Aims: Vitamin D (Vit-D) is an essential fat-soluble vitamin for the body whose central role is to regulate phosphorus and calcium homeostasis. Various studies have shown that Vit-D deficiency in pregnant women can have adverse consequences for the mother and the fetus. Therefore, we aimed to evaluate the relationship between Vit-D level and age in pregnant women in the Western Black Sea region of Turkey. Methods: A total 214 pregnant women analyzed Vit-D between 2015 and 2018 were included in this study. Pregnant women were divided into two groups as under 30 years old and over 30 years old. Serum Vit-D levels were measured by Liquid Chromatography Mass Spectrometry (LC-MS/MS). Vit-D < 12 ng/mL was considered as Vit-D deficiency, and 12-20 ng/mL was considered as Vit-D insufficiency. Results: There were 139 (64.95%) women under 30 years old and 75 (35.04%) women 30 years and older. There were 90 women (42.05%) with Vit-D deficiency and 92 women with Vit-D insufficiency (42.99%). The proportion of those under 30 years old who had the deficiency and insufficiency level of Vit-D was 60/91 (65.9%) and 61/91 (67.03%), respectively. The pregnant women aged 30 years and older with Vit-D deficiency and insufficiency were 31/91 (34.06%) and 30/91 (32.96%). There was no significant association between women ages and Vit- D levels (p = 0.381). Conclusion: Although the relationship between Vit-D levels in women younger than 30 years of age and older is not statistically different, we found that Vit-D deficiency is common in pregnant women in the Western Black Sea region. Vit-D supplementation should be considered in pregnant women to reduce morbidity and effects on fetuses and newborns during pregnancy and lactation.
{"title":"Evaluation of the relationship between vitamin-D status and age of pregnant women in the Western Black Sea region of Turkey","authors":"M. Nacar, G. Sel","doi":"10.51271/kmj-0089","DOIUrl":"https://doi.org/10.51271/kmj-0089","url":null,"abstract":"Aims: Vitamin D (Vit-D) is an essential fat-soluble vitamin for the body whose central role is to regulate phosphorus and calcium homeostasis. Various studies have shown that Vit-D deficiency in pregnant women can have adverse consequences for the mother and the fetus. Therefore, we aimed to evaluate the relationship between Vit-D level and age in pregnant women in the Western Black Sea region of Turkey.\u0000Methods: A total 214 pregnant women analyzed Vit-D between 2015 and 2018 were included in this study. Pregnant women were divided into two groups as under 30 years old and over 30 years old. Serum Vit-D levels were measured by Liquid Chromatography Mass Spectrometry (LC-MS/MS). Vit-D < 12 ng/mL was considered as Vit-D deficiency, and 12-20 ng/mL was considered as Vit-D insufficiency.\u0000Results: There were 139 (64.95%) women under 30 years old and 75 (35.04%) women 30 years and older. There were 90 women (42.05%) with Vit-D deficiency and 92 women with Vit-D insufficiency (42.99%). The proportion of those under 30 years old who had the deficiency and insufficiency level of Vit-D was 60/91 (65.9%) and 61/91 (67.03%), respectively. The pregnant women aged 30 years and older with Vit-D deficiency and insufficiency were 31/91 (34.06%) and 30/91 (32.96%). There was no significant association between women ages and Vit- D levels (p = 0.381).\u0000Conclusion: Although the relationship between Vit-D levels in women younger than 30 years of age and older is not statistically different, we found that Vit-D deficiency is common in pregnant women in the Western Black Sea region. Vit-D supplementation should be considered in pregnant women to reduce morbidity and effects on fetuses and newborns during pregnancy and lactation.","PeriodicalId":369732,"journal":{"name":"Kastamonu Medical Journal","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133724492","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}
Aims: Malnutrition may cause an increase in morbidity and mortality in intensive care patients. In this study, we aimed to investigate the relationship between nutritional scores and 28-day mortality in critically ill patients followed on a mechanical ventilator for non-surgical reasons. Methods: 91 patients admitted to the intensive care unit for non-surgical reasons, followed up on mechanical ventilators, and whose data were available were included. The prognostic nutrition index (PNI), geriatric nutrition risk index (GNRI), nutritional risk index (NRI), and controlling nutritional status (CONUT) score were calculated from the data of the patients. Patients were divided into two groups survival and non-survival. Results: NRI, PNI, and GNRI scores were statistically significantly higher in the Survivor group. Neutrophil lymphocyte ratio, LDH albumin ratio, CONUT, APACHE, and SAPS scores were statistically higher in the nonsurvivor group. In logistic regression analysis for nutritional scores, CONUT was found to be an independent risk factor for mortality (table 5). In the ROC analysis, the AUC value for CONUT was 0.925. The cut-off value for CONUT was 7.5, the sensitivity was 86.4%, and the specificity was 87.0%. Conclusion: The CONUT nutrition score, which can be easily calculated from routine parameters and does not cause extra costs, can be used as an independent evaluation tool in determining the 28-day mortality of intensive care patients.
{"title":"Relationship between butritional scores and 28-day mortality in critical patients who received mechanical ventilator support for non-surgical reasons","authors":"Ö. Taşkın, Özgür Yılmaz","doi":"10.51271/kmj-0092","DOIUrl":"https://doi.org/10.51271/kmj-0092","url":null,"abstract":"Aims: Malnutrition may cause an increase in morbidity and mortality in intensive care patients. In this study, we aimed to investigate the relationship between nutritional scores and 28-day mortality in critically ill patients followed on a mechanical ventilator for non-surgical reasons.\u0000Methods: 91 patients admitted to the intensive care unit for non-surgical reasons, followed up on mechanical ventilators, and whose data were available were included. The prognostic nutrition index (PNI), geriatric nutrition risk index (GNRI), nutritional risk index (NRI), and controlling nutritional status (CONUT) score were calculated from the data of the patients. Patients were divided into two groups survival and non-survival.\u0000Results: NRI, PNI, and GNRI scores were statistically significantly higher in the Survivor group. Neutrophil lymphocyte ratio, LDH albumin ratio, CONUT, APACHE, and SAPS scores were statistically higher in the nonsurvivor group. In logistic regression analysis for nutritional scores, CONUT was found to be an independent risk factor for mortality (table 5). In the ROC analysis, the AUC value for CONUT was 0.925. The cut-off value for CONUT was 7.5, the sensitivity was 86.4%, and the specificity was 87.0%.\u0000Conclusion: The CONUT nutrition score, which can be easily calculated from routine parameters and does not cause extra costs, can be used as an independent evaluation tool in determining the 28-day mortality of intensive care patients.\u0000\u0000","PeriodicalId":369732,"journal":{"name":"Kastamonu Medical Journal","volume":"22 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123505303","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}
Burcu İleri Fikri, Alev Öztaş, Hazal Özsağıroğlu, G. Turan
Aims: Candida spp. can cause fatal infections in the person in case of immunosuppression such as malignancy. The aim of our study is to examine the frequency, prognosis and risk factors of candida-related infections in our patients with malignancies followed in our intensive care unit (ICU). Methods: ICU patients with malignancy with fungal infection accepted as the case group and the patients without candida were considered as the control. Demographic characteristics, risk factors and candida risk scores were recorded and compared in both groups. Results: Candida spp. reproduction was observed at a very high rate with 24%. However, there was no difference in mortality between the two groups with and without candida infection. In our study; candida risk score, presence and duration of central venous catheter, antibiotic and steroid use in the last 1 month were found to be the factors determining the risk of candida infection. Conclusion: The contribution of the presence of fungal infection to mortality in our cancer patients does not seem different from others. However, in this patient group, it is difficult to distinguish colonization from invasive fungal infections. At this stage, the use of treatment decisions using risk factors and risk scoring comes to the fore.
{"title":"Candida spp. infection frequency and risk factors in malignant critical care patients","authors":"Burcu İleri Fikri, Alev Öztaş, Hazal Özsağıroğlu, G. Turan","doi":"10.51271/kmj-0090","DOIUrl":"https://doi.org/10.51271/kmj-0090","url":null,"abstract":"Aims: Candida spp. can cause fatal infections in the person in case of immunosuppression such as malignancy. The aim of our study is to examine the frequency, prognosis and risk factors of candida-related infections in our patients with malignancies followed in our intensive care unit (ICU).\u0000Methods: ICU patients with malignancy with fungal infection accepted as the case group and the patients without candida were considered as the control. Demographic characteristics, risk factors and candida risk scores were recorded and compared in both groups.\u0000Results: Candida spp. reproduction was observed at a very high rate with 24%. However, there was no difference in mortality between the two groups with and without candida infection. In our study; candida risk score, presence and duration of central venous catheter, antibiotic and steroid use in the last 1 month were found to be the factors determining the risk of candida infection.\u0000Conclusion: The contribution of the presence of fungal infection to mortality in our cancer patients does not seem different from others. However, in this patient group, it is difficult to distinguish colonization from invasive fungal infections. At this stage, the use of treatment decisions using risk factors and risk scoring comes to the fore.","PeriodicalId":369732,"journal":{"name":"Kastamonu Medical Journal","volume":"56 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125089138","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}
Hakan Şıvgın, A. Yılmaz, A. Rüstemoğlu, Banu Öztürk, Ş. Şahin, Turker Tasliyurt
Aims: Chronic HBV infection is associated with high morbidity and mortality rate due to increased risk of hepatic cirrhosis and hepatocellular cancer. Treatment modilities and resistance is currently investigated. Several mechanisms were underlying in drug resistance. P-glycoprotein (P-gp), the product of multidrug resistance gene (MDR-1), is well-known mechanism of MDR phenotype. MDR gene C1236T polymorphism is associated with decreased p-gp function. The mutation of MDR gene can affect the clinical course of disease and response rate to treatment. It was aimed to investigate the relationship between MDR gene polymorphism and clinical course and treatment responses in chronic HBV infection in our study. Methods: A total of 90 (male/female:69/21) patients with chronic HBV infection under Lamivudine treatment was enrolled in this study. Mean ages were 49.8±12.6 (range:22-75) years. The patients were categorized as: Treatment responded (group 1: HBV-DNA is negative at 24th week) and treatment refractory (group 2: HBV-DNA is still positive after 24th week). Group 1 was consisted of 51 (M/F: 38/13) and group 2 was consisted of 39 (M/F: 31/9) patients. There was no significant difference between ages and genders of two groups. Histologic activity indexes (HAI), total bilirubin, AST and ALT levels, HBV-DNA titers were significantly higher in the patients in group 2 than group 1 (p<0.05). Results: Genotype distributions; homozygous CC genotype was in 8 (15.7%),heterozygous CT genotype was in 37 (%72.5), homozygous TT genotype wasin 6 (11.8%) in patients at group 1. Homozygous CC genotype was in 13 (33.3%), heterozygous CT genotype was in 21 (53.8%), homozygous TT genotype was in 5 (12.8%) in patients at group 2. CC genotype was more common in group 2 than group 1 (p=0.044). C and T alleles’ frequencies in the group 1 and 2 were 51.96% and 60.26%, 48.04% and 39.74%, respectively (p>0.05). The patients with YMDD mutation positive at group 2 (n:11), 5 (45%) had have CC genotype, 5 (45%) had have CT, 1 (9%) had have TT genotype.The patients with YMDD mutation negative at group 2 (n:8), 3 (37%) patients had have CC and 5 (63%) patients had have CT genotype. CC genotype was more common in the patients with YMDD mutation positive than group 1 (p=0.043). Moreover, CC genotype was more common in the patients with HBV-DNA positive at 12nd month of Lamivudine treatment than group 1 (p=0.042). Conclusion: Consequently; MDR-1 and p-gp polymorphisms are important factors in the clinical course of chronic HBV infection and may influence the treatment responses. In the current study, it was found that the CC genotype of MDR-1 gene C1236T was more common in the patients with lamivudine resistant HBV infection.
{"title":"The effects of MDR-1 gene polymorphisms on the clinical course of chronic hepatitis B infection","authors":"Hakan Şıvgın, A. Yılmaz, A. Rüstemoğlu, Banu Öztürk, Ş. Şahin, Turker Tasliyurt","doi":"10.51271/kmj-0086","DOIUrl":"https://doi.org/10.51271/kmj-0086","url":null,"abstract":"Aims: Chronic HBV infection is associated with high morbidity and mortality rate due to increased risk of hepatic cirrhosis and hepatocellular cancer. Treatment modilities and resistance is currently investigated. Several mechanisms were underlying in drug resistance. P-glycoprotein (P-gp), the product of multidrug resistance gene (MDR-1), is well-known mechanism of MDR phenotype. MDR gene C1236T polymorphism is associated with decreased p-gp function. The mutation of MDR gene can affect the clinical course of disease and response rate to treatment. It was aimed to investigate the relationship between MDR gene polymorphism and clinical course and treatment responses in chronic HBV infection in our study. \u0000Methods: A total of 90 (male/female:69/21) patients with chronic HBV infection under Lamivudine treatment was enrolled in this study. Mean ages were 49.8±12.6 (range:22-75) years. The patients were categorized as: Treatment responded (group 1: HBV-DNA is negative at 24th week) and treatment refractory (group 2: HBV-DNA is still positive after 24th week). Group 1 was consisted of 51 (M/F: 38/13) and group 2 was consisted of 39 (M/F: 31/9) patients. There was no significant difference between ages and genders of two groups. Histologic activity indexes (HAI), total bilirubin, AST and ALT levels, HBV-DNA titers were significantly higher in the patients in group 2 than group 1 (p<0.05). \u0000Results: Genotype distributions; homozygous CC genotype was in 8 (15.7%),heterozygous CT genotype was in 37 (%72.5), homozygous TT genotype wasin 6 (11.8%) in patients at group 1. Homozygous CC genotype was in 13 (33.3%), heterozygous CT genotype was in 21 (53.8%), homozygous TT genotype was in 5 (12.8%) in patients at group 2. CC genotype was more common in group 2 than group 1 (p=0.044). C and T alleles’ frequencies in the group 1 and 2 were 51.96% and 60.26%, 48.04% and 39.74%, respectively (p>0.05). The patients with YMDD mutation positive at group 2 (n:11), 5 (45%) had have CC genotype, 5 (45%) had have CT, 1 (9%) had have TT genotype.The patients with YMDD mutation negative at group 2 (n:8), 3 (37%) patients had have CC and 5 (63%) patients had have CT genotype. CC genotype was more common in the patients with YMDD mutation positive than group 1 (p=0.043). Moreover, CC genotype was more common in the patients with HBV-DNA positive at 12nd month of Lamivudine treatment than group 1 (p=0.042). \u0000Conclusion: Consequently; MDR-1 and p-gp polymorphisms are important factors in the clinical course of chronic HBV infection and may influence the treatment responses. In the current study, it was found that the CC genotype of MDR-1 gene C1236T was more common in the patients with lamivudine resistant HBV infection.","PeriodicalId":369732,"journal":{"name":"Kastamonu Medical Journal","volume":"37 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130615564","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}
Tommy Alfandy Nazwar, Farhad Balafif, D. W. Wardhana, Sabrinadia Hanareta Hantoko, M. Mustofa
Perforation of the abdominal visceraand protrusionofthe distal end of the ventricul operitonealshunt are uncommon but serious complications of pediatric surgery. We report a case of distal ventriculoperitonealshunt protrusion into the appendix by transanal access in a patient who did not exhibit typical appendicitis symptoms. We report the case of a 2-year-old male with anal extrusion and assess his condition.
{"title":"Transanal protrusion ventriculoperitoneal shunt migration in hydrocephalus patients","authors":"Tommy Alfandy Nazwar, Farhad Balafif, D. W. Wardhana, Sabrinadia Hanareta Hantoko, M. Mustofa","doi":"10.51271/kmj-0097","DOIUrl":"https://doi.org/10.51271/kmj-0097","url":null,"abstract":"Perforation of the abdominal visceraand protrusionofthe distal end of the ventricul operitonealshunt are uncommon but serious complications of pediatric surgery. We report a case of distal ventriculoperitonealshunt protrusion into the appendix by transanal access in a patient who did not exhibit typical appendicitis symptoms. We report the case of a 2-year-old male with anal extrusion and assess his condition.","PeriodicalId":369732,"journal":{"name":"Kastamonu Medical Journal","volume":"21 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132742088","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}
Aims: Carotid artery disease is one of the most important causes of stroke. If left untreated, it causes serious mortality and morbidity. The gold standard treatment for carotid artery stenosis is carotid endarterectomy. The use of shunt, primary or patch closure of the arteriotomy varies according to clinical experience. In this article, we present the results of carotid endarterectomy performed with no shunt and primary closure method. Methods: Thirty cases who underwent carotid endarterectomy in our clinic between April 2021 and April 2022 were analyzed retrospectively. All patients underwent selective carotid surgery. All surgeries were performed with the same technique and under general anesthesia. The patients were evaluated in terms of demographic characteristics, operation time, cross-clamp time, mortality, morbidity, and hospital stay. Results: The clinical data of the early follow-up in the first month postoperatively were evaluated. Six (20%) of the patients were female and 24 (80%) were male. All of the males were active smokers. The mean age was 71.1 (min:65-max:82). Twenty five patients had a history of coronary artery disease. The mean cross-clamp time was 9.1 (±0.8) minutes. All surgeries were performed without using shunts. In all patients, primary closure was performed without the use of arterotomy grafts. Conclusion: As an early morbidity, dysphagia was detected in 1 patient. This symptom disappeared at follow-up at 1 month. No early mortality was observed in any patient at 1-month follow-up. With increasing experience, carotid endarterectomy operations can be performed safely with no shunt and primary closure method. Our early surgical results are consistent with the literature.
{"title":"Our early results of carotis endarterectomy with no shunt and primary closure method","authors":"B. Tamtekin, Güler Gülsen Ersoy, I. Dal","doi":"10.51271/kmj-0094","DOIUrl":"https://doi.org/10.51271/kmj-0094","url":null,"abstract":"Aims: Carotid artery disease is one of the most important causes of stroke. If left untreated, it causes serious mortality and\u0000morbidity. The gold standard treatment for carotid artery stenosis is carotid endarterectomy. The use of shunt, primary or patch closure of the arteriotomy varies according to clinical experience. In this article, we present the results of carotid endarterectomy performed with no shunt and primary closure method.\u0000Methods: Thirty cases who underwent carotid endarterectomy in our clinic between April 2021 and April 2022 were analyzed retrospectively. All patients underwent selective carotid surgery. All surgeries were performed with the same\u0000technique and under general anesthesia. The patients were evaluated in terms of demographic characteristics, operation time, cross-clamp time, mortality, morbidity, and hospital stay.\u0000Results: The clinical data of the early follow-up in the first month postoperatively were evaluated. Six (20%) of the patients\u0000were female and 24 (80%) were male. All of the males were active smokers. The mean age was 71.1 (min:65-max:82). Twenty\u0000five patients had a history of coronary artery disease. The mean cross-clamp time was 9.1 (±0.8) minutes. All surgeries were\u0000performed without using shunts. In all patients, primary closure was performed without the use of arterotomy grafts.\u0000Conclusion: As an early morbidity, dysphagia was detected in 1 patient. This symptom disappeared at follow-up at 1 month.\u0000No early mortality was observed in any patient at 1-month follow-up. With increasing experience, carotid endarterectomy\u0000operations can be performed safely with no shunt and primary closure method. Our early surgical results are consistent with\u0000the literature.","PeriodicalId":369732,"journal":{"name":"Kastamonu Medical Journal","volume":"140 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116461820","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}
Inherited hemolytic anemia is one of the most commonly seen anemias encountred in the pediatric age, especially in Türkiye, where consanguineous marriages are common. Inherited hemolytic anemias mainly includes hemoglobinopathies, erythrocyte membrane defects and enzyme defects. Hemolytic anemias have a wide etiology and clinical spectrum with acquired and hereditary causes in childhood. Always a careful self and family history review and synthesis of physical examination and laboratory findings are vital for differential diagnosis. Therefore, physicians should be competent about prevention methods and early diagnosis markers.
{"title":"Inherited hemolytic anemias in children","authors":"Şefika Akyol, Akif Tahiroğlu, E. Unal","doi":"10.51271/kmj-00112","DOIUrl":"https://doi.org/10.51271/kmj-00112","url":null,"abstract":"Inherited hemolytic anemia is one of the most commonly seen anemias encountred in the pediatric age, especially in Türkiye, where consanguineous marriages are common. Inherited hemolytic anemias mainly includes hemoglobinopathies, erythrocyte membrane defects and enzyme defects. Hemolytic anemias have a wide etiology and clinical spectrum with acquired and hereditary causes in childhood. Always a careful self and family history review and synthesis of physical examination and laboratory findings are vital for differential diagnosis. Therefore, physicians should be competent about prevention methods and early diagnosis markers.","PeriodicalId":369732,"journal":{"name":"Kastamonu Medical Journal","volume":"95 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126144212","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: A standard surgical technique has not been developed for Chiari Type-1 malformation. Recently, dural-splitting has also been introduced in addition to duraplasty. We aimed to determine both surgical techniques’ advantages/disadvantages clinically and radiologically. Material and Method: We retrospectively evaluated 28 patients’ data with Chiari Type-I malformation and operated at the Neurosurgery Department of Bülent Ecevit University between January 2014 and April 2018. We retrieved demographic characteristics, symptoms, physical/neurological findings, preoperative/postoperative imaging data/measurements, VAS, Chicago Chiari Outcome Scale, Neck Disability Index, Neurological Scoring System, and modified-JOA scores, operation and hospitalization times, and complications from the automation system. Results: Patients’ mean age was 38.5±13.0 years, and female/male ratio was 2.1/1. Syringomyelia was present in half of all cases. Mean tonsil herniation length was 11.64±4 mm, and mean tonsillo-dural distance was 4.18±1.7 mm. There were no significant relationships between tonsil herniation length and syringomyelia, and between tonsillo-dural distance and clinical improvement. Posterior fossa decompression was initially performed in all patients. Then, in 17 patients, duraplasty was performed. In 11 patients, dural-splitting was used. No significant differences were determined between duraplasty and dural-splitting regarding VAS, Chicago Chiari Outcome Scale, Neck Disability Index, Neurological Scoring System, and modified-JOA scores. Significant differences were present, favoring dural-splitting regarding operation time, hospital stay, and complication rates. Conclusion: Posterior fossa decompression/duraplasty is an effective surgical technique to treat Chiari Type-I malformation. Posterior fossa decompression/dural-splitting is an optimal surgical alternative with a lower complication rate, shorter operation time, and hospitalization period.
{"title":"Dural splitting has similar therapeutic efficacy with less complications, shorter operative and hospitalization times when compared to duraplasty in chiari type-I malformation","authors":"Eren Görkem Gün, Şanser Gül","doi":"10.51271/kmj-0081","DOIUrl":"https://doi.org/10.51271/kmj-0081","url":null,"abstract":"Background: A standard surgical technique has not been developed for Chiari Type-1 malformation. Recently, dural-splitting has also been introduced in addition to duraplasty. We aimed to determine both surgical techniques’ advantages/disadvantages clinically and radiologically. \u0000Material and Method: We retrospectively evaluated 28 patients’ data with Chiari Type-I malformation and operated at the Neurosurgery Department of Bülent Ecevit University between January 2014 and April 2018. We retrieved demographic characteristics, symptoms, physical/neurological findings, preoperative/postoperative imaging data/measurements, VAS, Chicago Chiari Outcome Scale, Neck Disability Index, Neurological Scoring System, and modified-JOA scores, operation and hospitalization times, and complications from the automation system. \u0000Results: Patients’ mean age was 38.5±13.0 years, and female/male ratio was 2.1/1. Syringomyelia was present in half of all cases. Mean tonsil herniation length was 11.64±4 mm, and mean tonsillo-dural distance was 4.18±1.7 mm. There were no significant relationships between tonsil herniation length and syringomyelia, and between tonsillo-dural distance and clinical improvement. Posterior fossa decompression was initially performed in all patients. Then, in 17 patients, duraplasty was performed. In 11 patients, dural-splitting was used. No significant differences were determined between duraplasty and dural-splitting regarding VAS, Chicago Chiari Outcome Scale, Neck Disability Index, Neurological Scoring System, and modified-JOA scores. Significant differences were present, favoring dural-splitting regarding operation time, hospital stay, and complication rates. \u0000Conclusion: Posterior fossa decompression/duraplasty is an effective surgical technique to treat Chiari Type-I malformation. Posterior fossa decompression/dural-splitting is an optimal surgical alternative with a lower complication rate, shorter operation time, and hospitalization period.","PeriodicalId":369732,"journal":{"name":"Kastamonu Medical Journal","volume":"32 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115752041","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}
Aims: Neonatal sepsis is a systemic condition that results in hemodynamic and clinical findings. We aimed to determine the role of hemogram parameters in the diagnosis of early neonatal sepsis. Methodology: This retrospective study was conducted with 126 neonates hospitalized in Kastamonu Training and Research Hospital Neonatal Intensive Care Unit between March 2018 to March 2022. There were 65 term neonates diagnosed with early neonatal sepsis in the patient group. In the control group, there were 61 term neonates who underwent hemogram within the first 72 hours (postnatal period) due to physiological jaundice and did not receive any antibiotic treatment. The assessment was made by comparing the hemogram parameters of these groups. Results: The Macro-R value, white blood cell count, absolute neutrophil count, monocyte count, immature erythrocyte count and percentage, immature granulocyte count and percentage and neutrophil-lymphocyte ratio were found to be significantly higher in the patient group than in the control group (p<0.05). Macro R, white blood cell count, absolute neutrophil count, immature erythrocyte count and percentage, immature granulocyte count and neutrophil/lymphocyte ratio had high sensitivity and specificity for the diagnosis of early neonatal sepsis. Conclusion: We think that these simple and easily accessible parameters have potential value in the diagnosis of ENS if they are used together with the clinical symptoms of ENS.
{"title":"Assessment of Micro-R/Macro-R values and other hemogram parameters for the diagnosis of early neonatal sepsis","authors":"Emrah Çiğri, Sedat Gülten","doi":"10.51271/kmj-0078","DOIUrl":"https://doi.org/10.51271/kmj-0078","url":null,"abstract":"Aims: Neonatal sepsis is a systemic condition that results in hemodynamic and clinical findings. We aimed to determine the role of hemogram parameters in the diagnosis of early neonatal sepsis. \u0000Methodology: This retrospective study was conducted with 126 neonates hospitalized in Kastamonu Training and Research Hospital Neonatal Intensive Care Unit between March 2018 to March 2022. There were 65 term neonates diagnosed with early neonatal sepsis in the patient group. In the control group, there were 61 term neonates who underwent hemogram within the first 72 hours (postnatal period) due to physiological jaundice and did not receive any antibiotic treatment. The assessment was made by comparing the hemogram parameters of these groups. \u0000Results: The Macro-R value, white blood cell count, absolute neutrophil count, monocyte count, immature erythrocyte count and percentage, immature granulocyte count and percentage and neutrophil-lymphocyte ratio were found to be significantly higher in the patient group than in the control group (p<0.05). Macro R, white blood cell count, absolute neutrophil count, immature erythrocyte count and percentage, immature granulocyte count and neutrophil/lymphocyte ratio had high sensitivity and specificity for the diagnosis of early neonatal sepsis. \u0000Conclusion: We think that these simple and easily accessible parameters have potential value in the diagnosis of ENS if they are used together with the clinical symptoms of ENS.","PeriodicalId":369732,"journal":{"name":"Kastamonu Medical Journal","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130265527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Y. Bi̇li̇r, F. Çiyiltepe, Gamze TANIRGAN ÇABAKLI, A. Saraçoğlu, K. Saraçoğlu
Introduction: This study aimed to determine how intensive care workers are affected by the pandemic period and the factors affecting burnout. Methods: 45assistants, 76nurses and 40specialists working in a tertiary intensive care unit(ICU) with 70 covid-beds participated in the study. Responses were collected through a website(www.surveymonkey.com). Results: The mean age of the respondents was 34.4±8.6 years, and the mean years of experience were 9.4±8.2. The general Emotional Exhaustion(EE), Depersonalization(DP), Reduced Personal Achievement(RPA) scores of the ICU workers were calculated as 20.7, 8.4 and 20.1 and the general arithmetic mean of the burnout scores was 49.1. It was found that the assistant doctors(AD) group had a statistically significantly higher risk in the EE and DP scales. (p=0,016 p<0,001). It was found that the risk of EE was higher in AD Group without child. Considering the satisfaction correlation of the scales, The rate of dissatisfaction was found statistically significantly higher in the intensive care nurses(ICN) group than AD and specialist doctors(SD) groups (p<0,001). Considering the factors affecting burnout, a statistically significant negative correlation was found between EE and ‘Appreciation at work during the pandemic period’ and ‘Adequacy of physical conditions’ in the SD group (p=0,005 p=0,044). There was a statistically significant negative correlation between RPA and being married in the AD group (p=0,023). A statistically significant negative correlation was found between DP and having a child in the ICN group (p=0,032). Conclusion: It is of importance to reveal the causes of burnout during the pandemic, and to make arrangements Keywords: COVID-19, Intensive Care Unit, Assistant Doctor, Specialist Doctor, Burnout Burnout
{"title":"Burnout levels of the intensive care unit team during extended COVID-19 outbreak and affecting factors","authors":"Y. Bi̇li̇r, F. Çiyiltepe, Gamze TANIRGAN ÇABAKLI, A. Saraçoğlu, K. Saraçoğlu","doi":"10.51271/kmj-0079","DOIUrl":"https://doi.org/10.51271/kmj-0079","url":null,"abstract":"Introduction: This study aimed to determine how intensive care workers are affected by the pandemic period and the factors affecting burnout. \u0000Methods: 45assistants, 76nurses and 40specialists working in a tertiary intensive care unit(ICU) with 70 covid-beds participated in the study. Responses were collected through a website(www.surveymonkey.com). \u0000Results: \u0000The mean age of the respondents was 34.4±8.6 years, and the mean years of experience were 9.4±8.2. The general Emotional Exhaustion(EE), Depersonalization(DP), Reduced Personal Achievement(RPA) scores of the ICU workers were calculated as 20.7, 8.4 and 20.1 and the general arithmetic mean of the burnout scores was 49.1. It was found that the assistant doctors(AD) group had a statistically significantly higher risk in the EE and DP scales. (p=0,016 p<0,001). It was found that the risk of EE was higher in AD Group without child. \u0000Considering the satisfaction correlation of the scales, The rate of dissatisfaction was found statistically significantly higher in the intensive care nurses(ICN) group than AD and specialist doctors(SD) groups (p<0,001). \u0000Considering the factors affecting burnout, a statistically significant negative correlation was found between EE and ‘Appreciation at work during the pandemic period’ and ‘Adequacy of physical conditions’ in the SD group (p=0,005 p=0,044). There was a statistically significant negative correlation between RPA and being married in the AD group (p=0,023). A statistically significant negative correlation was found between DP and having a child in the ICN group (p=0,032). \u0000Conclusion: It is of importance to reveal the causes of burnout during the pandemic, and to make arrangements \u0000Keywords: COVID-19, Intensive Care Unit, Assistant Doctor, Specialist Doctor, Burnout Burnout","PeriodicalId":369732,"journal":{"name":"Kastamonu Medical Journal","volume":"62 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134097853","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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