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European Research Journal
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Open Access journal
ISSN (Online) 2149-3189
Published by DergiPark

[185 journals]

Eisenmenger syndrome presenting with chronic thromboembolic disease
- Authors: Ahmet Cemal Pazarlı; Kayıhan Karaman, Tuğba Yıldırım
  Abstract: Eisenmenger syndrome is characterized by the reversal of blood flow due to increased pulmonary vascular resistance. It can be prevented with early diagnosis and surgical treatment. Thromboembolism is a leading cause of death in patients with Eisenmenger syndrome. Pulmonary endarterectomy is the primary treatment, but medical treatments may be considered in inoperable cases. Regular follow-up and a multidisciplinary approach are important for diagnosis and treatment. Lifestyle changes and medical therapy can improve patient's quality of life and prevent complications. Our case is presented because of the chronic thromboembolic disease in addition to the pulmonary hypertension due to the partial atrioventricular septal defect and the management of the treatment.
  PubDate: Thu, 04 Jul 2024 00:00:00 +030
Evolving paradigms in the diagnosis and management of premenopausal women
with abnormal uterine bleeding
- Authors: Mine Senem Yılmaz Aksoy; Teymur Bornaun
  Abstract: Abnormal uterine bleeding (AUB) is a common gynecological complaint among premenopausal women, encompassing a wide range of underlying disorders that complicate diagnosis and management. The evolving paradigms in medical science now incorporate advanced imaging techniques, personalized medicine, and molecular diagnostics to improve the accuracy of diagnoses and the effectiveness of treatment plans. This review examines recent advancements in the diagnostic approach, including the use of transvaginal ultrasonography, hysteroscopy, and biomarker analysis, which have significantly refined the identification of endometrial pathologies. Furthermore, we discuss the shift towards individualized treatment strategies that consider patient-specific factors such as age, reproductive plans, and comorbidities, facilitating tailored therapies. Special attention is given to the role of medical therapies ranging from hormonal treatments to novel non-hormonal drugs, as well as the consideration of minimally invasive surgical options as part of a comprehensive management strategy. By integrating current research findings with clinical practice guidelines, this article aims to provide a synthesized view of the dynamic field of AUB management, proposing a multidisciplinary approach to enhance patient outcomes in premenopausal women.
  PubDate: Thu, 04 Jul 2024 00:00:00 +030
The relationship between preoperative hemoglobin, albumin, lymphocyte, and
platelet (HALP) score and right colon cancer surgery outcomes: a
retrospective cohort study
- Authors: Oğuzhan Fatih Ay; Mehmet Fatih Erol, Sinan Arıcı, Mehmet Karadağ
  Abstract: Objectives: This study aims to investigate the association between the preoperative Hemoglobin Albumin Lymphocyte Platelet (HALP) score and surgical outcomes in right colon cancer patients.Methods: This retrospective cohort study included patients undergoing elective right colon adenocarcinoma surgery from January 2017 to June 2023 at Bursa Yuksek Ihtisas Training and Research Hospital. The HALP score, calculated from hemoglobin, albumin, lymphocyte, and platelet levels, aimed to predict perioperative morbidity through receiver operating characteristic (ROC) curve analysis.Results: The study involved 67 patients, mostly male with an average age of 68.28 years, undergoing 46 open and 21 laparoscopic surgeries. Although the HALP score's cutoff value was established, it did not significantly predict perioperative morbidity (P>0.05). However, lower platelet counts (<318×103/L) and open surgery type correlated significantly with higher morbidity (P<0.05). Conclusions: This study reveals that the HALP score may not effectively predict perioperative morbidity in right colon cancer surgeries, highlighting platelet counts as a more promising marker. Our findings also confirm the increased morbidity associated with open surgeries, challenging existing assumptions and guiding clinical practice.
  PubDate: Thu, 04 Jul 2024 00:00:00 +030
Distribution of neuropsychiatric profiles and comorbid diseases in
dementia subtypes
- Authors: Nazlı Gamze Bülbül; Sibel Karşıdağ, Nilgün Çınar, Miruna Florentina Ateş, Şevki Şahin, Fenise Selin Karalı, Özge Gönül Öner, Tuğba Okluoğlu, Fettah Eren, Dilek Yılmaz Okuyan, Özlem Totuk, Meltem Karacan Gölen, Esra Acıman Demirel, Zerrin Yıldırım, Hamdi Erhan, Büşra Sümeyye Arıca Polat, Nesrin Ergin, Esma Kobak Tur, Özlem Akdoğan
  Abstract: Objectives: Alzheimer’s disease (AH) is the most prevalent cause of dementia, followed closely by vascular dementia. Mixed vascular-Alzheimer’s dementia (MVAD) is more evident in individuals aged 80 and above. Frontotemporal dementia (FTD) is the second most common cause of early-onset dementia after AH. Vascular risk factors play important role in the pathogenesis of dementia syndromes. Behavioral and psychological symptoms represent a significant portion of the non-cognitive manifestations in dementia patients. This study aimed to evaluate the distribution of chronic diseases, behavioral disorders, psychiatric findings, and medication use in patients followed with different dementia diagnoses.Methods: Prevalance of chronic diseases, behavioral disorders, psychiatric findings as well as the usage of antidepressant and antipsychotic medications among patients followed up in dementia outpatient clinics with the diagnosis of AD, mild cognitive impairment (MCI), vascular dementia (VaD), FTD, and MVAD were investigated. Neuropsychiatric inventory (NPI) was applied to the patients.Results: Four hundred and fifty-five patients were accepted in the study. The patients were distributed as follows: AD (n=303, female/male: 187/115, age = 78±8 years), MCI (n=53, female/male: 31/22, age = 69±10 years), VaD (n=31, female/male: 18/13, age = 68±9 years), FTD (n=32, female/male: 17/15, age = 68±9 years), and MVAD (n=36, female/male: 16/20, age = 76±10 years). Both AD and MVAD groups were significantly older than the other groups (F = 23.2, P<0.0001). The ratio of comorbid chronic diseases was 80% in the AD group, 72% in the MCI group, 91% in the VaD group, 59% in the FTD group, and 93% in the MVAD group. In the whole group, antipsychotic drug use was 27.5% and antidepressant drug use was 28.9%. The mean NPI score was 32.9±28 in antipsychotic users and 16±19 in non-users (P<0.0001). The mean NPI of antidepressant users was 17.6±19 and 21.9±25 (P=0.055) in non-users.Conclusion: There is a comorbid chronic disease burden in all dementia subtypes, although at varying intensities, and as the chronic disease burden increases, behavioral disorders and psychotic findings increase, and accordingly, the use of antipsychotics also increases.
  PubDate: Thu, 04 Jul 2024 00:00:00 +030
Determining the awareness of surgical nurses regarding frail patients: a
cross-sectional study
- Authors: İsmail Öztaş; Ayla Yava, Barıış Çelik
  Abstract: Objective: The objective of this study is to determine the knowledge level and awareness of surgical nurses about fragile patients.Method: Obtained through Introductory Information Survey Form created by the researchers and Fragile Patient Information Evaluation Form methods.Results: The average age of the surgical nurses participating in the study was 28±5.01 years, the average professional experience was 5±5.09 years, and the average experience in the service they worked in was 3±2.83 years. The rate of those who heard the term 'frailty' for the first time is 63%. It was stated that 92.7% of the 110 surgical nurses participating in the study did not receive any training on fragility; It was stated that 50.9% of them think of the most vulnerable and weak patient when they think of a fragile patient. While 50% of them stated that when they suspected frailty in the patient, they evaluated involuntary weight loss, slowness (slowness in walking, muscle weakness), and fatigue; 70% stated that the biggest risk factor for frailty is being depressed or using antidepressant medication.Conclusions: According to the results of the study, it can be said that the awareness of surgical nurses about the "fragile patient" should be increased. In the light of the data obtained, it can be suggested to organize trainings on "fragile patients" for surgical nurses. 'Fragile patient' education should be included in pre-graduation education and in-service training.
  PubDate: Thu, 04 Jul 2024 00:00:00 +030
Comparison of the effect of erector spinae plane block for postoperative
analgesia on neutrophil/lymphocyte ratio and platelet/lymphocyte ratio in
patients operated for breast cancer
- Authors: Kübra Şahin Karadil; Ahmet Gültekin, Ayhan Şahin, Sibel Özkan Gürdal, İlker Yıldırım, Cavidan Arar
  Abstract: Objectives: It was seen that recurrence and metastasis after breast cancer surgery are related to the immune response of the host. Anesthetic agents modulate the surgical stress response or directly impair the functions of immune system cells. In our study, we aimed to compare the effects of nonsteroidal anti-inflammatory drugs and erector spinae plane block, which are among the methods we use for postoperative analgesia, on the neutrophil/lymphocyte ratio and platelet/lymphocyte ratio in patients undergoing breast cancer surgery. Methods: One hundred female patients aged 18-75 years, scheduled for unilateral breast cancer surgery, and who agreed to participate were included in our study. These cases were divided into two groups of the analgesia method: Those with erector spinae plane block (Group E) and those who were administered nonsteroidal anti-inflammatory drugs (Group N). According to the results, preoperative and postoperative neutrophil/lymphocyte ratio and platelet/lymphocyte ratio values were calculated and recorded. Results: Neutrophil/lymphocyte ratio and platelet/lymphocyte ratio were statistically higher in both groups in the postoperative period. No statistically significant difference was found when the preoperative and postoperative measurement changes of the laboratory parameters between the groups were compared. Postoperative VAS scores were statistically significantly lower in Group E. Conclusions: We concluded that when erector spinae plane block and nonsteroidal anti-inflammatory drug use were compared in managing postoperative analgesia in breast cancer surgery, their effects on the neutrophil/lymphocyte ratio and platelet/lymphocyte ratio were not superior to each other. However, the erector spinae plane block was superior for adequate pain control.
  PubDate: Thu, 04 Jul 2024 00:00:00 +030
Descemet membrane endothelial keratoplasty and penetrating keratoplasty in
pseudophakic bullous keratopathy: comparison of visual outcomes, graft
survival rates, and complications
- Authors: Ayşe Tüfekçi Balıkçı; Nurşah Demir, Ayşe Burcu, Züleyha Yalnız Akkaya, Evin Şingar, Selma Uzman
  Abstract: Objective: To compare the outcomes of Descemet Membrane Endothelial Keratoplasty (DMEK) and Penetrating Keratoplasty (PK) in patients with pseudophakic bullous keratopathy (PBK). Methods: Records of 51 eyes of 51 PBK patients (32 male, 19 female) who underwent PK (Group1=38 eyes) and DMEK (Group 2=13 eyes) were reviewed retrospectively. The two groups were compared for Best-corrected visual acuity (BCVA), graft survival rates, and complications. Results: The mean age was 69.1 and 67.1 years in group 1 and group 2, respectively. First-year cumulative survival rates for group 1 and group 2 were 92.1% and 61.5%, respectively, and 89.1% and 51.3% in the second year (P=0.001 by log-rank test). At the last follow-up visit, 2.7% of Group 1 and 30.8% of Group 2 had a BCVA of 0.3 or better (P=0.004). Graft failure was observed in 12 eyes (31.6%) in group 1 and 8 eyes (61.5%) in group 2 (P=0.056). At the last examination, the rates of transparent grafts were 73.7% and 69.2% in group 1 and group 2, respectively (P=0.756). Postoperative glaucoma was observed in 4 eyes (30.8%) in the group 2 and 4 eyes (10.5%) in the group 1 (P=0.083). There was no significant difference between the two groups regarding other complications (P>0.05). Conclusions: DMEK surgery offers a better visual outcome than PK for the treatment of PBK. Careful follow-up of patients is required in terms of glaucoma and graft failure after DMEK. Although the graft survival rate was lower in the DMEK group, a similar rate of graft transparency was achieved at the final examination with repeated DMEK surgery.
  PubDate: Thu, 04 Jul 2024 00:00:00 +030
Relationship between fortilin levels and coronary ischemia in heart
failure
- Authors: Sümeyra Gökçek; Cihan Aydın, Aykut Demirkıran, Şeref Alpsoy
  Abstract: Objective: Fortilin is a multifunctional protein that protects cells against apoptosis. We aimed to investigate the levels of fortilin in patients with heart failure.Methods: Patients with ejection fraction (EF) below 40% were divided into two groups according to coronary angiography results: those with ischemic heart failure (Group 1) and those with non-ischemic heart failure (Group 2). Patients with normal anatomy and EF over 50% were included in the control group (Group 3).Results: A total of 119 patients were prospectively included in the study. A total of 81 patients (41 patients with ischemic heart failure and 40 patients with non-ischemic heart failure) were included in the heart failure group. 38 patients with EF >50 and normal coronary anatomy were included in the control group. There was no significant difference in serum fortilin levels between the study groups (Group 1: 5.5±2.6 ng/mL, Group 2: 6.1±3.8 ng/mL, and Group 3: 5.6±3.6 ng/mL; P=0.693). Fortilin did not show a correlation with any other variables.Conclusion: In our study, there was no significant difference in fortilin levels between the groups, and no relationship was found between coronary ischemia and fortilin levels in heart failure.
  PubDate: Thu, 04 Jul 2024 00:00:00 +030
Exploring menopausal dynamics: a cross-sectional analysis of age,
symptomatology, and sociodemographic influences in a developing population
of women aged 40-60
- Authors: Fatma Tuba Engindeniz; Anıl Erturk, Necla Aytekin
  Abstract: Objectives: Menopause, a biological milestone, marks a pivotal phase in women's lives characterized by ovarian function cessation and age-related changes. Our objective was to investigate menopausal symptoms and knowledge among women aged 40-60 years.Methods: This cross-sectional epidemiological study was conducted between June 1 and September 30, 2005, in the Nilufer Public Health Education and Research Area (NPHERA) region, aimed to assess menopausal symptoms and their correlates among 1013 women aged 40-60. The individuals included in the study were selected through a systematic sampling method, stratified by neighborhood weights and age groups based on the NPHERA 2004 Work Report and regional data, as well as information from the Health Centers Information System (HCIS), where the Electronic Health Records (EHR) are registered.Results: The mean age of natural menopause was found to be 46.7±4.8 years, showcasing sociodemographic factors' influence. Postmenopausal women experienced higher rates of symptoms, with physical and mental exhaustion (82.8%), irritability (78.4%), and depressive mood (76.4%) prevailing. Logistic regression revealed that employment status significantly influenced menopausal status. Moreover, the age at menopause correlated positively with the age of the woman's mother. Conclusions: This study contributes insights into menopausal experiences in developing countries, emphasizing the need for tailored healthcare approaches. Longitudinal investigations are warranted to comprehensively understand these associations and enhance women's quality of life during menopause.
  PubDate: Thu, 04 Jul 2024 00:00:00 +030
ADMA, neutrophil to lymphocyte, platelet to lymphocyte ratios and phase
angle: effects on inflammation and nutrition in hemodialysis patients
- Authors: Bahar Gürlek Demirci; Mine Şebnem Karakan
  Abstract: Objectives: Neutrophil/lymphocyte ration (NLR) and platelet/lymphocyte ratio (PLR) levels can be used as systemic infallamotory parameters. Asymmetric dimethyl arginine (ADMA) inhibits endothelial nitric oxide synthase. Phase Angle (PhA) is a potential paremeter to screen for inflammatory abnormalities. In present study we aimed to determine the relations between NLR, PLR, ADMA, and PhA in terms of early markers for nutritonal status in addition to their well-known role in inflammation. Methods: A total of 89 patients undergoing maintenance hemodialysis 3 days a week at least 6 months were enrolled. To assess nutritional status, we performed the dietary questionnaire and mini nutritional assessment score (MNAS). ADMA was measured by ELISA. NLR and PLR are calculated from monthly complete blood count tests. Patients were divided into 2 groups accordng to NLR levels as group 1 (NLR≥4.6; n=48) ve and group 2 (NLR<4.6, n=41). Results: The mean ADMA level was 0.03±0.01 µmol/L, the mean PhA was 7.2±1.1º. In subgroup analysis, MNAS, albumin levels and phase angle of patients in group 1 were lower and CRP, PLR, ADMA levels were higher when compared to group 2. In correlation analysis, NLO was positively correlated with PLR, CRP and ADMA however negatively correlated with albumin and PhA levels. In regression analysis, NLR, PLR and ADMA were detected as independent predictors of MNAS. Conclusion: In conclusion our study suggests that NLR, PLR and ADMA are independent predictors for nutritional status and inflammation in patients ongoing hemodialysis.
  PubDate: Thu, 04 Jul 2024 00:00:00 +030
Obstructions of prosthetic heart valves: diagnosis and treatment
considerations
- Authors: Mehmet Nuri Karabulut; Rafet Günay, Mahmut Murat Demirtaş
  Abstract: Objectives: Since the first years of native heart valve replacement by - prosthetic valves; prosthesis thrombogenicity has kept its importance as a serious problem causing post-operative morbidities and mortality. This study aims to evaluate early postoperative morbidity and mortality of patients diagnosed with prosthetic valve thrombosis and treated surgically or non-surgically. Methods: Thirty-one patients diagnosed with and treated for prosthetic valve thrombosis were evaluated retrospectively. The patients were followed up for 58 months. Results: There were 24 females and 7 males. The mean patient age at the time of prosthetic valve thrombosis diagnosis was 40.7±11 (range, 10-57) years. The mean duration between prosthetic valve replacement and the first signs of prosthetic valve thrombosis was 67.67±66 (range, 1 to 300) months. All patients presented with a functional capacity of NYHA Class III or IV. A total of 32 interventions; 27 surgical and 5 thrombolytic treatments due to elevated aortic prosthetic valve pressure gradient which did not improve with thrombolysis. Of 27 surgical interventions for thrombosed prosthetic valves, 21 involved mitral, 2 aortic, and 4 tricuspid positions. A total of 9 patients died during follow-up. The overall mortality rate was 29.03%. The mortality rate was 29.62% after surgical interventions and 20% after thrombolytic treatment. Conclusion: Currently prosthetic valve replacement is the basic palliation method in the management of patients with diseased native heart valves. In the majority of mechanical prosthetic valve obstructions, the main pathology is fibrous tissue proliferation-related to irregular warfarin usage, which in turn causes the development of acute symptoms secondary to acute valve thrombosis. The necessary treatment method for prosthetic valve obstructions should be either the use of thrombolytic agents or the replacement of the obstructed prosthetic valve with a new one.
  PubDate: Thu, 04 Jul 2024 00:00:00 +030

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