3.5 and 4 (5 [1.17] versus 5.07 [1.26]; P=0.769), indicating the resulting scores were between nearly all accurate and correct for both models. Additionally, no statistically significant difference in the mean completeness scores of GPT 3.5 and GPT 4 (2.5 [0.51] vs 2.64 [0.49], P=0.541) was found, indicating scores between adequate and comprehensive for both models. Both models had similar total mean accuracy and completeness scores (3.75 [1.55] versus 3.86 [1.57]; P=0.717). In the GPT 3.5 model, hydroxychloroquine and Leflunomide received the highest full scores for both accuracy and completeness, while methotrexate, Sulfasalazine, Cyclophosphamide, Mycophenolate mofetil, and Tofacitinib received the highest total scores in the GPT 4 model. Nevertheless, for both models, one of the 14 drugs was scored as more incorrect than correct. Conclusions: When considering the safety and compatibility of anti-rheumatic medications during pregnancy, both ChatGPT versions 3.5 and 4 demonstrated satisfactory accuracy and completeness. On the other hand, the research revealed that the responses generated by ChatGPT also contained inaccurate information. Despite its good performance, ChatGPT should not be used as a standalone tool to make decisions about taking medications during pregnancy due to this AI tool’s limitations.
{"title":"Performance of artificial intelligence chatbot as a source of patient information on anti-rheumatic drug use in pregnancy","authors":"Nurdan Oruçoğlu, Elif Altunel Kılınç","doi":"10.28982/josam.7977","DOIUrl":"https://doi.org/10.28982/josam.7977","url":null,"abstract":"Background/Aim: Women with rheumatic and musculoskeletal disorders often discontinue using their medications prior to conception or during the few early weeks of pregnancy because drug use during pregnancy frequently results in anxiety. Pregnant women have reported seeking out health-related information from a variety of sources, particularly the Internet, in an attempt to ease their concerns about the use of such medications during pregnancy. The objective of this study was to evaluate the accuracy and completeness of health-related information concerning the use of anti-rheumatic medications during pregnancy as provided by Open Artificial Intelligence (AI's) Chat Generative Pre-trained Transformer (ChatGPT) versions 3.5 and 4, which are widely known AI tools. Methods: In this prospective cross-sectional study, the performances of OpenAI's ChatGPT versions 3.5 and 4 were assessed regarding health information concerning anti-rheumatic drugs during pregnancy using the 2016 European Union of Associations for Rheumatology (EULAR) guidelines as a reference. Fourteen queries from the guidelines were entered into both AI models. Responses were evaluated independently and rated by two evaluators using a predefined 6-point Likert-like scale (1 – completely incorrect to 6 – completely correct) and for completeness using a 3-point Likert-like scale (1 – incomplete to 3 – complete). Inter-rater reliability was evaluated using Cohen’s kappa statistic, and the differences in scores across ChatGPT versions were compared using the Mann–Whitney U test. Results: No statistically significant difference between the mean accuracy scores of GPT versions 3.5 and 4 (5 [1.17] versus 5.07 [1.26]; P=0.769), indicating the resulting scores were between nearly all accurate and correct for both models. Additionally, no statistically significant difference in the mean completeness scores of GPT 3.5 and GPT 4 (2.5 [0.51] vs 2.64 [0.49], P=0.541) was found, indicating scores between adequate and comprehensive for both models. Both models had similar total mean accuracy and completeness scores (3.75 [1.55] versus 3.86 [1.57]; P=0.717). In the GPT 3.5 model, hydroxychloroquine and Leflunomide received the highest full scores for both accuracy and completeness, while methotrexate, Sulfasalazine, Cyclophosphamide, Mycophenolate mofetil, and Tofacitinib received the highest total scores in the GPT 4 model. Nevertheless, for both models, one of the 14 drugs was scored as more incorrect than correct. Conclusions: When considering the safety and compatibility of anti-rheumatic medications during pregnancy, both ChatGPT versions 3.5 and 4 demonstrated satisfactory accuracy and completeness. On the other hand, the research revealed that the responses generated by ChatGPT also contained inaccurate information. Despite its good performance, ChatGPT should not be used as a standalone tool to make decisions about taking medications during pregnancy due to this AI tool’s limitations.","PeriodicalId":30878,"journal":{"name":"International Journal of Surgery and Medicine","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135646731","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}
Background/Aim: Mesh erosion is one of the feared complications in surgeries performed using mesh, and its frequency is increasing as more and more of these surgeries are performed. This study aims to evaluate transobturator tape (TOT) and tension-free vaginal tape (TVT) surgeries performed in the surgical treatment of stress urinary incontinence (SUI) in our clinic in terms of clinical results and mesh erosion. Methods: This study is a retrospective cohort study. The files of 50 patients who had SUI and underwent TOT and TVT surgery in our clinic between January 2022 and January 2023 were reviewed. Patients diagnosed with pure SUI and for whom surgery was performed were included in our study. The participants were divided into two groups: those who had TOT surgery and those who had TVT surgery. These groups were evaluated and compared in terms of mesh injury, mesh erosion, pelvic pain, dyspareunia symptoms, and urinary retention. The surgical data of patients, incidence of complications, pre- and postoperative incontinence impact questionnaires (IIQ-7) and the scores of the International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF) were recorded. Results: The mean follow-up period of the participants was 8.96 (8.47) (range, 6-17 months). TVT surgery was performed on 13 participants and TOT surgery was performed on 37 patients. When the two groups were compared, there was no statistically significant difference in terms of age, body mass index (BMI), parity, menopausal status, duration of incontinence, preoperative IIQ-7 scores, and ICIQ-SF scores (P<0.05). There were no statistically significant differences between surgical durations, length of hospital stay, early surgical complications, postoperative 3rd month IIQ-7, and ICIQ-SF scores (P<0.05). Furthermore, no difference in the rates of mesh erosion and mesh-related complications between the two groups (P<0.05) was observed. Conclusion: TOT and TVT surgeries seem to be quite safe in terms of complications, as well as being satisfactory in terms of patient satisfaction. Although mesh-related complications can be frightening, the rate of regression is low with appropriate management. Our results show that both operations are safe with an acceptable complication rate when performed by surgeons who have experience with anti-incontinence procedures.
{"title":"Evaluation of tension-free vaginal tape and transobturator tape surgery performed in one year in terms of mesh erosion","authors":"Elif Yıldız, Burcu Timur","doi":"10.28982/josam.7903","DOIUrl":"https://doi.org/10.28982/josam.7903","url":null,"abstract":"Background/Aim: Mesh erosion is one of the feared complications in surgeries performed using mesh, and its frequency is increasing as more and more of these surgeries are performed. This study aims to evaluate transobturator tape (TOT) and tension-free vaginal tape (TVT) surgeries performed in the surgical treatment of stress urinary incontinence (SUI) in our clinic in terms of clinical results and mesh erosion. Methods: This study is a retrospective cohort study. The files of 50 patients who had SUI and underwent TOT and TVT surgery in our clinic between January 2022 and January 2023 were reviewed. Patients diagnosed with pure SUI and for whom surgery was performed were included in our study. The participants were divided into two groups: those who had TOT surgery and those who had TVT surgery. These groups were evaluated and compared in terms of mesh injury, mesh erosion, pelvic pain, dyspareunia symptoms, and urinary retention. The surgical data of patients, incidence of complications, pre- and postoperative incontinence impact questionnaires (IIQ-7) and the scores of the International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF) were recorded. Results: The mean follow-up period of the participants was 8.96 (8.47) (range, 6-17 months). TVT surgery was performed on 13 participants and TOT surgery was performed on 37 patients. When the two groups were compared, there was no statistically significant difference in terms of age, body mass index (BMI), parity, menopausal status, duration of incontinence, preoperative IIQ-7 scores, and ICIQ-SF scores (P<0.05). There were no statistically significant differences between surgical durations, length of hospital stay, early surgical complications, postoperative 3rd month IIQ-7, and ICIQ-SF scores (P<0.05). Furthermore, no difference in the rates of mesh erosion and mesh-related complications between the two groups (P<0.05) was observed. Conclusion: TOT and TVT surgeries seem to be quite safe in terms of complications, as well as being satisfactory in terms of patient satisfaction. Although mesh-related complications can be frightening, the rate of regression is low with appropriate management. Our results show that both operations are safe with an acceptable complication rate when performed by surgeons who have experience with anti-incontinence procedures.","PeriodicalId":30878,"journal":{"name":"International Journal of Surgery and Medicine","volume":"44 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135789618","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}
Background/Aim: Coronary artery disease is a significant health concern worldwide. While coronary artery bypass grafting is a gold standard of treatment, acute kidney injury (AKI) is a possible postoperative complication of concern. Off-pump coronary artery bypass grafting (OPCABG) aims to curtail perioperative complications; however, its impact on postoperative AKI is debated. This retrospective study aims to inform patient care by identifying potential effects of OPCABG on AKI utilizing postoperative creatinine alterations. Methods: This retrospective study was conducted at Koç University Hospital in Istanbul, Turkey. We reviewed the records of patients who underwent OPCABG between June 2018 and June 2019. Patients with incomplete records or individuals who had undergone renal replacement therapy prior to surgery were excluded. The primary metric was serum creatinine levels, which were assessed preoperatively and up to 7 days postoperatively. Preoperative creatinine levels were compared with postoperative levels using the Wilcoxon signed-rank test. Acute kidney injury was defined using Kidney Disease: Improving Global Outcomes (KDIGO) criteria. Results: Seventy-two patients satisfied the inclusionary criteria. A significant increase in creatinine was observed on postoperative Day 1 (P<0.001); creatinine levels fell below baseline by postoperative Day 4 and 5. We note that the incidence of AKI was low; there were no instances of Stage 2 or higher AKI during the observation period. Conclusion: Our data suggest that OPCABG may result in a transient increase in creatinine post-surgery. Creatinine levels normalize over time, implicating the renal safety of OPCABG. Despite these promising findings, additional comprehensive studies are essential to validate these observations and assess long-term renal outcomes after OPCABG.
{"title":"Renal implications of off-pump coronary artery bypass grafting: A retrospective cohort study analyzing postoperative creatinine levels","authors":"Kamil Darcin, Muhammet Ahmet Karakaya","doi":"10.28982/josam.7970","DOIUrl":"https://doi.org/10.28982/josam.7970","url":null,"abstract":"Background/Aim: Coronary artery disease is a significant health concern worldwide. While coronary artery bypass grafting is a gold standard of treatment, acute kidney injury (AKI) is a possible postoperative complication of concern. Off-pump coronary artery bypass grafting (OPCABG) aims to curtail perioperative complications; however, its impact on postoperative AKI is debated. This retrospective study aims to inform patient care by identifying potential effects of OPCABG on AKI utilizing postoperative creatinine alterations. Methods: This retrospective study was conducted at Koç University Hospital in Istanbul, Turkey. We reviewed the records of patients who underwent OPCABG between June 2018 and June 2019. Patients with incomplete records or individuals who had undergone renal replacement therapy prior to surgery were excluded. The primary metric was serum creatinine levels, which were assessed preoperatively and up to 7 days postoperatively. Preoperative creatinine levels were compared with postoperative levels using the Wilcoxon signed-rank test. Acute kidney injury was defined using Kidney Disease: Improving Global Outcomes (KDIGO) criteria. Results: Seventy-two patients satisfied the inclusionary criteria. A significant increase in creatinine was observed on postoperative Day 1 (P<0.001); creatinine levels fell below baseline by postoperative Day 4 and 5. We note that the incidence of AKI was low; there were no instances of Stage 2 or higher AKI during the observation period. Conclusion: Our data suggest that OPCABG may result in a transient increase in creatinine post-surgery. Creatinine levels normalize over time, implicating the renal safety of OPCABG. Despite these promising findings, additional comprehensive studies are essential to validate these observations and assess long-term renal outcomes after OPCABG.","PeriodicalId":30878,"journal":{"name":"International Journal of Surgery and Medicine","volume":"34 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135195362","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}
Background/Aim: The most common genotypes of human papillomavirus (HPV) in patients with cervical cancer worldwide are HPV16 and HPV18. The persistence of these genotypes is associated with cervical cancer and detection, and HPV genotyping, particularly in women with abnormal Pap smears, has become a crucial tool for cervical cancer screening, diagnosis and management. We evaluated the overall prevalence of HPV in women with abnormal Pap smear cytology and also investigated age-specific HPV prevalence and HPV genotype distribution. Methods: We analyzed 716 cervical smear specimens in this retrospective cohort study. Cytological diagnoses of typical squamous cells of undetermined significance (ASCUS), low-grade squamous intraepithelial lesions (LSILs), and high-grade squamous intraepithelial lesions (HSILs) were made utilizing the Bethesda System. The Papanicolaou method was used for the staining of the Pap smears. The specimens were pre-screened for HPV DNA positivity using an HC2 assay (Qiagen, USA). After the pre-screening, a Cobas 4800 HPV test system (Roche Diagnostics GmBH, Germany) was used to genotype the HPV-positive samples. Results: Of the 716 cervical smear samples, 520 (72.6%) were found to be HPV-negative. Among the HPV-positive samples, 106 (23.2%), 57 (28.8%) and 33 (53.2%) were identified from 456 ASCUS, 198 LSIL and 62 HSIL cases, respectively. These findings revealed a gradual decrease in HPV prevalence with increased cytological grade (P<0.05). For high-risk, low-risk and high-risk/low-risk HPV types, 76 (38.8%), 78 (39.8%) and 42 (21.4) were positive according to the HC2 assay, respectively (P<0.05) Only 117 of the 196 HPV-positive samples were found to be HPV-positive with the Cobas 4800 HPV test system. HPV16 was the most prevalent type detected by the Cobas 4800 HPV test: 55 out of 117 HPV-positive smear samples across all age groups (47%). HPV16 was significantly more frequently detected in the HSIL samples than HPV18 (P<0.05). The prevalence of HPV was the highest in women with ages between 29 and 38 (71/196, 36.22%) and declined with age. Conclusion: We found that HPV16 and HPV18 were the most prevalent genotypes of HPV in a cohort of Turkish women; HPV16 was most frequently detected in HSIL samples from women with ages between 29 and 38. We conclude that investigating the incidence of HPV16 and HPV18 genotypes will be important for implementing new programs and protocols to reduce the incidence of cervical cancer. These data may contribute to the development of preventive strategies to reduce the cervical cancer burden in Turkey.
{"title":"A retrospective cohort study of human papillomavirus (HPV) genotypes in women with abnormal Pap smear cytology in Turkey","authors":"Hayati Beka","doi":"10.28982/josam.7910","DOIUrl":"https://doi.org/10.28982/josam.7910","url":null,"abstract":"Background/Aim: The most common genotypes of human papillomavirus (HPV) in patients with cervical cancer worldwide are HPV16 and HPV18. The persistence of these genotypes is associated with cervical cancer and detection, and HPV genotyping, particularly in women with abnormal Pap smears, has become a crucial tool for cervical cancer screening, diagnosis and management. We evaluated the overall prevalence of HPV in women with abnormal Pap smear cytology and also investigated age-specific HPV prevalence and HPV genotype distribution. Methods: We analyzed 716 cervical smear specimens in this retrospective cohort study. Cytological diagnoses of typical squamous cells of undetermined significance (ASCUS), low-grade squamous intraepithelial lesions (LSILs), and high-grade squamous intraepithelial lesions (HSILs) were made utilizing the Bethesda System. The Papanicolaou method was used for the staining of the Pap smears. The specimens were pre-screened for HPV DNA positivity using an HC2 assay (Qiagen, USA). After the pre-screening, a Cobas 4800 HPV test system (Roche Diagnostics GmBH, Germany) was used to genotype the HPV-positive samples. Results: Of the 716 cervical smear samples, 520 (72.6%) were found to be HPV-negative. Among the HPV-positive samples, 106 (23.2%), 57 (28.8%) and 33 (53.2%) were identified from 456 ASCUS, 198 LSIL and 62 HSIL cases, respectively. These findings revealed a gradual decrease in HPV prevalence with increased cytological grade (P<0.05). For high-risk, low-risk and high-risk/low-risk HPV types, 76 (38.8%), 78 (39.8%) and 42 (21.4) were positive according to the HC2 assay, respectively (P<0.05) Only 117 of the 196 HPV-positive samples were found to be HPV-positive with the Cobas 4800 HPV test system. HPV16 was the most prevalent type detected by the Cobas 4800 HPV test: 55 out of 117 HPV-positive smear samples across all age groups (47%). HPV16 was significantly more frequently detected in the HSIL samples than HPV18 (P<0.05). The prevalence of HPV was the highest in women with ages between 29 and 38 (71/196, 36.22%) and declined with age. Conclusion: We found that HPV16 and HPV18 were the most prevalent genotypes of HPV in a cohort of Turkish women; HPV16 was most frequently detected in HSIL samples from women with ages between 29 and 38. We conclude that investigating the incidence of HPV16 and HPV18 genotypes will be important for implementing new programs and protocols to reduce the incidence of cervical cancer. These data may contribute to the development of preventive strategies to reduce the cervical cancer burden in Turkey.","PeriodicalId":30878,"journal":{"name":"International Journal of Surgery and Medicine","volume":"50 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135131840","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}
Background/Aim: Rapid identification of patients with myeloproliferative neoplasms (MPNs) is crucial for clinical decision-making and healthcare management. Sarcopenia is characterized by muscle loss and increases the risks for adverse outcomes; there is limited information in the literature regarding possible links between sarcopenia and MPNs. This study evaluated the frequency of sarcopenia in patients with MPNs and investigated whether biochemical or clinical features were associated with the development of sarcopenia. Methods: Fifty-six BCR-ABL1-negative patients were included in this randomized prospective cohort research study. Muscle strength was measured using a handgrip dynamometer. Muscle mass was evaluated using a bioelectrical-impedance analyzer, and physical performance was evaluated via gait speed in a 6-minute walking test. Results: The mean handgrip strength of the cohort was 27.7 kg, and 13 patients (23.2%) tested positive for low muscle strength. Mean muscle mass was found to be 7.58 (1.17) kg/m2, and seven patients (12.5%) exhibited low muscle mass. Three patients (5.4%) had low muscle quality. Nine patients (16.1%) were diagnosed with probable sarcopenia, and four patients (7.1%) were diagnosed with severe sarcopenia. There was no difference between the groups in terms of clinical features (P>0.05), nutritional assessment (macro and micronutrients) (P=0.959), comorbidities (P=0.476), or laboratory measurements (P>0.05). Conclusion: There was a high prevalence of sarcopenia among patients with MPNs, which indicates that periodic measurements of muscle strength, body composition and physical performance may contribute to the management of MPNs.
{"title":"The prevalence and impact of sarcopenia in myeloproliferative neoplasms","authors":"Yildiz Ipek, MüJgan Kaya Tuna","doi":"10.28982/josam.7979","DOIUrl":"https://doi.org/10.28982/josam.7979","url":null,"abstract":"Background/Aim: Rapid identification of patients with myeloproliferative neoplasms (MPNs) is crucial for clinical decision-making and healthcare management. Sarcopenia is characterized by muscle loss and increases the risks for adverse outcomes; there is limited information in the literature regarding possible links between sarcopenia and MPNs. This study evaluated the frequency of sarcopenia in patients with MPNs and investigated whether biochemical or clinical features were associated with the development of sarcopenia. Methods: Fifty-six BCR-ABL1-negative patients were included in this randomized prospective cohort research study. Muscle strength was measured using a handgrip dynamometer. Muscle mass was evaluated using a bioelectrical-impedance analyzer, and physical performance was evaluated via gait speed in a 6-minute walking test. Results: The mean handgrip strength of the cohort was 27.7 kg, and 13 patients (23.2%) tested positive for low muscle strength. Mean muscle mass was found to be 7.58 (1.17) kg/m2, and seven patients (12.5%) exhibited low muscle mass. Three patients (5.4%) had low muscle quality. Nine patients (16.1%) were diagnosed with probable sarcopenia, and four patients (7.1%) were diagnosed with severe sarcopenia. There was no difference between the groups in terms of clinical features (P>0.05), nutritional assessment (macro and micronutrients) (P=0.959), comorbidities (P=0.476), or laboratory measurements (P>0.05). Conclusion: There was a high prevalence of sarcopenia among patients with MPNs, which indicates that periodic measurements of muscle strength, body composition and physical performance may contribute to the management of MPNs.","PeriodicalId":30878,"journal":{"name":"International Journal of Surgery and Medicine","volume":"54 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135194976","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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