Purpose: The aim of this study was to evaluate how surgical and medical treatments affect the quality of life, depression status and social participation of women with Stress Urinary Incontinence (SUI). Materials and Methods: The study included 32 women with diagnoses of SUI. Among these women, 16 were designated as the medical treatment group (MTG), and the other 16 were designated as the surgical treatment group (STG). Before the treatment and 8 weeks after its completion, the patients were evaluated with the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF), Incontinence Quality of Life Questionnaire (I-QOL), World Health Organization Quality of Life Instrument, Short Form (WHOQOL-BREF), Beck Depression Inventory (BDI) and Social Participation Questionnaire (SPQ). Results: The mean age of the subjects was 54.31±11.48 years in MTG and 48.38±10.01 years in STG. The mean body mass index (BMI) values of the groups were respectively 27.56±2.79 and 26.56±2.25 kg/m2. Following the treatment, statistically significant improvements were observed in urinary incontinence, depression, social participation and overall and disease-specific quality of life in both groups (p<0.05). Comparative analysis of the post-treatment changes in both groups showed statistically significant differences in the BDI score, the total work activity and household activity scores in the Social Participation Questionnaire and the psychosocial subgroups of both WHOQOL-BREF and I-QOL (p<0.05). Conclusion: Both treatments proved to be effective and usable to reduce the severity of SUI and depression, prevent social isolation and improve the quality of life. However, extensive research is required on the effects of SUI treatment methods on larger patient groups.
{"title":"Effects Of Surgical And Medical Treatments On Stress Urinary Incontinence","authors":"Burçin UGUR TOSUN","doi":"10.25000/acem.1184054","DOIUrl":"https://doi.org/10.25000/acem.1184054","url":null,"abstract":"Purpose: The aim of this study was to evaluate how surgical and medical treatments affect the quality of life, depression status and social participation of women with Stress Urinary Incontinence (SUI).\u0000\u0000Materials and Methods: The study included 32 women with diagnoses of SUI. Among these women, 16 were designated as the medical treatment group (MTG), and the other 16 were designated as the surgical treatment group (STG). Before the treatment and 8 weeks after its completion, the patients were evaluated with the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF), Incontinence Quality of Life Questionnaire (I-QOL), World Health Organization Quality of Life Instrument, Short Form (WHOQOL-BREF), Beck Depression Inventory (BDI) and Social Participation Questionnaire (SPQ). \u0000\u0000Results: The mean age of the subjects was 54.31±11.48 years in MTG and 48.38±10.01 years in STG. The mean body mass index (BMI) values of the groups were respectively 27.56±2.79 and 26.56±2.25 kg/m2. Following the treatment, statistically significant improvements were observed in urinary incontinence, depression, social participation and overall and disease-specific quality of life in both groups (p<0.05). Comparative analysis of the post-treatment changes in both groups showed statistically significant differences in the BDI score, the total work activity and household activity scores in the Social Participation Questionnaire and the psychosocial subgroups of both WHOQOL-BREF and I-QOL (p<0.05).\u0000\u0000Conclusion: Both treatments proved to be effective and usable to reduce the severity of SUI and depression, prevent social isolation and improve the quality of life. However, extensive research is required on the effects of SUI treatment methods on larger patient groups.","PeriodicalId":8220,"journal":{"name":"ARCHIVES OF CLINICAL AND EXPERIMENTAL MEDICINE","volume":"8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84193718","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}
M. Gün, F. Çakmak, I. Ikizceli, S. Özkan, A. Ipekci, S. Biberoğlu, Y. Akdeniz
Aim: Especially in recent years, with the increase in the number of patients admitted to the emergency services the number of urological emergencies is increasing. Some of these require immediate attention. There are not enough studies on urological emergencies in our country. In this study, we aimed to investigate the demographic data of patients over the age of 18 who presented to the emergency department with non-traumatic urological emergency complaints. Materials and Methods: This study was designed based on a 6-month prospective, cross-sectional study. After obtaining the approval of the ethics committee, patients over the age of 18 with urological emergency complaints were examined between 06.11.2019 and 06.05.2020. Results: The ratio of urological emergencies to all patients was found to be 1.5%. 56.76% (n: 231) of the patients were male and 43.24% (n = 176) were female. In the study was found 44.7% of the patients to be urinary tract infection, 31.45% renal colic, 8.8% hematuria, 6.88% acute urinary retention. In our study, urology consultation was requested for 19% of urological emergency patients. Emergency intervention was applied to 21.13% of all urological emergency cases. Emergency operation was required for 1.47% of the patients. 10.81% of the patients required hospitalization. Conclusion: As a result, urological emergencies are common. Among these cases, there may be diseases that require urgent intervention or surgery. It is very important for the patients the emergency physicians who evaluate the patient first to make a careful and meticulous evaluation and to make a urology consultation if necessary.
{"title":"Evaluation Of Urological Emergency Cases Admitted To Emergency Department","authors":"M. Gün, F. Çakmak, I. Ikizceli, S. Özkan, A. Ipekci, S. Biberoğlu, Y. Akdeniz","doi":"10.25000/acem.1219948","DOIUrl":"https://doi.org/10.25000/acem.1219948","url":null,"abstract":"Aim: Especially in recent years, with the increase in the number of patients admitted to the emergency services the number of urological emergencies is increasing. Some of these require immediate attention. There are not enough studies on urological emergencies in our country. In this study, we aimed to investigate the demographic data of patients over the age of 18 who presented to the emergency department with non-traumatic urological emergency complaints.\u0000Materials and Methods: This study was designed based on a 6-month prospective, cross-sectional study. After obtaining the approval of the ethics committee, patients over the age of 18 with urological emergency complaints were examined between 06.11.2019 and 06.05.2020.\u0000Results: The ratio of urological emergencies to all patients was found to be 1.5%. 56.76% (n: 231) of the patients were male and 43.24% (n = 176) were female. In the study was found 44.7% of the patients to be urinary tract infection, 31.45% renal colic, 8.8% hematuria, 6.88% acute urinary retention. In our study, urology consultation was requested for 19% of urological emergency patients. Emergency intervention was applied to 21.13% of all urological emergency cases. Emergency operation was required for 1.47% of the patients. 10.81% of the patients required hospitalization.\u0000Conclusion: As a result, urological emergencies are common. Among these cases, there may be diseases that require urgent intervention or surgery. It is very important for the patients the emergency physicians who evaluate the patient first to make a careful and meticulous evaluation and to make a urology consultation if necessary.","PeriodicalId":8220,"journal":{"name":"ARCHIVES OF CLINICAL AND EXPERIMENTAL MEDICINE","volume":"83 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79356221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Aim: To compare the effects of endoscopic intragastric balloon (IGB) placement and intragastric botulinum toxin-A (BTX-A) injection in terms of weight loss among patients with non-morbid obesity. Methods: This retrospective single center study was conducted between 01.08.2020 and 01.01.2022. A total of 39 patients with a body mass index (BMI) of <40 without comorbidities were included in the study. Nineteen underwent intragastric BTX-A injection and 20 underwent IGB placement. Patients were evaluated 1 month and 6 months after the procedures. Results: Mean age was 39.4 ± 8.6 in the BTX-A group and 37.3 ± 10.4 in the IGB group (p = 0.496). 78.9% of the BTX-A group and 75.0% of the IGB group were female (p = 1.000). In both groups, the median weight 1 month after the procedure was significantly lower than before the procedure, and the median weight 6 months after the procedure was significantly lower than 1 month after the procedure (p<0.001 for both groups). The median weight loss in the IGB group at both the 1st and 6th months was significantly greater than the corresponding values of the BTX-A group (p < 0.001 for both). Conclusion: IGB insertion appears to be a more successful endoscopic bariatric procedure than intragastric BTX-A injection, as measured by weight loss at post-intervention 1 month and 6 months. IGB may be preferred in patients with a BMI below 40 without obesity-related comorbidity.
{"title":"Comparison of The Short-Term Effects of Intragastric Balloon and Botulinum Toxin Injection On Weight Loss","authors":"M. Al","doi":"10.25000/acem.1168617","DOIUrl":"https://doi.org/10.25000/acem.1168617","url":null,"abstract":"Aim: To compare the effects of endoscopic intragastric balloon (IGB) placement and intragastric botulinum toxin-A (BTX-A) injection in terms of weight loss among patients with non-morbid obesity.\u0000Methods: This retrospective single center study was conducted between 01.08.2020 and 01.01.2022. A total of 39 patients with a body mass index (BMI) of <40 without comorbidities were included in the study. Nineteen underwent intragastric BTX-A injection and 20 underwent IGB placement. Patients were evaluated 1 month and 6 months after the procedures.\u0000Results: Mean age was 39.4 ± 8.6 in the BTX-A group and 37.3 ± 10.4 in the IGB group (p = 0.496). 78.9% of the BTX-A group and 75.0% of the IGB group were female (p = 1.000). In both groups, the median weight 1 month after the procedure was significantly lower than before the procedure, and the median weight 6 months after the procedure was significantly lower than 1 month after the procedure (p<0.001 for both groups). The median weight loss in the IGB group at both the 1st and 6th months was significantly greater than the corresponding values of the BTX-A group (p < 0.001 for both). \u0000Conclusion: IGB insertion appears to be a more successful endoscopic bariatric procedure than intragastric BTX-A injection, as measured by weight loss at post-intervention 1 month and 6 months. IGB may be preferred in patients with a BMI below 40 without obesity-related comorbidity.","PeriodicalId":8220,"journal":{"name":"ARCHIVES OF CLINICAL AND EXPERIMENTAL MEDICINE","volume":"18 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75240057","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}
The most important mortality and morbidity causes in diabetic patients are coronary, peripheral and cerebral diseases. The aim of our study was to noninvasively determine dysfunction in epicardial coronary arteries and microvascular circulation with measurement of coronary flow reserve using transthoracic echocardiography in patients with type 2 diabetes despite absence of ischemic symptoms, and to demonstrate the amelioration in endothelial functions, glycemic control and insulin resistance along with increase in coronary flow reserve after 8 weeks of regular exercise. 40 patients diagnosed with type 2 diabetes in Istanbul Facuty of Medicine, Department of Diabetes, who were on follow-up for at least three years due to diabetes, without ischemic symptoms and 20 healthy subjects took part in study. Basal values before exercise of diabetic patients who were included in the exercise program were compared with basal values of diabetic patients who did not exercise regularly. To summarize, regular exercise and physical activity are highly important in diabetic patients for primary and secondary protection against cardiovascular incidents. Physical activity increases insulin sensitivity in diabetic patients, and has many positive effects on glucose metabolism. It is the important way to decrease obesity and visceral fat tissue. There is evidence pointing out that regular exercise can defer or even prevent initiation of diabetes.
{"title":"Effects of Exercise On Coronary Flow Reserve And Biochemical Parameters in Patients With Type 2 Diabetes Mellitus","authors":"Göksel Güz, H. Oflaz","doi":"10.25000/acem.1145353","DOIUrl":"https://doi.org/10.25000/acem.1145353","url":null,"abstract":"The most important mortality and morbidity causes in diabetic patients are coronary, peripheral and cerebral diseases. The aim of our study was to noninvasively determine dysfunction in epicardial coronary arteries and microvascular circulation with measurement of coronary flow reserve using transthoracic echocardiography in patients with type 2 diabetes despite absence of ischemic symptoms, and to demonstrate the amelioration in endothelial functions, glycemic control and insulin resistance along with increase in coronary flow reserve after 8 weeks of regular exercise. 40 patients diagnosed with type 2 diabetes in Istanbul Facuty of Medicine, Department of Diabetes, who were on follow-up for at least three years due to diabetes, without ischemic symptoms and 20 healthy subjects took part in study. Basal values before exercise of diabetic patients who were included in the exercise program were compared with basal values of diabetic patients who did not exercise regularly. To summarize, regular exercise and physical activity are highly important in diabetic patients for primary and secondary protection against cardiovascular incidents. Physical activity increases insulin sensitivity in diabetic patients, and has many positive effects on glucose metabolism. It is the important way to decrease obesity and visceral fat tissue. There is evidence pointing out that regular exercise can defer or even prevent initiation of diabetes.","PeriodicalId":8220,"journal":{"name":"ARCHIVES OF CLINICAL AND EXPERIMENTAL MEDICINE","volume":"299 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89030674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Aim Anemia is a major public health problem, affecting about one-third of the world's population, and is most commonly caused by iron deficiency. Iron deficiency anemia requires oral or intravenous iron replacement therapy. The purpose of this study was to assess the change in several hematological parameters, vitamin B12, and folic acid from baseline to the first month of follow-up following therapy with oral ferrous glycine sulfate or intravenous ferric carboxymaltose. Methods: All patients who received oral ferrous glycine sulfate or intravenous ferric carboxymaltose for the treatment of iron deficiency anemia between January 1, 2016, and December 31, 2018, were included in the trial. Along with age and gender information, values of hemoglobin, ferritin, transferrin saturation, mean corpuscular volume, vitamin B12, and folic acid were derived from patients’ records at the beginning of treatment and first month follow-up. Results: Laboratory values obtained after treatment showed statistically significant improvement in both groups (intra group, p<0.001). When the percentage of change between groups was compared: Percentage-based increases in hemoglobin, mean corpuscular volume, transferrin saturation and ferritin values were significantly higher in the ferric carboxymaltose group (p<0.001). The percentage decrease in vitamin B12 and folic acid values was higher in the ferric carboxymaltose group (p=0.005 and p=0.01, respectively) when compared with oral ferrous glycine sulfate group. Conclusions: According to the findings of our study, iron deficiency anemia can be treated very successfully using ferric carboxymaltose; however, it should be remembered that concurrent supplementation of elements such vitamin B12 and folic acid is necessary for the appropriate progression of erythropoiesis.
{"title":"Ferric Carboxymaltose Versus Ferrous Glycine Sulfate For Treatment of Iron Deficiency Anemia and Their Effect On Vitamin B12 And Folic Acid: A Retrospective Study","authors":"Mustafa Genco Erdem","doi":"10.25000/acem.1203980","DOIUrl":"https://doi.org/10.25000/acem.1203980","url":null,"abstract":"Aim Anemia is a major public health problem, affecting about one-third of the world's population, and is most commonly caused by iron deficiency. Iron deficiency anemia requires oral or intravenous iron replacement therapy. The purpose of this study was to assess the change in several hematological parameters, vitamin B12, and folic acid from baseline to the first month of follow-up following therapy with oral ferrous glycine sulfate or intravenous ferric carboxymaltose.\u0000Methods: All patients who received oral ferrous glycine sulfate or intravenous ferric carboxymaltose for the treatment of iron deficiency anemia between January 1, 2016, and December 31, 2018, were included in the trial. Along with age and gender information, values of hemoglobin, ferritin, transferrin saturation, mean corpuscular volume, vitamin B12, and folic acid were derived from patients’ records at the beginning of treatment and first month follow-up.\u0000Results: Laboratory values obtained after treatment showed statistically significant improvement in both groups (intra group, p<0.001). When the percentage of change between groups was compared: Percentage-based increases in hemoglobin, mean corpuscular volume, transferrin saturation and ferritin values were significantly higher in the ferric carboxymaltose group (p<0.001). The percentage decrease in vitamin B12 and folic acid values was higher in the ferric carboxymaltose group (p=0.005 and p=0.01, respectively) when compared with oral ferrous glycine sulfate group.\u0000Conclusions: According to the findings of our study, iron deficiency anemia can be treated very successfully using ferric carboxymaltose; however, it should be remembered that concurrent supplementation of elements such vitamin B12 and folic acid is necessary for the appropriate progression of erythropoiesis.","PeriodicalId":8220,"journal":{"name":"ARCHIVES OF CLINICAL AND EXPERIMENTAL MEDICINE","volume":"33 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74004116","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}
Andrej Ni̇kolovski̇, Kristijan Dervi̇shov, Cem Ulusoy
Amaç: Kolorektal kanserlerde yeterli onkolojik cerrahiyi yapabilmek için, rezeke edilen spesmenin yeterli cerrahi sağlam marjinle çıkarılması ve komplet mezokolik eksizyon yapılması gerekiyor ki posteperatif doğru patolojik evreleme yapılabilsin. Günümüzde en az 12 lenf nodu çıakrılması önerilmektedir. Acil kolorektal cerrahide çıkarılan lenf nodu sayıları üzerine sorular yükselmektedir. Bu çalışmanın amacı, acil kolorektal kanser cerrahisinin lenf nodu sayısı alımı üzerindeki etkisini belirlemektir. Metod: 1 yıllık periyodda kolorektal kanser tanısıyla ameliyat edilmiş olan 102 hasta retrospektif olarak incelendi. İki grup (acil ve elektif) oluşturuldu. Ameliyatlar altı cerrah (üçü yüksek volüm, üçü düşük volüm) tarafından gerçekleştirildi. Bulgular: 20 hasta acil olarak ameliyat edilmişti ve 66 hasta elektif ameliyat edilmişti. Evre IV 16 hasta çalışma dışında tutuldu. Acil ameliyat edilen grupta çıkarılan ortalama lenf nodu sayısı 11.1 [5-20] ve elektif grupta 14.7 [4-34] dir (p = 0.004). Acil ameliyat edilen grupta 7 hastada, elektif ameliyat edilen grupta 48 hastada yeterli sayıda lenf nodu (≥12) çıkarılmıştır. (p = 0.003) Sonuç:Acil kolon cerrahisinin çıkarılan lenf nodu sayısı üzerine etkisi vardır. Yeterli kolorektal cerrahi eğitimi cerrahi tekniği geliştirerek güvenilir TNM sınıflaması sonuçlarını etki edecektir.
{"title":"Kolorektal kanser cerrahisinde acil cerrahinin çıkarılan lenf nodu sayısına etkisi var mı?","authors":"Andrej Ni̇kolovski̇, Kristijan Dervi̇shov, Cem Ulusoy","doi":"10.25000/acem.1071023","DOIUrl":"https://doi.org/10.25000/acem.1071023","url":null,"abstract":"Amaç: Kolorektal kanserlerde yeterli onkolojik cerrahiyi yapabilmek için, rezeke edilen spesmenin yeterli cerrahi sağlam marjinle çıkarılması ve komplet mezokolik eksizyon yapılması gerekiyor ki posteperatif doğru patolojik evreleme yapılabilsin. Günümüzde en az 12 lenf nodu çıakrılması önerilmektedir. Acil kolorektal cerrahide çıkarılan lenf nodu sayıları üzerine sorular yükselmektedir. Bu çalışmanın amacı, acil kolorektal kanser cerrahisinin lenf nodu sayısı alımı üzerindeki etkisini belirlemektir. \u0000Metod: 1 yıllık periyodda kolorektal kanser tanısıyla ameliyat edilmiş olan 102 hasta retrospektif olarak incelendi. İki grup (acil ve elektif) oluşturuldu. Ameliyatlar altı cerrah (üçü yüksek volüm, üçü düşük volüm) tarafından gerçekleştirildi. \u0000Bulgular: 20 hasta acil olarak ameliyat edilmişti ve 66 hasta elektif ameliyat edilmişti. Evre IV 16 hasta çalışma dışında tutuldu. Acil ameliyat edilen grupta çıkarılan ortalama lenf nodu sayısı 11.1 [5-20] ve elektif grupta 14.7 [4-34] dir (p = 0.004). Acil ameliyat edilen grupta 7 hastada, elektif ameliyat edilen grupta 48 hastada yeterli sayıda lenf nodu (≥12) çıkarılmıştır. (p = 0.003) \u0000Sonuç:Acil kolon cerrahisinin çıkarılan lenf nodu sayısı üzerine etkisi vardır. Yeterli kolorektal cerrahi eğitimi cerrahi tekniği geliştirerek güvenilir TNM sınıflaması sonuçlarını etki edecektir.","PeriodicalId":8220,"journal":{"name":"ARCHIVES OF CLINICAL AND EXPERIMENTAL MEDICINE","volume":"2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91016096","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}
Amaç: Koledok taşlarının altın standart güncel tedavi yöntemi endoskopik retrograd kolanjiopankreatografi (ERCP) ile taş çıkarılmasıdır. Bunun başarısız olduğu durumlarda alternatif cerrahi tedavi yöntemleri ön plana çıkmaktadır. Geleneksel bir yöntem olan koledokoduodenostomi (CDD) de bunlardan biridir. Biz de ERCP'nin başarısız olduğu hastalardaki konvansiyonel CDD sonuçlarımızı sunmayı amaçladık. Yöntemler: Mart 2015 ve Şubat 2022 tarihleri arasında ERCP ile tedavi edilemeyen koledok taşı olan ve konvansiyonel koledok eksplorasyonu, taş çıkarılması ve CDD uygulanan 23 hastanın klinikodemografik verileri, perioperatif bulguları ve postoperatif sonuçları retrospektif olarak analiz edildi. Bulgular: Hastaların median yaşı 71 (41-85) olup, 13’ü (%56) kadındı. Hastaların 5’inde (21%) geçirilmiş kolesistektomi, 7’sinde (30%) gastrektomi + gastroenterostomi ameliyatı öyküsü vardı. En sık başvuru semptomu karın ağrısıydı (39 %). Başarısız ERCP sayısı median 1 (1-6) olup, başarısızlık nedenleri 7 hastada gastroenterostomi olması, 9 hastada impakte taş olması, 6 hastada taş boyutu ve sayısının fazla olması, 1 hastada da papilla açılım anomalisiydi. Hastaların median koledok çapı 15 (10-40) mm'di. Operasyon süresi median 120 (60-240) dk olup, perioperatif komplikasyon gelişmedi. Yatış süresi median 7 (4-14) gündü. Postoperatif erken dönemde 2 (8%) hastada yara yeri enfeksiyonu, 1 (4%) hastada da eviserasyon görüldü. Mortalite izlenmedi. Hastaların ortalama takip süresi median 27 (2-77) aydı ve geç dönemde 2 (8%) hastada insizyonel herni ile karşılaşıldı. Sump sendromuna ait bulgular hiçbir hastamızda gözlenmedi. Sonuç: ERCP ile çıkarılamayan koledok taşlarının tedavisinde CDD seçilmiş hastalarda efektif ve güvenli bir cerrahi tedavi yöntemidir.
{"title":"Endoskopik olarak tedavi edilemeyen koledok taşlarında koledokoduodenostomi. Hem geleneksel hem de güncel yöntem","authors":"Mehmet Can Aydin, Oğuzhan Özşay, Kağan Karabulut","doi":"10.25000/acem.1101714","DOIUrl":"https://doi.org/10.25000/acem.1101714","url":null,"abstract":"Amaç: Koledok taşlarının altın standart güncel tedavi yöntemi endoskopik retrograd kolanjiopankreatografi (ERCP) ile taş çıkarılmasıdır. Bunun başarısız olduğu durumlarda alternatif cerrahi tedavi yöntemleri ön plana çıkmaktadır. Geleneksel bir yöntem olan koledokoduodenostomi (CDD) de bunlardan biridir. Biz de ERCP'nin başarısız olduğu hastalardaki konvansiyonel CDD sonuçlarımızı sunmayı amaçladık. \u0000Yöntemler: Mart 2015 ve Şubat 2022 tarihleri arasında ERCP ile tedavi edilemeyen koledok taşı olan ve konvansiyonel koledok eksplorasyonu, taş çıkarılması ve CDD uygulanan 23 hastanın klinikodemografik verileri, perioperatif bulguları ve postoperatif sonuçları retrospektif olarak analiz edildi. \u0000Bulgular: Hastaların median yaşı 71 (41-85) olup, 13’ü (%56) kadındı. Hastaların 5’inde (21%) geçirilmiş kolesistektomi, 7’sinde (30%) gastrektomi + gastroenterostomi ameliyatı öyküsü vardı. En sık başvuru semptomu karın ağrısıydı (39 %). Başarısız ERCP sayısı median 1 (1-6) olup, başarısızlık nedenleri 7 hastada gastroenterostomi olması, 9 hastada impakte taş olması, 6 hastada taş boyutu ve sayısının fazla olması, 1 hastada da papilla açılım anomalisiydi. Hastaların median koledok çapı 15 (10-40) mm'di. Operasyon süresi median 120 (60-240) dk olup, perioperatif komplikasyon gelişmedi. Yatış süresi median 7 (4-14) gündü. Postoperatif erken dönemde 2 (8%) hastada yara yeri enfeksiyonu, 1 (4%) hastada da eviserasyon görüldü. Mortalite izlenmedi. Hastaların ortalama takip süresi median 27 (2-77) aydı ve geç dönemde 2 (8%) hastada insizyonel herni ile karşılaşıldı. Sump sendromuna ait bulgular hiçbir hastamızda gözlenmedi. \u0000Sonuç: ERCP ile çıkarılamayan koledok taşlarının tedavisinde CDD seçilmiş hastalarda efektif ve güvenli bir cerrahi tedavi yöntemidir.","PeriodicalId":8220,"journal":{"name":"ARCHIVES OF CLINICAL AND EXPERIMENTAL MEDICINE","volume":"28 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81741122","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Aim: Inflammatory process plays a critical role in the progression of aortic valve sclerosis (AVS). This study aims to evaluate the haematological and biochemical inflammatory markers in AVS patients.Methods: A retrospective observational study was included consecutive 557 patients who underwent an echocardiogram between June 2021 and September 2021. The study population was divided into two groups according to the presence of AVS. The groups were compared in terms of C-reactive protein (CRP), Neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and monocyte-HDL cholesterol ratio (MHR).Results: The mean age was 63 ± 10 years. C-reactive protein (CRP), NLR, PLR and MHR were significantly higher in patients with AVS. The best cut-off values of the NLR were 1.4 (a sensitivity of 84%, a specificity of 74%), PLR was 116 (a sensitivity of 75%, a specificity of 54%), and MHR was 9.5 (a sensitivity of 78%, a specificity of 75%). CRP (OR: 1.246, 95% CI: 1.117 – 1.389; p < 0.001), NLR (OR: 2.10, 95% CI: 1.456 – 3.032; p < 0.001), and MHR (OR: 1.227, 95% CI: 1.125 – 1.339; p < 0.001) were independent predictors of the AVS when NLR and MHR analysed as a continuous variable. Using a cut off level of NLR > 1.4 (OR: 4.825, 95% CI: 2.430 – 9.583; p < 0.001) and MHR > 9.5 (OR: 13.937, 95% CI: 7.464 – 26.023; p < 0.001) were independent predictors of the AVS.Conclusion: Increased CRP levels, NLR and MHR were found to be independent predictors for AVS. Hematological inflammatory biomarkers are cost effective and helpful approach for prediction of AVS presence.
{"title":"Aort Kapak Sklerozunun Öngörülmesinde Yeni Hematolojik İnflamatuar Parametrelerin Önemi","authors":"Özge ÇAKMAK KARAASLAN, Funda Başyiğit","doi":"10.25000/acem.1107825","DOIUrl":"https://doi.org/10.25000/acem.1107825","url":null,"abstract":"Aim: Inflammatory process plays a critical role in the progression of aortic valve sclerosis (AVS). This study aims to evaluate the haematological and biochemical inflammatory markers in AVS patients.Methods: A retrospective observational study was included consecutive 557 patients who underwent an echocardiogram between June 2021 and September 2021. The study population was divided into two groups according to the presence of AVS. The groups were compared in terms of C-reactive protein (CRP), Neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and monocyte-HDL cholesterol ratio (MHR).Results: The mean age was 63 ± 10 years. C-reactive protein (CRP), NLR, PLR and MHR were significantly higher in patients with AVS. The best cut-off values of the NLR were 1.4 (a sensitivity of 84%, a specificity of 74%), PLR was 116 (a sensitivity of 75%, a specificity of 54%), and MHR was 9.5 (a sensitivity of 78%, a specificity of 75%). CRP (OR: 1.246, 95% CI: 1.117 – 1.389; p < 0.001), NLR (OR: 2.10, 95% CI: 1.456 – 3.032; p < 0.001), and MHR (OR: 1.227, 95% CI: 1.125 – 1.339; p < 0.001) were independent predictors of the AVS when NLR and MHR analysed as a continuous variable. Using a cut off level of NLR > 1.4 (OR: 4.825, 95% CI: 2.430 – 9.583; p < 0.001) and MHR > 9.5 (OR: 13.937, 95% CI: 7.464 – 26.023; p < 0.001) were independent predictors of the AVS.Conclusion: Increased CRP levels, NLR and MHR were found to be independent predictors for AVS. Hematological inflammatory biomarkers are cost effective and helpful approach for prediction of AVS presence.","PeriodicalId":8220,"journal":{"name":"ARCHIVES OF CLINICAL AND EXPERIMENTAL MEDICINE","volume":"32 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89446503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Aim: Postpartum hemorrhage is a life-threatening obstetric emergent clinical situation accompanied by blood loss of more than 500 ml after vaginal delivery and more than 1000 ml after cesarean section. This situation, frequently encountered in placental adhesion anomalies, is essential in terms of follow-up, treatment, and multidisciplinary management. We aimed to retrospectively evaluate the perioperative anesthesia management, transfusion requirement, and postoperative intensive care unit requirement of patients diagnosed with placental invasion anomaly who had an intraoperative hemorrhage Methods: In our single-center study, a total of 58 female patients diagnosed with of placental invasion anomaly with a cesarean section between 2017-2020 were examined. Patients under 18 years of age and missing data were excluded from the study. Demographic data of patients (age, American Society of Anesthesiologists score (ASA)), diagnosis, duration of operation, perioperative laboratory findings, anesthesia type, perioperative hemodynamics (highest heart rate, lowest mean arterial pressure, shock index), amount of bleeding, blood products, and fluids used, surgical interventions (B-Lynch, Bacri balloon application, uterine artery ligation, hysterectomy), intraoperative vasopressor/inotrope use, ICU stay, laboratory results in the first 24 hours postoperatively, and total hospital stay were recorded. Results: In the preoperative evaluation, 27 (46.5%) patients were diagnosed with placenta accreta, and placenta previa was diagnosed in 19 (32.7%) patients. Perioperatively mean of 3.08 ± 1.7 units of Red blood cell was used. In patients with postoperative intensive care unit hospitalization, the highest intraoperative lactate value was 3.5±1.8 mmol/L, shock index was 1.3±0.3 (0.6-1.8). In patients given intraoperative fibrinogen concentrate, the intraoperative shock index was 1.5±0.2 (0.9-1.8), the amount of intraoperative bleeding was 2575±302.2 ml, and the fibrinogen levels measured in the first 24 hours after surgery were 294.7±79.7 mg/dl. Conclusions: Anesthesia management of patients diagnosed with abnormal placental invasion is important because of significant hemorrhage. Due to unstable hemodynamics, preoperative blood product preparation with a multidisciplinary approach and a postoperative intensive care unit plan should be made for these patients.
{"title":"Plasental invazyon anomalisi olan hastalarda anestezi yönetimi: Tek merkez deneyimi","authors":"Güneş Özlem Yıldız, Canberk Çeti̇nel, Elif Marangoz, Özlem Melike Ekşi̇, Fidan Aygün, Sema Karakaş, Gökhan Sertçakacilar","doi":"10.25000/acem.1112799","DOIUrl":"https://doi.org/10.25000/acem.1112799","url":null,"abstract":"Aim: Postpartum hemorrhage is a life-threatening obstetric emergent clinical situation accompanied by blood loss of more than 500 ml after vaginal delivery and more than 1000 ml after cesarean section. This situation, frequently encountered in placental adhesion anomalies, is essential in terms of follow-up, treatment, and multidisciplinary management. We aimed to retrospectively evaluate the perioperative anesthesia management, transfusion requirement, and postoperative intensive care unit requirement of patients diagnosed with placental invasion anomaly who had an intraoperative hemorrhage \u0000Methods: In our single-center study, a total of 58 female patients diagnosed with of placental invasion anomaly with a cesarean section between 2017-2020 were examined. Patients under 18 years of age and missing data were excluded from the study. Demographic data of patients (age, American Society of Anesthesiologists score (ASA)), diagnosis, duration of operation, perioperative laboratory findings, anesthesia type, perioperative hemodynamics (highest heart rate, lowest mean arterial pressure, shock index), amount of bleeding, blood products, and fluids used, surgical interventions (B-Lynch, Bacri balloon application, uterine artery ligation, hysterectomy), intraoperative vasopressor/inotrope use, ICU stay, laboratory results in the first 24 hours postoperatively, and total hospital stay were recorded. \u0000Results: In the preoperative evaluation, 27 (46.5%) patients were diagnosed with placenta accreta, and placenta previa was diagnosed in 19 (32.7%) patients. Perioperatively mean of 3.08 ± 1.7 units of Red blood cell was used. In patients with postoperative intensive care unit hospitalization, the highest intraoperative lactate value was 3.5±1.8 mmol/L, shock index was 1.3±0.3 (0.6-1.8). In patients given intraoperative fibrinogen concentrate, the intraoperative shock index was 1.5±0.2 (0.9-1.8), the amount of intraoperative bleeding was 2575±302.2 ml, and the fibrinogen levels measured in the first 24 hours after surgery were 294.7±79.7 mg/dl. \u0000Conclusions: Anesthesia management of patients diagnosed with abnormal placental invasion is important because of significant hemorrhage. Due to unstable hemodynamics, preoperative blood product preparation with a multidisciplinary approach and a postoperative intensive care unit plan should be made for these patients.","PeriodicalId":8220,"journal":{"name":"ARCHIVES OF CLINICAL AND EXPERIMENTAL MEDICINE","volume":"60 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76965960","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Aim: To evaluate the outcomes of transcanalicular diode laser DCR (TL-DCR) in patients with chronic dacryostenosis. Methods: In this retrospective study we included 75 eyes of 67 patients with chronic dacryostenosis who underwent TL-DCR. In 65 patients transnasal endoscopic debridement the opening and nasalacrimal syringing was performed every week for 1 month (Group 1, 65 patients). The later patients who did not have postoperative visits were defined as Group 2 (10 patients). All patients were examined at postoperative 3 months. Results: In group 1, 65 of 63 patients had complete surgical success and two had restenosis. In group 2, six of 10 patients had success however four had restenosis. In group 1 the surgical success rate was 98% whereas it was 60% in group 2 (p< 0.001). None of the patients had any serious complications including infection and bleeding. Conclusions: The surgical success rate of TL-DCR may increase by endoscopic debridement after the surgery.
{"title":"Haftalık endoskopik debridmanın endoskopik transkanaliküler diod lazer dakriyosistorinostominin başarı oranı üzerine etkisi","authors":"Cevat Uçar, Selim Genç","doi":"10.25000/acem.1129840","DOIUrl":"https://doi.org/10.25000/acem.1129840","url":null,"abstract":"Aim: To evaluate the outcomes of transcanalicular diode laser DCR (TL-DCR) in patients with chronic dacryostenosis. \u0000Methods: In this retrospective study we included 75 eyes of 67 patients with chronic dacryostenosis who underwent TL-DCR. In 65 patients transnasal endoscopic debridement the opening and nasalacrimal syringing was performed every week for 1 month (Group 1, 65 patients). The later patients who did not have postoperative visits were defined as Group 2 (10 patients). All patients were examined at postoperative 3 months. \u0000Results: In group 1, 65 of 63 patients had complete surgical success and two had restenosis. In group 2, six of 10 patients had success however four had restenosis. In group 1 the surgical success rate was 98% whereas it was 60% in group 2 (p< 0.001). None of the patients had any serious complications including infection and bleeding. \u0000Conclusions: The surgical success rate of TL-DCR may increase by endoscopic debridement after the surgery.","PeriodicalId":8220,"journal":{"name":"ARCHIVES OF CLINICAL AND EXPERIMENTAL MEDICINE","volume":"20 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90168152","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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