Pub Date : 2021-11-19DOI: 10.32552/2021.actamedica.566
M. Bahap, Pinar Bakir Ekinci, Ş. Alp, S. G. Oz, K. Demirkan
Three formulations of amphotericin B are available: liposomal, lipid complex and conventional. The liposomal amphotericin B is more preferred agent than other formulations because of its tolerability, safety and potent antifungal activity. However, the liposomal amphotericin B can cause infusion-related reactions. In this case report, we aimed to report a patient who developed infusion-related reactions during the treatment with the liposomal amphotericin B but eventually tolerated the prolonged infusion. In this case report, we present a patient who developed an infusion-related reaction during The liposomal amphotericin B treatment. A 26-year-old male patient with acute promyelocytic leukemia was hospitalized for the third course of chemotherapy. Due to the invasive fungal infection history in previous hospitalizations, the liposomal amphotericin B 400 mg (IV, 5 mg/kg) once daily was initiated as secondary antifungal prophylaxis. Swelling in infusion site and chest pain were reported within 10 minutes of the liposomal amphotericin B administration, and the infusion rate was slowed down to 400 mg/6 hours from 400 mg/2 hours. All these reactions disappeared with prolonged infusion time. The patient received a total of 7 liposomal amphotericin B doses subsequently without any reaction during the chemotherapy cycle. In our experience, the liposomal amphotericin B-induced infusion-related reactions can be resolved by prolonging the infusion time.
{"title":"Liposomal Amphotericin B Induced Acute Reactions","authors":"M. Bahap, Pinar Bakir Ekinci, Ş. Alp, S. G. Oz, K. Demirkan","doi":"10.32552/2021.actamedica.566","DOIUrl":"https://doi.org/10.32552/2021.actamedica.566","url":null,"abstract":"Three formulations of amphotericin B are available: liposomal, lipid complex and conventional. The liposomal amphotericin B is more preferred agent than other formulations because of its tolerability, safety and potent antifungal activity. However, the liposomal amphotericin B can cause infusion-related reactions. In this case report, we aimed to report a patient who developed infusion-related reactions during the treatment with the liposomal amphotericin B but eventually tolerated the prolonged infusion. In this case report, we present a patient who developed an infusion-related reaction during The liposomal amphotericin B treatment. A 26-year-old male patient with acute promyelocytic leukemia was hospitalized for the third course of chemotherapy. Due to the invasive fungal infection history in previous hospitalizations, the liposomal amphotericin B 400 mg (IV, 5 mg/kg) once daily was initiated as secondary antifungal prophylaxis. Swelling in infusion site and chest pain were reported within 10 minutes of the liposomal amphotericin B administration, and the infusion rate was slowed down to 400 mg/6 hours from 400 mg/2 hours. All these reactions disappeared with prolonged infusion time. The patient received a total of 7 liposomal amphotericin B doses subsequently without any reaction during the chemotherapy cycle. In our experience, the liposomal amphotericin B-induced infusion-related reactions can be resolved by prolonging the infusion time.","PeriodicalId":50891,"journal":{"name":"Acta Medica Mediterranea","volume":"44 1","pages":""},"PeriodicalIF":0.3,"publicationDate":"2021-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74426100","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 : 2021-11-17DOI: 10.32552/2021.actamedica.544
Ahmad Izani Mohd Safian, A. Mohamad, R. Ramli, I. Mohamad
NK/T cell lymphoma is one of the most unique and rare forms of extranodal non-Hodgkin’s lymphoma, mostly derived from natural killer cell lineages and occasionally cytotoxic T cell lines. Due to the non-specific presentation of NK/T cell lymphoma such as nasal obstruction, nasal discharge, and epistaxis, diagnosis is often an issue and can be misleading. Oronasal fistula following a non-healing ulcer on the soft palate, can be one of the clinical presentations of NK/T cell lymphoma. Here, we are reporting a rare case of NK/T cell lymphoma in a 32-year-old gentleman who presented with an oronasal fistula post tissue biopsy for a non-healing ulcer over the soft palate. The tissue biopsy of the soft palate mass was revealed as NK/T cell lymphoma and was staged as Stage1b after computed tomographic imaging revealed a local tumour invasion without sign of nodal involvement and no metastasis. The patient eventually started with the SMILE Protocol and responded well up to the date. The ulcer healed but the fistula persisted. Primary closure was planned by the oromaxillofacial surgery team after completion of chemotherapy.
{"title":"NK/T cell Lymphoma as a Rare Cause of an Oronasal Fistula","authors":"Ahmad Izani Mohd Safian, A. Mohamad, R. Ramli, I. Mohamad","doi":"10.32552/2021.actamedica.544","DOIUrl":"https://doi.org/10.32552/2021.actamedica.544","url":null,"abstract":"NK/T cell lymphoma is one of the most unique and rare forms of extranodal non-Hodgkin’s lymphoma, mostly derived from natural killer cell lineages and occasionally cytotoxic T cell lines. Due to the non-specific presentation of NK/T cell lymphoma such as nasal obstruction, nasal discharge, and epistaxis, diagnosis is often an issue and can be misleading. Oronasal fistula following a non-healing ulcer on the soft palate, can be one of the clinical presentations of NK/T cell lymphoma. Here, we are reporting a rare case of NK/T cell lymphoma in a 32-year-old gentleman who presented with an oronasal fistula post tissue biopsy for a non-healing ulcer over the soft palate. The tissue biopsy of the soft palate mass was revealed as NK/T cell lymphoma and was staged as Stage1b after computed tomographic imaging revealed a local tumour invasion without sign of nodal involvement and no metastasis. The patient eventually started with the SMILE Protocol and responded well up to the date. The ulcer healed but the fistula persisted. Primary closure was planned by the oromaxillofacial surgery team after completion of chemotherapy.","PeriodicalId":50891,"journal":{"name":"Acta Medica Mediterranea","volume":"23 1","pages":""},"PeriodicalIF":0.3,"publicationDate":"2021-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91161859","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 : 2021-11-17DOI: 10.32552/2021.actamedica.634
Filiz Froohari Damarsoy, Nalan Metin Aksu, E. Öztürk, Meltem Akkaş
Objectives: Abdominal pain occupies most of the emergency department admissions. This entity leads to research various markers for the early detection of causes in patients presenting with abdominal pain. There is limited data about collaborations between lactate levels and vital signs at admission in abdominal pain. Materials and Methods: Patients aged 18 years and older, who had presented with abdominal pain to the Emergency Department, in total 102 patients, were included to the study. The patients’ demographics, vital signs, abdominal physical examination findings, diagnosis and outcomes of patients were recorded. The 1 ml venous blood samples were collected by blood gase injectors from the patients and lactate levels were analyzed. Results: Female patients’ percentile was 68,6% and mean age was 39 years old. The systolic blood pressure levels were normal in 45 patients, low in 26% patients and high in 29% patients. The seventy-six of the patients had normal pulse rate and 26 of them were tachycardic. Most common diagnosis was non-specific abdominal pain (37,25%) and the least common was ovarian torsion/intracystic hemorrhage (0,98%) and obstruction due to hernia (0,98%). There was no statistically significant relation between lactate level and pulse rate (p=0,637), systolic blood pressure (p=0,052), diastolic blood pressure (p=0,095), respiratory rate (p=0,527), body temperature (p=0,040) and oxygen saturation (p=0,905). Similarly, no significant association occurred between lactate levels and diagnosis and outcomes. Conclusion: Further studies including more patients groups have to be done in order to attain more reliable data about this topic.
{"title":"Could We Use Vital Signs and Lactate Levels Together to Predict the Prognosis in Abdominal Pain?","authors":"Filiz Froohari Damarsoy, Nalan Metin Aksu, E. Öztürk, Meltem Akkaş","doi":"10.32552/2021.actamedica.634","DOIUrl":"https://doi.org/10.32552/2021.actamedica.634","url":null,"abstract":"Objectives: Abdominal pain occupies most of the emergency department admissions. This entity leads to research various markers for the early detection of causes in patients presenting with abdominal pain. There is limited data about collaborations between lactate levels and vital signs at admission in abdominal pain. \u0000Materials and Methods: Patients aged 18 years and older, who had presented with abdominal pain to the Emergency Department, in total 102 patients, were included to the study. The patients’ demographics, vital signs, abdominal physical examination findings, diagnosis and outcomes of patients were recorded. The 1 ml venous blood samples were collected by blood gase injectors from the patients and lactate levels were analyzed. \u0000Results: Female patients’ percentile was 68,6% and mean age was 39 years old. The systolic blood pressure levels were normal in 45 patients, low in 26% patients and high in 29% patients. The seventy-six of the patients had normal pulse rate and 26 of them were tachycardic. Most common diagnosis was non-specific abdominal pain (37,25%) and the least common was ovarian torsion/intracystic hemorrhage (0,98%) and obstruction due to hernia (0,98%). There was no statistically significant relation between lactate level and pulse rate (p=0,637), systolic blood pressure (p=0,052), diastolic blood pressure (p=0,095), respiratory rate (p=0,527), body temperature (p=0,040) and oxygen saturation (p=0,905). Similarly, no significant association occurred between lactate levels and diagnosis and outcomes. \u0000Conclusion: Further studies including more patients groups have to be done in order to attain more reliable data about this topic.","PeriodicalId":50891,"journal":{"name":"Acta Medica Mediterranea","volume":"65 1","pages":""},"PeriodicalIF":0.3,"publicationDate":"2021-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85782294","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 : 2021-11-16DOI: 10.32552/2021.actamedica.630
A. Çeliker, Emre Kara, S. Karahan
Objective: Exploring and categorizing the drug and/or poisoning information resources available in community pharmacies in Ankara according to some variables, and revealing common opinions regarding the future of the profession and information resources. Materials and Methods: This study was conducted as an online questionnaire for community pharmacists in Ankara. It had four headings on the pharmacists’ demographics, their general information resources, specific resources in specific topics, and 4 suggestions regarding the future of pharmacy and drug information resources. Results: The number of participants was 134 as 17.9% of 746 e-mail addresses. Mean ages±standart deviation were 40.9±12.0 years. The top 3 information sources on poisonings were the internet, colleagues, and physicians with 74.6%, 43.3%, and 30.6%, respectively. Participants in the “colleagues” group in terms of poisoning preferences had a shorter period after graduation (p=0.001). In the drug information inquiries package inserts, internet and colleagues were preferred mostly, with 69.4%, 63.4%, and 35.8%, respectively. Age groups and graduation years were statistically different regarding the “package inserts” and “colleagues” groups (p=0.012 and p=0.001, and p=0.019 and p<0.001, respectively). The most “totally agreed” suggestion was accepting the pharmacies’ being important drug and/or poison information resources for consumers with 68.7%. Conclusion: The pharmacists have been fulfilling their duty of “being an information resource” through rather limited resources. To equip community pharmacists properly, authorities, professional institutions, and universities need to contribute to the process in different ways together with pharmacists being aware of their responsibilities.
{"title":"An Evaluation of Information Sources Regarding Drug Use and/or Poisoning Cases of Community Pharmacists in Ankara, Turkey","authors":"A. Çeliker, Emre Kara, S. Karahan","doi":"10.32552/2021.actamedica.630","DOIUrl":"https://doi.org/10.32552/2021.actamedica.630","url":null,"abstract":"Objective: Exploring and categorizing the drug and/or poisoning information resources available in community pharmacies in Ankara according to some variables, and revealing common opinions regarding the future of the profession and information resources. \u0000Materials and Methods: This study was conducted as an online questionnaire for community pharmacists in Ankara. It had four headings on the pharmacists’ demographics, their general information resources, specific resources in specific topics, and 4 suggestions regarding the future of pharmacy and drug information resources. \u0000Results: The number of participants was 134 as 17.9% of 746 e-mail addresses. Mean ages±standart deviation were 40.9±12.0 years. The top 3 information sources on poisonings were the internet, colleagues, and physicians with 74.6%, 43.3%, and 30.6%, respectively. Participants in the “colleagues” group in terms of poisoning preferences had a shorter period after graduation (p=0.001). In the drug information inquiries package inserts, internet and colleagues were preferred mostly, with 69.4%, 63.4%, and 35.8%, respectively. Age groups and graduation years were statistically different regarding the “package inserts” and “colleagues” groups (p=0.012 and p=0.001, and p=0.019 and p<0.001, respectively). The most “totally agreed” suggestion was accepting the pharmacies’ being important drug and/or poison information resources for consumers with 68.7%. \u0000Conclusion: The pharmacists have been fulfilling their duty of “being an information resource” through rather limited resources. To equip community pharmacists properly, authorities, professional institutions, and universities need to contribute to the process in different ways together with pharmacists being aware of their responsibilities.","PeriodicalId":50891,"journal":{"name":"Acta Medica Mediterranea","volume":"23 1","pages":""},"PeriodicalIF":0.3,"publicationDate":"2021-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87641529","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 : 2021-11-16DOI: 10.32552/2021.actamedica.623
E. Bilgin, U. Kalyoncu
Objectives: Psoriatic arthritis is a chronic musculoskeletal disorder which may affect skin, joints, bone and enthesis. Conventional synthetic disease modifying anti-rheumatic drugs are first-line treatment options and biologic disease modifying anti-rheumatic drugs are recommended in psoriatic arthritis patients who are intolerant/not controlled well with conventional synthetic disease modifying anti-rheumatic drugs. Although survival data of the conventional synthetic disease modifying anti-rheumatic drugs without concomitant biologic disease modifying anti-rheumatic drugs are available, the effect of biologic disease modifying anti-rheumatic drugs on the retention of conventional synthetic disease modifying anti-rheumatic drugs is still a question of interest. Materials and Methods: Psoriatic arthritis patients who received at least 1 dose of biologic disease modifying anti-rheumatic drugs, using at least 1 conventional synthetic disease modifying anti-rheumatic drugs (methotrexate, leflunomide, hydroxychloroquine and sulfasalazine) at the time of biologic disease modifying anti-rheumatic drugs starting visit and registered in the Hacettepe University BIOlogical Database-Psoriatic Arthritis were included in this retrospective longitudinal analysis. Demographic and disease-specific data at first and last follow-up visit were collected. Unadjusted retention rate of each conventional synthetic disease modifying anti-rheumatic drugs was assessed. Overall prescription of conventional synthetic disease modifying anti-rheumatic drugs at first and last follow-up visit were compared. Results: A total of 266 (191(71.8%) female) patients was included. Median follow-up duration under biologic treatment was 43.4 (19.4-80.1) months. Median retention duration of each conventional synthetic disease modifying anti-rheumatic drugs were similar. Between the first and last visit; there was a 29.3% decrease in methotrexate use (61.7% vs. 43.6%; p<0.001), 8.4% decrease in leflunomide use (31.2% vs. 28.6%; p=0.30), 30.0% decrease in sulfasalazine use (11.3% vs. 7.9%; p=0.05), 31.1% decrease in hydroxychloroquine use (16.9% vs. 11.7%; p=0.001), 12.5 % decrease in glucocorticoids use (51.1% vs. 44.7%; p=0.015). At last visit, 59 (22.2%) patients were conventional synthetic disease modifying anti-rheumatic drugs -free: 20 (7.5%) patients were using only glucocorticoids, 39 (14.7%) patients were conventional synthetic disease modifying anti-rheumatic drugs + glucocorticoid-free. Conclusion: Although conventional synthetic disease modifying anti-rheumatic drugs were significantly discontinued in an important percent of patients after the initiation of biologic disease modifying anti-rheumatic drugs, percentage of patients using glucocorticoids at last visit was still high. Studies aiming to demonstrate when, in whom and how to discontinue conventional synthetic disease modifying anti-rheumatic drugs are needed.
目的:银屑病关节炎是一种慢性肌肉骨骼疾病，可影响皮肤，关节，骨骼和髋部。常规合成抗病性抗风湿药物是一线治疗选择，对于常规合成抗病性抗风湿药物不耐受/控制不好的银屑病关节炎患者，推荐使用生物抗病性抗风湿药物。虽然目前已有常规合成疾病修饰抗风湿药物的生存数据，但生物疾病修饰抗风湿药物对常规合成疾病修饰抗风湿药物保留的影响仍然是一个值得关注的问题。材料和方法:银屑病关节炎患者在开始使用生物疾病修饰抗风湿药物时接受至少1剂生物疾病修饰抗风湿药物，使用至少1种传统合成疾病修饰抗风湿药物(甲氨蝶呤、来氟米特、羟氯喹和磺胺嘧啶)，并在Hacettepe大学生物数据库-银屑病关节炎中登记，纳入本回顾性纵向分析。收集首次和最后一次随访时的人口统计学和疾病特异性数据。评估各种常规合成疾病修饰抗风湿药物的未调整保留率。比较常规综合抗风湿药首访和末访时的总体处方。结果:共纳入266例患者，其中女性191例，占71.8%。生物治疗组的中位随访时间为43.4(19.4-80.1)个月。两种常规合成抗风湿药物的中位保留时间相似。在第一次和最后一次访问之间;甲氨蝶呤使用率下降29.3% (61.7% vs 43.6%;P <0.001)，来氟米特使用率下降8.4% (31.2% vs 28.6%;P =0.30)，磺胺吡啶的使用减少30.0% (11.3% vs. 7.9%;P =0.05)，羟氯喹使用减少31.1% (16.9% vs. 11.7%;P =0.001)，糖皮质激素使用减少12.5% (51.1% vs. 44.7%;p = 0.015)。末次访时，59例(22.2%)患者不使用常规综合抗风湿药物，20例(7.5%)患者仅使用糖皮质激素，39例(14.7%)患者使用常规综合抗风湿药物+不使用糖皮质激素。结论:虽然有相当一部分患者在开始使用生物疾病修饰类抗风湿药物后明显停用了常规合成疾病修饰类抗风湿药物，但最后一次就诊时使用糖皮质激素的患者比例仍然很高。需要进行旨在证明何时、对谁以及如何停用常规合成疾病修饰抗风湿药的研究。
{"title":"Conventional Synthetic Dmards in Psoriatic Arthritis: Changing Practice in Biologic Era; Real-Life Results from HURBIO-PsA Registry","authors":"E. Bilgin, U. Kalyoncu","doi":"10.32552/2021.actamedica.623","DOIUrl":"https://doi.org/10.32552/2021.actamedica.623","url":null,"abstract":"Objectives: Psoriatic arthritis is a chronic musculoskeletal disorder which may affect skin, joints, bone and enthesis. Conventional synthetic disease modifying anti-rheumatic drugs are first-line treatment options and biologic disease modifying anti-rheumatic drugs are recommended in psoriatic arthritis patients who are intolerant/not controlled well with conventional synthetic disease modifying anti-rheumatic drugs. Although survival data of the conventional synthetic disease modifying anti-rheumatic drugs without concomitant biologic disease modifying anti-rheumatic drugs are available, the effect of biologic disease modifying anti-rheumatic drugs on the retention of conventional synthetic disease modifying anti-rheumatic drugs is still a question of interest. \u0000Materials and Methods: Psoriatic arthritis patients who received at least 1 dose of biologic disease modifying anti-rheumatic drugs, using at least 1 conventional synthetic disease modifying anti-rheumatic drugs (methotrexate, leflunomide, hydroxychloroquine and sulfasalazine) at the time of biologic disease modifying anti-rheumatic drugs starting visit and registered in the Hacettepe University BIOlogical Database-Psoriatic Arthritis were included in this retrospective longitudinal analysis. Demographic and disease-specific data at first and last follow-up visit were collected. Unadjusted retention rate of each conventional synthetic disease modifying anti-rheumatic drugs was assessed. Overall prescription of conventional synthetic disease modifying anti-rheumatic drugs at first and last follow-up visit were compared. \u0000Results: A total of 266 (191(71.8%) female) patients was included. Median follow-up duration under biologic treatment was 43.4 (19.4-80.1) months. Median retention duration of each conventional synthetic disease modifying anti-rheumatic drugs were similar. Between the first and last visit; there was a 29.3% decrease in methotrexate use (61.7% vs. 43.6%; p<0.001), 8.4% decrease in leflunomide use (31.2% vs. 28.6%; p=0.30), 30.0% decrease in sulfasalazine use (11.3% vs. 7.9%; p=0.05), 31.1% decrease in hydroxychloroquine use (16.9% vs. 11.7%; p=0.001), 12.5 % decrease in glucocorticoids use (51.1% vs. 44.7%; p=0.015). At last visit, 59 (22.2%) patients were conventional synthetic disease modifying anti-rheumatic drugs -free: 20 (7.5%) patients were using only glucocorticoids, 39 (14.7%) patients were conventional synthetic disease modifying anti-rheumatic drugs + glucocorticoid-free. \u0000Conclusion: Although conventional synthetic disease modifying anti-rheumatic drugs were significantly discontinued in an important percent of patients after the initiation of biologic disease modifying anti-rheumatic drugs, percentage of patients using glucocorticoids at last visit was still high. Studies aiming to demonstrate when, in whom and how to discontinue conventional synthetic disease modifying anti-rheumatic drugs are needed.","PeriodicalId":50891,"journal":{"name":"Acta Medica Mediterranea","volume":"69 1","pages":""},"PeriodicalIF":0.3,"publicationDate":"2021-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79562289","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 : 2021-11-05DOI: 10.32552/2021.actamedica.595
Yusuf Samir Hasanlı, M. Türk
Objective: Pneumoconiosis is a fatal, irreversible interstitial lung disease caused by various inorganic dust and chemicals. The disease is radiologically characterized by micronodules, pleural plaques, emphysema, mediastinal and hilar lymphadenopathies (HL). There are hypotheses that fibrotic lymph nodes increase the dust load of the lungs in patients with pneumoconiosis. Our aim is to determine the frequency of HL and related factors in pneumoconiosis patients admitted to our unit in the light of current data. Material and Methods: 76 patients diagnosed with pneumoconiosis who applied to our unit between November, 2015 and October, 2020 were retrospectively screened. Sociodemographic characteristics, radiological, laboratory and clinical findings were evaluated. The frequency of HL and related factors were analyzed. Results: We found the rate of HL as 29,3%. The average age was 43,78 ± 7,54. There was no significant age difference between patients with and without HL (44,41±8,90 / 43,34±6,93 p=0,578). All of the patients were male. As the ILO (International Labor Organization) category rose, we saw an increase in the number of HL. 59,1% of the patients with HL had at least one active complaint (dyspnea, cough or sputum). The most common complaint was dyspnea (50%). We found a statistically significant increase in NLR (Neutrophil to Lymphocyte Ratio) and TLR (Thrombocyte to Lymphocyte Ratio) values in patients with HL compared to those without (2,38±0,70; 1,97±0,59 p=0,016 and 133,79±39,06; 109,03±29,00 p=0,005). Another important finding was that the albumin values of patients with HL were found to be statistically significantly lower (4.42 ± 0.41; 4.67 ± 0.29 p = 0.008). Conclusion: 29.3% of patients had HL. We found significant increase in NLR and TLR in pneumoconiosis patients with HL and decrease in serum albumin levels. We think that these markers may have prognostic value in pneumoconiosis patients with lymphadenopathy.
目的:尘肺病是由多种无机粉尘和化学物质引起的致死性、不可逆的间质性肺疾病。该疾病的放射学特征为微结节、胸膜斑块、肺气肿、纵隔和肺门淋巴结病(HL)。有假说认为纤维化淋巴结增加尘肺患者肺部的粉尘负荷。我们的目的是根据目前的数据确定我们单位收治的尘肺患者HL的频率和相关因素。材料与方法:回顾性筛选2015年11月至2020年10月在我科室就诊的确诊尘肺患者76例。评估了社会人口学特征、放射学、实验室和临床结果。分析HL的发生频率及相关因素。结果:HL发生率为29.3%。平均年龄43,78±7,54岁。HL患者与非HL患者的年龄差异无统计学意义(44,41±8,90 / 43,34±6,93 p= 0.578)。所有患者均为男性。随着ILO(国际劳工组织)类别的增加，我们看到HL的数量有所增加。59.1%的HL患者至少有一种主诉(呼吸困难、咳嗽或咳痰)。最常见的主诉是呼吸困难(50%)。我们发现，与非HL患者相比，HL患者NLR(中性粒细胞与淋巴细胞比值)和TLR(血小板与淋巴细胞比值)值有统计学意义的增加(2,38±0,70;1,97±0,59 p=0,016和133,79±39,06;109年,03±29日00 p = 0005)。另一个重要发现是HL患者的白蛋白值有统计学意义(4.42±0.41;4.67±0.29 p = 0.008)。结论:29.3%的患者有HL。我们发现合并HL的尘肺患者NLR和TLR显著升高，血清白蛋白水平降低。我们认为这些指标可能对尘肺伴淋巴结病患者有预后价值。
{"title":"The Prevalence of Hilar Lymphadenopathy and Related Factors in Pneumoconiosis Patients of a University Hospital Occupational Diseases Polyclinic","authors":"Yusuf Samir Hasanlı, M. Türk","doi":"10.32552/2021.actamedica.595","DOIUrl":"https://doi.org/10.32552/2021.actamedica.595","url":null,"abstract":"Objective: Pneumoconiosis is a fatal, irreversible interstitial lung disease caused by various inorganic dust and chemicals. The disease is radiologically characterized by micronodules, pleural plaques, emphysema, mediastinal and hilar lymphadenopathies (HL). There are hypotheses that fibrotic lymph nodes increase the dust load of the lungs in patients with pneumoconiosis. Our aim is to determine the frequency of HL and related factors in pneumoconiosis patients admitted to our unit in the light of current data. \u0000Material and Methods: 76 patients diagnosed with pneumoconiosis who applied to our unit between November, 2015 and October, 2020 were retrospectively screened. Sociodemographic characteristics, radiological, laboratory and clinical findings were evaluated. The frequency of HL and related factors were analyzed. \u0000Results: We found the rate of HL as 29,3%. The average age was 43,78 ± 7,54. There was no significant age difference between patients with and without HL (44,41±8,90 / 43,34±6,93 p=0,578). All of the patients were male. As the ILO (International Labor Organization) category rose, we saw an increase in the number of HL. 59,1% of the patients with HL had at least one active complaint (dyspnea, cough or sputum). The most common complaint was dyspnea (50%). We found a statistically significant increase in NLR (Neutrophil to Lymphocyte Ratio) and TLR (Thrombocyte to Lymphocyte Ratio) values in patients with HL compared to those without (2,38±0,70; 1,97±0,59 p=0,016 and 133,79±39,06; 109,03±29,00 p=0,005). Another important finding was that the albumin values of patients with HL were found to be statistically significantly lower (4.42 ± 0.41; 4.67 ± 0.29 p = 0.008). \u0000Conclusion: 29.3% of patients had HL. We found significant increase in NLR and TLR in pneumoconiosis patients with HL and decrease in serum albumin levels. We think that these markers may have prognostic value in pneumoconiosis patients with lymphadenopathy.","PeriodicalId":50891,"journal":{"name":"Acta Medica Mediterranea","volume":"32 6 1","pages":""},"PeriodicalIF":0.3,"publicationDate":"2021-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82817859","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 : 2021-11-03DOI: 10.32552/2021.actamedica.581
Elbrus Zarbaliyev, Murat Sevmiş, D. Sarsenov, P. Hacısalihoğlu, M. Caglikulekci
Objective: Hydatid cyst disease is a widespread zoonotic disease infecting humans as an intermediate host. Since the first description of this pathology, many modalities have been introduced into modern treatment protocols. Minimally invasive surgical treatment is well-described and widely used, but has many points where rationalization and modification can be applied. In this case series, we describe small differences in surgical technique and the corresponding treatment results. Materials and Methods: Out of 44 patients, 16 were included in this study. Patients were retrospectively evaluated in two groups in accordance with the preferred cyst aspiration technique, i.e. via a standard laparoscopic aspirator or a large diameter venous catheter (the control and study groups, respectively). Demographic, clinical and surgical data like duration of surgery, hospital stay and complication rates were evaluated in both groups. Results: Equal numbers of males and females participated, with a median age of 40 years. Most patients had a type III hydatid cyst (n=11, 68.75%). Surgery duration and hospital stay were significantly shorter in the study group, without a significant difference in terms of complication rates. Conclusion: Laparoscopic procedures quickly became plausible for selected hydatid cysts located in liver. Success of such procedures shows to be depending on the success and duration of the laparoscopic intervention. The latter, according to our calculations, seems to be inversely proportional to the diameter of the aspirator tip and its piping.
{"title":"Laparoscopic Treatment of Hydatid Liver and Pancreas Disease: Some Technical Aspects and Importance","authors":"Elbrus Zarbaliyev, Murat Sevmiş, D. Sarsenov, P. Hacısalihoğlu, M. Caglikulekci","doi":"10.32552/2021.actamedica.581","DOIUrl":"https://doi.org/10.32552/2021.actamedica.581","url":null,"abstract":"Objective: Hydatid cyst disease is a widespread zoonotic disease infecting humans as an intermediate host. Since the first description of this pathology, many modalities have been introduced into modern treatment protocols. Minimally invasive surgical treatment is well-described and widely used, but has many points where rationalization and modification can be applied. In this case series, we describe small differences in surgical technique and the corresponding treatment results. \u0000Materials and Methods: Out of 44 patients, 16 were included in this study. Patients were retrospectively evaluated in two groups in accordance with the preferred cyst aspiration technique, i.e. via a standard laparoscopic aspirator or a large diameter venous catheter (the control and study groups, respectively). Demographic, clinical and surgical data like duration of surgery, hospital stay and complication rates were evaluated in both groups. \u0000Results: Equal numbers of males and females participated, with a median age of 40 years. Most patients had a type III hydatid cyst (n=11, 68.75%). Surgery duration and hospital stay were significantly shorter in the study group, without a significant difference in terms of complication rates. \u0000Conclusion: Laparoscopic procedures quickly became plausible for selected hydatid cysts located in liver. Success of such procedures shows to be depending on the success and duration of the laparoscopic intervention. The latter, according to our calculations, seems to be inversely proportional to the diameter of the aspirator tip and its piping.","PeriodicalId":50891,"journal":{"name":"Acta Medica Mediterranea","volume":"29 1","pages":""},"PeriodicalIF":0.3,"publicationDate":"2021-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89902035","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 : 2021-11-01DOI: 10.32552/2021.actamedica.564
T. Bonanzinga, F. M. Gambaro, Riccardo Garibaldi, Federico Adravanti, G. Fusco, M. Marcacci
Objective: Cemented total knee arthroplasty still represents the reference standard in the field of prothesis knee replacement; but since cementless total knee arthroplasties were introduced there have been strong discussions over the years among cemented and non-cemented total knee arthroplasties to establish which gives the best benefits for the patient and for the surgeon. The purpose of this meta-analysis is to systematically analyze the use of cemented and cementless total knee arthroplasties by investigating clinical and radiological outcomes and rate of complications, in order to assess which techniques confers more benefits to the patient and the surgeon. Materials and Methods: The current systematic review has been written in accordance to the Cochrane handbook and the PRISMA statement for reporting of systematic reviews incorporating network. Results: Six randomized controlled trials were finally included in this systematic review. The statistical analysis revealed no significant differences in all clinical scores of interest (Knee Society Score, clinical and functional, Oxford Knee Score, Visual Analogue Score) and a similar revision rate. Conclusion: the results of the current metanalysis suggest the non-inferiority of cementless fixation with respect to cemented total knee arthroplasties in terms of clinical outcomes and survival rates of the implants.
{"title":"Non-inferiority of The Cementless Total TKA Compared to The Cemented TKA, A m-Metanalysis","authors":"T. Bonanzinga, F. M. Gambaro, Riccardo Garibaldi, Federico Adravanti, G. Fusco, M. Marcacci","doi":"10.32552/2021.actamedica.564","DOIUrl":"https://doi.org/10.32552/2021.actamedica.564","url":null,"abstract":"Objective: Cemented total knee arthroplasty still represents the reference standard in the field of prothesis knee replacement; but since cementless total knee arthroplasties were introduced there have been strong discussions over the years among cemented and non-cemented total knee arthroplasties to establish which gives the best benefits for the patient and for the surgeon. \u0000The purpose of this meta-analysis is to systematically analyze the use of cemented and cementless total knee arthroplasties by investigating clinical and radiological outcomes and rate of complications, in order to assess which techniques confers more benefits to the patient and the surgeon. \u0000Materials and Methods: The current systematic review has been written in accordance to the Cochrane handbook and the PRISMA statement for reporting of systematic reviews incorporating network. \u0000Results: Six randomized controlled trials were finally included in this systematic review. The statistical analysis revealed no significant differences in all clinical scores of interest (Knee Society Score, clinical and functional, Oxford Knee Score, Visual Analogue Score) and a similar revision rate. \u0000Conclusion: the results of the current metanalysis suggest the non-inferiority of cementless fixation with respect to cemented total knee arthroplasties in terms of clinical outcomes and survival rates of the implants.","PeriodicalId":50891,"journal":{"name":"Acta Medica Mediterranea","volume":"15 1","pages":""},"PeriodicalIF":0.3,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82245122","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 : 2021-09-28DOI: 10.32552/2021.actamedica.672
N. Çelik, R. Emiroğlu
Objective: Very rare monogenic metabolic diseases without structural liver damage can be cured by liver transplantation. This process is a surgical enzyme replacement therapy, and defective enzymes may or may not be confined to the liver. The aims of this single center study of children with metabolic diseases showing structurally normal liver parenchyma were to analyze the indications and post-operative outcomes of liver transplantation, identification of developmental and metabolic benefits of the procedure with recognition of peri-operative difficulties to improve the success rate. Materials and Methods: Patients under the age of 19-year-old who underwent liver transplantation for metabolic disorders with no structural liver injury between January 2015 and June 2021 analyzed retrospectively. Patient and graft survivals, indications for transplantation, presence of extra-hepatic enzyme deficiency causing other organ damage, inclusion of simultaneous or sequential kidney transplantation, immunosuppressive protocols, post-transplant complications, and metabolic outcomes were identified. Results: Eight children with primary hyperoxaluria type 1 (n = 4), Maple syrup urine disease (n = 1), Crigler-Najjar syndrome type 1 (n=1), familial hypercholesterolemia (n=1) and propionic acidemia (n = 1) received left lobe (n=6) and left lateral segment (2) allografts from living donors. The median age of 4 girls and 4 boys at time of transplantation was 6.8 years (range 2.2-12.7 years). The median follow-up time was 3.3 years (range 1.5-5.7 years). The most common post-transplant complications were biliary system complications and infections and, two patients died because of sepsis. Six patients are alive with normal functioning allografts and metabolically stable on unrestricted diet. Conclusion: Liver transplantation is a lifesaving treatment and improves patient’s and parent’s life quality for metabolic disorders with no parenchymal injury despite strict dietary restrictions and medical therapies. Especially, living donor liver transplantation is very important for populations with very low organ donation rates.
{"title":"Pediatric Liver Transplantation as Enzyme Replacement Therapy for Rare Metabolic Diseases with No Structural Liver Damage","authors":"N. Çelik, R. Emiroğlu","doi":"10.32552/2021.actamedica.672","DOIUrl":"https://doi.org/10.32552/2021.actamedica.672","url":null,"abstract":"Objective: Very rare monogenic metabolic diseases without structural liver damage can be cured by liver transplantation. This process is a surgical enzyme replacement therapy, and defective enzymes may or may not be confined to the liver. The aims of this single center study of children with metabolic diseases showing structurally normal liver parenchyma were to analyze the indications and post-operative outcomes of liver transplantation, identification of developmental and metabolic benefits of the procedure with recognition of peri-operative difficulties to improve the success rate. \u0000Materials and Methods: Patients under the age of 19-year-old who underwent liver transplantation for metabolic disorders with no structural liver injury between January 2015 and June 2021 analyzed retrospectively. Patient and graft survivals, indications for transplantation, presence of extra-hepatic enzyme deficiency causing other organ damage, inclusion of simultaneous or sequential kidney transplantation, immunosuppressive protocols, post-transplant complications, and metabolic outcomes were identified. \u0000Results: Eight children with primary hyperoxaluria type 1 (n = 4), Maple syrup urine disease (n = 1), Crigler-Najjar syndrome type 1 (n=1), familial hypercholesterolemia (n=1) and propionic acidemia (n = 1) received left lobe (n=6) and left lateral segment (2) allografts from living donors. The median age of 4 girls and 4 boys at time of transplantation was 6.8 years (range 2.2-12.7 years). The median follow-up time was 3.3 years (range 1.5-5.7 years). The most common post-transplant complications were biliary system complications and infections and, two patients died because of sepsis. Six patients are alive with normal functioning allografts and metabolically stable on unrestricted diet. \u0000Conclusion: Liver transplantation is a lifesaving treatment and improves patient’s and parent’s life quality for metabolic disorders with no parenchymal injury despite strict dietary restrictions and medical therapies. Especially, living donor liver transplantation is very important for populations with very low organ donation rates.","PeriodicalId":50891,"journal":{"name":"Acta Medica Mediterranea","volume":"74 1","pages":""},"PeriodicalIF":0.3,"publicationDate":"2021-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91259836","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 : 2021-09-27DOI: 10.32552/2021.actamedica.580
E. Ceyhan, Burak Yılmaz, B. Öztürk
Objective: To assess the incoherence rates between prostate biopsies and radical prostatectomy specimens with the use of the International Society of Urological Pathology grading system and to identify the related factors. Materials and Methods: 89 radical prostatectomy patients were analyzed retrospectively. Patients with Gleason score≥6 were included to the study. Patients’ prostate spesific antigen levels, digital rectal examination, prostate biopsy parameters, prostate cancer risk groups and final prostatectomy pathologies were examined. Gleason scores and International Society of Urological Pathology grades of prostate biopsy and prostatectomy specimens were compared. The coherence, upgrading and downgrading rates of pathologies assessed and related factors were identified. Results: Patients’ mean age was 63.1±6.0 years. Prostate spesific antigen levels ranged from 2.8 to 114.0ng/mL(mean:14.8±16.7). The mean number of cores biopsied was 10.9±3.1. Number of patients in low, intermediate and high risk group were 27(30.3%), 34(38.2%) and 28(31.5%) respectively. The coherence, upgrading and downgrading rates according to International Society of Urological Pathology grading were 49.4%, 33.7% and 16.9% respectively. The low risk prostate cancer group showed the most coherent pathologies with the rate of 70.4%(p<0.05, both for International Society of Urological Pathology grading and Gleason scoring). There was no significant relation between prostate spesific antigen level, number of cores biopsied, percentage of cancer involvement, presence of perineural invasion coherence, upgrading and downgrading. Also no significant difference found between coherent, upgrading and downgrading pathologies with respect to the time to radical prostatectomy. Conclusion: The incoherence between prostate biopsy and radical prostatectomy is challenging. Risk of upgrading and downgrading should be considered in decision making. Low risk prostate cancer shows the most coherent pathology between prostate biopsy and radical prostatectomy.
{"title":"The Comparison of ISUP Grades Between Prostate Biopsy and Radical Prostatectomy: The Incoherence and Related Factors","authors":"E. Ceyhan, Burak Yılmaz, B. Öztürk","doi":"10.32552/2021.actamedica.580","DOIUrl":"https://doi.org/10.32552/2021.actamedica.580","url":null,"abstract":"Objective: To assess the incoherence rates between prostate biopsies and radical prostatectomy specimens with the use of the International Society of Urological Pathology grading system and to identify the related factors. \u0000Materials and Methods: 89 radical prostatectomy patients were analyzed retrospectively. Patients with Gleason score≥6 were included to the study. Patients’ prostate spesific antigen levels, digital rectal examination, prostate biopsy parameters, prostate cancer risk groups and final prostatectomy pathologies were examined. Gleason scores and International Society of Urological Pathology grades of prostate biopsy and prostatectomy specimens were compared. The coherence, upgrading and downgrading rates of pathologies assessed and related factors were identified. \u0000Results: Patients’ mean age was 63.1±6.0 years. Prostate spesific antigen levels ranged from 2.8 to 114.0ng/mL(mean:14.8±16.7). The mean number of cores biopsied was 10.9±3.1. Number of patients in low, intermediate and high risk group were 27(30.3%), 34(38.2%) and 28(31.5%) respectively. The coherence, upgrading and downgrading rates according to International Society of Urological Pathology grading were 49.4%, 33.7% and 16.9% respectively. The low risk prostate cancer group showed the most coherent pathologies with the rate of 70.4%(p<0.05, both for International Society of Urological Pathology grading and Gleason scoring). There was no significant relation between prostate spesific antigen level, number of cores biopsied, percentage of cancer involvement, presence of perineural invasion coherence, upgrading and downgrading. Also no significant difference found between coherent, upgrading and downgrading pathologies with respect to the time to radical prostatectomy. \u0000Conclusion: The incoherence between prostate biopsy and radical prostatectomy is challenging. Risk of upgrading and downgrading should be considered in decision making. Low risk prostate cancer shows the most coherent pathology between prostate biopsy and radical prostatectomy.","PeriodicalId":50891,"journal":{"name":"Acta Medica Mediterranea","volume":"51 1","pages":""},"PeriodicalIF":0.3,"publicationDate":"2021-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76039948","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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