Background/Aim: Post-operative delirium, which usually develops in geriatric patients, also causes an increase in mortality and morbidity for various reasons, such as difficulty in compliance with treatment. Estimating the effects of the anesthesia method on delirium contributes to the prevention of possible complications. In this study, effects due to use of different anesthesia methods on the post-operative delirium development in geriatric patients who underwent orthopedic surgery were investigated. Methods: In our retrospective cohort study, scanning of the patient files was performed for 276 patients who were older than 65 years and who had undergone surgery for lower extremity fractures in Malatya education and research hospital, orthopedics department between May 1, 2022 and October 15, 2022. Demographic data, comorbid conditions, anesthesia type, lengths of surgery, and level of delirium development were recorded for each scanned patient. Results: In our study, 201 patients were included. The mean age of the patients was 74.1 (7.3) (min–max: 65–98); 133 (66.2%) were female, and 68 (33.8%) were male. It was noticed that patients who had undergone regional anesthesia developed a significantly smaller rate of delirium development (8.1%) compared to those who had received general anesthesia (20.6%; P=0.012). Ages (P<0.001), lengths of surgery (P<0.001), and lengths of hospitalization stays (P<0.001) were significantly higher in patients with delirium compared to those without. Conclusion: Based on the data obtained in this study, it was concluded that to reduce the risk of delirium development after orthopedic surgery, regional rather than general anesthesia should be selected, and the time of hospitalization stay should be minimized.
{"title":"A retrospective study of the effects of anesthesia methods on post-operative delirium in geriatric patients having orthopedic surgery: Anesthesia methods on post-operative delirium","authors":"L. Delen, Z. Korkmaz Disli","doi":"10.28982/josam.7710","DOIUrl":"https://doi.org/10.28982/josam.7710","url":null,"abstract":"Background/Aim: Post-operative delirium, which usually develops in geriatric patients, also causes an increase in mortality and morbidity for various reasons, such as difficulty in compliance with treatment. Estimating the effects of the anesthesia method on delirium contributes to the prevention of possible complications. In this study, effects due to use of different anesthesia methods on the post-operative delirium development in geriatric patients who underwent orthopedic surgery were investigated.\u0000Methods: In our retrospective cohort study, scanning of the patient files was performed for 276 patients who were older than 65 years and who had undergone surgery for lower extremity fractures in Malatya education and research hospital, orthopedics department between May 1, 2022 and October 15, 2022. Demographic data, comorbid conditions, anesthesia type, lengths of surgery, and level of delirium development were recorded for each scanned patient.\u0000Results: In our study, 201 patients were included. The mean age of the patients was 74.1 (7.3) (min–max: 65–98); 133 (66.2%) were female, and 68 (33.8%) were male. It was noticed that patients who had undergone regional anesthesia developed a significantly smaller rate of delirium development (8.1%) compared to those who had received general anesthesia (20.6%; P=0.012). Ages (P<0.001), lengths of surgery (P<0.001), and lengths of hospitalization stays (P<0.001) were significantly higher in patients with delirium compared to those without.\u0000Conclusion: Based on the data obtained in this study, it was concluded that to reduce the risk of delirium development after orthopedic surgery, regional rather than general anesthesia should be selected, and the time of hospitalization stay should be minimized.","PeriodicalId":30878,"journal":{"name":"International Journal of Surgery and Medicine","volume":"18 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91263081","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: Tranexamic acid (TXA) is known to reduce intra-articular bleeding during arthroscopic procedures, which can improve visibility and reduce postoperative pain and knee joint swelling from hemarthrosis. However, insufficient data supports the routine use of TXA in arthroscopic meniscectomy. This study aimed to evaluate the effect of a single dose of intravenous (IV) TXA on visual clarity in arthroscopic meniscectomy without a tourniquet. Methods: A randomized, double-blind, controlled trial was conducted to assess the use of TXA for visibility in routine arthroscopic meniscectomy without a tourniquet. Between January 2021 and February 2022, 53 patients undergoing arthroscopic meniscectomy were randomly assigned to either the TXA group (n=27), who received 1 g IV-TXA, or the control group (n=26), who received 100 ml of normal saline. Visual clarity was evaluated using a Numeric Rating Scale (NRS). Patients were also assessed for the need for a tourniquet, tourniquet time, total operative time, volume of irrigation fluid, postoperative pain, hemarthrosis, and knee function on postoperative day 3 and weeks 1, 2, and 4, using the Lysholm knee scoring scale. Results: There was no significant difference in intra-operative arthroscopic visibility between the TXA and control groups (P=0.394). Tourniquet was required in three cases in the TXA group and four cases in the control group (P=0.646). There was no significant difference between the two groups regarding postoperative pain, grade of postoperative hemarthrosis, knee motion, or the Lysholm Knee Score after the operation. Conclusion: The administration of IV-TXA in arthroscopic meniscectomy without a tourniquet did not provide any benefits such as enhanced surgical visualization, reduction in the need to inflate the tourniquet due to obstructed visibility, or decrease in hemarthrosis, VAS pain score, or improved range of motion of the knee in the postoperative period when compared to the control group.
{"title":"The effect of a single dose of intravenous tranexamic acid on visual clarity in knee arthroscopic meniscectomy without a tourniquet","authors":"Aziz Çataltape, K. Öznam","doi":"10.28982/josam.1127788","DOIUrl":"https://doi.org/10.28982/josam.1127788","url":null,"abstract":"Background/Aim: Tranexamic acid (TXA) is known to reduce intra-articular bleeding during arthroscopic procedures, which can improve visibility and reduce postoperative pain and knee joint swelling from hemarthrosis. However, insufficient data supports the routine use of TXA in arthroscopic meniscectomy. This study aimed to evaluate the effect of a single dose of intravenous (IV) TXA on visual clarity in arthroscopic meniscectomy without a tourniquet. \u0000Methods: A randomized, double-blind, controlled trial was conducted to assess the use of TXA for visibility in routine arthroscopic meniscectomy without a tourniquet. Between January 2021 and February 2022, 53 patients undergoing arthroscopic meniscectomy were randomly assigned to either the TXA group (n=27), who received 1 g IV-TXA, or the control group (n=26), who received 100 ml of normal saline. Visual clarity was evaluated using a Numeric Rating Scale (NRS). Patients were also assessed for the need for a tourniquet, tourniquet time, total operative time, volume of irrigation fluid, postoperative pain, hemarthrosis, and knee function on postoperative day 3 and weeks 1, 2, and 4, using the Lysholm knee scoring scale. \u0000Results: There was no significant difference in intra-operative arthroscopic visibility between the TXA and control groups (P=0.394). Tourniquet was required in three cases in the TXA group and four cases in the control group (P=0.646). There was no significant difference between the two groups regarding postoperative pain, grade of postoperative hemarthrosis, knee motion, or the Lysholm Knee Score after the operation. \u0000Conclusion: The administration of IV-TXA in arthroscopic meniscectomy without a tourniquet did not provide any benefits such as enhanced surgical visualization, reduction in the need to inflate the tourniquet due to obstructed visibility, or decrease in hemarthrosis, VAS pain score, or improved range of motion of the knee in the postoperative period when compared to the control group.","PeriodicalId":30878,"journal":{"name":"International Journal of Surgery and Medicine","volume":"30 40","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72489018","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: Inflammation is a crucial component in the pathophysiology of systemic lupus erythematosus (SLE) nephritis. Immune-based scores, such as the neutrophil-lymphocyte and the platelet-lymphocyte ratios (NLR and PLR, respectively) have been suggested as predictors of inflammation and prognosis in SLE. This study aimed to investigate the value of the systemic immune-inflammation index (SII), inflammatory prognostic index (IPI), and systemic inflammatory response index (SIRI) in SLE and lupus nephritis (LN). Methods: This case-control study consisted of 108 newly diagnosed SLE patients (separated into two subgroups, which included 34 patients with biopsy-proven LN and 74 without nephritis) and 108 age- and gender-matched healthy controls who presented to our outpatient clinic between October 2015 and June 2020. Patients with malignancy, lymphoproliferative and hematologic disorders, active infection, and autoimmune diseases other than SLE were excluded. Inflammation-based biomarkers were calculated at the first presentation of the disease and before any medication was administered. SII was calculated as Neutrophil/Lymphocyte x Platelet, SIRI as Neutrophil x Monocyte/Lymphocyte, and IPI as CRP x NLR/serum albumin. The Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K) was used to measure disease activity. The capability of SII, SIRI, NLR, PLR, and IPI to distinguish between SLE patients with or without nephritis was assessed using receiver operating characteristic (ROC) curves. Correlations of inflammation-based scores (SII, SIRI, IPI, NLR) with disease activity and laboratory data of SLE patients were analyzed. Results: SII, SIRI, and IPI were significantly higher in SLE patients than in healthy controls (P=0.003, P=0.019, and P<0.001, respectively) and also significantly higher in patients with nephritis than in those without (P<0.001, P=0.009, and P=0.007, respectively). The area under the curve (AUC) for SII, SIRI, and IPI in terms of differentiating SLE patients with or without nephritis was 0.748, 0.690, and 0.663, respectively. The cut-off value of SII, SIRI, and IPI to predict LN was 552.25 (sensitivity: 64.7%; specificity: 64.9%; P<0.001), 1.08 (sensitivity: 61.8%; specificity: 62.2%; P=0.002), and 4.48 (sensitivity: 61.8%; specificity, 62.2%; P=0.007), respectively. Conclusion: SII, SIRI, and IPI may be valuable and promising inflammation-based biomarkers in SLE and for the presence of nephritis in SLE patients. SII was found to be the most reliable predictor of SLE among the inflammation-based biomarkers in our study.
{"title":"Inflammation-based biomarkers for the prediction of nephritis in systemic lupus erythematosus","authors":"N. Oruçoğlu","doi":"10.28982/josam.7674","DOIUrl":"https://doi.org/10.28982/josam.7674","url":null,"abstract":"Background/Aim: Inflammation is a crucial component in the pathophysiology of systemic lupus erythematosus (SLE) nephritis. Immune-based scores, such as the neutrophil-lymphocyte and the platelet-lymphocyte ratios (NLR and PLR, respectively) have been suggested as predictors of inflammation and prognosis in SLE. This study aimed to investigate the value of the systemic immune-inflammation index (SII), inflammatory prognostic index (IPI), and systemic inflammatory response index (SIRI) in SLE and lupus nephritis (LN).\u0000Methods: This case-control study consisted of 108 newly diagnosed SLE patients (separated into two subgroups, which included 34 patients with biopsy-proven LN and 74 without nephritis) and 108 age- and gender-matched healthy controls who presented to our outpatient clinic between October 2015 and June 2020. Patients with malignancy, lymphoproliferative and hematologic disorders, active infection, and autoimmune diseases other than SLE were excluded. Inflammation-based biomarkers were calculated at the first presentation of the disease and before any medication was administered. SII was calculated as Neutrophil/Lymphocyte x Platelet, SIRI as Neutrophil x Monocyte/Lymphocyte, and IPI as CRP x NLR/serum albumin. The Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K) was used to measure disease activity. The capability of SII, SIRI, NLR, PLR, and IPI to distinguish between SLE patients with or without nephritis was assessed using receiver operating characteristic (ROC) curves. Correlations of inflammation-based scores (SII, SIRI, IPI, NLR) with disease activity and laboratory data of SLE patients were analyzed.\u0000Results: SII, SIRI, and IPI were significantly higher in SLE patients than in healthy controls (P=0.003, P=0.019, and P<0.001, respectively) and also significantly higher in patients with nephritis than in those without (P<0.001, P=0.009, and P=0.007, respectively). The area under the curve (AUC) for SII, SIRI, and IPI in terms of differentiating SLE patients with or without nephritis was 0.748, 0.690, and 0.663, respectively. The cut-off value of SII, SIRI, and IPI to predict LN was 552.25 (sensitivity: 64.7%; specificity: 64.9%; P<0.001), 1.08 (sensitivity: 61.8%; specificity: 62.2%; P=0.002), and 4.48 (sensitivity: 61.8%; specificity, 62.2%; P=0.007), respectively.\u0000Conclusion: SII, SIRI, and IPI may be valuable and promising inflammation-based biomarkers in SLE and for the presence of nephritis in SLE patients. SII was found to be the most reliable predictor of SLE among the inflammation-based biomarkers in our study.","PeriodicalId":30878,"journal":{"name":"International Journal of Surgery and Medicine","volume":"121 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77449619","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: Papillary neoplasia encompasses both malignant and benign lesions, and core needle biopsy (CNB) is crucial in their diagnosis. Histological findings determine their management. Here we compare volumetric apparent diffusion coefficient (ADC) histogram analysis of carcinomas and benign pathologies identified by histopathology from excisional biopsies. Methods: This retrospective study included 524 patients who underwent breast magnetic resonance imaging (MRI) for a suspicious breast mass from January 2018 to October 2022. Patients with benign lesions, incompatible ultrasound-guided CNB results with papillary neoplasia, and those with MRI exams insufficient for diagnosis due to motion artifacts were excluded. After applying the exclusion criteria, the study included 48 patients (average aged 61.5 (14.8) years; range, 31 to 72 years). After excisional biopsies, 30 benign lesions and 18 carcinomas were identified. MRI was acquired at 1.5 T (Verio; Siemens Medical Solutions, Erlangen, Germany), and the b-values for diffusion-weighted imaging were calculated at 1000 s/mm2. Histogram parameters were computed. Receiver operating characteristic (ROC) curve analysis was performed to investigate diagnostic accuracy, evaluate histogram analysis performance, and determine threshold values. Results: The ADCmin, ADCmean, ADCmax, and all ADC value percentiles were significantly lower in the carcinoma group than in the benign group (P<0.001). The variance, skewness, and kurtosis were higher in the carcinoma group. ADCmax had the highest area under the curve (AUC: 0.985; cut-off 1.247 × 10-3 mm2/s; sensitivity 86%, and specificity 92%), followed by ADCmean (AUC: 0.950; cut-off 0.903 × 10-3 mm2/s; sensitivity 94%, and specificity 96%). Conclusion: Volumetric ADC histogram analysis of papillary neoplasia at higher b-values can be an imaging marker to detect carcinoma and quantitatively reveal the lesions’ diffusion characteristics.
背景/目的:乳头状瘤变包括恶性和良性病变，核心穿刺活检(CNB)在诊断中至关重要。组织学结果决定了其处理方法。在这里，我们比较体积表观扩散系数(ADC)直方图分析癌和良性病理组织病理从切除活检。方法:本回顾性研究纳入了2018年1月至2022年10月期间因可疑乳房肿块接受乳房磁共振成像(MRI)检查的524例患者。排除良性病变、超声引导下CNB结果不一致伴乳头状瘤变、MRI检查因运动伪影不足以诊断的患者。应用排除标准后，纳入48例患者，平均年龄61.5(14.8)岁;范围:31至72年)。经切除活检，发现30个良性病变和18个癌。在1.5 T (Verio;Siemens Medical Solutions, Erlangen, Germany)，在1000 s/mm2下计算弥散加权成像的b值。计算直方图参数。进行受试者工作特征(ROC)曲线分析，以调查诊断准确性，评估直方图分析性能，并确定阈值。结果:癌组的ADCmin、ADCmean、ADCmax及所有ADC值百分位数均显著低于良性组(P<0.001)。癌组的方差、偏度和峰度较高。ADCmax曲线下面积最高(AUC: 0.985;截止时间1.247 × 10-3 mm2/s;灵敏度86%，特异性92%)，其次是ADCmean (AUC: 0.950;截止时间0.903 × 10-3 mm2/s;灵敏度94%，特异性96%)。结论:高b值的体积ADC直方图分析可作为检测肿瘤的影像学标记，定量揭示病变的扩散特征。
{"title":"The efficiency of volumetric apparent diffusion coefficient histogram analysis in breast papillary neoplasms","authors":"M. O. Nalbant, A. Gemici, M. Karadağ, E. Inci","doi":"10.28982/josam.7715","DOIUrl":"https://doi.org/10.28982/josam.7715","url":null,"abstract":"Background/Aim: Papillary neoplasia encompasses both malignant and benign lesions, and core needle biopsy (CNB) is crucial in their diagnosis. Histological findings determine their management. Here we compare volumetric apparent diffusion coefficient (ADC) histogram analysis of carcinomas and benign pathologies identified by histopathology from excisional biopsies.\u0000Methods: This retrospective study included 524 patients who underwent breast magnetic resonance imaging (MRI) for a suspicious breast mass from January 2018 to October 2022. Patients with benign lesions, incompatible ultrasound-guided CNB results with papillary neoplasia, and those with MRI exams insufficient for diagnosis due to motion artifacts were excluded. After applying the exclusion criteria, the study included 48 patients (average aged 61.5 (14.8) years; range, 31 to 72 years). After excisional biopsies, 30 benign lesions and 18 carcinomas were identified. MRI was acquired at 1.5 T (Verio; Siemens Medical Solutions, Erlangen, Germany), and the b-values for diffusion-weighted imaging were calculated at 1000 s/mm2. Histogram parameters were computed. Receiver operating characteristic (ROC) curve analysis was performed to investigate diagnostic accuracy, evaluate histogram analysis performance, and determine threshold values.\u0000Results: The ADCmin, ADCmean, ADCmax, and all ADC value percentiles were significantly lower in the carcinoma group than in the benign group (P<0.001). The variance, skewness, and kurtosis were higher in the carcinoma group. ADCmax had the highest area under the curve (AUC: 0.985; cut-off 1.247 × 10-3 mm2/s; sensitivity 86%, and specificity 92%), followed by ADCmean (AUC: 0.950; cut-off 0.903 × 10-3 mm2/s; sensitivity 94%, and specificity 96%).\u0000Conclusion: Volumetric ADC histogram analysis of papillary neoplasia at higher b-values can be an imaging marker to detect carcinoma and quantitatively reveal the lesions’ diffusion characteristics.","PeriodicalId":30878,"journal":{"name":"International Journal of Surgery and Medicine","volume":"72 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82499084","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}
Abdulkadir Sarı, B. Erdal, A. Çelikkol, M. Ü. Çetin
Background/Aim: Fractures are the most common form of trauma in current orthopedic practice. Although studies have shed light on the relationship between the factors affecting the healing process after fracture, this process is still not fully understood. In this study, we aimed to investigate the changes in serum biomediator levels and fracture healing in different trauma patterns, such as head trauma (HT), long bone fracture (LBF), a combination of HT + LBF injury (CI), and in different time points of the healing period. Methods: Forty Wistar rats were included in the study and divided into five groups. Group 1, the donor group, included rats with HT; Group 2 included rats with LBFs who were administered the serum taken from rats in Group 1; Group 3 included the rats with isolated LBFs; and Group 4 the rats with CI. Group 5 comprised the control rats. An experimental closed HT and fracture model was applied to rats. The rats in Groups 2, 3 and 4 were sacrificed on the 10th, 20th, and 30th days. The biomediator levels in the serum taken after sacrification were studied, while closed femoral fracture models were examined radiologically. Results: Statistically significant differences were found among the groups regarding radiological scores on the 10th, 20th, and 30th days. On Day 10, Group 2a had significantly higher scores than Group 3a (P=0.03), and Group 3a had lower scores than Group 4a (P=0.01). On Day 20, Group 2b had significantly higher scores than Group 3b (P=0.004) but lower than Group 4b (P=0.03). On Day 30, Group 2c had significantly higher scores than Group 3c but lower than Group 4c (P=0.001). The mean Ca, TGF beta 1, beta-catenin, IL-10, IL-17A, TNF alpha, CRP, Wnt-16, ALP, GH, PTH, IL-1 beta, IL-6, and IL-22 levels were significantly different among the groups (P<0.05). No significant difference was observed in the biomediator levels among the groups at different time points of the healing period. Conclusion: We concluded that inflammatory cytokines (IL-1 beta, IL-6, IL-17A, IL-17F, IL-23, and TNF alpha) were elevated in the early period in individuals with isolated head trauma and that this effect could be transferred to other individuals by serum transfer. On the other hand, the negative relationship between the IL-10 level, which is a negative modulator in fracture union, and callus thickness was significant. Our study contributes by providing a molecular description of the positive union effect transferred between individuals by serum. We believe our findings will play a significant role in developing new therapeutic agents for fracture healing.
{"title":"Investigation of the effects of inflammatory and metabolic factors on fracture union in head trauma and long bone fractures","authors":"Abdulkadir Sarı, B. Erdal, A. Çelikkol, M. Ü. Çetin","doi":"10.28982/josam.1084466","DOIUrl":"https://doi.org/10.28982/josam.1084466","url":null,"abstract":"Background/Aim: Fractures are the most common form of trauma in current orthopedic practice. Although studies have shed light on the relationship between the factors affecting the healing process after fracture, this process is still not fully understood. In this study, we aimed to investigate the changes in serum biomediator levels and fracture healing in different trauma patterns, such as head trauma (HT), long bone fracture (LBF), a combination of HT + LBF injury (CI), and in different time points of the healing period. \u0000Methods: Forty Wistar rats were included in the study and divided into five groups. Group 1, the donor group, included rats with HT; Group 2 included rats with LBFs who were administered the serum taken from rats in Group 1; Group 3 included the rats with isolated LBFs; and Group 4 the rats with CI. Group 5 comprised the control rats. An experimental closed HT and fracture model was applied to rats. The rats in Groups 2, 3 and 4 were sacrificed on the 10th, 20th, and 30th days. The biomediator levels in the serum taken after sacrification were studied, while closed femoral fracture models were examined radiologically. \u0000Results: Statistically significant differences were found among the groups regarding radiological scores on the 10th, 20th, and 30th days. On Day 10, Group 2a had significantly higher scores than Group 3a (P=0.03), and Group 3a had lower scores than Group 4a (P=0.01). On Day 20, Group 2b had significantly higher scores than Group 3b (P=0.004) but lower than Group 4b (P=0.03). On Day 30, Group 2c had significantly higher scores than Group 3c but lower than Group 4c (P=0.001). The mean Ca, TGF beta 1, beta-catenin, IL-10, IL-17A, TNF alpha, CRP, Wnt-16, ALP, GH, PTH, IL-1 beta, IL-6, and IL-22 levels were significantly different among the groups (P<0.05). No significant difference was observed in the biomediator levels among the groups at different time points of the healing period. \u0000Conclusion: We concluded that inflammatory cytokines (IL-1 beta, IL-6, IL-17A, IL-17F, IL-23, and TNF alpha) were elevated in the early period in individuals with isolated head trauma and that this effect could be transferred to other individuals by serum transfer. On the other hand, the negative relationship between the IL-10 level, which is a negative modulator in fracture union, and callus thickness was significant. Our study contributes by providing a molecular description of the positive union effect transferred between individuals by serum. We believe our findings will play a significant role in developing new therapeutic agents for fracture healing.","PeriodicalId":30878,"journal":{"name":"International Journal of Surgery and Medicine","volume":"24 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87543420","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: Graded motor imagery is an increasingly popular motion representation technique. However, treatment protocols for graded motor imagery vary depending on various diseases. This study aims to summarize the cases in which graded motor imagery therapy is used, study protocols, and outcome measures in studies. Methods: The literature search was done with Web of Science, Pubmed, Scopus, and PEDro databases. The last search was carried out on September 13, 2022. A series-specific bias risk assessment tool was used with randomized, non-randomized, and case reports. All clinical studies that performed graded motor imagery, available in full text, describing their methods and findings, were included. The gender of the participants was not significant. The intervention was graded motor imagery. Outcome measures were mainly pain severity, other pain-related measures (e.g., pressure pain threshold, pain catastrophe), range of motion, strength, reaction time, kinesiophobia, neurophysiological measures, depression, function, or quality of life measures. Results: Complex regional pain syndrome, distal radius fracture, phantom limb pain, stroke, cancer, pathological pain (phantom pain after amputation, pain after brachial plexus avulsion), elbow stiffness, frozen shoulder, chronic shoulder pain, and osteoarthritis conditions were included. The intervention duration in the studies varies from 2 to 8 weeks. A common outcome measure could not be determined among studies. The pain was assessed in 15 studies, although different rating scales were used. Graded motor imagery resulted in a reduction in pain in 14 of the 15 studies. Conclusions: Due to the heterogeneity of the studies, a general conclusion regarding the effect of the disease-specific intervention was not possible. Based on pain outcome, graded motor imagery effectively decreased pain severity in various painful conditions.
背景/目的:分级运动意象是一种日益流行的运动表征技术。然而，分级运动意象的治疗方案因不同疾病而异。本研究旨在总结使用分级运动意象疗法的病例、研究方案和研究结果。方法:采用Web of Science、Pubmed、Scopus、PEDro数据库进行文献检索。最后一次搜寻是在2022年9月13日。随机、非随机和病例报告采用系列特异性偏倚风险评估工具。所有进行分级运动意象的临床研究均包含在全文中，描述了他们的方法和发现。参与者的性别差异不显著。干预被分级为运动意象。结果测量主要是疼痛严重程度、其他疼痛相关测量(如压痛阈值、疼痛突变)、活动范围、力量、反应时间、运动恐惧症、神经生理测量、抑郁、功能或生活质量测量。结果:包括复杂区域疼痛综合征、桡骨远端骨折、幻肢痛、中风、癌症、病理性疼痛(截肢后幻肢痛、臂丛撕脱痛)、肘关节僵硬、肩周炎、慢性肩周痛和骨关节炎。研究中的干预时间从2周到8周不等。在研究中无法确定共同的结果测量。15项研究对疼痛进行了评估，尽管使用了不同的评分标准。在15项研究中，有14项的运动意象分级导致疼痛减轻。结论:由于研究的异质性，无法得出针对特定疾病的干预效果的一般性结论。基于疼痛结果，分级运动意象有效地降低了各种疼痛状况下的疼痛严重程度。
{"title":"Graded motor imagery in orthopedic and neurological rehabilitation: A systematic review of clinical studies","authors":"Busra Candiri, Burcu Talu, G. Karabıcak","doi":"10.28982/josam.7669","DOIUrl":"https://doi.org/10.28982/josam.7669","url":null,"abstract":"Background/Aim: Graded motor imagery is an increasingly popular motion representation technique. However, treatment protocols for graded motor imagery vary depending on various diseases. This study aims to summarize the cases in which graded motor imagery therapy is used, study protocols, and outcome measures in studies.\u0000Methods: The literature search was done with Web of Science, Pubmed, Scopus, and PEDro databases. The last search was carried out on September 13, 2022. A series-specific bias risk assessment tool was used with randomized, non-randomized, and case reports. All clinical studies that performed graded motor imagery, available in full text, describing their methods and findings, were included. The gender of the participants was not significant. The intervention was graded motor imagery. Outcome measures were mainly pain severity, other pain-related measures (e.g., pressure pain threshold, pain catastrophe), range of motion, strength, reaction time, kinesiophobia, neurophysiological measures, depression, function, or quality of life measures.\u0000Results: Complex regional pain syndrome, distal radius fracture, phantom limb pain, stroke, cancer, pathological pain (phantom pain after amputation, pain after brachial plexus avulsion), elbow stiffness, frozen shoulder, chronic shoulder pain, and osteoarthritis conditions were included. The intervention duration in the studies varies from 2 to 8 weeks. A common outcome measure could not be determined among studies. The pain was assessed in 15 studies, although different rating scales were used. Graded motor imagery resulted in a reduction in pain in 14 of the 15 studies.\u0000Conclusions: Due to the heterogeneity of the studies, a general conclusion regarding the effect of the disease-specific intervention was not possible. Based on pain outcome, graded motor imagery effectively decreased pain severity in various painful conditions.","PeriodicalId":30878,"journal":{"name":"International Journal of Surgery and Medicine","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72998838","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}
Secondary pancreatic involvement can be seen up to 30% of advance staged non-Hodgkin’s lymphoma cases, but primary pancreatic lymphomas constitute only 1% of extranodal lymphomas. Furthermore, 0.2% of the pancreatic space-occupying lesions are primary pancreatic lymphomas, which usually present as a mass in the head of the pancreas with nonspecific symptoms. Therefore, primary pancreatic lymphomas should be considered as differential diagnosis of pancreatic solid lesions. Herein, we report two cases with different clinical presentation and different course of disease resulting in the diagnosis of primary and metastatic pancreatic lymphoma.
{"title":"Primary pancreatic lymphoma and metastatic lymphoma cases diagnosed with ultrasonography guided tru-cut needle biopsy; Two case reports","authors":"Işıl Bağcı, N. Şeker","doi":"10.28982/josam.1122921","DOIUrl":"https://doi.org/10.28982/josam.1122921","url":null,"abstract":"Secondary pancreatic involvement can be seen up to 30% of advance staged non-Hodgkin’s lymphoma cases, but primary pancreatic lymphomas constitute only 1% of extranodal lymphomas. Furthermore, 0.2% of the pancreatic space-occupying lesions are primary pancreatic lymphomas, which usually present as a mass in the head of the pancreas with nonspecific symptoms. Therefore, primary pancreatic lymphomas should be considered as differential diagnosis of pancreatic solid lesions. Herein, we report two cases with different clinical presentation and different course of disease resulting in the diagnosis of primary and metastatic pancreatic lymphoma.","PeriodicalId":30878,"journal":{"name":"International Journal of Surgery and Medicine","volume":"15 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89649926","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: Tuberculosis is a disease involving many systems, such as the lung, gastrointestinal system, genitourinary system, etc. Detecting this disease in its latency significantly reduces the morbidity and mortality associated with tuberculosis. One of the tests used in latent TB screening is the interferon gamma release test. In rheumatology practices, it is routinely used to screen for latent tuberculosis infections before treatment with biological agents and Janus kinase (JAK) inhibitors, and it can also be used to exclude tuberculosis infection in clinical practice. In our study, we aimed to evaluate the reasons for requesting interferon gamma release tests and the results of this test in patients who requested it. Methods: Patients admitted to internal medicine and rheumatology outpatient clinics were retrospectively screened within the retrospective cohort study. In total, 364 patients who requested interferon gamma release testing were included in the study. Nine patients with unclear test results were excluded. Laboratory results, demographic data, reasons for requesting the interferon gamma release test, and results were evaluated. Results: The interferon gamma release test was requested by 355 patients. Of these, 266 patients (74.9%) asked for latent tuberculosis screening before treatment with biological agents and JAK inhibitors. This was followed by patients with peripheral lymphadenopathy-lung nodules, patients with unexplained elevated acute phase reactants, and patients with constitutional symptoms, respectively. Ten out of 107 patients (9.3%) had an active tuberculosis infection, while six out of ten patients (60%) had pulmonary tuberculosis, and four (40%) had extrapulmonary tuberculosis. Conclusion: The most common reason for requesting the interferon gamma release test in internal medicine and rheumatology clinics was screening for latent tuberculosis before treatment with biologic agents and JAK inhibitors. In internal medicine, it has been observed that this test can also be requested by patients with constitutional symptoms, unexplained elevated acute phase reactants, and a preliminary diagnosis of tuberculosis in order to rule out or strengthen the preliminary diagnosis.
{"title":"Reasons for requesting an interferon gamma release test from internal medicine and rheumatology clinics and evaluation of the results","authors":"Alper Sarı, Adem Ertürk, Petek Şarlak Konya","doi":"10.28982/josam.7759","DOIUrl":"https://doi.org/10.28982/josam.7759","url":null,"abstract":"Background/Aim: Tuberculosis is a disease involving many systems, such as the lung, gastrointestinal system, genitourinary system, etc. Detecting this disease in its latency significantly reduces the morbidity and mortality associated with tuberculosis. One of the tests used in latent TB screening is the interferon gamma release test. In rheumatology practices, it is routinely used to screen for latent tuberculosis infections before treatment with biological agents and Janus kinase (JAK) inhibitors, and it can also be used to exclude tuberculosis infection in clinical practice. In our study, we aimed to evaluate the reasons for requesting interferon gamma release tests and the results of this test in patients who requested it. Methods: Patients admitted to internal medicine and rheumatology outpatient clinics were retrospectively screened within the retrospective cohort study. In total, 364 patients who requested interferon gamma release testing were included in the study. Nine patients with unclear test results were excluded. Laboratory results, demographic data, reasons for requesting the interferon gamma release test, and results were evaluated. Results: The interferon gamma release test was requested by 355 patients. Of these, 266 patients (74.9%) asked for latent tuberculosis screening before treatment with biological agents and JAK inhibitors. This was followed by patients with peripheral lymphadenopathy-lung nodules, patients with unexplained elevated acute phase reactants, and patients with constitutional symptoms, respectively. Ten out of 107 patients (9.3%) had an active tuberculosis infection, while six out of ten patients (60%) had pulmonary tuberculosis, and four (40%) had extrapulmonary tuberculosis. Conclusion: The most common reason for requesting the interferon gamma release test in internal medicine and rheumatology clinics was screening for latent tuberculosis before treatment with biologic agents and JAK inhibitors. In internal medicine, it has been observed that this test can also be requested by patients with constitutional symptoms, unexplained elevated acute phase reactants, and a preliminary diagnosis of tuberculosis in order to rule out or strengthen the preliminary diagnosis.","PeriodicalId":30878,"journal":{"name":"International Journal of Surgery and Medicine","volume":"2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74206858","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}
Although ovarian cancer is the second most common gynecological cancer, it is the most common gynecological malignancy that causes death. Approximately 75% of the patients are diagnosed at an advanced stage, and high-grade serous-type ovarian cancer is detected in most of these patients. The final pathology result in our case was high-grade serous ovarian carcinoma. Our patient, 39 years old, applied to our emergency department with complaints of inability to urinate for three days and new onset abdominal pain. We were consulted because of detection of an 11 cm solid mass and globe vesicle in the pelvic region detected on the computed tomography (CT) taken in the emergency department. The patient's initial hemoglobin value was 11.2 g/dL and the beta-human chorionic gonadotropin (ß-HCG) value was negative. During the follow-up, the patient’s hemoglobin values were 9.2 and then decreased to 8.6, 8.1, and 6.5 g/dL after which hypotensive shock developed in the patient. The patient was taken for an emergency laparotomy. Intra-operatively, 1500 mL of intra-abdominal hemorrhagic fluid and diffuse tumor fragments were observed. In the right adnexal area, approximately 11 cm of ruptured tumor tissue, which may originate from the ovary or uterus, was observed. It was observed that the Douglas pouch and uterine, internal iliac , and some parts of the external iliac arteries were extensively invaded by the tumor and active bleeding occurred. Total Abdominal Hysterectomy + Bilateral Salpingo-Oopherectomy (TAH+BSO) was performed on the patient. Additional surgical intervention could not be performed because the patient had extensive vascular tumor invasion, heavy bleeding, and was in hypotensive shock. Six anti-bleeding sponges were placed on intra-abdominal bleeding areas. In addition, packing was applied to the patient by placing four sterile compresses and soft drains inside the abdomen. Tranexamic acid was administered to the patient, and six units of red blood cell suspension and four units of fresh frozen plasma were transfused. The patient was transferred by ambulance to a higher institution, which is a gynecological oncology center, for follow-up, treatment, and complementary surgery. In this case, we aimed to draw attention to a rare case of ovarian malignancy rupture and hypotensive shock.
{"title":"A case of spontaneous ovarian malignant neoplasm rupture and life-threatening massive intra-abdominal bleeding","authors":"İsa Kaplan","doi":"10.28982/josam.1059670","DOIUrl":"https://doi.org/10.28982/josam.1059670","url":null,"abstract":"Although ovarian cancer is the second most common gynecological cancer, it is the most common gynecological malignancy that causes death. Approximately 75% of the patients are diagnosed at an advanced stage, and high-grade serous-type ovarian cancer is detected in most of these patients. The final pathology result in our case was high-grade serous ovarian carcinoma. Our patient, 39 years old, applied to our emergency department with complaints of inability to urinate for three days and new onset abdominal pain. We were consulted because of detection of an 11 cm solid mass and globe vesicle in the pelvic region detected on the computed tomography (CT) taken in the emergency department. The patient's initial hemoglobin value was 11.2 g/dL and the beta-human chorionic gonadotropin (ß-HCG) value was negative. During the follow-up, the patient’s hemoglobin values were 9.2 and then decreased to 8.6, 8.1, and 6.5 g/dL after which hypotensive shock developed in the patient. The patient was taken for an emergency laparotomy. Intra-operatively, 1500 mL of intra-abdominal hemorrhagic fluid and diffuse tumor fragments were observed. In the right adnexal area, approximately 11 cm of ruptured tumor tissue, which may originate from the ovary or uterus, was observed. It was observed that the Douglas pouch and uterine, internal iliac , and some parts of the external iliac arteries were extensively invaded by the tumor and active bleeding occurred. Total Abdominal Hysterectomy + Bilateral Salpingo-Oopherectomy (TAH+BSO) was performed on the patient. Additional surgical intervention could not be performed because the patient had extensive vascular tumor invasion, heavy bleeding, and was in hypotensive shock. Six anti-bleeding sponges were placed on intra-abdominal bleeding areas. In addition, packing was applied to the patient by placing four sterile compresses and soft drains inside the abdomen. Tranexamic acid was administered to the patient, and six units of red blood cell suspension and four units of fresh frozen plasma were transfused. The patient was transferred by ambulance to a higher institution, which is a gynecological oncology center, for follow-up, treatment, and complementary surgery. In this case, we aimed to draw attention to a rare case of ovarian malignancy rupture and hypotensive shock.","PeriodicalId":30878,"journal":{"name":"International Journal of Surgery and Medicine","volume":"42 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77512064","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: Expression of extracellular matrix proteins and metalloproteases (MMPs) has been implicated in neoplasm recurrence. Some recent studies have suggested a correlation between matrix modifier proteins and recurrence or invasion of meningiomas. Based on previous data, the aim of this study was to find a correlation between the immunohistochemical (IHC) expression patterns of a group of matrix modifier proteins, including CD147, Matrix Metalloprotease 2 and 9 (MMP2 and 9, respectively), Epithelial Cadherin (ECAD), and Galectin-3 (GAL3) with World Health Organization (WHO)-defined grade, brain invasion, recurrence, and other clinicopathological features. Methods: This study was a cohort study. All patients with meningioma who underwent resection over a 10-year period were identified from the electronic pathology archives. Tissue microarrays (TMAs) were created for IHC studies, and IHC staining was performed using standard methodology. Results: A total of 231 cases fulfilled the study criteria. Histological review identified 198 grade 1 tumors (85.3%), 28 grade 2 tumors (12.6%), and five grade 3 tumors (2.2%). CD147 was determined to be positively correlated with WHO-defined grade (P=0.009). ECAD, MMP2, MMP9, GAL3 were not found to be correlated with brain invasion, recurrence, or WHO grade. Conclusion: The study results demonstrated that CD147 could be a target for diagnosis, prognosis, and treatment of meningiomas.
{"title":"Immunohistochemical study of CD147 and matrix metalloproteases in meningiomas","authors":"Ilkay Cinar, F. Karagöz","doi":"10.28982/josam.7618","DOIUrl":"https://doi.org/10.28982/josam.7618","url":null,"abstract":"Background/Aim: Expression of extracellular matrix proteins and metalloproteases (MMPs) has been implicated in neoplasm recurrence. Some recent studies have suggested a correlation between matrix modifier proteins and recurrence or invasion of meningiomas. Based on previous data, the aim of this study was to find a correlation between the immunohistochemical (IHC) expression patterns of a group of matrix modifier proteins, including CD147, Matrix Metalloprotease 2 and 9 (MMP2 and 9, respectively), Epithelial Cadherin (ECAD), and Galectin-3 (GAL3) with World Health Organization (WHO)-defined grade, brain invasion, recurrence, and other clinicopathological features.\u0000Methods: This study was a cohort study. All patients with meningioma who underwent resection over a 10-year period were identified from the electronic pathology archives. Tissue microarrays (TMAs) were created for IHC studies, and IHC staining was performed using standard methodology.\u0000Results: A total of 231 cases fulfilled the study criteria. Histological review identified 198 grade 1 tumors (85.3%), 28 grade 2 tumors (12.6%), and five grade 3 tumors (2.2%). CD147 was determined to be positively correlated with WHO-defined grade (P=0.009). ECAD, MMP2, MMP9, GAL3 were not found to be correlated with brain invasion, recurrence, or WHO grade.\u0000Conclusion: The study results demonstrated that CD147 could be a target for diagnosis, prognosis, and treatment of meningiomas.","PeriodicalId":30878,"journal":{"name":"International Journal of Surgery and Medicine","volume":"50 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91020938","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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