Pub Date : 2023-03-26DOI: 10.32552/2023.actamedica.887
B. Çeltikçi, E. Sayın Gülensoy
Objective: The associations of inflammation and immunity of host lead to higher mortality in both community-acquired and hospital-acquired pneumonia patients. Therefore, several inflammatory and immunological biomarkers are essential for diagnosis, prognosis, and survival. Among these inflammatory markers, such as older age, and higher blood urea nitrogen, creatinine, procalcitonin and C-reactive protein, and lower albumin levels have been shown to have strong correlations with worse outcomes and high mortality, especially in community-acquired pneumonia patients. In this study, we investigated the correlation between several biochemical markers, which are mostly involved in inflammation, and mortality in not only community-acquired but also hospital-acquired pneumonia patients. Material and Methods: This was a retrospective study of hospitalized community-acquired and hospital-acquired pneumonia patients in a third degree university hospital. In their initial blood tests (also used for diagnosis), blood urea nitrogen, creatinine, procalcitonin, C-reactive protein and albumin levels, and white blood cell, lymphocyte, neutrophil, platelet and erythrocyte counts, red blood cell distribution width and hemoglobin levels were measured. The outcome variable was mortality at 30 days. Statistical analysis included univariate comparisons of continuous variables between deceased and survivor groups, subject to mortality analysis and logistic regression in both community-acquired and hospital-acquired pneumonia patients. Results: 272 hospitalized community-acquired and 80 hospital-acquired pneumonia patients were included. Patients who died during follow-up had older age and higher levels of procalcitonin, blood urea nitrogen, creatinine, and red blood cell distribution width in community-acquired pneumonia group. Remarkably, logistic regression analysis showed a significant relationship between creatinine and mortality, regardless of age, severity of community-acquired pneumonia and comorbidities. Creatinine is a strong independent prognostic factor, subject to mortality in community-acquired pneumonia group. Conclusions: Older age, higher procalcitonin, blood urea nitrogen, creatinine and red blood cell distribution width levels are significant biomarkers for prediction of higher mortality in hospitalized community-acquired pneumonia patients.
{"title":"Evaluating the Correlation of Mortality and Biochemical Parameters in Community-acquired and Hospital-acquired Pneumonia","authors":"B. Çeltikçi, E. Sayın Gülensoy","doi":"10.32552/2023.actamedica.887","DOIUrl":"https://doi.org/10.32552/2023.actamedica.887","url":null,"abstract":"Objective: The associations of inflammation and immunity of host lead to higher mortality in both community-acquired and hospital-acquired pneumonia patients. Therefore, several inflammatory and immunological biomarkers are essential for diagnosis, prognosis, and survival. Among these inflammatory markers, such as older age, and higher blood urea nitrogen, creatinine, procalcitonin and C-reactive protein, and lower albumin levels have been shown to have strong correlations with worse outcomes and high mortality, especially in community-acquired pneumonia patients. In this study, we investigated the correlation between several biochemical markers, which are mostly involved in inflammation, and mortality in not only community-acquired but also hospital-acquired pneumonia patients.\u0000Material and Methods: This was a retrospective study of hospitalized community-acquired and hospital-acquired pneumonia patients in a third degree university hospital. In their initial blood tests (also used for diagnosis), blood urea nitrogen, creatinine, procalcitonin, C-reactive protein and albumin levels, and white blood cell, lymphocyte, neutrophil, platelet and erythrocyte counts, red blood cell distribution width and hemoglobin levels were measured. The outcome variable was mortality at 30 days. Statistical analysis included univariate comparisons of continuous variables between deceased and survivor groups, subject to mortality analysis and logistic regression in both community-acquired and hospital-acquired pneumonia patients.\u0000Results: 272 hospitalized community-acquired and 80 hospital-acquired pneumonia patients were included. Patients who died during follow-up had older age and higher levels of procalcitonin, blood urea nitrogen, creatinine, and red blood cell distribution width in community-acquired pneumonia group. Remarkably, logistic regression analysis showed a significant relationship between creatinine and mortality, regardless of age, severity of community-acquired pneumonia and comorbidities. Creatinine is a strong independent prognostic factor, subject to mortality in community-acquired pneumonia group.\u0000Conclusions: Older age, higher procalcitonin, blood urea nitrogen, creatinine and red blood cell distribution width levels are significant biomarkers for prediction of higher mortality in hospitalized community-acquired pneumonia patients.","PeriodicalId":50891,"journal":{"name":"Acta Medica Mediterranea","volume":"38 1","pages":""},"PeriodicalIF":0.3,"publicationDate":"2023-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89335549","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-03-26DOI: 10.32552/2023.actamedica.877
İ. Koç, Y. Kapucu, H. Kıratlı
Purpose: Our aim in this study is to report the clinical features and treatment results of patients with conjunctival melanoma (CM) diagnosed in our clinic in the last 20 years. Materials and Methods: Demographic information, tumor diameter, accompanying melanosis, presence of recurrence and survival data were obtained retrospectively from the records of patients who had histopathologically confirmed CM diagnosis. Results: Conjunctival melanoma was detected in 84 eyes of 84 patients with a mean age of 61.5±24.6 years. In total 45.2% of the patients were female and 54.8% were male. The two most common primary lesion locations were limbus in 23.8% and bulbar conjunctiva in 22.6% of the patients. In ophthalmological evaluation, 46.3% of the patients had concomitant primary acquired melanosis. Appropriate surgical excision to the extent of the disease was performed primarily in all patients. After a median follow-up of 55 months, local recurrence rate was 45.2%, while the survival rate was found to be 74.3%. Conclusion: Conjunctival melanoma is a malignant neoplasm seen in advanced adulthood, often involving the bulbar surface of the conjunctiva. Even using the standard surgical approach, CM is associated with a 45.2% local recurrence rate and a 25.7% mortality rate. In our study, there was no clinical parameter that showed a statistically significant relationship with survival.
{"title":"Clinical Features and Treatment Results of Conjunctival Melanoma: Cross-Sectional Study","authors":"İ. Koç, Y. Kapucu, H. Kıratlı","doi":"10.32552/2023.actamedica.877","DOIUrl":"https://doi.org/10.32552/2023.actamedica.877","url":null,"abstract":"Purpose: Our aim in this study is to report the clinical features and treatment results of patients with conjunctival melanoma (CM) diagnosed in our clinic in the last 20 years.\u0000Materials and Methods: Demographic information, tumor diameter, accompanying melanosis, presence of recurrence and survival data were obtained retrospectively from the records of patients who had histopathologically confirmed CM diagnosis.\u0000Results: Conjunctival melanoma was detected in 84 eyes of 84 patients with a mean age of 61.5±24.6 years. In total 45.2% of the patients were female and 54.8% were male. The two most common primary lesion locations were limbus in 23.8% and bulbar conjunctiva in 22.6% of the patients. In ophthalmological evaluation, 46.3% of the patients had concomitant primary acquired melanosis. Appropriate surgical excision to the extent of the disease was performed primarily in all patients. After a median follow-up of 55 months, local recurrence rate was 45.2%, while the survival rate was found to be 74.3%.\u0000Conclusion: Conjunctival melanoma is a malignant neoplasm seen in advanced adulthood, often involving the bulbar surface of the conjunctiva. Even using the standard surgical approach, CM is associated with a 45.2% local recurrence rate and a 25.7% mortality rate. In our study, there was no clinical parameter that showed a statistically significant relationship with survival.","PeriodicalId":50891,"journal":{"name":"Acta Medica Mediterranea","volume":"40 1","pages":""},"PeriodicalIF":0.3,"publicationDate":"2023-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87118315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-03-26DOI: 10.32552/2023.actamedica.883
Coşkun Çifci, Çiğdem Yalçın, M. A. Salman, N. Çelebi, A. Şahin
Aim: Chronic back pain is a common health problem which deteriorates quality of life which may be managed by medical therapy, interventions and surgery. Interventional therapies, including facet blocks and facet denervations are used regularly. Music therapy may be used before or during the painful interventional procedures with or without sedation. The study was designed to assess the effects of listening to music on procedural analgesia and anxiety during diagnostic facet block procedure. Method: Volunteering 52 patients that were involved in the study were randomly allocated into intervention and control groups of 26 patients each. The intervention group listened to music of their choice, if they demanded or classical music with headphones during the procedure. The control group did not listen to music. A combination of midazolam, morphine and fentanyl were used for sedation and analgesia in both groups. Results: The majority of the patients were women (77%) and the mean age was 55. We used Numeric Rating Scale (NRS) to assess pain, Spielberger State Trait Anxiety Inventory-6 (STAI-6) to assess anxiety and Ramsay Sedation Scale to determine the clinical level of sedation. No clinical or statistical significant differences in pain scores between control and intervention groups were found, when sedation effect was corrected (p=0.68). Ramsey Sedation Scores and NRS Scores were similar. Mean STAI-6 Score s were 9.5 ± 0.611 in the intervention group and 12.5 ± 0.726 in the control group (mean ± SE). The reduction in anxiety scores was significant both clinically and statistically, when sedation effect was corrected (p=0.006). Conclusion: Listening to music is an easy to use method that may be effective to reduce anxiety in patients with chronic low back pain during facet block procedure.
{"title":"The Effect of Music on Procedural Analgesia and Anxiety of Patients Undergoing Diagnostic Facet Block for Low Back Pain","authors":"Coşkun Çifci, Çiğdem Yalçın, M. A. Salman, N. Çelebi, A. Şahin","doi":"10.32552/2023.actamedica.883","DOIUrl":"https://doi.org/10.32552/2023.actamedica.883","url":null,"abstract":"Aim: Chronic back pain is a common health problem which deteriorates quality of life which may be managed by medical therapy, interventions and surgery. Interventional therapies, including facet blocks and facet denervations are used regularly. Music therapy may be used before or during the painful interventional procedures with or without sedation. The study was designed to assess the effects of listening to music on procedural analgesia and anxiety during diagnostic facet block procedure.\u0000Method: Volunteering 52 patients that were involved in the study were randomly allocated into intervention and control groups of 26 patients each. The intervention group listened to music of their choice, if they demanded or classical music with headphones during the procedure. The control group did not listen to music. A combination of midazolam, morphine and fentanyl were used for sedation and analgesia in both groups.\u0000Results: The majority of the patients were women (77%) and the mean age was 55. We used Numeric Rating Scale (NRS) to assess pain, Spielberger State Trait Anxiety Inventory-6 (STAI-6) to assess anxiety and Ramsay Sedation Scale to determine the clinical level of sedation. No clinical or statistical significant differences in pain scores between control and intervention groups were found, when sedation effect was corrected (p=0.68). Ramsey Sedation Scores and NRS Scores were similar. Mean STAI-6 Score s were 9.5 ± 0.611 in the intervention group and 12.5 ± 0.726 in the control group (mean ± SE). The reduction in anxiety scores was significant both clinically and statistically, when sedation effect was corrected (p=0.006).\u0000Conclusion: Listening to music is an easy to use method that may be effective to reduce anxiety in patients with chronic low back pain during facet block procedure.","PeriodicalId":50891,"journal":{"name":"Acta Medica Mediterranea","volume":"2 1","pages":""},"PeriodicalIF":0.3,"publicationDate":"2023-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75112828","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-12-28DOI: 10.32552/2022.actamedica.846
R. Tuna Doğrul, A. Dogrul, M. C. Kızılarslanoğlu, H. Çalışkan, C. Balcı, G. Sengul Aycicek, Cemile Ozsurekci, A. Konan, M. Halil, M. Cankurtaran, B. B. Doğu
Introduction: This study investigated the effect of preoperative comprehensive geriatric assessment(CGA) and frailty assessment on long-term mortality.Methods: This study which evaluated a total of 81 older patients underwent the CGA prior to general surgery. Katz ADL, the Lawton Brody IADL, the Mini-Nutrition Assessment test (MNAsf), the Mini-Mental State Examination (MMSE), and Yesavage Geriatric Depression Scale (GDS) were performed. Fried criteria were utilized for the assessment of frailty. The Physiological and Operative Severity Scores for the Enumeration of Mortality and Morbidity (POSSUM) score, and the Charlson Comorbidity Index (CCI) were used for operative risk assessment. The patients were screened for 3-year mortality. Results: The median age of the patients was 71 years (range, 65-84 years). 58.02% of the patients were female and 24.69% were in the frail group. The mortality rate of the frail group was significantly higher than those of the pre-frail and robust groups (p: 0.030). The Cox regression analyses revealed that MMSE (p: 0.020), Physiological Severity Score (PSS) (p: 0.034), BUPA score (p: 0.030) and educational background (p: 0.031) were independently correlated with mortality in Model 1, while MNA (p: 0.003), PSS score (p: 0.080) and educational background (p: 0.002) were correlated with mortality in Model 2. ADL, MMSE, CDT, MNA-SF, Fried score, length of hospital stay, PSS score, and BUPA score were the best predictors of mortality (AUC values: 0.61, 0.74, 0.72, 0.73, 0.69, 0.74, 0.64, and 0.66respectively). Conclusion: The results of the study demonstrated that CGA components and frailty predicted long-term mortality in general surgery patients.
{"title":"How Effective is Frailty and Comprehensive Geriatric Assessment to Predict the Long-Term Mortality After General Surgery?","authors":"R. Tuna Doğrul, A. Dogrul, M. C. Kızılarslanoğlu, H. Çalışkan, C. Balcı, G. Sengul Aycicek, Cemile Ozsurekci, A. Konan, M. Halil, M. Cankurtaran, B. B. Doğu","doi":"10.32552/2022.actamedica.846","DOIUrl":"https://doi.org/10.32552/2022.actamedica.846","url":null,"abstract":"Introduction: This study investigated the effect of preoperative comprehensive geriatric assessment(CGA) and frailty assessment on long-term mortality.Methods: This study which evaluated a total of 81 older patients underwent the CGA prior to general surgery. Katz ADL, the Lawton Brody IADL, the Mini-Nutrition Assessment test (MNAsf), the Mini-Mental State Examination (MMSE), and Yesavage Geriatric Depression Scale (GDS) were performed. Fried criteria were utilized for the assessment of frailty. The Physiological and Operative Severity Scores for the Enumeration of Mortality and Morbidity (POSSUM) score, and the Charlson Comorbidity Index (CCI) were used for operative risk assessment. The patients were screened for 3-year mortality.\u0000Results: The median age of the patients was 71 years (range, 65-84 years). 58.02% of the patients were female and 24.69% were in the frail group. The mortality rate of the frail group was significantly higher than those of the pre-frail and robust groups (p: 0.030). The Cox regression analyses revealed that MMSE (p: 0.020), Physiological Severity Score (PSS) (p: 0.034), BUPA score (p: 0.030) and educational background (p: 0.031) were independently correlated with mortality in Model 1, while MNA (p: 0.003), PSS score (p: 0.080) and educational background (p: 0.002) were correlated with mortality in Model 2. ADL, MMSE, CDT, MNA-SF, Fried score, length of hospital stay, PSS score, and BUPA score were the best predictors of mortality (AUC values: 0.61, 0.74, 0.72, 0.73, 0.69, 0.74, 0.64, and 0.66respectively).\u0000Conclusion: The results of the study demonstrated that CGA components and frailty predicted long-term mortality in general surgery patients.","PeriodicalId":50891,"journal":{"name":"Acta Medica Mediterranea","volume":"29 1","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82701578","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-12-26DOI: 10.32552/2022.actamedica.738
M. Yıldız, Esen Ağaoğlu, K. Başar
Objective: Some patients refuse inpatient psychiatric treatment and are discharged against medical advice in the first few days itself. Reviewing related features prior to hospitalization is vital for taking precautions related to these conditions. Materials and methods: Twenty-three patients admitted to psychiatry inpatient unit and discharged voluntarily within 72 hours were compared with a control group matched in terms of diagnosis, age, and sex, comprising patients who were hospitalized in the same period and discharged after the treatment. These two groups were compared with respect to sociodemographic and clinical characteristics, inpatient and outpatient evaluation, and treatment procedures. Results: Sociodemographic characteristics, waiting time for hospitalization, the level of compliance with outpatient treatment, the percentage of voluntary admissions, and the type of hospitalization were similar, whereas the history of hospitalization (p = .022) and administration of psychotropics in the early period of hospitalization (p = .005) were fewer in the refusal group. There was no difference in the number of the interviews made with the staff; communication of the patients with their relatives was higher in the control group (p < .001). Conclusion: Treatment refusal is associated with the post-admission procedures rather than the pre-admission practices, decision, and type of admission. Evaluation of these procedures in larger samples is important for taking necessary precautions related to discharge against medical advice.
{"title":"Discharge Against Medical Advice in The Early Period of Inpatient Psychiatric Treatment","authors":"M. Yıldız, Esen Ağaoğlu, K. Başar","doi":"10.32552/2022.actamedica.738","DOIUrl":"https://doi.org/10.32552/2022.actamedica.738","url":null,"abstract":"Objective: Some patients refuse inpatient psychiatric treatment and are discharged against medical advice in the first few days itself. Reviewing related features prior to hospitalization is vital for taking precautions related to these conditions.\u0000Materials and methods: Twenty-three patients admitted to psychiatry inpatient unit and discharged voluntarily within 72 hours were compared with a control group matched in terms of diagnosis, age, and sex, comprising patients who were hospitalized in the same period and discharged after the treatment. These two groups were compared with respect to sociodemographic and clinical characteristics, inpatient and outpatient evaluation, and treatment procedures.\u0000Results: Sociodemographic characteristics, waiting time for hospitalization, the level of compliance with outpatient treatment, the percentage of voluntary admissions, and the type of hospitalization were similar, whereas the history of hospitalization (p = .022) and administration of psychotropics in the early period of hospitalization (p = .005) were fewer in the refusal group. There was no difference in the number of the interviews made with the staff; communication of the patients with their relatives was higher in the control group (p < .001).\u0000Conclusion: Treatment refusal is associated with the post-admission procedures rather than the pre-admission practices, decision, and type of admission. Evaluation of these procedures in larger samples is important for taking necessary precautions related to discharge against medical advice.","PeriodicalId":50891,"journal":{"name":"Acta Medica Mediterranea","volume":"90 1","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76054231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-12-26DOI: 10.32552/2022.actamedica.813
Galip Gencay Üstün, Kutluhan Yusuf Küçük, G. Sert, Murat Kara, H. Uzun
Purpose: Returning to work requires a certain period of time for patients who have suffered a hand injury as a result of a work accident. Evaluating the factors influencing the time to return to work (time off work) is aimed. Methods: A total of 111 patients were involved in the study. Data collected from medical records and phone reviews. Independent variables such as age, gender, Hand Injury Severity Scale (HISS) score, fracture on plain radiography, treatment method (surgical/conservative), physical demand of the occupation, mechanism of injury, and physiotherapy were reviewed. Afterwards, the relationship between these variables and time to return to work has been evaluated. Results: In 111 subjects, 107 were able to resume their previous jobs after the injury. Average time to return to work was 58.6 days among patients who were able to return to work. It took more time for patients to return to work which were considered heavy/very heavy. Patients with fractures, higher HISS scores, who were treated surgically and undergone physiotherapy returned to work later. The effect of age, gender and mechanism of injury was statistically insignificant. Conclusion: HISS score and fracture on radiography can be used to predict time off work following surgery. If the necessary counseling is given to the patients with these conditions, it will be easier to plan the return of the patients to their lives.
{"title":"Factors Influencing the Time to Return to Work After Occupational Hand Injuries","authors":"Galip Gencay Üstün, Kutluhan Yusuf Küçük, G. Sert, Murat Kara, H. Uzun","doi":"10.32552/2022.actamedica.813","DOIUrl":"https://doi.org/10.32552/2022.actamedica.813","url":null,"abstract":"Purpose: Returning to work requires a certain period of time for patients who have suffered a hand injury as a result of a work accident. Evaluating the factors influencing the time to return to work (time off work) is aimed.\u0000Methods: A total of 111 patients were involved in the study. Data collected from medical records and phone reviews. Independent variables such as age, gender, Hand Injury Severity Scale (HISS) score, fracture on plain radiography, treatment method (surgical/conservative), physical demand of the occupation, mechanism of injury, and physiotherapy were reviewed. Afterwards, the relationship between these variables and time to return to work has been evaluated.\u0000Results: In 111 subjects, 107 were able to resume their previous jobs after the injury. Average time to return to work was 58.6 days among patients who were able to return to work. It took more time for patients to return to work which were considered heavy/very heavy. Patients with fractures, higher HISS scores, who were treated surgically and undergone physiotherapy returned to work later. The effect of age, gender and mechanism of injury was statistically insignificant.\u0000Conclusion: HISS score and fracture on radiography can be used to predict time off work following surgery. If the necessary counseling is given to the patients with these conditions, it will be easier to plan the return of the patients to their lives.","PeriodicalId":50891,"journal":{"name":"Acta Medica Mediterranea","volume":"26 1","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82614435","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-12-26DOI: 10.32552/2022.actamedica.787
Ecem Bostan, B. Yalıcı-Armağan, B. Yel, O. Gokoz
Verrucous venocapillary malformation, formerly known as verrucous hemangioma, presents itself as single or multiple, well-demarcated, erythematous plaques that eventually acquire hyperkeratinization, oozing, bleeding and become thicker and darker over time. We report a case of verrucous venocapillary malformation in 33-year old woman referred to the dermatology outpatient clinic with the complaint of hyperkeratotic plaques covering the entire right leg and thigh, present since birth.
{"title":"Unilateral Hyperkeratotic Dark Plaques Covering the Entire Right Lower Extremity: A Rare Entity","authors":"Ecem Bostan, B. Yalıcı-Armağan, B. Yel, O. Gokoz","doi":"10.32552/2022.actamedica.787","DOIUrl":"https://doi.org/10.32552/2022.actamedica.787","url":null,"abstract":"Verrucous venocapillary malformation, formerly known as verrucous hemangioma, presents itself as single or multiple, well-demarcated, erythematous plaques that eventually acquire hyperkeratinization, oozing, bleeding and become thicker and darker over time. We report a case of verrucous venocapillary malformation in 33-year old woman referred to the dermatology outpatient clinic with the complaint of hyperkeratotic plaques covering the entire right leg and thigh, present since birth.","PeriodicalId":50891,"journal":{"name":"Acta Medica Mediterranea","volume":"133 1","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80162341","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-12-25DOI: 10.32552/2022.actamedica.844
Pınar Aysert Yıldız, Dilek Karamanlıoğlu, H. S. Özger, Hakan Katı, Özlem Güzel Tunçcan, M. Dizbay
Objective: The aim of this study is to evaluate patients with EPTB in terms of demographics, anatomic localization, diagnosis and risk factors on early mortality. Materials and methods: The data of 217 inpatients who were followed up with EPTB, between January 2010 and December 2020, were evaluated retrospectively. Patients were followed-up during hospital admission and early mortality was considered. Risk factors on mortality were identified in multivariate analysis using logistic regression model. Results: The median age was 54 (IQR: 37-67) and the rate of male patients was 43.3%. 76 (35%) patients had at least one comorbidity. The most common underlying conditions were diabetes mellitus and immunosuppressive treatment. The most common forms of EPTB were lymph node, bone and CNS. Microbiological findings (ARB and/or TB-culture and/or M. tuberculosis PCR) were positive in 75 patients and histopathological findings (necrotising granuloma with/without pathological caseification) were supportive for diagnosis in 68.2%. The overall mortality rate was 8.5%. In the multivariate analysis, factors independently associated with increased risk of death included advanced age, elevated sedimentation rate above 50mmHg, miliary TB and CNS TB. Conclusion: In conclusion, EPTB is an important health problem in developing countries with significant mortality in specific forms. The most common forms of EPTB are lymph node, bone and CNS TB. The most common underlying conditions are diabetes and immunosuppressive therapy although most patients do not have any underlying diseases. The diagnosis is forcing and a substantial proportion of patients have negative microbiological findings. The diagnosis are based on pathological, radiological and/or clinical findings in patients without definitive microbiological diagnosis. Advanced age, high sedimentation rate and severe forms such as CNS and miliary TB are associated with early mortality.
{"title":"Extrapulmonary Tuberculosis: Clinical and Diagnostic Features and Risk Factors for Early Mortality","authors":"Pınar Aysert Yıldız, Dilek Karamanlıoğlu, H. S. Özger, Hakan Katı, Özlem Güzel Tunçcan, M. Dizbay","doi":"10.32552/2022.actamedica.844","DOIUrl":"https://doi.org/10.32552/2022.actamedica.844","url":null,"abstract":"Objective: The aim of this study is to evaluate patients with EPTB in terms of demographics, anatomic localization, diagnosis and risk factors on early mortality.\u0000Materials and methods: The data of 217 inpatients who were followed up with EPTB, between January 2010 and December 2020, were evaluated retrospectively. Patients were followed-up during hospital admission and early mortality was considered. Risk factors on mortality were identified in multivariate analysis using logistic regression model.\u0000Results: The median age was 54 (IQR: 37-67) and the rate of male patients was 43.3%. 76 (35%) patients had at least one comorbidity. The most common underlying conditions were diabetes mellitus and immunosuppressive treatment. The most common forms of EPTB were lymph node, bone and CNS. Microbiological findings (ARB and/or TB-culture and/or M. tuberculosis PCR) were positive in 75 patients and histopathological findings (necrotising granuloma with/without pathological caseification) were supportive for diagnosis in 68.2%. The overall mortality rate was 8.5%. In the multivariate analysis, factors independently associated with increased risk of death included advanced age, elevated sedimentation rate above 50mmHg, miliary TB and CNS TB.\u0000Conclusion: In conclusion, EPTB is an important health problem in developing countries with significant mortality in specific forms. The most common forms of EPTB are lymph node, bone and CNS TB. The most common underlying conditions are diabetes and immunosuppressive therapy although most patients do not have any underlying diseases. The diagnosis is forcing and a substantial proportion of patients have negative microbiological findings. The diagnosis are based on pathological, radiological and/or clinical findings in patients without definitive microbiological diagnosis. Advanced age, high sedimentation rate and severe forms such as CNS and miliary TB are associated with early mortality.","PeriodicalId":50891,"journal":{"name":"Acta Medica Mediterranea","volume":"15 1","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89617636","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-12-25DOI: 10.32552/2022.actamedica.773
Saygın Kamacı, Sancar Bakırcıoğlu, Ömür Çaglar, B. Atilla, A. M. Tokgözoğlu
Objective: Femoral neck fractures mostly occurs due to high-energy trauma in young population and management differs compared to elderly. Different geometric parameters in the hip joint can play a role in fracture morphology regarding to the age. Present study aims to compare hip morphology between young and elderly population Materials and methods: 45 patients with isolated femoral neck fracture included to the study. Patients were divided into two regarding to the age; group 1 (younger than 60 yr.) and group 2 (older than 60 yr.). Garden and Pauwels classifications, Sharp angle (acetabular index-AI), acetabular depth (AD), Hip-axis length (HLA), Neck-shaft angle (NSA), Center-edge angle (CE), Singh indexes and femur head extrusion indexes were compared between groups. Results: The mean age of group 1 (22 patients) was 48 ± 10.4 while the mean age of group 2 (23 patients) was 77 ± 6.3. Significant differences found in 3 parameters; the mean HLA (13.4 ± 1.4 cm vs 12 ± 1.1 cm) (p: 0,034), the Sharp angle (37.9° ± 5° vs 40.3° ± 3°) (p: 0.047) and the CE (38.1° ± 6.2° vs 34.8° ± 4.5°) (p: 0.48) between group 1 and 2 respectively. No statistically significant difference was found in terms of AD, NSA, Singh index and extrusion index. Conclusions: Our study shows influence of proximal femoral and acetabular morphology on femoral neck fracture in young patients and may help future studies to reveal the relevance between hip morphology and fractures type.
目的:青年人股骨颈骨折多因高能外伤引起，治疗方法与老年人不同。不同年龄的髋关节几何参数对骨折形态有影响。本研究旨在比较青年和老年人群的髋关节形态。材料和方法:纳入45例孤立性股骨颈骨折患者。患者按年龄分为两组;第一组(小于60岁)和第二组(大于60岁)。比较两组间Garden和Pauwels分类、尖锐角度(髋臼指数- ai)、髋臼深度(AD)、髋轴长度(HLA)、颈轴角(NSA)、中心边缘角(CE)、Singh指数和股骨头挤压指数。结果:组1(22例)平均年龄48±10.4岁，组2(23例)平均年龄77±6.3岁。3个参数有显著差异;两组的平均HLA(13.4±1.4 cm vs 12±1.1 cm) (p: 0.034)、锐角(37.9°±5°vs 40.3°±3°)(p: 0.047)、CE(38.1°±6.2°vs 34.8°±4.5°)(p: 0.48)。AD、NSA、Singh指数、挤压指数均无统计学差异。结论:我们的研究显示了股骨近端和髋臼形态对年轻患者股骨颈骨折的影响，可能有助于未来研究揭示髋部形态与骨折类型之间的相关性。
{"title":"Age-related Comparison of Hip Joint Morphology in Isolated Femur Neck Fractures","authors":"Saygın Kamacı, Sancar Bakırcıoğlu, Ömür Çaglar, B. Atilla, A. M. Tokgözoğlu","doi":"10.32552/2022.actamedica.773","DOIUrl":"https://doi.org/10.32552/2022.actamedica.773","url":null,"abstract":"Objective: Femoral neck fractures mostly occurs due to high-energy trauma in young population and management differs compared to elderly. Different geometric parameters in the hip joint can play a role in fracture morphology regarding to the age. Present study aims to compare hip morphology between young and elderly population\u0000Materials and methods: 45 patients with isolated femoral neck fracture included to the study. Patients were divided into two regarding to the age; group 1 (younger than 60 yr.) and group 2 (older than 60 yr.). Garden and Pauwels classifications, Sharp angle (acetabular index-AI), acetabular depth (AD), Hip-axis length (HLA), Neck-shaft angle (NSA), Center-edge angle (CE), Singh indexes and femur head extrusion indexes were compared between groups.\u0000Results: The mean age of group 1 (22 patients) was 48 ± 10.4 while the mean age of group 2 (23 patients) was 77 ± 6.3. Significant differences found in 3 parameters; the mean HLA (13.4 ± 1.4 cm vs 12 ± 1.1 cm) (p: 0,034), the Sharp angle (37.9° ± 5° vs 40.3° ± 3°) (p: 0.047) and the CE (38.1° ± 6.2° vs 34.8° ± 4.5°) (p: 0.48) between group 1 and 2 respectively. No statistically significant difference was found in terms of AD, NSA, Singh index and extrusion index.\u0000Conclusions: Our study shows influence of proximal femoral and acetabular morphology on femoral neck fracture in young patients and may help future studies to reveal the relevance between hip morphology and fractures type.","PeriodicalId":50891,"journal":{"name":"Acta Medica Mediterranea","volume":"130 1","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90334707","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-12-25DOI: 10.32552/2022.actamedica.772
Burak Ardıçlı, I. User, F. Uzumcugil, S. Ekinci
Objective: Surgical exposure has utmost importance in the success of oncological surgery. Traditional incisions may not be adequate for exposure and total excision of the giant tumors. Thoracoabdominal incision favors excision of giant upper abdominal and lower thoracal tumors eliminating telescopic vision and providing excellent exposure of vascular structures. This study is designed to review our institutional experience in upper retroperitoneal tumor excision via thoracoabdominal approach. Material and methods: The records of children who were operated for neuroblastoma, adrenocortical tumor and Wilms tumor with thoracoabdominal incision between 2015 and 2020 are reviewed retrospectively. Results: Eleven children underwent surgery via thoracoabdominal approach for neuroblastoma (n=8), adrenocortical carcinoma (n=2), and Wilms tumor (n=1). The female to male ratio was 1.2. The median age at operation was 58 months (IQR, 18-85). Patients with neuroblastoma had total resection (n=6) and near total resection (n=2). En bloc resection of tumor with adjacent viscera was performed in two patients with adrenocortical carsinoma. These patients had simultaneous ipsilateral pulmonary metastasectomy. Radical nephroureterectomy was performed in one with giant Wilms tumor. All patients had morphine patient–controlled analgesia for the first 2 days, and then paracetamol was used. Prolonged analgesia was not required in any patient. There was no pulmonary morbidity. Postoperative course was uneventful and the patients were discharged in 5 days (IQR, 4-6) The median follow-up time was 12 months (IQR, 10-18). Conclusion: The thoracoabdominal incision for difficult upper abdominal tumor is tolerated well by the patients. The enhanced exposure facilitates resection and improves local control. Simultaneous pulmonary metastasectomy can be performed with this incision.
{"title":"Thoracoabdominal Approach for Giant Tumor Resection in Children","authors":"Burak Ardıçlı, I. User, F. Uzumcugil, S. Ekinci","doi":"10.32552/2022.actamedica.772","DOIUrl":"https://doi.org/10.32552/2022.actamedica.772","url":null,"abstract":"Objective: Surgical exposure has utmost importance in the success of oncological surgery. Traditional incisions may not be adequate for exposure and total excision of the giant tumors. Thoracoabdominal incision favors excision of giant upper abdominal and lower thoracal tumors eliminating telescopic vision and providing excellent exposure of vascular structures. This study is designed to review our institutional experience in upper retroperitoneal tumor excision via thoracoabdominal approach.\u0000Material and methods: The records of children who were operated for neuroblastoma, adrenocortical tumor and Wilms tumor with thoracoabdominal incision between 2015 and 2020 are reviewed retrospectively.\u0000Results: Eleven children underwent surgery via thoracoabdominal approach for neuroblastoma (n=8), adrenocortical carcinoma (n=2), and Wilms tumor (n=1). The female to male ratio was 1.2. The median age at operation was 58 months (IQR, 18-85). Patients with neuroblastoma had total resection (n=6) and near total resection (n=2). En bloc resection of tumor with adjacent viscera was performed in two patients with adrenocortical carsinoma. These patients had simultaneous ipsilateral pulmonary metastasectomy. Radical nephroureterectomy was performed in one with giant Wilms tumor. All patients had morphine patient–controlled analgesia for the first 2 days, and then paracetamol was used. Prolonged analgesia was not required in any patient. There was no pulmonary morbidity. Postoperative course was uneventful and the patients were discharged in 5 days (IQR, 4-6) The median follow-up time was 12 months (IQR, 10-18).\u0000Conclusion: The thoracoabdominal incision for difficult upper abdominal tumor is tolerated well by the patients. The enhanced exposure facilitates resection and improves local control. Simultaneous pulmonary metastasectomy can be performed with this incision.","PeriodicalId":50891,"journal":{"name":"Acta Medica Mediterranea","volume":"14 3 1","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88670200","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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