Aim: Postoperative pain is an essential problem that affects morbidity in surgical cases. We aimed to provide maximal benefits with minimal side effects, facilitate the recovery period, accelerate mobilization, and provide patient safety and comfort through the usage of the drug and method of our choice to provide postoperative analgesia.Material and Method: Our study included 60 elective or urgent lumbar disc surgery cases. The patients were randomly divided into two groups; (a) The Group S; patients receiving general anesthesia and intraoperative epidural saline injection, and (b) The Group L; patients receiving general anesthesia and intraoperative epidural 2.5 mg/mL levobupivacaine 10 mL injection. The patient’s hemodynamic parameters were monitored perioperatively. To all patients, in case of necessity, patient-controlled analgesia with IV morphine was administered. The pain assessment was done using a numeric pain rating scale and visual analog scale. In addition, morphine usage during the 24 hours, pain scores, mobilization time, patient satisfaction, and side effects were evaluated.Results: In the levobupivacaine group, the pain scores were lower during the whole trial, the morphine consumption in the 24 hour period was lower, the first time of mobilization was shorter, the patient satisfaction was more remarkable, and this group was more clinically significant considering side effects.Conclusion: The usage of epidural bupivacaine combined with IV morphine instead of IV morphine alone for postoperative analgesia is more beneficial for early mobilization, reducing complications, and better patient satisfaction
{"title":"The effect of intraoperative epidural levobupivacaine administration in lumbar disc surgery for postoperative pain","authors":"Serpil Çetin Gül, Ayşe Yılmaz, Zeynep Balaban, Özgür Yılmaz, D. Yörükoğlu","doi":"10.51271/kmj-0039","DOIUrl":"https://doi.org/10.51271/kmj-0039","url":null,"abstract":"Aim: Postoperative pain is an essential problem that affects morbidity in surgical cases. We aimed to provide maximal benefits with minimal side effects, facilitate the recovery period, accelerate mobilization, and provide patient safety and comfort through the usage of the drug and method of our choice to provide postoperative analgesia.Material and Method: Our study included 60 elective or urgent lumbar disc surgery cases. The patients were randomly divided into two groups; (a) The Group S; patients receiving general anesthesia and intraoperative epidural saline injection, and (b) The Group L; patients receiving general anesthesia and intraoperative epidural 2.5 mg/mL levobupivacaine 10 mL injection. The patient’s hemodynamic parameters were monitored perioperatively. To all patients, in case of necessity, patient-controlled analgesia with IV morphine was administered. The pain assessment was done using a numeric pain rating scale and visual analog scale. In addition, morphine usage during the 24 hours, pain scores, mobilization time, patient satisfaction, and side effects were evaluated.Results: In the levobupivacaine group, the pain scores were lower during the whole trial, the morphine consumption in the 24 hour period was lower, the first time of mobilization was shorter, the patient satisfaction was more remarkable, and this group was more clinically significant considering side effects.Conclusion: The usage of epidural bupivacaine combined with IV morphine instead of IV morphine alone for postoperative analgesia is more beneficial for early mobilization, reducing complications, and better patient satisfaction","PeriodicalId":369732,"journal":{"name":"Kastamonu Medical Journal","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122031519","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:: COVID-19 disease, which has taken over the world for more than a year, is unfortunately not yet understood and a definitive treatment has not been found. The aim of this study is to investigate the changes in clinical and laboratory tests of critical COVID-19 patients followed in the intensive care unit between March/2020 and December/2020 and to evaluate the factors that cause these changes with literature information. Materıal and Method: In the study, during the beginning of the pandemic and its progress; 50 COVID-19 patients treated in the intensive care unit between March-April-May/2020 were defined as group 1, and 50 COVID-19 patients treated in the intensive care unit between October-November-December/2020 were defined as group 2.Clinical, laboratory and intensive care processes of the patients in the groups were analyzed retrospectively and compared. Results:Demographic data were similar between groups. Group 2 patients had higher 28-day mortality, and this result was statistically significant (p = 0.006). Transfer rates of group 1 patients to the service after intensive care were found to be statistically higher (p = 0.029). Conclusıons:28-day mortality was found to be different between similar patient groups who were admitted to intensive care during different periods of the pandemic. The reasons for this may be: changes in pathogenicity as a result of viral mutations, different immune responses of hosts to viral infection, intensive care experience of healthcare professionals.
{"title":"Change of critical COVID-19 disease in time","authors":"U. Demir, V. G. Soylu, Ö. Taşkın, Ayşe Yılmaz","doi":"10.51271/kmj-39","DOIUrl":"https://doi.org/10.51271/kmj-39","url":null,"abstract":"Background:: COVID-19 disease, which has taken over the world for more than a year, is unfortunately not yet understood and a definitive treatment has not been found. The aim of this study is to investigate the changes in clinical and laboratory tests of critical COVID-19 patients followed in the intensive care unit between March/2020 and December/2020 and to evaluate the factors that cause these changes with literature information. \u0000Materıal and Method: In the study, during the beginning of the pandemic and its progress; 50 COVID-19 patients treated in the intensive care unit between March-April-May/2020 were defined as group 1, and 50 COVID-19 patients treated in the intensive care unit between October-November-December/2020 were defined as group 2.Clinical, laboratory and intensive care processes of the patients in the groups were analyzed retrospectively and compared. \u0000Results:Demographic data were similar between groups. Group 2 patients had higher 28-day mortality, and this result was statistically significant (p = 0.006). Transfer rates of group 1 patients to the service after intensive care were found to be statistically higher (p = 0.029). \u0000Conclusıons:28-day mortality was found to be different between similar patient groups who were admitted to intensive care during different periods of the pandemic. The reasons for this may be: changes in pathogenicity as a result of viral mutations, different immune responses of hosts to viral infection, intensive care experience of healthcare professionals.","PeriodicalId":369732,"journal":{"name":"Kastamonu Medical Journal","volume":"74 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126467168","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}
Calcinosis cutis is a rare condition defined as the pathological accumulation of amorphous insoluble calcium salts in cutaneous and subcutaneous tissue. There are four subtypes - dystrophic, idiopathic, metastatic, and iatrogenic calcification. The dystrophic form is the most common type of calcinosis cutis, the major agent being trauma. Serum calcium and phosphorus values are within normal limits in these patients. The clinical manifestation generally involves small white papules, and subcutaneous nodules or plaques. The first choice in the treatment of calcinosis cutis is surgery. Surgical procedures have been recommended as the first and most effective option in almost all cases in the literature. We report a case of a patient presenting with growing, painless swelling following trauma to the auricle of the ear identified as dystrophic calcinosis cutis following surgical excision.
{"title":"Calcinosis cutis in the auricle: a case report","authors":"F. Atalay, K. Topal, Ayhan Kars","doi":"10.51271/kmj-38","DOIUrl":"https://doi.org/10.51271/kmj-38","url":null,"abstract":"Calcinosis cutis is a rare condition defined as the pathological accumulation of amorphous insoluble calcium salts in cutaneous and subcutaneous tissue. There are four subtypes - dystrophic, idiopathic, metastatic, and iatrogenic calcification. The dystrophic form is the most common type of calcinosis cutis, the major agent being trauma. Serum calcium and phosphorus values are within normal limits in these patients. The clinical manifestation generally involves small white papules, and subcutaneous nodules or plaques. The first choice in the treatment of calcinosis cutis is surgery. Surgical procedures have been recommended as the first and most effective option in almost all cases in the literature. We report a case of a patient presenting with growing, painless swelling following trauma to the auricle of the ear identified as dystrophic calcinosis cutis following surgical excision.","PeriodicalId":369732,"journal":{"name":"Kastamonu Medical Journal","volume":"43 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133446462","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}
Aim Reproductive adverse events may be observed in patients with epilepsy associated with antiepileptic drugs. This study aimed to evaluate changes in sex hormone levels in patients receiving antiepileptic treatment as monotherapy and polytherapy. Method In this case-control study, the sex hormone levels and free androgen indexes were evaluated in 83 patients and 40 controls. In the hormone evaluations, measurements were performed for dehydroepiandrosterone sulfate, sex hormone-binding globulin, follicle-stimulating hormone, luteinizing hormone, total and free testosterone, prolactin and estradiol levels. Results A total of 83 patients (42 males, 41 females) with a mean age of 28±7.2 years and a control group of 40 healthy subjects (14 males, 26 females) with a mean age of 33±8.7 years were included. In the patient group, 45 were receiving monotherapy and 38 polytherapy, 13 (15.7%) patients had focal onset seizures, 68 (81.9%) had generalized onset seizure and 2 (2.4%) had seizure type of unknown origin. In the males of the study group, no difference was determined in the hormone levels. In the females of the study group, the free androgen index was determined to be significantly low in the carbamazepine group compared to the control group (p=0.04) and the sex hormone-binding globulin values were significantly high (p=0.01). In males, a significant positive correlation was determined between serum carbamazepine and follicle-stimulating hormone (p=0.046) and prolactin (p=0.035) and a significant negative correlation was determined with the free androgen index (p=0.032). In females, a statistically significant positive correlation was determined between carbamazepine and prolactin (p=0.036). Conclusion The use of antiepileptic drugs creates changes in the sex hormone levels in males, and associated reproductive side-effects may be seen. In the management of patients with epilepsy, an awareness of these side-effects and individual evaluation could have a positive effect on treatment compliance and patient satisfaction.
{"title":"An Examination of sex hormone levels in epilepsy patients taking antiepileptic treatment","authors":"","doi":"10.51271/kmj-0033","DOIUrl":"https://doi.org/10.51271/kmj-0033","url":null,"abstract":"Aim\u0000\u0000Reproductive adverse events may be observed in patients with epilepsy associated with antiepileptic drugs. This study aimed to evaluate changes in sex hormone levels in patients receiving antiepileptic treatment as monotherapy and polytherapy.\u0000\u0000Method\u0000\u0000In this case-control study, the sex hormone levels and free androgen indexes were evaluated in 83 patients and 40 controls. In the hormone evaluations, measurements were performed for dehydroepiandrosterone sulfate, sex hormone-binding globulin, follicle-stimulating hormone, luteinizing hormone, total and free testosterone, prolactin and estradiol levels.\u0000\u0000Results\u0000\u0000A total of 83 patients (42 males, 41 females) with a mean age of 28±7.2 years and a control group of 40 healthy subjects (14 males, 26 females) with a mean age of 33±8.7 years were included. In the patient group, 45 were receiving monotherapy and 38 polytherapy, 13 (15.7%) patients had focal onset seizures, 68 (81.9%) had generalized onset seizure and 2 (2.4%) had seizure type of unknown origin. In the males of the study group, no difference was determined in the hormone levels. In the females of the study group, the free androgen index was determined to be significantly low in the carbamazepine group compared to the control group (p=0.04) and the sex hormone-binding globulin values were significantly high (p=0.01). In males, a significant positive correlation was determined between serum carbamazepine and follicle-stimulating hormone (p=0.046) and prolactin (p=0.035) and a significant negative correlation was determined with the free androgen index (p=0.032). In females, a statistically significant positive correlation was determined between carbamazepine and prolactin (p=0.036).\u0000\u0000 \u0000\u0000Conclusion\u0000\u0000The use of antiepileptic drugs creates changes in the sex hormone levels in males, and associated reproductive side-effects may be seen. In the management of patients with epilepsy, an awareness of these side-effects and individual evaluation could have a positive effect on treatment compliance and patient satisfaction.","PeriodicalId":369732,"journal":{"name":"Kastamonu Medical Journal","volume":"22 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131650406","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}
Hereditary dystrophies of the posterior segment are the common name for a group of syndromic diseases in which the retina is affected. Until recently, the information available on these diseases has been limited and a wide range of clinical findings were reported. However, recent advances in genetics research suggest a better outlook. Here we review the recent advances in the following: Pseudoxanthoma Elasticum, Refsum Disease, Bietti Cryistalline Dystrophy, Alport’s Syndrome
{"title":"Hereditary dystrophies of the posterior segment of the retina","authors":"","doi":"10.51271/kmj-0029","DOIUrl":"https://doi.org/10.51271/kmj-0029","url":null,"abstract":"Hereditary dystrophies of the posterior segment are the common name for a group of syndromic diseases in which the retina is affected. Until recently, the information available on these diseases has been limited and a wide range of clinical findings were reported. However, recent advances in genetics research suggest a better outlook. Here we review the recent advances in the following: Pseudoxanthoma Elasticum, Refsum Disease, Bietti Cryistalline Dystrophy, Alport’s Syndrome","PeriodicalId":369732,"journal":{"name":"Kastamonu Medical Journal","volume":"16 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123828704","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}
Objective: During the pandemic, some surgeries were postponed due to the large number of patients admitted by hospitals. It was tried to shorten the hospitalization period of some patients. Hemodialysis patients who had to come to the hospital frequently were also affected by this situation. Physicians working during the pandemic period prefer to use less invasive techniques. In this study, it was aimed to investigate whether there is a change in the choice of vascular access used for hemodialysis in this period. Material and Method: In this study, 552 patients who were treated for hemodialysis vascular access in the cardiovascular surgery clinic of Kastamonu Training and Research Hospital between March 2019 and 2021 were retrospectively analyzed. The patients were divided into two groups as pre-pandemic (Group 1) and pandemic (Group 2). Patients in Group 1 and Group 2 needed high-flow vascular access to perform hemodialysis. For this purpose, 2 techniques are frequently used, the first being arteriovenous fistula(AVF) and the other permanent hemodialysis catheter insertion. The distribution of these techniques used in patients was examined. Results: In our study, we found that before the pandemic between March 2019-2020, 109 patients had AVF and 193 patients had a permanent tunneled catheter. Between March 2020- 2021, which started with the pandemic process, we found that AVF was opened in 74 patients and a permanent tunnel catheter was placed in 176 patients. Conclusion: Uremic patients who need hemodialysis should not be affected by the pandemic problem and the most permanent procedures should be applied for these patients. Like all vascular patients, dialysis patients should not become secondary afflictions of Covid-19
{"title":"Evaluation of the approach to hemodialysis vascular access during the pandemic period","authors":"","doi":"10.51271/kmj-0031","DOIUrl":"https://doi.org/10.51271/kmj-0031","url":null,"abstract":"Objective: During the pandemic, some surgeries were postponed due to the large number of patients admitted by hospitals. It was tried to shorten the hospitalization period of some patients. Hemodialysis patients who had to come to the hospital frequently were also affected by this situation. Physicians working during the pandemic period prefer to use less invasive techniques. In this study, it was aimed to investigate whether there is a change in the choice of vascular access used for hemodialysis in this period.\u0000\u0000Material and Method: In this study, 552 patients who were treated for hemodialysis vascular access in the cardiovascular surgery clinic of Kastamonu Training and Research Hospital between March 2019 and 2021 were retrospectively analyzed. The patients were divided into two groups as pre-pandemic (Group 1) and pandemic (Group 2). Patients in Group 1 and Group 2 needed high-flow vascular access to perform hemodialysis. For this purpose, 2 techniques are frequently used, the first being arteriovenous fistula(AVF) and the other permanent hemodialysis catheter insertion. The distribution of these techniques used in patients was examined.\u0000\u0000Results: In our study, we found that before the pandemic between March 2019-2020, 109 patients had AVF and 193 patients had a permanent tunneled catheter. Between March 2020- 2021, which started with the pandemic process, we found that AVF was opened in 74 patients and a permanent tunnel catheter was placed in 176 patients.\u0000\u0000Conclusion: Uremic patients who need hemodialysis should not be affected by the pandemic problem and the most permanent procedures should be applied for these patients. Like all vascular patients, dialysis patients should not become secondary afflictions of Covid-19","PeriodicalId":369732,"journal":{"name":"Kastamonu Medical Journal","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130398814","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}
Coronavirus disease 2019 (COVID-19) is an infectious disease, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The relationship of COVID-19 with rheumatological disorders has been researched since 2019. Rheumatoid arthritis (RA) is one of the most common rheumatoid diseases. The relationship between RA and COVID-19 is particularly interesting due to common cytokines in etiopathogenesis. SARS-CoV-2 was involved in triggering RF-positive and ACPA-positive arthritis, which might be diagnosed as rheumatoid arthritis, but we cannot rule out the possibility that the onset of this arthritis could have been coincidental. We report the case who has the first flare of RA with a high titer of Rheumatoid Factor (RF) and Anti Citrullinated Protein Antibody (ACPA) after mild SARS-CoV- 2 infection.
{"title":"The new onset seropositive rheumatoid arthritis after COVID-19 infection: coincidental or related","authors":"","doi":"10.51271/kmj-0034","DOIUrl":"https://doi.org/10.51271/kmj-0034","url":null,"abstract":"Coronavirus disease 2019 (COVID-19) is an infectious disease, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The relationship of COVID-19 with rheumatological disorders has been researched since 2019. Rheumatoid arthritis (RA) is one of the most common rheumatoid diseases. The relationship between RA and COVID-19 is particularly interesting due to common cytokines in etiopathogenesis. SARS-CoV-2 was involved in triggering RF-positive and ACPA-positive arthritis, which might be diagnosed as rheumatoid arthritis, but we cannot rule out the possibility that the onset of this arthritis could have been coincidental. We report the case who has the first flare of RA with a high titer of Rheumatoid Factor (RF) and Anti Citrullinated Protein Antibody (ACPA) after mild SARS-CoV- 2 infection.","PeriodicalId":369732,"journal":{"name":"Kastamonu Medical Journal","volume":"31 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127790817","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}
Purpose: We aimed to identify patients diagnosed with acute coronary syndrome (ACS) in the emergency department and for whom medical treatment was decided during coronary angiography, according to their neutrophil/lymphocyte ratios at the time of admission. Material and Method: Patients diagnosed with ACS in the emergency department and undergoing coronary angiography (CAG) were included. The patients were divided into two groups as non-ST-segment elevation acute coronary syndrome and ST-segment elevation myocardial infarction. According to their CAG results, the patients in both groups were classified as those who underwent coronary intervention and those who did not. In addition, demographic data such as age and gender, neutrophil/lymphocyte ratio, monocytes, aspartate aminotransferase, and C-reactive protein values of these patients were recorded in the data form. These values were statistically compared between those who decided on a coronary intervention during CAG and those who did not. Results: A total of 647 patients were included in the study. The patients were divided into 325 patients with non-ST-segment elevation acute coronary syndrome and 322 with ST-segment elevation myocardial infarction. The age range of the patients in both groups was 30 to 93. Monocyte, aspartate aminotransferase, neutrophil/lymphocyte ratio, and gender were significant in the diagnosis process. The diagnosis was the only effective factor in detecting patients for whom a coronary intervention was decided during CAG. Gender, age, neutrophil/lymphocyte ratio, aspartate aminotransferase, C-reactive protein, and monocyte values were insignificant. Conclusion: Even if some parameters such as monocyte count, N/L ratio, and aspartate aminotransferase in patients diagnosed with ACS in the emergency department are ineffective in predicting the medical treatment decision during CAG, they may help in the clinical decision-making process.
{"title":"Investigation of relationship between coronary angiography results and neutrophil/lymphocyte ratios of patients with acute coronary syndrome in the emergency department","authors":"","doi":"10.51271/kmj-0030","DOIUrl":"https://doi.org/10.51271/kmj-0030","url":null,"abstract":"Purpose: We aimed to identify patients diagnosed with acute coronary syndrome (ACS) in the emergency department and for whom medical treatment was decided during coronary angiography, according to their neutrophil/lymphocyte ratios at the time of admission.\u0000\u0000Material and Method: Patients diagnosed with ACS in the emergency department and undergoing coronary angiography (CAG) were included. The patients were divided into two groups as non-ST-segment elevation acute coronary syndrome and ST-segment elevation myocardial infarction. According to their CAG results, the patients in both groups were classified as those who underwent coronary intervention and those who did not. In addition, demographic data such as age and gender, neutrophil/lymphocyte ratio, monocytes, aspartate aminotransferase, and C-reactive protein values of these patients were recorded in the data form. These values were statistically compared between those who decided on a coronary intervention during CAG and those who did not.\u0000\u0000Results: A total of 647 patients were included in the study. The patients were divided into 325 patients with non-ST-segment elevation acute coronary syndrome and 322 with ST-segment elevation myocardial infarction. The age range of the patients in both groups was 30 to 93. Monocyte, aspartate aminotransferase, neutrophil/lymphocyte ratio, and gender were significant in the diagnosis process. The diagnosis was the only effective factor in detecting patients for whom a coronary intervention was decided during CAG. Gender, age, neutrophil/lymphocyte ratio, aspartate aminotransferase, C-reactive protein, and monocyte values were insignificant.\u0000\u0000Conclusion: Even if some parameters such as monocyte count, N/L ratio, and aspartate aminotransferase in patients diagnosed with ACS in the emergency department are ineffective in predicting the medical treatment decision during CAG, they may help in the clinical decision-making process.","PeriodicalId":369732,"journal":{"name":"Kastamonu Medical Journal","volume":"36 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134389653","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}
Drug-induced fever (DIF) is an uncommon, difficult-to-diagnose complication which is one of the possible causes of fever of unknown origin (FUO). In addition, Covid-19 infection is also a cause of fever in these pandemic days we live. Everolimus (EVR), an inhibitor of the mammalian target of rapamycin (mTOR), is employed as an immunosuppressant in combination with calcineurin inhibitors, following a procedure of organ transplantation, and as a proliferation signal inhibitor coated on a drug-eluting stent and in cancer therapy. EVR has many adverse effects that require follow-up, but fever is not one of the well-known adverse effects thereof. In our literature search, we have found only a single case of fever due to EVR use which had been reported in a patient following a cardiac transplantation in 2004. On the other hand, our case is a patient with a diagnosis of alcohol-induced liver cirrhosis and hepatocellular carcinoma (HCC) who has been subjected to a liver transplantation (LT) has developed fever in the course of our follow-up just after the initiation of EVR treatment at the third month post-transplantation and during the covid-19 pandemic.
{"title":"A rare drug fever due to everolimus use in a patient with liver transplantation: a case report during the Covid-19 pandemic","authors":"","doi":"10.51271/kmj-0035","DOIUrl":"https://doi.org/10.51271/kmj-0035","url":null,"abstract":"Drug-induced fever (DIF) is an uncommon, difficult-to-diagnose complication which is one of the possible causes of fever of unknown origin (FUO). In addition, Covid-19 infection is also a cause of fever in these pandemic days we live. Everolimus (EVR), an inhibitor of the mammalian target of rapamycin (mTOR), is employed as an immunosuppressant in combination with calcineurin inhibitors, following a procedure of organ transplantation, and as a proliferation signal inhibitor coated on a drug-eluting stent and in cancer therapy. EVR has many adverse effects that require follow-up, but fever is not one of the well-known adverse effects thereof. In our literature search, we have found only a single case of fever due to EVR use which had been reported in a patient following a cardiac transplantation in 2004. On the other hand, our case is a patient with a diagnosis of alcohol-induced liver cirrhosis and hepatocellular carcinoma (HCC) who has been subjected to a liver transplantation (LT) has developed fever in the course of our follow-up just after the initiation of EVR treatment at the third month post-transplantation and during the covid-19 pandemic.","PeriodicalId":369732,"journal":{"name":"Kastamonu Medical Journal","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131218295","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:The ishak score determined by liver biopsy is the most reliable indicator of fibrosis, but biopsy is an invasive procedure. Numerous noninvasive tests have been investigated to determine the hepatic fibrosis score. We aimed to investigate the relationship between the mean platelet volume(MPV) and neutrophillymphocyte ratio (NLR) measurements in patients with chronic hepatitis B virus (CHB) infection, and liver fibrosis stage, which was determined by biopsy and ishak score. Material and Method:CHB patients followed between 2016 and 2020 in our gastroenterology outpatient clinic were included in our study. CHB patients; They were divided into two groups as non-cirrhotic group (ishak fibrosis score in biopsy; F0-F4) and cirrhotic group (F5-F6). Then, 30 healthy control (HC) groups consisting of health personnel who had routine health screenings and blood tests in the same period were formed. MPV, NLR measurements of these two main groups and CHB subgroups and liver biopsy results of CHB patients were evaluated retrospectively, and possible relationships between the groups were investigated. Results:There was no statistically significant difference between the mean age and gender of the cases in the CHB and HC groups. A total of 54 patients with CHB were identified, of which 13 patients were cirrhotic and 41 patients were non-cirrhotic. MPV measurements were found to be significantly higher in the CHB group than in the SC group (11.15±1.77; 10.02±0.92; p=0.002). While there was no significant difference between NLR measurements, it was found to be higher in the CHB group (1.98±0.81; 1.81±0.69). While there was no significant difference between the cirrhotic and non-cirrhotic subgroups of the CHB group in terms of NLR (1.86±0.68; 2.36±1.04) and MPV (11.09±1.89; 11.35±1.36) measurements, NLR and MPV measurements were higher in the cirrhotic group. Conclusion:In our study, MPV values were found to be significantly increased in patients in the CHB group compared to the HC group. In addition, although not statistically significant, NLR and MPV measurements were found to be higher in the cirrhotic group than in the non-cirrhotic group. According to our study, it can be thought that with increasing MPV and NLR measurements in HBV patients, there may be an increase in chronicity and fibrosis scores without an invasive procedure such as biopsy.
{"title":"The Correlation of Mean Platelet Volume and Neutrophil-lymphocyte Ratio Measurements, and the Ishak Fibrosis Score in Our Patients with Chronic Hepatitis B","authors":"","doi":"10.51271/kmj-0032","DOIUrl":"https://doi.org/10.51271/kmj-0032","url":null,"abstract":"Background:The ishak score determined by liver biopsy is the most reliable indicator of fibrosis, but biopsy is an invasive procedure. Numerous noninvasive tests have been investigated to determine the hepatic fibrosis score. We aimed to investigate the relationship between the mean platelet volume(MPV) and neutrophillymphocyte ratio (NLR) measurements in patients with chronic hepatitis B virus (CHB) infection, and liver fibrosis stage, which was determined by biopsy and ishak score.\u0000\u0000Material and Method:CHB patients followed between 2016 and 2020 in our gastroenterology outpatient clinic were included in our study. CHB patients; They were divided into two groups as non-cirrhotic group (ishak fibrosis score in biopsy; F0-F4) and cirrhotic group (F5-F6). Then, 30 healthy control (HC) groups consisting of health personnel who had routine health screenings and blood tests in the same period were formed. MPV, NLR measurements of these two main groups and CHB subgroups and liver biopsy results of CHB patients were evaluated retrospectively, and possible relationships between the groups were investigated.\u0000\u0000Results:There was no statistically significant difference between the mean age and gender of the cases in the CHB and HC groups. A total of 54 patients with CHB were identified, of which 13 patients were cirrhotic and 41 patients were non-cirrhotic. MPV measurements were found to be significantly higher in the CHB group than in the SC group (11.15±1.77; 10.02±0.92; p=0.002). While there was no significant difference between NLR measurements, it was found to be higher in the CHB group (1.98±0.81; 1.81±0.69). While there was no significant difference between the cirrhotic and non-cirrhotic subgroups of the CHB group in terms of NLR (1.86±0.68; 2.36±1.04) and MPV (11.09±1.89; 11.35±1.36) measurements, NLR and MPV measurements were higher in the cirrhotic group.\u0000\u0000Conclusion:In our study, MPV values were found to be significantly increased in patients in the CHB group compared to the HC group. In addition, although not statistically significant, NLR and MPV measurements were found to be higher in the cirrhotic group than in the non-cirrhotic group. According to our study, it can be thought that with increasing MPV and NLR measurements in HBV patients, there may be an increase in chronicity and fibrosis scores without an invasive procedure such as biopsy.","PeriodicalId":369732,"journal":{"name":"Kastamonu Medical Journal","volume":"100 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131983789","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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