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Journal of Surgery and Medicine
Number of Followers: 4  

  This is an Open Access Journal Open Access journal
ISSN (Online) 2602-2079
Published by DergiPark Homepage  [188 journals]
  • The effects of capsular repair on quality of life after hip arthroplasty
           with the anterolateral approach

    • Authors: Mehmet YETİŞ; Emre YURDAKUL
      Abstract: Background/Aim: Hip fractures, commonly observed worldwide, cause severe functional problems and pose an economic burden. This study investigated the effects of different surgical approaches of joint capsule repair on morbidity and mortality and aimed to increase the quality of life after surgery with the most proper treatment option.Methods: This prospective case-control study was conducted on 186 patients over 65 years of age admitted to our clinic from 2006 to 2012 for displaced femoral neck fracture. All patients were treated via a hemiarthroplasty. The patients (66 males, 110 females with an overall mean age of 80.43 years (70-90)) were followed up regularly. All patients were divided into two groups: Group 1 was treated with capsular repair, and Group 2 without. The groups were compared in terms of pre-and peri-operative data, demographics, concomitant diseases, post-operative complications, mortality rates, pain level, and hip scores. Hospitalization time, average surgical duration, and time from fracture to the operation were also noted. Results: We found no significant differences between the groups in terms of surgery preferences (P>0.05). The survival of patients was significantly higher, blood loss was significantly less, and perioperative mortality rates were insignificantly lower in the noncapsular repair group (p=0.005, p=0.015, and p=0.515, respectively). Conclusion: The use of capsule repair during hip hemiarthroplasty in patients over 65 years of age had no negative impact on mortality or morbidity. Surgical preference changes during hip arthroplasty procedures are essential.
      PubDate: Wed, 01 Sep 2021 00:00:00 +030
  • Increased mouse double minute X expression in human placental villous
           macrophages (Hofbauer cells) in gestational diabetes mellitus

    • Authors: Sefa ARLIER; Sadik KÜKRER, Cevdet ADIGÜZEL
      Abstract: Background/Aim: Gestational diabetes mellitus is a common metabolic problem in pregnancy, and its prevalence ranges between 5-20%. Hofbauer cells are tissue macrophages of the feto-placental component that are raised in the villous tree of the placenta during pregnancy, but their quantity falls off with growing gestational age. We theorize that Hofbauer cells play a significant role in placental pathophysiology in GDM by controlling the MDMX (mouse double minute X/MDM4/HDMX) gene.Methods: We performed immunohistochemistry on human placental specimens to determine cell-specific expression of MDMX in Hofbauer cells (HC) among the control and GDM (n=8 in each group) groups with matching gestational ages. Results: Immunohistochemical analysis revealed that MDMXs were secreted by Hofbauer cells in the placental villous tree and compared to the placenta got from normal pregnancies, significantly higher MDMX HSCORE levels were detected in placenta Hofbauer cells (32.8 (24.52) vs. 190.1 (32.54), P=0.001) of the GDM group. Conclusion: We revealed Hofbauer cells to be a source of MDMX secretion in human placenta. MDM2 levels in Hofbauer cells are also increased in GDM. This study found higher levels of MDMX in the Hofbauer cells from GDM placentas, suggesting an induction of MDMX secretion. GDM interaction in placental Hofbauer cells may contribute to GDM-associated feto-placental complications. Further studies are needed to define the significance of this relationship.
      PubDate: Wed, 01 Sep 2021 00:00:00 +030
  • Does vitamin D replacement therapy cause a regression in fatty liver
           disease' A case control study of comparison of vitamin D and other
           common therapy modalities

      Abstract: Background/Aim: Non-alcoholic fatty liver is quite common among modern populations, and simpler methods are researched for its early diagnosis and therapy. Studies are stating that vitamin D deficiency could play a role in the etiopathogenesis of fatty liver. This study aimed to compare the efficacy of metformin and vitamin D therapy in improving fatty liver disease.Methods: A total of 86 patients with non-alcoholic fatty liver disease were included in this case control study and classified into four groups according to the treatment received. In the study group, 23 patients were using metformin only, and 21 patients were using both metformin and vitamin D. Twenty-one patients were using vitamin D only, and 21 patients were on a diet and an exercise regimen (control group). Weight, BMI, waist circumference, fatty liver index (FLI), HOMA-IR, AST, ALT, GGT, triglyceride parameters were evaluated before and after four weeks of therapy.Results: There was a significant regression in the fatty liver disease of the patients who used both metformin and vitamin D (FLI-%5, 90 (11.1) P=0.025). Among patients who used only metformin and only vitamin D, the decrease in FLI was not significant (P>0.05); however, FLI was observed to significantly decrease in the control group (-7.30, P=0.018). The serum CRP levels were also observed to significantly decrease in the control, Met and Met-D vit groups (P=0.025, P=0.002, P=0.006, respectively).Conclusions: The combination of vitamin D and metformin therapy could positively contribute to the improvement of NAFLD in patients with vitamin D deficiency.
      PubDate: Wed, 01 Sep 2021 00:00:00 +030
  • The relationship between renal oxygen saturation and renal function in
           patients with and without diabetes following coronary artery bypass
           grafting surgery

    • Authors: Hazal ŞEREN; Onat BERMEDE, Süheyla KARADAĞ, Çiğdem DENKER
      Abstract: Background/Aim: Acute kidney injury may occur due to renal ischemia and hypoxia during coronary artery bypass surgery. Monitoring of renal regional tissue oxygenation might be useful to determine renal hypoxia. We aimed to investigate whether renal oxygen saturation values differ between diabetic and non-diabetic patients and evaluate the relationship between intra-operative renal oxygen saturation values and postoperative renal function.Methods: Forty consecutive patients aged 18-65 years, who underwent elective coronary artery bypass grafting, were included in this prospective case-control study. Body mass index ≥30 kg/m2 and the presence of renal damage were considered the exclusion criteria. Group I consisted of diabetic patients (n = 20), and Group II consisted of non-diabetic patients (n = 20). Near Infrared Spectroscopy (NIRS) recorded renal saturation values just before the intubation as the basal value and every 10 minutes after intubation in all patients. Creatinine clearances and glomerular filtration rates were calculated along with blood urea nitrogen and creatinine values on the postoperative 1st and 3rd days of all patients. Results: The two groups were similar in terms of gender, age, body mass index, duration of surgery, cross-clamp time, and total cardiopulmonary bypass duration (P>0.05). While there was no difference between baseline values, significant differences were found between preoperative BUN and creatinine and POD 3 BUN and creatinine values in Group 1 (P=0.003 and P=0.046, respectively) and Group 2 (P=0.018 and P=0.030, respectively). There was no significant difference between two groups in renal oxygen saturation values considering both basal and post-intubation measurements (P>0.05 for all). However, an earlier decrease in renal oxygen saturation values was seen in diabetic patients (P0.05 for all).Conclusion: Although coronary artery graft bypass surgery does not lead to a significant difference in renal saturation values, as determined by Near Infrared Spectroscopy, in diabetic patients compared to non-diabetic patients, NIRS may be helpful and beneficial to show renal ischemia in these patients.
      PubDate: Wed, 01 Sep 2021 00:00:00 +030
  • Investigation of septum pellucidum and its variations with magnetic
           resonance imaging

    • Authors: Keziban KARACAN; Alper KARACAN
      Abstract: Background/Aim: The septum pellucidum (SP) is the thin layer formed by the two laminas that form the medial wall of the lateral ventricle. When the laminas do not fuse, a cavity called cavum septum pellucidum (CSP) or Cavum Vergae (CV) forms. CSP is a developmental anomaly with unclear pathological significance and is common in people with neuropsychiatric diseases, especially schizophrenia, as well as post-traumatic stress disorder, Tourette's disease, and patients who suffer from recurrent and severe head trauma. However, few studies in the literature examine the CSP morphology among healthy individuals. Therefore, we aimed to evaluate the morphology and variations of septum pellucidum in healthy individuals.Methods: In this retrospective cohort study, the septum pellucidum was morphologically evaluated in 509 patients who underwent brain Magnetic Resonance Imaging (MRI) at Sakarya University Faculty of Medicine, Sakarya Training and Research Hospital. We classified the anatomical variations of the septum pellucidum as CSP, CV, CVI and evaluated their dimensions.Results: CSP was detected in 11.98% of the cases, and CV, in 1.38%. While 55.74% of individuals with CSP were male, 44.26 % were female. The mean CSP length and height were 7.71 (2.95) mm (P=0.103), and 2.80 (1.12) mm (P=0.649), respectively, and the mean length and height of the SP were 30.98 (7.36) mm (P=0.001), and 11.89 (3.32) mm (P=0.042), respectively. Conclusion: Knowledge of CSP, one of the septum pellucidum variations, is of great importance in the differential diagnosis of midline cystic mass lesions. Its volumetric changes may be related to the development of psychiatric disorders in childhood and adulthood.
      PubDate: Wed, 01 Sep 2021 00:00:00 +030
  • The publication rate of presented abstracts at a congress and determining
           its publication factor

    • Authors: Sami AÇAR
      Abstract: Background/Aim: Congresses, scientific fairs on an academic platform, are held in numerous disciplines all over the world and bring physicians together. Through these congresses, the physicians can follow the latest developments in their profession and present their work. Many researchers first present their work in a congress, then update their work in the light of the feedbacks and publish them in a peer-reviewed journal. Although many oral and poster presentations are made in scientific congresses, a small portion are finally published in a peer-reviewed journal. This may be because the effort spent in preparing an abstract is much less than that spent during the preparation of an entire manuscript. However, the publication of a presentation in a peer-reviewed journal is a gold standard factor showing the quality of research and that it is worthy of publication. More detailed congress abstract evaluation criteria and their proximity to the procedures involved during the journal acceptance stage will likely enhance the publication rate. The purpose of this study was to perform a detailed evaluation of presentations at congresses held by the European Society of Trauma and Emergency Surgery (ESTES) in 2013, 2014, 2015 and determine their rates of publication in peer-reviewed journals.Methods: The booklets for three consecutive annual ESTES congresses (2013, 2014, 2015) containing presented papers were accessed online. All oral and poster presentations were analyzed, and published studies in peer-reviewed journals that are indexed in Google Scholar database until 2019 were identified. These published studies were then analyzed and used to determine the Publication Factor for Congress (PFC) for these congresses.Results: The total number of presentations at ESTES congresses in 2013-2015 was 1746, of which 878 were oral (50.2%) and 868 (49.8%) were in poster form. 450 (25.7%) of these were subsequently published in peer-reviewed journals that are indexed in Google Scholar database. 148 of the published papers (32.9%) were based on poster presentations, and 302 (67.1%) were from oral presentations. Conclusion: The publication rate of oral and poster presentations presented at the 2013-2015 ESTES congresses from the date of the congress to 2019 was 25.7%. Oral presentations were published more than poster presentations. It suggests that the papers with high publication potential have a high tendency to be presented as oral presentations by the authors. Determination of publication rates and publication factor for a congress at specific intervals may increase the motivation of authors at the participation and submission stages and strengthen the brand value.
      PubDate: Wed, 01 Sep 2021 00:00:00 +030
  • Is this coccyx fractured, or is it a normal variant' A cohort study

    • Authors: Serdar TOY; Alperen ZEYNEL, Kemal ZENCİRLİ
      Abstract: Background/Aim: The coccyx has several variants which could sometimes be confused with fractures. Our study aimed to alert physicians about the types of coccyges that can be easily confused with coccyx fractures in daily practice.Methods: Mid-sagittal and mid-coronal computerized images of 75 patients were analyzed to determine the types of coccygeal fracture, the coccyx types, number of segments, joint fusion, coccygeal bony spicules, subluxation, sacrococcygeal angle (SCA), intercoccygeal angle (ICA), and lateral deviation of the coccyx.Results: The mean age of the patients was 43.5 (13.6) years. There were 33 (44%) males and 42 (56%) females. While 57 (76%) patients were thought to have a coccygeal fracture, only 18 patients (24%) actually had them. There was a significant difference between the coccyx types mistaken for fractures and actual coccygeal fractures (P
      PubDate: Wed, 01 Sep 2021 00:00:00 +030
  • Investigation of the effect of anti-epileptic drugs on bone metabolism
           using osteoprotegerin and bone-specific alkaline phosphatase: The direct
           effects of antiepileptic drugs on bone metabolism

    • Authors: Buket TUĞAN YILDIZ; Tuba Tülay KOCA, Muhammed SEYİTHANOĞLU, Duygun ALTINTAŞ AYKAN
      Abstract: Background/Aim: Anti-epileptic drugs are long-term medications; thus, side-effects are frequently seen. An important but insufficiently known side-effect is the emergence of metabolic bone diseases. The mechanism of this entity is not clearly known, but it is usually seen with the use of cytochrome P450 enzyme-inducing anti-epileptics. However, recent studies demonstrated that non-enzyme-inducing molecules also cause bone mineral impairment. The aim of this study was to shed light on the pathogenesis of anti-epileptic metabolic bone disease using bone turnover markers.Methods: This comparative, prospective case-control study included 37 patients followed-up in our outpatient clinic and 39 healthy control subjects. All the patients were female, aged over 18 years and in the premenopausal period, and had received the same anti-epileptic treatment for at least 3 months. Male patients, females who were
      PubDate: Wed, 01 Sep 2021 00:00:00 +030
  • The effect of recruitment maneuver on the development of expansion defect
           and atelectasis after lobectomy: A double-blind randomized controlled

    • Authors: Kadir İDİN
      Abstract: Background/Aim: In pulmonary lobectomy operations, the operation is performed with one-lung ventilation by collapsing the related lung. Postoperative expansion failure on the deflated side is a critical issue. We aimed to correct the expansion failure and atelectasis with the recruitment maneuver performed at the end of the operation.Methods: A total of 61 cases who underwent elective lobectomy under one-lung ventilation were included in this double-blind and prospective study. They were randomized into two groups comprising thirty and thirty-one cases. The first group included patients in whom the cycling recruitment maneuver (cRM) was performed, and the second group comprised patients who underwent the manual recruitment maneuver. Both groups were ventilated similarly during the one-lung ventilation period. After switching to double-lung ventilation, a standardized cycling recruitment maneuver was performed in the first group, and a high-volume manual recruitment maneuver with an anesthetic reservoir bag was used in the second group. Preoperative and postoperative inspiratory and hemodynamic parameters, wakefulness level, pain scores, developments of complications and durations of the hospitalization were noted. Expansion failure and atelectasis were evaluated both with chest radiography and thorax computerized tomography.Results: There was no statistically significant difference among the two groups in terms of age, smoking, duration of operation, preoperative forced expiratory volume in 1 second (FEV1), SpO2 levels, respiratory and hemodynamic parameters noted during the operation, invasive arterial pressure monitoring results, electrocardiogram (ECG) findings, modified Aldrete score (MAS), and visual analogue scores (VAS) (P>0.05 for all). The gender distribution and types of operations performed were also similar. No complications were observed. Expansion failure was seen in 23.3% and 48.8% (P=0.042) of the patients in the cRM and mRM groups, respectively. Additional procedures were needed in 4 patients (13.3%) in the cRM group and in 11 patients (35.5%) in the mRM group. The duration of hospital stay was significantly shorter in the cRM group (P=0.045). Regression analysis revealed a 3.08-times increase in the incidence of expansion failure in the mRM group compared to group cRM.Conclusion: In pulmonary lobectomy operations, we observed that with the utilization of the recruitment maneuver which is performed after switching to double-lung ventilation, the rate of expansion failure, the need for additional procedures and duration of hospital stay decreased.
      PubDate: Wed, 01 Sep 2021 00:00:00 +030
  • Our experience of treating children with primary monosymptomatic enuresis
           nocturna in a pediatric bedwetting clinic

    • Authors: Ali Erdal KARAKAYA
      Abstract: Background/Aim: Enuresis nocturna is an important problem that negatively affects the self-confidence and quality of life of millions of children. Controversial points still exist regarding the treatment algorithm of enuresis. This study aimed to discuss the approach to this condition which deeply affects the child and their family and contribute to the literature by analyzing the success in the treatment steps.Methods: This study was conducted by reviewing the files of the patients who presented to the pediatric bedwetting outpatient clinic between May 2017 and March 2019 with the complaint of nocturia. The diagnoses and treatment outcomes were recorded from the patient files. The first step was motivation therapy, the second step was alarm treatment, and the third step was drug therapy, which were combined if necessary.Results: Among 95 primary monosymptomatic enuresis nocturna patients with a mean age of 8.5 years, all patients received supportive treatment to increase motivation as the first step. The second step consisted of alarm treatment administered to 32 patients and as the third step, medical drug treatment was prescribed to eight. Enuresis decreased in 58% of the patients receiving motivation therapy, 63% of the patients receiving alarm therapy and >90% of the patients receiving drug therapy; however, it relapsed when the medication was discontinued. Conclusion: According to the experience acquired in this study, a specific enuresis polyclinic is important in terms of ease of presentation for patients, and motivation treatment should be the first line of treatment. Other treatment steps can be added as necessary. All three steps in primary monosymptomatic enuresis nocturna can be combined or administered alone.
      PubDate: Wed, 01 Sep 2021 00:00:00 +030
  • Evaluation of ultrasonic intravascular thrombectomy system on a rabbit
           model in the treatment of deep vein thrombosis

    • Authors: Ferit KASİMZADE; Fatih ADA, Özhan KARATAŞ
      Abstract: Background/Aim: Advanced treatment options are needed in deep venous thrombosis (DVT), which is a special subgroup of venous disease. We examined this subgroup on an animal model and aimed to evaluate the effects of the ultrasonic intravascular thrombectomy system on vascular endothelial damage.Methods: A total of 24 rabbits in 3 groups were used in the study. DVT was created in the common iliac vein by the administration of intravascular fibrin. One hour passed for DVT formation. The ultrasonic intravascular thrombectomy system and the mechanical thrombectomy system were used separately in the DVT groups. After one hour, samples obtained from the groups were examined histologically.Results: Significantly less endothelial damage was detected in the ultrasonic intravascular thrombectomy system group compared to the mechanical thrombectomy group (P
      PubDate: Wed, 01 Sep 2021 00:00:00 +030
  • The effect of cardiac rehabilitation on anxiety and depression in
           percutaneous coronary intervention (PCI) and coronary artery bypass
           grafting (CABG) patients

    • Authors: Pınar DEMİR GÜNDOĞMUŞ; İbrahim GÜNDOĞMUŞ
      Abstract: Background/Aim: It is well-known that Cardiac Rehabilitation (CR) brings about a marked improvement in depression and anxiety. As far as we know, there are no studies that research the effect of CR, Percutaneous Coronary Intervention (PCI), and Coronary Artery Bypass Grafting (CABG) on anxiety and depression. This study aimed to investigate the effects of the CR program on anxiety and depression and the change of anxiety and depression symptoms in patients who underwent PCI and CABG.Methods: This cross-sectional study included 27 patients with PCI and 16 patients who had undergone CABG admitted to the CR program. The Beck Depression Inventory (BDI) was used to determine the severity of depression symptoms, and the Situational and Trait Anxiety Inventory (STAI I-II) were used. Results: After CR, the BDI, STAI-1, and STAI-2 significantly decreased in both the PCI (P
      PubDate: Wed, 01 Sep 2021 00:00:00 +030
  • Percutaneous cholecystostomy results of 136 acute cholecystitis patients:
           A retrospective cohort study

    • Authors: Metin YEŞİLTAŞ; Dursun Özgür KARAKAŞ, Serkan ARIBAL, Berk GÖKÇEK, Seracettin EĞİN, Semih HOT
      Abstract: Background/Aim: Percutaneous cholecystostomy (PC) is an alternative procedure to surgery in selected patients with acute cholecystitis (AC). This study aimed to review the clinical and surgical results of patients who underwent percutaneous cholecystostomy. Methods: The records of patients who underwent PC for AC were evaluated for age, gender, comorbidities, survey, catheterization timing, complications, control, removal timing, operation type, interval time, pathology, C-reactive protein (CRP) level and white blood cell count (WBC), ultrasonography (USG) and computed tomography (CT) results. Results: One hundred and thirty-six AC patients who underwent PC were included in the study. The median age was 73 (32-96) years and 57.3% of the patients were male. Out of the 136, 106 (78%) had an American Society of Anesthesiologists (ASA) classification score of 3 or 4. The median Charlson’s comorbidity index (CCI) score was 5 (0-13). The median timing of catheterization was 23 (20-144) hours and length of hospital stay (LOS) was 3 (1-25) days. Dislocation was the most common complication of PC, and 7.4% (n=10) had recurrent AC. The median time until tube removal was 26.5 (1-238) days. Among all, 41.2% (n=56) of the patients underwent interval cholecystectomy, which equates to 76.8% of the those performed laparoscopically. The median time until the operation was 100 (1-264) days. Chronic cholecystitis was the most common pathology of cholecystectomy after PC. Bacterial bile cultures were analyzed in 36 of the patients and showed positive results in 66.7%, with no overall effect on the outcome. Nine patients (6.6%) died.Conclusion: The importance of PC in AC increased with the Covid19 pandemic. PC was performed especially for old patients with ASA ≥3, and CCI ≥5 due to lower complication and recurrence rates. PC could be the final treatment for selected AC patients. Interval cholecystectomies performed after 8 weeks had a shorter LOS and a lower rate of complication.
      PubDate: Wed, 01 Sep 2021 00:00:00 +030
  • Topical mitomycin C treatment in corneal and conjunctival intraepithelial
           neoplasia: A case report

    • Authors: Asena KELEŞ ŞAHİN; Aslıhan UZUN, Havva ERDEM
      Abstract: Corneal and conjunctival intraepithelial neoplasia is a slowly progressive ocular surface lesion with low malignant potential. Owing to the high recurrence rates, cryotherapy or topical chemotherapy is used with surgical treatment. In this paper, we report the histopathologic findings and treatment of a case of intraepithelial neoplasia that began in the conjunctiva and progressed to the cornea. A 75-year-old woman presented with complaints of redness, irritation and lacrimation in her left eye for around 1 month. Slit-lamp examination revealed a papilliform mass on the nasal conjunctiva along with involvement of the adjacent corneal epithelium. Conjunctival excisional biopsy showed a moderate epithelial dysplasia. Topical 0.04% mitomycin C was administered 4 times daily for 3 weeks. No recurrence was observed in the following 18 months.
      PubDate: Wed, 01 Sep 2021 00:00:00 +030
  • The rate and associated factors with antibody response in patients with
           COVID-19 infection

    • Authors: Semiha ÇELİK EKİNCİ; Bengü ŞAYLAN
      Abstract: Background/Aim: It remains unknown in what form and to what extent antibodies to SARS-CoV-2 confer immunity and whether these antibodies from previous infections could ensure protection from reinfection. This study aimed to investigate the rate of antibody positivity among patients who recovered from COVID-19 infection and the factors influencing antibody production among these patients.Methods: This prospective case control study included 111 males (mean age: 34 years, range: 18-60 years) who recovered from PCR-confirmed COVID-19. The patients underwent antibody testing on the 28th day of recovery. Sixty-seven patients (60.4%) had antibodies against COVID-19 as well as positive IgM and IgG, and 39.6% of patients were negative for Ab production.Results: The mean ages of the antibody-positive and negative groups were 43 and 29 years, respectively, the age of the positive group was significantly higher than the age of the negative group (P
      PubDate: Wed, 01 Sep 2021 00:00:00 +030
  • Giant retroperitoneal schwannoma removed with the laparoscopic approach: A
           case report

    • Authors: Emel ÖZVERİ; Deniz Esin TEKCAN ŞANLI, Metin ERTEM
      Abstract: Retroperitoneal tumors are extremely rare and the vast majority are malignant tumors. One of the least determined benign retroperitoneal tumors is schwannoma. We report the case of a 64-year-old male patient who had a solid mass in the left infrarenal space shown by computed tomography (CT). Percutaneous CT-guided biopsy of the mass was performed, and histopathological examination revealed a schwannoma. The mass was resected laparoscopically. Surgical resection of retroperitoneal tumors is difficult due to posterior deep location and adjacent major vessels and nerves. The laparoscopic approach for retroperitoneal tumors may allow better visualization of the surgical field, reduction of postoperative pain, and better cosmesis. Laparoscopy seems to be a safe and feasible method in the treatment of schwannomas and other retroperitoneal tumors.
      PubDate: Wed, 01 Sep 2021 00:00:00 +030
  • Where is it logical to break-up a ureter stone with endoscopic

    • Authors: Mehmet CANİKLİOĞLU; Volkan SELMİ, Sercan SARI, Ünal ÖZTEKİN, Emin GÜRTAN, Levent IŞIKAY
      Abstract: Background/Aim: Today, we have the technology to break up a ureter stone in the ureter, as well as in the renal pelvis, with ureterorenoscopic procedures. In the past, when this option was not available, the surgeons improved several techniques and antiretropulsion devices to let the stone migrate through the renal pelvis. This study was conducted to clarify whether it is more advantageous to dust a stone in the ureter where it is impacted or in a wider area such as the renal pelvis. Methods: The data of 134 patients who underwent semirigid ureterorenoscopy (srURS) due to single and primary upper ureteral stones were included and analyzed in this retrospective cohort study. The patients were divided into two groups according to the development of spontaneous push-up during surgery (Group 1: The non-push-up group, Group 2: The push-up group).Results: While hemoglobin levels lowered significantly in both groups after the surgery, creatinine levels increased (P0.05). Operation times were similar in both groups, in contrast with the literature. Stone-free rates were significantly higher in srURS than in intrarenal surgery (RIRS) (P=0.03). Complication rates were also similar in this study.Conclusion: The application of srURS after fixing an upper ureter stone at its location using a Stone Cone® results in higher stone-free rates than pushing it back to dust it in renal pelvis. We recommend srURS supported by an antiretropulsion method as a treatment for upper ureteral stones.
      PubDate: Wed, 01 Sep 2021 00:00:00 +030
  • Two-year outcomes in patients undergoing rotational atherectomy and drug
           coated balloon therapy for chronic total occluded peripheral arterial
           diseases: A retrospective cohort study

    • Authors: Mustafa Özer ULUKAN; Atalay KARAKAYA, Murat UĞURLUCAN, Korhan ERKANLI
      Abstract: Background/Aim: Atherectomy is a minimally invasive endovascular surgery technique for removing atherosclerotic plaques in stenosed arteries. It seems to increase the success of angioplasty in the treatment of peripheral artery disease. We aimed to evaluate the outcomes of patients who underwent rotational atherectomy and drug-coated balloon therapy. Methods: In this retrospective cohort study, thirty-four patients who underwent rotational atherectomy and drug-coated balloon angioplasty between August 2016 and January 2019 were evaluated. The Rotablator System (Boston Scientific Corporation; Scimed, Plymouth, MN, USA) was used in all cases. Drug-coated balloons were used in the femoropopliteal section in all patients.Results: The mean age of patients was 65.55 (8.36) years. Seventeen had diabetes mellitus, for which 12 were using oral antidiabetic drugs and 5 were using insulin. At the 3rd postprocedural month, 94.1% of patients (n=32) had no clinical symptoms (P
      PubDate: Wed, 01 Sep 2021 00:00:00 +030
  • Long-term results of laparoscopic Heller myotomy with Dor-fundoplication
           in surgical treatment of achalasia: A single-center experience

    • Authors: Ali SÜRMELİOĞLU; Doğukan AKKUŞ
      Abstract: Background/Aim: Laparoscopic Heller myotomy with Dor fundoplication (LHD) is a widely used surgical method in achalasia treatment. However, it has not been well studied in terms of symptomatic relief effect and anti-reflux success in the long term. This study aimed to investigate the long-term success of LHD on symptom relief and acid reflux control. Methods: Patients who underwent LHD between February 2011 and June 2020 were included in this retrospective cohort study. Patients’ demographics, post-operative follow-up outcomes and esophagitis signs on endoscopy were retrieved from the institutional database. Eckardt scores of all study patients were calculated. Those with insufficient follow-up data were excluded. Disease free rates were calculated using the Kaplan-Meier analysis. Results: A total of 24 patients, 11 males and 13 females, were included. The mean age of all patients was 47.9 (11.3) years. The median follow-up time was 71.0 (12.0-117.0) months. Cumulative symptomatic relief (Eckardt ≤3) rate of LHD was 87.5% (21/24). Kaplan-Meier analysis showed that the time-dependent probability of Eckardt score being ≤3 at 3 and 5 years after the surgery were 100% and 94.7%, respectively. The mean expected survival time with Eckardt score ≤3 was 102.5 (95% CI: 87.6-117.3) months. The post-LHD esophagitis rate was 20.8% (5/24). The probability of no reflux esophagitis at 3 and 5 years after the surgery were 95.0% and 89.4%, respectively. The mean expected esophagitis-free survival was 94.2 (95% CI: 80.6-107.7) months.Conclusion: LHD seems successful and safe in terms of long-term symptomatic relief and acid reflux control in the surgical treatment of achalasia.
      PubDate: Wed, 01 Sep 2021 00:00:00 +030
  • Arthroscopic microfracture alone or combined application of acellular
           scaffold: Which one is more effective in the treatment of osteochondral
           lesions of the talus'

    • Authors: Bertan CENGİZ; Ramin MORADİ
      Abstract: Background/Aim: The optimal treatment method of the talar osteochondral lesions (TOLs) is still controversial. Although the success of arthroscopic microfracture treatment (AMFx) in smaller lesions is known, different treatment methods are tried in larger-sized TOLs. This study aimed to compare the clinical and radiological outcomes of the single-step AMFx repair procedure and the combined application of AMFx and cell-free scaffold (CFS) in the treatment of TOLs.Methods: This retrospective cohort study included patients presenting with a TOL larger than 1.5 cm2 and smaller than 3 cm2 between March 2015 and June 2018 who received arthroscopic treatment and attended follow-up for at least 24 months. Eighteen patients (group 1) were treated with the AMFx method, and 16 patients (group 2) with AMFx + CFS. American Orthopedic Foot and Ankle Society (AOFAS), Visual Analog Scale (VAS), and Tegner Activity Scores were used for clinical evaluation, and MOCART (magnetic resonance observation of cartilage repair tissue) score was used to assess cartilage repair tissue.Results: The mean patient age was 33.47 (8.67) years and the mean follow-up time was 32.24 (9.33) months. There was no significant difference between the two groups in terms of age (P=0.984), body mass index (P=0.450), defect size (P=0.081) and follow-up time (P=0.484). The median AOFAS score increased from preoperative assessment until follow-up assessment at 12 months in groups 1 (P
      PubDate: Wed, 01 Sep 2021 00:00:00 +030
  • Comparison of anterior tab flap and underlay tympanoplasty techniques in
           anterior tympanic membrane perforations

    • Authors: Fatih MUTLU; Kasım DURMUŞ, Murat ÖZTÜRK, Hasan Mervan DEĞER
      Abstract: Background/Aim: Closure of anterior tympanic membrane perforation is surgically demanding with high rates of graft failure. The anterior tab flap (ATF) technique is a modification of underlay tympanoplasty which claims higher success rates for repairing anterior and subtotal perforations. Our main aim was to compare graft take rates of ATF and underlay techniques in anterior tympanic membrane perforations.Method: In this retrospective cohort study, 41 patients with anterior tympanic membrane perforations who underwent tympanoplasty at a tertiary referral center were analyzed. The patients were grouped according to the technique used. Demographic, clinical, and follow-up information as well as preoperative and postoperative 6th-month audiometric data were collected and compared between the groups. Results: Four patients were lost to follow-up. Eighteen patients in the ATF arm and 19 patients in the underlay arm were compared. Graft take rates were 94.4% in the ATF group and 73.7% in the underlay group (P=0.180). An air conduction threshold average of 0.05). The postoperative ABG of the ATF and underlay group patients were less than 20 dB in 76.5% and 78.9%, respectively (P>0.05). No graft lateralization, anterior blunting, or cholesteatoma were observed.Conclusion: ATF is a safe and effective technique with a higher success rate for repairing anterior tympanic membrane perforation.
      PubDate: Wed, 01 Sep 2021 00:00:00 +030
  • Correlation between neck circumference measurement and obesity type with
           difficult intubation in obese patients undergoing elective surgery

    • Authors: Gözde ÇELİK; Seniyye ZENGİN, Meliha ORHON ERGÜN, Tümay UMUROĞLU
      Abstract: Background/Aim: The number of obese patients undergoing elective surgery is increasing day by day. However, there are conflicting data in the literature about factors predicting difficult tracheal intubation in obese patients. The aim of this study was to evaluate the commonly used predictors of difficult intubation in obese patients (body mass index (BMI) >35 kg/m2) who wish to undergo elective surgery and to examine the association of neck circumference and obesity type with difficult intubation.Methods: This observational, cross-sectional, prospective study was performed after obtaining approval from the ethics committee. Obese patients over the age of 18 years, requiring tracheal intubation, undergoing elective surgery, and with a BMI greater than 35 were included in this study. Patients with a history of cervical spine anomaly or trauma, congenital facial anomaly or trauma affecting this region, those who would undergo emergency surgery, patients with a known history of difficult airway or upper respiratory tract disease, and those with planned awake intubation were excluded from the study. Preoperative anesthetic evaluation was performed for all patients, their relevant measurements were obtained, and medical histories were taken as required for the study. The association of the patients’ BMI, Mallampati classification, thyromental distance, Cormack–Lehane grade, obstructive sleep apnea, neck circumference, and obesity type with difficult intubation was evaluated. Preoperative and peroperative measurements were recorded in the follow-up forms.Results: A total of 85 patients, 62 females and 23 males, between the ages of 19 and 77 years were included in this study. A significant difference was found in the patients’ BMI, neck circumference, thyromental distance, Mallampati classifications, and Cormack–Lehane grades in terms of intubation difficulty (P
      PubDate: Wed, 01 Sep 2021 00:00:00 +030
  • Anesthesia management in dystrophic epidermolysis bullosa: A case report

    • Authors: Sibel TETİKER; Nilgün ALPAY
      Abstract: Epidermolysis bullosa (EB) is a rare hereditary disorder characterized by an abnormal increase in the fragility of the skin and mucosal surface and recurrent blistering. Blisters and scar formation can be seen in tissues even after a minor trauma. Due to the healing of this disease by leaving a contracted scar tissue, the findings, especially on the airway, may cause important anesthetic problems. In addition, the protection of the skin and the mucosa during the procedures to be performed, prevention of new bulla formation and prevention of infection constitute the main difficulty in anesthesia management.This case report describes the anesthesia management for the dental treatment of a patient diagnosed with dystrophic epidermolysis bullosa (DEB) and aims to review the current information.
      PubDate: Wed, 01 Sep 2021 00:00:00 +030
  • Preoperative effects of magnesium sulfate on hemodynamics and muscle

    • Authors: Funda ATAR; Helin ŞAHİNTÜRK, Murat ÜNSEL, Cengiz YUMRU
      Abstract: Background/Aim: Although there are many studies on the effects of magnesium sulfate in the literature, there is no publication on the effects of low doses of magnesium sulfate, as we administered in our study. This prospective randomized study aimed to reveal that the use of low-dose magnesium sulfate (MgSO4) shortens the onset time and prolongs the block duration of neuromuscular blockers (NMBs) without changing the hemodynamics in patients monitored using the train-of-four (TOF) ratio.Methods: This is a prospective randomized study. A total of 60 cases aged between 18–65 years with American Society of Anesthesiologists classifications I–II who were scheduled for elective open cholecystectomy were randomly divided into 3 groups. Notably, 15 minutes before the anesthesia induction, 25 mg/kg MgSO4 in intravenous 0.9% saline (total volume, 100 mL) was administered to the MgSO4 group (MS group), 0.03 mg/kg midazolam was administered to the midazolam group (MD group), and the same volume of 0.9% saline solution was administered to the control group (PSS group). Nerve-muscle conduction monitoring was performed using TOF-Watch® SX (Organon, Ireland) and anesthesia depth was monitored with a BIS® monitor (A-2000; Aspect Medical Systems, USA).Results: NMB onset times were 83.95 (26.8), 111.15 (28.12), and 163.7 (34.16) seconds (P=0.001) in the MS, MD, and PSS groups, respectively. The times until additional rocuronium requirement after the intubation dose were 60.1 (4.19), 50.8 (4.99), and 38.25 (7.27) minutes in the MS, MD, and PSS groups, respectively, which was significantly longer in the MS group compared to the other groups (P95% was longer in the MS group than in the other groups. No difference was found between the groups in terms of hemodynamic data.Conclusion: Low-dose MgSO4 administration before rocuronium injection significantly reduces neuromuscular agent consumption without altering hemodynamics and causing a residual neuromuscular block.
      PubDate: Wed, 01 Sep 2021 00:00:00 +030
  • Histological investigation of the protective effect of metformin on testis
           and sperm parameters in obese rats with type 2 diabetes mellitus

    • Authors: Özcan BUDAK
      Abstract: Background/Aim: Diabetes mellitus (DM) is thought to have adverse effects on the male reproductive system. Metformin (MTF) is a widely used drug in the treatment of DM. This study hypothesized that MTF can reduce the harmful effects of DM on the male reproductive system in addition to diabetes treatment.Methods: Twenty-one adult (15-18 g, 11-12 months) C57BL6 male mice were randomly assigned to three groups, as follows: The Control group (C), Diabetes group (D), and Diabetes + Metformin (D+MTF) treatment group. Groups D and D+MTF were fed a diet composed of 60% fat for four weeks. DM was created by administering a single dose of 30 mg/kg streptozotocin intraperitoneally (i.p.). MTF was given through gavage at a dose of 300 mg/kg/day. At the end of the experiment, sperm parameters were evaluated in the testicular tissue. Histomorphology features and immune expressions of VEGF, Caspase-3, and Ki-67 were evaluated in testicular tissue sections stained with Hematoxylin and Eosin (HE).Results: Sperm concentration, motility, and morphological characteristics of diabetic mice were significantly reduced compared to control, and MTF-treated mice. Seminiferous tubule diameters and Johnsen scores were significantly higher in the control and D+MTF groups when compared to the diabetic group. VEGF and Ki-67 immune expression were significantly higher in the control and D+MTF groups compared to the D group (P=0.001, and P=0.002, respectively). Because of D, Caspase-3 positive cell density was higher in the D group compared to the control and D+MTF groups (P=0.002).Conclusion: Diabetes mellitus had adverse effects on sperm parameters and the testicular tissue. High glucose levels with decreased VEGF immune expression damaged spermatogenic cells and decreased proliferation and differentiation due to impaired intratesticular vascularity. MTF treatment reduced the damage in spermatogenic cells and contributed to the differentiation and division of cells through the restoration of vascularization.
      PubDate: Wed, 01 Sep 2021 00:00:00 +030
  • Evaluation of sinonasal complaints in obstructive sleep apnea

    • Authors: Ceyhun CENGİZ
      Abstract: Background/Aim: Sinonasal complaints are frequently observed in patients with obstructive sleep apnea (OSA). This study aimed to correlate the severity of OSA with sinonasal complaints.Methods: A total of 90 patients, including 30 patients with mild, 30 with moderate, and 30 with severe OSA, were enrolled in this cross-sectional study. None of the patients received any treatment for OSA at the time of enrollment. All participants were asked to complete the SNOT-22 questionnaire. Subdomain scores obtained from the patients with the SNOT-22 questionnaire, total scores, and scores obtained for each complaint were investigated for any correlations with severity of OSA. Also, mild, moderate, and severe OSA groups were compared with each in terms of these scores. Results: A significant, positive correlation was found between AHI values and “nasal obstruction,” “runny nose,” “lack of a good night's sleep” and “waking up tired” items of the SNOT-22 (P=0.008, P=0.022, P=0.037, P=0.005, respectively) and nonrhinologic otolaryngologic subdomain scores (P=0.036). A significant, positive correlation existed between the severity of OSA and sleep subdomain score (P=0.039) and the total score (P=0.047) in addition to all the above-mentioned elements. There was no difference between mild and moderate OSA groups in nasal obstruction and runny nose complaints (P=0.858, P=0.990, respectively) but a difference was noted between mild and severe (P=0.016, P=0.011, respectively), and moderate and severe OSA groups (P=0.015, P=0.011, respectively). While there was no difference between mild and moderate (P=0.268), and moderate and severe OSA groups (P=0.036) in terms of the 'waking up tired' item, the mild and severe OSA groups differed significantly (P=0.009).Conclusion: OSA causes various sinonasal complaints such as nasal obstruction, runny nose, and waking up tired. An increase in OSA severity leads to an increase in these complaints, and treatment may lead to increased quality of life.
      PubDate: Wed, 01 Sep 2021 00:00:00 +030
  • The effect of the Covid-19 outbreak on the management of acute
           appendicitis: A retrospective comparative cohort study

    • Authors: Metin YEŞİLTAŞ
      Abstract: Background/Aim: Covid-19 pandemic (Cov19) has affected the world since December 2019. The management of acute appendicitis (AA) has also changed distinctly during the Cov19 outbreak. The aim of this study is to evaluate and compare the results of AA during the pre-pandemic period and the first wave of the Cov19 outbreak.Methods: Patients diagnosed with AA from March to July 2019 (pre-pandemic, 2019), and from March to July 2020 (first wave of the pandemic, 2020) were included in this study, and evaluated for age, gender, nationality, length of stay (LOS), ultrasonography (USG), computed tomography (CT) findings, C-reactive protein level (CRP), white blood cell count (WBC), treatment results, operation type, and pathological examination results retrospectively. Results: One hundred patients from 2019, and seventy-seven patients from 2020 were included in the study. The male ratio, false negative USG, number of CTs performed (especially among conservatively treated patients), CRP levels, the rate of conservative treatment were higher, and LOS was longer among patients treated in 2020 (P
      PubDate: Wed, 01 Sep 2021 00:00:00 +030
  • The impact of Covid-19 on ECG: A case-control study

    • Authors: Bedri Caner KAYA; Berna KAYA
      Abstract: Background/Aim: Coronavirus Disease 2019 (Covid-19) is a pandemic with fatal effects on the respiratory and cardiovascular systems. Early recognition of complications in the cardiovascular system in Covid-19 disease will guide our treatment management. Therefore, we aimed to examine the changes that occurred in the ECGs of patients with a Covid-19 infection in the last year who were admitted with palpitations.Methods: Patients who presented to the Cardiology and Internal Medicine outpatient clinics with a complaint of palpitation between June 2021 and July 2021 and who had a Covid-19 infection in the last year were included in this study. A total of 212 patients with a history of Covid-19 and a control group of 185 people without Covid-19 history and cardiac diseases were compared. At admission, QTc, Tp-e interval, frontal QRS-T angle, and fragmented QRS were evaluated on Electrocardiography (ECG).Results: Among patients with a history of Covid-19 disease, there were 127 (59.91%) males and 85 (40.09%) females. Within the control group, 71 (38.38%) were males and 114 (61.62%) were females. In patients who had a Covid-19 infection, QTc (OR: 1.071, 95% CI: 1.042-1.100, P
      PubDate: Wed, 01 Sep 2021 00:00:00 +030
  • Which anti-TNF is most effective for my patient' Which one should I

    • Authors: Melih PAMUKCU; Rabia AYDOGAN BAYKARA
      Abstract: Background/Aim: Multicenter controlled studies were conducted on the effect of anti-Tumor Necrosis Factor (TNF) agents in rheumatoid arthritis (RA) and varying effectiveness rates were reported. These agents have different advantages over each other. We aimed to compare the disease activation parameters in patients with RA at the beginning and the 52nd week of therapy in patients who were followed up in our center and started on anti-TNF (etanercept, adalimumab, and golimumab), and examine the effects of the drugs that are used by comparing them with each other.Methods: This retrospective cohort study included 187 patients with RA who were started on anti-TNF therapy because the disease activity could not be controlled by the concomitant use of at least three different conventional Disease-Modifying Anti-Rheumatic drugs, and whose adequate response to anti-TNF were observed at the 12th-week follow-up. RA disease activity was measured using the 28-joint Disease Activity Score incorporating erythrocyte sedimentation rate (DAS-28 ESR) and the patients were evaluated by a Health Assessment Questionnaire (HAQ). For each drug group, disease activation and laboratory parameters were compared before treatment initiation and at 52 weeks of treatment. These values were then compared between the drug groups.Results: The mean age of 187 patients included in the study was 52.70 (10.17) years, 119 (63.6%) were female and 68 (36.4%) were male. Of the patients, 63 (33.7%) were using adalimumab, 62 (33.2%) were using etanercept and 62 (33.2%) were using golimumab. In all patients, there was a significant improvement in all parameters except mean corpuscular hemoglobin, gamma-glutamyl transferase, and creatinine. There were significant changes in hemoglobin, leukocyte and platelet count, erythrocyte sedimentation rate, C reactive protein, neutrophil count, serum albumin, DAS-28 ESR, and HAQ levels in all three groups (P
      PubDate: Wed, 01 Sep 2021 00:00:00 +030
  • A new parameter for the determination of normal right ventricular function
           in patients with acute pulmonary embolism

    • Authors: Murat KERKÜTLÜOĞLU; Hakan GÜNEŞ, Oguzhan YÜCEL, Ömer DOĞAN, Mehmet Birhan YILMAZ
      Abstract: Background/Aim: The performance of the right ventricular myocardium is crucial in various pathological states and the right ventricular dysfunction has a prognostic value in pulmonary embolism. We sought to bring out which parameters were helpful in predicting a normal right ventricular function in patients with acute pulmonary embolism.Methods: Consecutive 100 acute pulmonary embolism patients, who were hospitalized and confirmed by computed tomography angiography, were enrolled in this cohort study. All patients’ demographics, symptoms on admission, risk factors, electrocardiography and laboratory findings, and hemodynamic parameters were assessed. Echocardiography was performed in the first 24 hours. The study group of pulmonary embolism patients was divided into two groups based on their basic characteristics: Patients with normal right ventricular function and patients with right ventricular failure.Results: The average age of the patients was 63 (16) years, with 48 (48%) of them being male. Twenty three patients (23%) had normal RV functions. According to the multiple logistic regression analysis, age (P=0.041, OR: 1.174, 95% CI: 1.007 to 1.368), oxygen saturation (P=0.026, OR: 1.372, 95% CI: 1.039 to 1.812) and heart rate (P=0.049, OR: 1.160, 95% CI: 1.001 to 1.346) were independent predictors of normal RV function. The setting in which all three parameters (Age, Heart rate, Oxygen saturation) were positive was considered AHO index=1, with a positive predictive value of 100% a sensitivity of 44%, a negative predictive value of 85.6% and a specificity of 100% (AUC: 0.717, 95% CI: 0.619 to 0.803) for normal RV function.Conclusion: In acute pulmonary embolism patients who were younger than 53 years of age with a heart rate of ≤118 bpm and an oxygen saturation of >90% (AHO index=1), right ventricular functions were normal. Accordingly, without the need of computed tomography angiography or echocardiography, the clinician may predict normal right ventricular function with available demographic and noninvasive hemodynamic parameters.
      PubDate: Wed, 01 Sep 2021 00:00:00 +030
  • Evaluating the role of SmartpilotĀ® view assisted target-controlled
           infusion anesthesia during intracranial mass surgery: A comparative
           retrospective study with bispectral index-guided standard anesthesia

    • Authors: Gözde İNAN; Gökçen EMMEZ, Kutluk PAMPAL, Zerrin ÖZKÖSE ŞATIRLAR
      Abstract: Background/Aim: Neuroanesthesia necessitates the control of both systemic and cerebral hemodynamics, the prevention of intracranial pressure increase, knowledge of anesthetics’ cerebral effects, and early neurological recovery. The titration of anesthetics becomes crucial to optimize the appropriate level of anesthesia required for surgery while reducing postoperative neurological consequences. Smartpilot® View (SPV) is a new decision support system that uses pharmacologic models to optimize anesthetic depth and improve patient outcomes. The goal of this study was to compare the effectiveness of SPV with standard BIS-guided anesthesia administration in terms of intraoperative hemodynamic stabilization, anesthetic consumption, and postoperative recovery times during intracranial mass surgery.Methods: Following ethics committee approval, the records of the patients who underwent elective supratentorial craniotomy between November 15, 2017 and March 15, 2018 were reviewed retrospectively. The demographics of the patients, anesthesia and surgery times, eye opening and extubation times, time to reach an Aldrete score of 9 and anesthetic consumptions were compared between those who were monitored with SPV in addition to BIS (SPV Group) and those who were monitored with solely BIS for standard anesthetic follow-up (BIS Group).Results: A total of 139 subjects were analyzed (SPV (n=71), BIS (n=68)). Hemodynamic responses to induction and intubation were more pronounced in the BIS group (P
      PubDate: Wed, 01 Sep 2021 00:00:00 +030
  • The effect of online education during the pandemic on ocular surface

    • Authors: Abdullah BEYOĞLU; Muhammed Mustafa BEYOĞLU
      Abstract: Background/Aim: During the pandemic, eye symptoms increased. This study aimed to investigate the effects of online education on ocular surface symptoms, which was a part of the distance learning model during the COVID-19 pandemic, to be able to prevent the formation of irreversible damage.Methods: This cohort study included 315 students who were undertaking online education and presented at the Ophthalmology Department of a university hospital. The sociodemographic data, Schirmer test results, tear break-up time (TBUT) and Ocular Surface Disease Index (OSDI) scores of the students were noted. The data were analyzed using SPSS v. 22.0 software and a value of P
      PubDate: Wed, 01 Sep 2021 00:00:00 +030
  • Prognostic value of preoperative glucose to lymphocytes ratio in patients
           with resected gastric cancer

    • Authors: Murat Baki YILDIRIM; Murat Bulut ÖZKAN
      Abstract: Background/Aim: There are no definitive tests that determine postoperative survival in gastric cancer. Simple and cheap laboratory markers are needed for clinicians to guide them preoperatively. The aims of our study were to analyze the importance of preoperative glucose-lymphocyte ratio (GLR) in the prognosis of patients with gastric cancer (GC), and to compare the success of GLR in predicting prognosis with the success of neutrophil-lymphocyte ratio (NLR) and C-reactive protein-albumin ratio (CAR).Methods: We carried out a cross-sectional study on 196 GC patients. CAR, NLR and GLR values were calculated from the blood samples taken 24 hours before the surgery. Lymphovascular invasion, serosal invasion, and the number of metastatic lymph nodes were determined, and the prediction ability of glucose to lymphocyte ratio (GLR), neutrophil to lymphocyte ratio (NLR), and C-reactive protein to albumin ratio (CAR) were evaluated. In addition, the effect of GLR and NLR on the ability to predict overall survival was assessed. The mean follow-up period was 37 (6-69) months. Results: A moderate and weak positive correlation was found between GLR, NLR and the number of metastatic lymph nodes (r=0.415, P
      PubDate: Wed, 01 Sep 2021 00:00:00 +030
  • Nano-based ceramic surgical blade accelerates wound healing

    • Authors: Fatih ADA; Erkan GÜMÜŞ, Ferit KASIMZADE
      Abstract: Background/Aim: Many factors affect the results of a surgical operation, one of which is the harmony of the materials used during surgery with the tissue. Zirconia is a material with antimicrobial properties, high surface sensitivity and robustness. This study was conducted to observe the acute and subacute effects of the nano-based zirconia surgical blade on living tissue. Methods: The study was conducted after approval was granted by the Sivas Cumhuriyet University Animal Experiments Local Ethics Committee with the decision number 65202830-050.04.04-33. A total of 16 rats were used in the study. Eight were incised with classic steel surgical blade and eight, with nano-based zirconia surgical blade. A total of 4 incisions were performed to each rat and the incisions were closed with 3.0 polypropylene suture. Tissue samples were obtained from the incisions on day 0, 3, 7 and 21, and examined histologically.Results: The epidermis layer thickness on days 7 and 21 (P=0.030, P=0.025), the dermis layer thickness on days 3 and 7 (P=0.035, P=0.030), muscle layer thickness on days 7 and 21 (P=0.030, P=0.025) were significantly increased and inflammatory cells were significantly less on days 3, 7 and 21 (P=0.030, P=0.020, P=0.025) in the nano-ceramic surgical blade compared to the other group. Collagen tissue density was significantly higher in favor of the nano-ceramic blade on the 3rd and 7th days (P=0.025, P=0.020).Conclusion: Nano-based zirconia surgical blade has been shown to have positive effects on wound healing. The use of nano-based zirconia surgical blade should be kept in mind in patient groups with wound healing problems.
      PubDate: Wed, 01 Sep 2021 00:00:00 +030
  • Combination of the Simplified Modified Geneva and Wells Clinical
           Prediction Scoring promise a good performance in pulmonary embolism

    • Authors: Gökhan ÇORAPLI; Ayşe Füsun TOPÇU
      Abstract: Background/Aim: Pulmonary thromboembolism (PTE) has high mortality and morbidity, is difficult to diagnose, and is generally preventable. Clinical scoring is used for early diagnosis. Two of these often-used scoring systems include the Wells and Simplified Modified Geneva scoring systems. We aimed to comparatively determine the values of the Wells and the Simplified Modified Geneva scoring systems in showing PTE. Methods: This prospective cohort study included 195 patients who underwent computerized tomography pulmonary angiography (CTPA) with suspected PTE between May 2018 and November 2018. The Wells and Simplified Modified Geneva scores of the patients were calculated. Wells Clinical Scoring results were grouped as having a weak/strong probability of PTE, while those of the Modified Geneva clinical scoring were categorized as possible/unlikely PTE. The analyses were performed with the SPSS package 21.0 program. Results: One hundred and nine (55.9%) patients presented to the emergency department and eighty-six (44.1%) patients visited the outpatient clinic for chest diseases. Of all cases, 83 (42.6%) were male and 112 (57.4%) were female. The mean age was 57.16 (18.62) years. Forty-one (21%) patients had PTE. The sensitivity and specificity of Wells Clinical Scoring for PTE were 87.8% and 83.8%, respectively, while those of the Simplified Modified Geneva Clinical Scoring were 82.9% and 53.3%, respectively. The chi-square analysis for two clinical scorings revealed a p-value of 0.001. The negative predictive values of Wells and Simplified Modified Geneva Scores were 96.2% and 92.1%, respectively. The positive predictive value was the highest in the emergency department (80% and 39.4%, respectively). When the two clinical scores were used together, the negative and positive predictive values were 95.6% and 61.1%, respectively. Conclusion: We found that Wells Clinical Scoring is superior to the Simplified Modified Geneva Score in terms of sensitivity and specificity. The use of these two clinical scores in the outpatient clinic was more useful in excluding PT, while in the emergency department, their combination was more effective in diagnosing it.
      PubDate: Wed, 01 Sep 2021 00:00:00 +030
  • Early enteral nutrition with L-glutamine improves anastomotic healing in
           rats administered hyperthermic intraperitoneal chemotherapy with cisplatin
           and 5-FU

    • Authors: Hüseyin ALAKUŞ; Mustafa GÖKSU, Siraç ERTEN
      Abstract: Background/Aim: One of the most significant aspects of intestinal surgery is anastomotic wound healing. After intestinal surgery, the most serious complication is gastrointestinal leakage, which is associated with a high rate of morbidity and mortality. The rate of morbidity and mortality can be reduced by increasing the mechanical resistance of the anastomosis. Glutamine improves impaired wound healing through effects on the healing process. This study investigated the effects of early enteral glutamine supplementation on colonic anastomosis healing in rats treated with hyperthermic intraperitoneal chemotherapy (HIPEC) with cisplatin and fluorouracil (5-FU).Methods: Twenty-four rats were divided into three groups. Group 1 underwent colonic anastomosis and intraabdominal hyperthermic saline administration, Group 2 underwent colonic anastomosis and HIPEC, and Group 3 underwent colonic anastomosis and HIPEC and postoperative administration of glutamine solution via an orogastric tube for 7 days. On day 7, all rats were sacrificed and anastomotic bursting pressure (ABP) was evaluated. Tissue specimens were taken to examine tissue hydroxyproline levels and histopathological changes in the anastomotic line.Results: The ABP was significantly greater in Group 2 than in Groups 1 and 3 (P=0.001 and P=0.046, respectively). The tissue hydroxyproline level was higher in Group 1 and Group 3 than in Group 2 (P=0.001 and P=0.043, respectively). The histopathological findings in Group 3 were better than those in Group 2. The histopathological findings were observed to improve in the early enteral nutrition with Glutamine group.Conclusions: The findings of this study indicate that early enteral glutamine supplementation facilitates colonic anastomosis healing following HIPEC with cisplatin and 5-FU, by increasing the ABP and tissue concentrations of hydroxyproline and decreasing the inflammatory response.
      PubDate: Wed, 01 Sep 2021 00:00:00 +030
  • Likelihood of cancer in breast cancer imaging according to BI-RADS

    • Authors: Mahmut ÇORAPLI; Hacı Taner BULUT, Gökhan ÇORAPLI, Burcin PEHLİVANOGLU, Hüseyin ALAKUŞ, Hasan SOYSALDI
      Abstract: Background/Aim: Breast cancer is the most common type of cancer among women and one of the most common causes of cancer-related death. Breast Imaging-Reporting and Data System (BI-RADS) is widely used in breast imaging and aims to provide effective communication between physicians. This study aimed to investigate the positive predictive values (PPVs) of BI-RADS categories as assessed by different imaging modalities in reference to Tru-Cut biopsy results.Methods: This retrospective cross-sectional observational study included 415 lesions obtained by Tru-Cut biopsy between March 2018 and December 2020. The lesions were examined by ultrasound (US), mammography, and magnetic resonance imaging (MRI) and categorized as BI-RADS 3, 4, or 5. In this system, every category has its own likelihood of cancer ratio.Results: The most common malign and benign lesions were invasive ductal carcinoma and fibroepithelial lesion, respectively. The PPVs of US BI-RADS category 3, 4, and 5 lesions were 2.15%, 47.44%, and 95.19%, respectively, those of mammographic BI-RADS 3, 4, and 5 lesions were 3.79%, 53.45%, and 94.2%, respectively, and those of MRI BI-RADS 3, 4, and 5 lesions were 0%, 57.89%, and 88.1%, respectively.Conclusion: Predicting the probability of cancer in breast imaging is of significance for patient management and effective communication between the radiologist and other physicians. We demonstrated the compatibility of our experience with the literature with this study, in which we demonstrated the possibility of imaging modalities to predict cancer according to BIRADS categories.
      PubDate: Wed, 01 Sep 2021 00:00:00 +030
  • Evaluation of macular perfusion in patients with treatment-naive overt
           hypothyroidism using optical coherence tomography angiography

    • Authors: Ayşegül MAVİ YILDIZ; Gülçin ŞAHİNGÖZ ERDAL, Hatice TARAKCİOGLU, Ali Atakhan YILDIZ, Sami YILMAZ
      Abstract: Background/Aim: Thyroid hormones play an essential role in retinal development and physiological functions. Although the effects of hyperthyroidism on ocular circulation are well-defined, no studies report the effects of clinical hypothyroidism on retinal and choroidal circulation. We aimed to compare the macular vessel density and flow indexes of patients with treatment-naive hypothyroidism and healthy controls using optical coherence tomography angiography (OCTA).Methods: This case-control study included 104 eyes of 52 participants. Group 1 (n=24) consisted of patients with treatment-naive overt hypothyroidism, while Group 2 (n=28) consisted of age and sex-matched healthy controls. Images were obtained using AngioVue software 2.0 of the OCTA device in a 6 × 6 mm area centered on the macula. Foveal avascular zone (FAZ) area, macular retinal thickness, FAZ perimeter (PERIM), choroidal flow index (CF), outer retinal flow index (ORF) and macular vessel density (VD) in the superficial (SCP) and deep retinal capillary plexus (DCP) were recorded for all patients.Results: The whole [Group 1: 49.9 (7.0)%; Group 2: 54.6 (5.9)%], parafoveal [Group 1: 54.7 (4.8)%; Group 2: 58.6 (3.9)%] and perifoveal [Group 1: 51.5 (7.2)%; Group 2: 55.9 (6.8)% ] VD in DCP were significantly lower in Group 1 compared to Group 2 (P=0.012; P=0.002 and P=0.028 respectively). However, parafoveal VD in SCP was significantly higher in Group 1 [52.4 (2.26)] than in Group 2 [49.9 (6.87)] (P=0.032). The mean VD in DCP was significantly positively correlated with the choroidal (P=0.021) and outer retinal flow indexes (P=0.033). The mean foveal VD in DCP was significantly positively correlated with the mean foveal (P
      PubDate: Wed, 01 Sep 2021 00:00:00 +030
  • Effects of antenatal magnesium sulfate use for neuroprotection on
           cardiorespiratory complications during the early neonatal period in
           preterm infants

    • Authors: Nuran ÜSTÜN; Meryem HOCAOĞLU, Abdulkadir TURGUT, Fahri OVALI
      Abstract: Background/Aim: Antenatal magnesium sulfate (MgSO4) treatment is widely used for fetal neuroprotection in women at risk of preterm delivery. Possible adverse effects of MgSO4 include respiratory depression and delay in closure of ductus arteriosus by antagonism of calcium channels. The aim of this study was to investigate the effects of antenatal MgSO4 exposure on cardiorespiratory complications during the early neonatal period in premature infants.Methods: A retrospective cohort study was performed on 340 preterm infants born between 23 and 32 weeks of gestational age. Patients were divided into two groups according to antenatal MgSO4 exposure: The MgSO4 group (n=186) and the no-MgSO4 group (n=154). Outcomes were acute cardiorespiratory events (intubation at birth, respiratory support, and hypotension in first day of life), and hemodynamically significant patent ductus arteriosus (HsPDA).Results: Mothers in the MgSO4 group were more likely to have preeclampsia and antenatal steroid treatment, while their infants were younger in gestation and weighed less (P
      PubDate: Wed, 01 Sep 2021 00:00:00 +030
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