Introduction: Congenital afibrinogenemia is a rare coagulation disorder characterized by a deficiency in the fibrinogen molecule. Fibrinogen is a hexameric glycoprotein consisting of a polypeptide chain encoded by FGB, FGA, and FGG and is required for normal hemostasis. Changes in FGA, FGB, and FGG may affect fibrinogen at different levels. As a result of these changes, fibrinogen cannot be detected in the blood. Clinical manifestations of such changes range from asymptomatic to life-threatening bleeding or thromboembolic events. Since it is an autosomal recessive disease, the risk is higher in children whose parents are related. Therefore, the disease is more common in regions where consanguineous marriage rates are high. Diagnosis is made by laboratory tests that show the absence of fibrinogen. These patients need to be treated with fibrinogen replacement therapy. Case presentation: This study reports the case of a newborn with congenital afibrinogenemia. The baby born from a first-degree consanguineous marriage was referred to our hospital due to bleeding and ecchymosis, and afibrinogenemia was diagnosed after coagulation tests were performed. Blood samples of the patient and his parents were sent to the Genetic Diseases Diagnosis Center for a genetic diagnosis of afibrinogenemia. A new homozygous mutation of FGB exon 7: c.1220c>t (p.t407 m) (p.thr407 met) was identified in the patient. The patients' parents were heterozygous for the same mutation. Prophylaxis was not recommended for our patient who was asymptomatic in the follow-up. DOI: 10.5937/sanamed0-40292 Case report Online First: October 28, 2022 ISSN-1452-662X 2 Conclusions: We present the case of a hemorrhagic neonatal patient diagnosed with congenital afibrinogenemia and emphasize that fibrinogen testing should be included in the evaluation of such patients. Furthermore, congenital fibrinogen disorders may be more severe when caused due to unknown specific mutation genes. Therefore, a more center-involved genetic analysis is required to identify undiagnosed fibrinogen and fibrinogen mutations.
简介:先天性纤维蛋白原血症是一种罕见的凝血障碍，其特征是纤维蛋白原分子缺乏。纤维蛋白原是由FGB、FGA和FGG编码的多肽链组成的六聚体糖蛋白，是正常止血所必需的。FGA、FGB和FGG的变化可能影响不同水平的纤维蛋白原。由于这些变化，血液中无法检测到纤维蛋白原。这些变化的临床表现从无症状到危及生命的出血或血栓栓塞事件。由于这是一种常染色体隐性遗传病，父母有亲属关系的儿童患此病的风险更高。因此，该病在近亲结婚率高的地区更为常见。诊断是通过实验室检查显示缺乏纤维蛋白原。这些患者需要接受纤维蛋白原替代疗法。病例介绍:本研究报告一例新生儿先天性纤维蛋白原血症。一级近亲婚姻所生婴儿因出血淤斑转诊至我院，经凝血检查诊断为纤原蛋白血症。将患者及其父母的血液样本送到遗传疾病诊断中心进行纤维蛋白原血症的遗传诊断。在患者中发现了一个新的FGB外显子7纯合突变:c.1220c>t (p.t407 m) (p.s r407 met)。患者的父母是杂合的，具有相同的突变。我们的患者在随访中无症状，不建议预防。结论:我们提出了一例诊断为先天性纤维蛋白原血症的出血性新生儿患者，并强调纤维蛋白原检测应包括在此类患者的评估中。此外，由于未知的特定突变基因引起的先天性纤维蛋白原疾病可能更为严重。因此，需要更多的中心基因分析来识别未诊断的纤维蛋白原和纤维蛋白原突变。
{"title":"Congenital afibrinogenemia in a newborn","authors":"Mustafa Özay, M. Kara, Z. Keskin","doi":"10.5937/sanamed0-40292","DOIUrl":"https://doi.org/10.5937/sanamed0-40292","url":null,"abstract":"Introduction: Congenital afibrinogenemia is a rare coagulation disorder characterized by a deficiency in the fibrinogen molecule. Fibrinogen is a hexameric glycoprotein consisting of a polypeptide chain encoded by FGB, FGA, and FGG and is required for normal hemostasis. Changes in FGA, FGB, and FGG may affect fibrinogen at different levels. As a result of these changes, fibrinogen cannot be detected in the blood. Clinical manifestations of such changes range from asymptomatic to life-threatening bleeding or thromboembolic events. Since it is an autosomal recessive disease, the risk is higher in children whose parents are related. Therefore, the disease is more common in regions where consanguineous marriage rates are high. Diagnosis is made by laboratory tests that show the absence of fibrinogen. These patients need to be treated with fibrinogen replacement therapy. Case presentation: This study reports the case of a newborn with congenital afibrinogenemia. The baby born from a first-degree consanguineous marriage was referred to our hospital due to bleeding and ecchymosis, and afibrinogenemia was diagnosed after coagulation tests were performed. Blood samples of the patient and his parents were sent to the Genetic Diseases Diagnosis Center for a genetic diagnosis of afibrinogenemia. A new homozygous mutation of FGB exon 7: c.1220c>t (p.t407 m) (p.thr407 met) was identified in the patient. The patients' parents were heterozygous for the same mutation. Prophylaxis was not recommended for our patient who was asymptomatic in the follow-up. DOI: 10.5937/sanamed0-40292 Case report Online First: October 28, 2022 ISSN-1452-662X 2 Conclusions: We present the case of a hemorrhagic neonatal patient diagnosed with congenital afibrinogenemia and emphasize that fibrinogen testing should be included in the evaluation of such patients. Furthermore, congenital fibrinogen disorders may be more severe when caused due to unknown specific mutation genes. Therefore, a more center-involved genetic analysis is required to identify undiagnosed fibrinogen and fibrinogen mutations.","PeriodicalId":53269,"journal":{"name":"Sanamed","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71046362","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: To present the functional status of a child with 16p13.11 microduplication syndrome by evaluating it under the International Classification of the World Health Organization's International Framework for Functioning, Disability and Health (ICF). Case Description: An 11-year-old girl with 16p13.11 microduplication syndrome was assessed using the tools classified according to ICF for Children and Youth (ICF-CY) categories to evaluate body function, activity participation, and environmental factors. There was a wide range of problems, from body functions to activity participation and environmental factors. Besides these problems, there were social and cognitive disorders as well. Conclusion: Physical and cognitive problems in body function and activity together constitute great barriers to participation in daily life.
目的:根据世界卫生组织《国际功能、残疾和健康框架》(ICF)的国际分类，对1例16p13.11微复制综合征儿童的功能状况进行评价。病例描述:使用ICF for Children and Youth (ICF- cy)分类的工具评估患有16p13.11微复制综合征的11岁女孩，评估身体功能，活动参与和环境因素。存在各种各样的问题，从身体功能到活动参与和环境因素。除了这些问题，还有社会和认知障碍。结论:身体功能和活动方面的生理和认知问题共同构成参与日常生活的巨大障碍。
{"title":"Evaluation of a girl with 16p13.11 microduplication syndrome according to the International Classification of Functioning, Disability and Health perspectives","authors":"Fidan Hande, M. Günel, Haliloğlu Göknur, Eda Gülen, Kiper Pelin, Özlem Şimşek","doi":"10.5937/sanamed0-40595","DOIUrl":"https://doi.org/10.5937/sanamed0-40595","url":null,"abstract":"Objective: To present the functional status of a child with 16p13.11 microduplication syndrome by evaluating it under the International Classification of the World Health Organization's International Framework for Functioning, Disability and Health (ICF). Case Description: An 11-year-old girl with 16p13.11 microduplication syndrome was assessed using the tools classified according to ICF for Children and Youth (ICF-CY) categories to evaluate body function, activity participation, and environmental factors. There was a wide range of problems, from body functions to activity participation and environmental factors. Besides these problems, there were social and cognitive disorders as well. Conclusion: Physical and cognitive problems in body function and activity together constitute great barriers to participation in daily life.","PeriodicalId":53269,"journal":{"name":"Sanamed","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71046433","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}
Sönmez Süleyman, Bozdağ Emre, Cingöz Mehmet, C. eda, S. Vugar
Background: Biliary stone disease is a frequently encountered problem among the population with a variety of causes and resulting in a wide range of symptoms from vague abdominal discomfort to life-threatening conditions requiring urgent surgical intervention. Magnetic resonance cholangiopancreatography (MRCP) has become a noninvasive radiological diagnostic method extensively used in the evaluation of the biliary tract providing excellent anatomical detail. Apart from the classical causes widely described in the literature in stone etiology, the effect of anatomical variations of the bile tract is a subject that has been investigated recently. The present study aimed to manifest the effect of anatomical variations of the extrahepatic biliary tract on the etiology of choledocholithiasis. Methods: The data of 182 patients who underwent MRCP in our hospital between 2016 and 2021 were retrospectively scanned. The patients were divided into two groups, asymptomatic patients and acute cholangitis. Cystic duct, common hepatic duct, choledochal lengths, and variations in cystic duct opening were analyzed by an experienced radiologist in MRCP. Results: The relation was detected between the cystic choledochal variance of the patients (p<0.001). The cystic duct length of the patients showed statistically significant differences (p<0.05). Conclusion: When the extrahepatic bile duct variations were evaluated, some notable values were found for the etiology, as well as being critical in acute cholangitis. There is a need for studies with larger sample sizes in the literature on this subject.
{"title":"The effect and importance of extrahepatic bile duct anatomy variations in the etiology of choledocholithiasis","authors":"Sönmez Süleyman, Bozdağ Emre, Cingöz Mehmet, C. eda, S. Vugar","doi":"10.5937/sanamed0-40131","DOIUrl":"https://doi.org/10.5937/sanamed0-40131","url":null,"abstract":"Background: Biliary stone disease is a frequently encountered problem among the population with a variety of causes and resulting in a wide range of symptoms from vague abdominal discomfort to life-threatening conditions requiring urgent surgical intervention. Magnetic resonance cholangiopancreatography (MRCP) has become a noninvasive radiological diagnostic method extensively used in the evaluation of the biliary tract providing excellent anatomical detail. Apart from the classical causes widely described in the literature in stone etiology, the effect of anatomical variations of the bile tract is a subject that has been investigated recently. The present study aimed to manifest the effect of anatomical variations of the extrahepatic biliary tract on the etiology of choledocholithiasis. Methods: The data of 182 patients who underwent MRCP in our hospital between 2016 and 2021 were retrospectively scanned. The patients were divided into two groups, asymptomatic patients and acute cholangitis. Cystic duct, common hepatic duct, choledochal lengths, and variations in cystic duct opening were analyzed by an experienced radiologist in MRCP. Results: The relation was detected between the cystic choledochal variance of the patients (p<0.001). The cystic duct length of the patients showed statistically significant differences (p<0.05). Conclusion: When the extrahepatic bile duct variations were evaluated, some notable values were found for the etiology, as well as being critical in acute cholangitis. There is a need for studies with larger sample sizes in the literature on this subject.","PeriodicalId":53269,"journal":{"name":"Sanamed","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71045550","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}
Tolevska Djoleva, N. Matveeva, D. Georgieva, Stojanoska Bojadzieva
Introduction: The management of developmental dysplasia of the hips (DDH) type Graf IIa is still controversial. This study aims to examine the outcomes of ultrasound-monitored Pavlik harness treatment, as well as the effects of associated factors, such as gender, side of DDH, the age at the treatment start, and laterality on the treatment outcomes in different Graf type II subtypes. Methods: A cohort retrospective investigation was performed on 88 ultrasound-screened infants or 125 hips diagnosed with Graf type II dysplasia during a six-month period at a single institution, the University Clinic for Orthopedic Surgery, Skopje. Subsequently, 47 infants (18 boys, 29 girls) or 73 hips who underwent Pavlik harness treatment with at least one follow-up throughout treatment monitoring were included in this study. Results: The treatment success rate of the right DDH Graf type IIa (-) was higher (70.8%) compared to the rate of success (50%) in the treatment of left Graf type IIa (-) hips. The mean age of the infants at the treatment start in successfully treated Graf type IIa (-) hips was lower (9.12 ±2.27 weeks) compared to the age of the infants with treatment failure at the last follow-up (11.33 ±3.06 weeks), P= 0.04.
{"title":"Outcomes of ultrasound-monitored treatment of divelopmental dysplasia of the hip Graf type II","authors":"Tolevska Djoleva, N. Matveeva, D. Georgieva, Stojanoska Bojadzieva","doi":"10.5937/sanamed0-40197","DOIUrl":"https://doi.org/10.5937/sanamed0-40197","url":null,"abstract":"Introduction: The management of developmental dysplasia of the hips (DDH) type Graf IIa is still controversial. This study aims to examine the outcomes of ultrasound-monitored Pavlik harness treatment, as well as the effects of associated factors, such as gender, side of DDH, the age at the treatment start, and laterality on the treatment outcomes in different Graf type II subtypes. Methods: A cohort retrospective investigation was performed on 88 ultrasound-screened infants or 125 hips diagnosed with Graf type II dysplasia during a six-month period at a single institution, the University Clinic for Orthopedic Surgery, Skopje. Subsequently, 47 infants (18 boys, 29 girls) or 73 hips who underwent Pavlik harness treatment with at least one follow-up throughout treatment monitoring were included in this study. Results: The treatment success rate of the right DDH Graf type IIa (-) was higher (70.8%) compared to the rate of success (50%) in the treatment of left Graf type IIa (-) hips. The mean age of the infants at the treatment start in successfully treated Graf type IIa (-) hips was lower (9.12 ±2.27 weeks) compared to the age of the infants with treatment failure at the last follow-up (11.33 ±3.06 weeks), P= 0.04.","PeriodicalId":53269,"journal":{"name":"Sanamed","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71046411","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}
Pub Date : 2021-09-16DOI: 10.24125/sanamed.v16i2.522
Sanamed Sanamed
{"title":"RETRACTED ARTICLE: COMPARATIVE STUDY ON THE EVALUATION OF TEMPOROMANDIBULAR JOINT AND NECK STRUCTURES IN HEALTHY VOLUNTEERS AND IDIOPATHIC SCOLIOSIS PATIENTS","authors":"Sanamed Sanamed","doi":"10.24125/sanamed.v16i2.522","DOIUrl":"https://doi.org/10.24125/sanamed.v16i2.522","url":null,"abstract":"","PeriodicalId":53269,"journal":{"name":"Sanamed","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47199539","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}
Pub Date : 2021-09-08DOI: 10.24125/sanamed.v16i2.506
Neslihan Ergun Suzer, O. Sirkeci, E. E. Sirkeci
Aim: During rapid sequence intubation (RSI), the O 2 reserve limits the intubation duration. The study objective was to examine the impact of RSI on arterial blood gases (ABG) during the preoxygenation phase. Methods: This open, prospective clinical study examined samples of patients who had endotracheal intubation (ETI) as RSI between March 2014 and September 2014 in our emergency department. The variations in ABG PaO 2 and PaCO 2 before and after preoxygenation and after intubation were examined and compared with demographic and clinical variables. Results : The study included 67 patients (46 male, 21 female) with a mean age of 69.9 years. SBP, DBP, and MABP decreased, while pulse rate and SpO 2 increased. No difference was observed between PaO 2 values and demographic and clinical variables; however, a statistically significant relationship was found between the difference (Δ) between PaO 2 values measured after endotracheal tracheal intubation (ETI) and after preoxygenation and the ABG SpO 2 and the SpO 2 classification before preoxygenation. Conclusion: The relationship between SpO 2 and its classification following ETI and increased ABG SpO 2 was statistically significant. Our real-life study emphasises that deciding on intubation without desaturating patients could have positive effects on intubation success. Regardless, increasing SpO 2 prior to ETI will contribute positively to the O 2 reserve by the end of ETI. The ΔPaO 2 , before and after preoxygenation, was not affected by age; gender; body mass index (BMI) and its classification; GCSS; vital signs and ABG findings gathered before preoxygenation; respiration rate (RR) during preoxygenation; preoxygenation duration; oral air passage usage or air leakage.
{"title":"THE IMPACT OF A RAPID SEQUENCE INTUBATION ON ARTERIAL BLOOD GASES DURING THE PREOXYGENATION PHASE PERFORMED IN A HOSPITAL EMERGENCY DEPARTMENT","authors":"Neslihan Ergun Suzer, O. Sirkeci, E. E. Sirkeci","doi":"10.24125/sanamed.v16i2.506","DOIUrl":"https://doi.org/10.24125/sanamed.v16i2.506","url":null,"abstract":"Aim: During rapid sequence intubation (RSI), the O 2 reserve limits the intubation duration. The study objective was to examine the impact of RSI on arterial blood gases (ABG) during the preoxygenation phase. Methods: This open, prospective clinical study examined samples of patients who had endotracheal intubation (ETI) as RSI between March 2014 and September 2014 in our emergency department. The variations in ABG PaO 2 and PaCO 2 before and after preoxygenation and after intubation were examined and compared with demographic and clinical variables. Results : The study included 67 patients (46 male, 21 female) with a mean age of 69.9 years. SBP, DBP, and MABP decreased, while pulse rate and SpO 2 increased. No difference was observed between PaO 2 values and demographic and clinical variables; however, a statistically significant relationship was found between the difference (Δ) between PaO 2 values measured after endotracheal tracheal intubation (ETI) and after preoxygenation and the ABG SpO 2 and the SpO 2 classification before preoxygenation. Conclusion: The relationship between SpO 2 and its classification following ETI and increased ABG SpO 2 was statistically significant. Our real-life study emphasises that deciding on intubation without desaturating patients could have positive effects on intubation success. Regardless, increasing SpO 2 prior to ETI will contribute positively to the O 2 reserve by the end of ETI. The ΔPaO 2 , before and after preoxygenation, was not affected by age; gender; body mass index (BMI) and its classification; GCSS; vital signs and ABG findings gathered before preoxygenation; respiration rate (RR) during preoxygenation; preoxygenation duration; oral air passage usage or air leakage.","PeriodicalId":53269,"journal":{"name":"Sanamed","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48177991","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}
Pub Date : 2021-09-08DOI: 10.24125/sanamed.v16i2.515
I. Sengul, D. Sengul
{"title":"DELICATE NEEDLE WITH THE FINEST GAUGE FOR A BUTTERFLY GLAND, THE THYROID:IS IT WORTH MENTIONING?","authors":"I. Sengul, D. Sengul","doi":"10.24125/sanamed.v16i2.515","DOIUrl":"https://doi.org/10.24125/sanamed.v16i2.515","url":null,"abstract":"","PeriodicalId":53269,"journal":{"name":"Sanamed","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45764779","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}
Pub Date : 2021-09-08DOI: 10.24125/sanamed.v16i2.509
G. Okut, M. Karahan
Objective: Appendiceal neoplasms are usually diagnosed incidentally after appendectomy for the treatment of acute appendicitis. This study aimed to present incidental malignancy cases that we detected retrospectively by examining our appendectomy results. Materials and Methods: 6748 appendectomy cases performed in Van Research and Training Hospital, Department of Surgery, Turkey, between January 2016 and January 2020, were retrospectively analyzed. After histopathological analysis, 22 patients were found to have low-grade appendiceal mucinous neoplasia (LAMN) and appendiceal neuroendocrine tumors (NET). The complete data of the patients were recorded, including the demographic, laboratory, imaging, and histopathological data. Results: The median age of 22 patients included in the study was 39 years (18-72 years), and 14 (63.6%) were women. Malignancy was suspected in only 4 (18%) patients during exploration. Histologically, the tumor was located distally in 19 (83.4%) patients and was located at the base of the appendix in 3 patients. Histopathological analysis; resulted as grade 1 NET in 15 patients, LAMN in 5 patients, grade 2 NET in 1 patient, and mixed type (mucinous + neuroendocrine tumor) in 1 patient. The Median follow-up time was 45.5 months (range: 26-53). During the follow-up, one of our patients who underwent right hemicolectomy due to the tumor at the surgical margin was diagnosed with pseudomyxoma peritonei. Conclusion: Appendiceal neoplasms are often diagnosed in the results of postoperative pathological examinations. In patients with suspected malignancy during the perioperative examination, it is crucial to carefully examine intra-abdominal organs and avoid surgical margin positivity. Malignancy risks should always be kept in mind in non-routine appendix appearances.
{"title":"MALIGNANT TUMORS OF THE APPENDIX:EVALUATION OF 6748 APPENDECTOMY CASES","authors":"G. Okut, M. Karahan","doi":"10.24125/sanamed.v16i2.509","DOIUrl":"https://doi.org/10.24125/sanamed.v16i2.509","url":null,"abstract":"Objective: Appendiceal neoplasms are usually diagnosed incidentally after appendectomy for the treatment of acute appendicitis. This study aimed to present incidental malignancy cases that we detected retrospectively by examining our appendectomy results. Materials and Methods: 6748 appendectomy cases performed in Van Research and Training Hospital, Department of Surgery, Turkey, between January 2016 and January 2020, were retrospectively analyzed. After histopathological analysis, 22 patients were found to have low-grade appendiceal mucinous neoplasia (LAMN) and appendiceal neuroendocrine tumors (NET). The complete data of the patients were recorded, including the demographic, laboratory, imaging, and histopathological data. Results: The median age of 22 patients included in the study was 39 years (18-72 years), and 14 (63.6%) were women. Malignancy was suspected in only 4 (18%) patients during exploration. Histologically, the tumor was located distally in 19 (83.4%) patients and was located at the base of the appendix in 3 patients. Histopathological analysis; resulted as grade 1 NET in 15 patients, LAMN in 5 patients, grade 2 NET in 1 patient, and mixed type (mucinous + neuroendocrine tumor) in 1 patient. The Median follow-up time was 45.5 months (range: 26-53). During the follow-up, one of our patients who underwent right hemicolectomy due to the tumor at the surgical margin was diagnosed with pseudomyxoma peritonei. Conclusion: Appendiceal neoplasms are often diagnosed in the results of postoperative pathological examinations. In patients with suspected malignancy during the perioperative examination, it is crucial to carefully examine intra-abdominal organs and avoid surgical margin positivity. Malignancy risks should always be kept in mind in non-routine appendix appearances.","PeriodicalId":53269,"journal":{"name":"Sanamed","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47709979","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}
Pub Date : 2021-09-08DOI: 10.24125/sanamed.v16i2.517
Ensar Durmuş, Fatih Guneysu, Necip Gokhan Guner, Nuray Aslan, Y. Yürümez
Introduction: This study aims to understand the burden of invoice costs of outpatients with mild Covid-19 symptoms on Social Security Institution (SSI); also, how it may have influenced the current economic situation. Material and Method: This research is a cross-sectional, retrospective, and descriptive study. The study universe includes the cases who applied to the emergency room (ER) with the symptoms of Covid-19. The sample group was the patients who applied to the Sakarya Training and Research Hospital (SEAH) pandemic ER between 01/09/2020 and 30/06/2021. Results: During the study period, 130,975 patients were admitted to the pandemic ER. The mean emergency service bill of the cases was $10.6 (± 9), and the lowest was $2.2; the highest was $201.7. There was a weak but significant positive correlation between the patients' age and invoice amount (spearman= 0.051, p=0.001). It was perceived that the emergency service bills of the inpatients (mean=21.9 $) were more than twice that of the outpatients (mean=10.3 $). Conclusion: In pandemic ER, mild symptomatic young patients' bills can be cheap. It was observed that emergency physicians did not apply too many tests and imaging methods in this patient group and were content only with Rt-PCR scanning. Also, ER bills can increase with age.
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