Trephine stoma: Outcomes in a single center
Abdullah Oğuz, Ahmet Türkoğlu, Metehan Gümüş, Zübeyir Bozdağ, Mehmet Veysi Bahadır, Fatma Teke, Hıdır Budak, Abdullah Böyük
J Clin Exp Invest 2015;6(2):87-90.
https://doi.org/10.5799/ahinjs.01.2015.02.0495
Research Article
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ABSTRACT
Objective: Fecal diversion is often indicated in cases with fecal incontinence, Fournier’s gangrene, anal fistula, and inoperable obstructive anorectal cancer. Trephine colostomy can be performed without necessitating laparotomy. We present our experience related to the outcome of trephine sigmoid colostomy.
Methods: The retrospective study included 14 patients who underwent trephine colostomy due to various conditions including Fournier’s gangrene, inoperable anorectal cancer, recto-vaginal fistula, and benign stricture due to radiotherapy at our clinic between January 2010 and January 2015.
Results: Patients comprised 4 females and 10 males with a mean age of 52.07 years. The indications for stoma formation were Fournier’s gangrene in 7 cases, inoperable anorectal cancer in 5, rectovaginal fistula in 1, and benign stricture due to radiotherapy in 1 case. Eight patients underwent surgery under regional anesthesia. All the patients underwent trephine loop sigmoid colostomy. One patient had second operation on the postoperative period due to colostomy prolapse. The temporary stomas were closed in 3 months. Mean length of hospital stay was 14 days.
Conclusion: Trephine stoma is a relatively simple, safe and rapid procedure and an effective alternative to colostomy formation without laparotomy indications. It can be performed under emergency or elective conditions with low morbidity.
Keywords: Fecal diversion, trephine stoma, outcomes
Comparison of eGFR Values Calculated by Using Serum Cystatin C and Serum Creatinine in Patients with Diabetes Mellitus
Cevdet Türkyürek, Müjgan Ercan, Esra Oğuz, Serpil Erdoğan, Fatma Meriç Yılmaz
J Clin Exp Invest 2015;6(2):91-95.
https://doi.org/10.5799/ahinjs.01.2015.02.0496
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Objective: In this study, we aimed to compare estimated glomerular filtration rate (eGFR) formulas based on cystatin C and serum creatinine and investigate whether the formulas can detect the renal damage at microalbuminuric level in diabetic patients.
Methods: Totally, 99 type 2 diabetic patients were included and divided into 3 groups according to 24 hour urine albumin levels as normoalbuminuric group (group 1), microalbuminuric group (group 2) and macroalbuminuric group (group 3). Creatinine clearance, Cockcroft-Gault (C-G), Modification of Diet in Renal Disease (MDRD), The Chronic Kidney Disease Epidemiology (CKD-EPI), eGFR1, eGFR2 and eGFR3 levels were calculated using formulas.
Results: There were significant differences between group 1-3 and group 2-3, but there was no significant difference between group 1 and 2 in calculated GFR levels. Cystatin C-based formulas were found to have a better correlation with creatinine clearance.
Conclusion: As a result, cystatin C-based formulas were found to predict creatinine clearance better than the other calculated GFR formulas in diabetic patients. However none of the formulas can discriminate the renal damage at microalbuminuric level.
Keywords: eGFR, cystatin C, diabetic nephropathy, creatinine, CKD-EPI
Clinical and pathological investigation of adnexal masses in adolescents who underwent surgery in a tertiary center
Hediye Dağdeviren, Hüseyin Cengiz, Ammar Kanawati, Sema Süzen Çaypınar, Murat Ekin
J Clin Exp Invest 2015;6(2):96-101.
https://doi.org/10.5799/ahinjs.01.2015.02.0497
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Objective: Adnexal masses are the most common reason for gynecologic surgery in adolescent patients. Early detection and adequate management of adnexal lesions are very important for saving lives and preserving fertility. In this study, we analyzed the clinical characteristics of 106 Turkish adolescent women who underwent surgery for adnexal masses.
Methods: The study included 106 patients aged ≤20 years that underwent surgery for adnexal masses at our hospital between January 2008 and December 2013. Clinical profiles were retrospectively collected from the hospital medical records. The records were analyzed for demographic profiles, initial symptoms, preoperative radiologic findings, operative approach, surgical procedure, pathology findings, and the maximum diameter of the adnexal mass.
Results: The age of the patients ranged from 12 to 20 years (median, 18.8 years). The most common initial symptom in these patients was abdominal pain (56.6%). Non-neoplastic ovarian lesions in the patients included 7 (6.6%) corpora hemorrhagica, 10 (9.4%) corpus luteal cysts, 4 (3.8%) paratubal cysts, and 7 (6.6%) simple cysts. Benign neoplastic tumors included 20 (18.9%) mature cystic teratomas (i.e., dermoid tumors), 10 (9.4%) serous cystadenomas, 1 (0.9%) mucinous cystadenomas, and 7 (6.6%) endometriomas. The most common surgical approach and procedure were laparoscopy (67.0%) and cystectomy (60.4%), respectively.
Conclusion: Laparoscopy can be performed in many adolescent patients and conservative, adnexal-sparing surgery should be encouraged for all patients. Ovarian-preserving techniques should be a priority when surgery is performed for benign masses in order to optimize future fertility potential.
Keywords: Adolescent, adnexal, laparoscopy
Masked hypertension in children and its relationship with target organ damage
Seçil Conkar, Sevgi Mir, Betül Sözeri, Ümmügülsüm Yıldız, İpek Kaplan Bulut, Sibel Bozovalı, Ebru Yılmaz
J Clin Exp Invest 2015;6(2):102-109.
https://doi.org/10.5799/ahinjs.01.2015.02.0498
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Objective: Ambulatory blood pressure monitoring (ABPM) is important for the early diagnosis of masked hypertension. In present study, we aimed to determine the frequency of target organ damage in masked hypertension and establish a follow-up strategy in the early-stage for children.
Methods: The study population consisted of children and adolescents who were referred to our clinic for evaluation of suspected hypertension. A total of 120 children and adolescents aged 6 -17 years were investigated. Office blood pressure measurements were performed in all patients. Patients’ hypertension was evaluated with regard to target organ damage. Measurements were performed using Vicorder device. Patients underwent 24 h ambulatory blood pressure monitoring.
Results: ABPM revealed that 82 of 120 patients had hypertension. Hypertension was detected in 59 of 120 patients, by conventional blood pressure measurements. The frequency of masked hypertension was 42.7% (n=44), white coat hypertension 20.3% (n=21), and high ambulatory blood pressure was 36.8% (n=38). Increased carotid intima-media thickness was most frequently observed during the evaluation of early vascular changes in patients. We identified hypertensive retinopathy in 29 patients (24%), microalbuminuria in 21 (20.4%), and increased left ventricular mass index in 13 patients (10.8%). The frequency of hypertensive retinopathy was high, and increased carotid intima-media thickness and augmentation index were more common in masked hypertension.
Conclusion: In this study, higher frequency of masked hypertension was found in children than reported in the literature.
Keywords: Children, masked hypertension, ambulatory blood pressure monitoring, end organ damage
Assessment of hand dysfunction in patients receiving hemodialysis through arteriovenous fistula
Zeynep Tuna, Deran Oskay, Dilan Onder, Salih Inal
J Clin Exp Invest 2015;6(2):110-114.
https://doi.org/10.5799/ahinjs.01.2015.02.0499
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Objective: Patients receiving haemodialysis treatment generally tend to avoid using the upper extremity with arteriovenous (AV) fistulae and it results in impairment of hand functions. Limited data are available about impairment associated with hand complications in those patients The aim of this pilot study is to evaluate the handgrip and pinching strengths and functional level of both hands in patients receiving haemodialysis.
Methods: Fifteen chronic renal failure patients receiving haemodialysis (30-83 years) and 11 age-matched healthy volunteers participated in the study. All the patients were undergoing treatment through arteriovenous fistulae in the upper extremity. Handgrip strength with a manual dynamometer and pinch strength with a pinchmeter were measured. Functional level of both hands was evaluated with Nine-Hole Peg Test.
Results: Handgrip strengths of both hands were lower in patients receiving haemodialysis than healthy control group (p<0.01). Lateral, bipod and tripod pinching strengths were also lower in patients (p<0.05) with excepting right hand lateral pinching (p>0.05). 9-Hole Peg Test results in both placement and removal showed a great significant difference in both hands with a statistical significance of p<0.001.
Conclusion: Our first results revealed that chronic renal failure patients receiving haemodialysis treatment through arteriovenous fistulae in the upper extremity have a significant impairment in strength and functional level of hand. The lack of differences between two hands may be concluded that the upper extremity impairment in patients results from the disease course or haemodialysis treatment, not from the vascular access.
Keywords: Arteriovenous fistula, dexterity, haemodialysis, hand functions, vascular access
Evaluation of pregnant patients admitted to the emergency department with suicide attempt
Yılmaz Zengin, Ercan Gündüz, Recep Dursun, Mustafa İçer, Hasan Mansur Durgun, Ertuğrul Kara, Ahmet Gündüzalp, Cahfer Güloğlu
J Clin Exp Invest 2015;6(2):115-120.
https://doi.org/10.5799/ahinjs.01.2015.02.0500
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Objective: In the pregnancy period, the incidence of suicide attempt is lower compared to other life-periods. However, according to the recent studies, suicide attempts may lead life-threatening consequences in high-risk pregnant women. The aim of this study is to compare pregnant patients admitted to the emergency department for suicide attempt in terms of their sociodemographic and clinical properties and suicide attempt methods.
Methods: In this study, 56 patients admitted to the emergency department of university for suicide attempt between January 1, 2009, and December 31, 2014, were included and they were classified according to suicide attempt methods into 2 groups as violent ones. Group 1 included violent methods as hanging, jumping, shooting and Group 2 included non-violent method as drugs. The study was a retrospective cross-sectional study. The sociodemographic, psychiatric and clinical properties of the patients were identified by patient registry system and patient files, and inter-group differences were compared.
Results: In this study, 15 (26.7%) patients in the violent suicide attempt group, and 41 (73.3%) patients in the non-violent suicide attempt group, totally 56 patients were included. In the non-violent suicide attempt group, cigarette smoking, suicide attempt due to boredom, and live birth was significantly higher as compared to violent group; hospitalization period and fetal death was lower (p=0.04; p=0.006; p=0.004; p=0.004, respectively).
Conclusion: Most of our pregnant suicide attempt patients are in the non-violent group, however, violent suicide attempt increased hospitalization period and fetal mortality significantly.
Keywords: Emergency department, pregnant, suicide attempt
Assessment of dehydroepiandrosterone sulphate and total serum testosterone in Iraqi women with post-adolescent acne
Samer Abdulamir Dhaher, Khalil I. Al-Hamdi, Jinan Q. Mohammed
J Clin Exp Invest 2015;6(2):121-125.
https://doi.org/10.5799/ahinjs.01.2015.02.0501
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Objectives: The aim of this study was to assess dehydroepiandrosterone sulphate (DHEA-S) and total serum testosterone (TST) in women with post-adolescent acne and their relationship to severity of acne and clinical markers of androgenicity.
Methods: Two hundred forty women with post-adolescent acne (PAA), 132 women with late- onset acne (LOA) and 108 women with persistent acne (PA) were recruited in this cross-sectional study. All patients were examined clinically and by ultrasound for evidence of polycystic ovaries (PCO), and serum DHEA-S and TST levels were measured.
Results: The results showed that there was an excess in androgens (DHEA-S) and TST levels. Serum androgens level were significantly correlated to the severity of PAA. In addition, clinical markers of androgenicity were frequently observed in women with PAA.
Conclusion: There is an increased level of circulating androgens in significant proportion of women with PAA and it seems that hyperandrogenism appears to play an important role in the etiopathogenesis of acne. In addition, there was a direct correlation between severity of acne and androgen levels suggesting that both ovarian and adrenal abnormalities are common at this patients group.
Keywords: Dehydroepiandrosterone sulphate, total serum testosterone, post-adolescent acne
How urgent are cases brought to the emergency department by ambulance?
Melih Yüksel, Caner Sağlam, Muharrem Çakmak, Erkan Baysal, Aynur Altunbay, Sultan Baran
J Clin Exp Invest 2015;6(2):126-129.
https://doi.org/10.5799/ahinjs.01.2015.02.0502
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Objective: Emergency departments are the first places to which patients present with unexpected or unforeseen health problems. The purpose of this study was to assess the urgency of cases brought by ambulance to the Hospital on the basis of a three-level triage system.
Methods: This study was performed between 01.06.2013 and 31.09.2013 at the Diyarbakır Education and Research Hospital. Our emergency service unit is a third degree service for all adult patient groups and all child trauma types. Triage of patients brought to the emergency department by ambulance was performed by emergency medicine specialists. Patients’ vital findings, identity data and triage categories were assessed.
Results: 712 patients were included, 382 (53.7%) male and 330 (46.3%) female, with a mean age of 45. In this study, 619 (86.9%) patients were transferred from the scene and 93 (13.1) between hospitals, 483 (67.8%) patients were brought by emergency medicine technician (EMT) teams, 107 (15%) by physician-led teams, 107 (15) by paramedic teams and 15 (2.1%) by other teams, 442 (62.1%) patients were assessed as yellow, 141 (19.8%) as green and 129 (19.1%) as red zone. Five hundred eighty (81.5%) patients were discharged and 115 (15.9%) were hospitalized.
Conclusion: Emergency health services are clearly developing rapidly in Turkey. In order for pre-hospital emergency health services not to be abused, we think that these services should be up to the standards of those in developed countries and that public awareness needs to be increased, particularly with regard to triage.
Keywords: Emergency medicine, triage, ambulance
Patient management and clinical outcomes in non-traumatic small bowel perforations
Ahmet Türkoğlu, Abdullah Oğuz, Zübeyir Bozdağ, Yılmaz Zengin, Zülfü Arıkanoğlu, Metehan Gümüş
J Clin Exp Invest 2015;6(2):130-134.
https://doi.org/10.5799/ahinjs.01.2015.02.0503
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Objective: The aim of this study was to report our management and outcomes of patients who underwent surgery with the diagnosis of non-traumatic small bowel perforation.
Methods: The records of 30 patients who underwent surgery for non-traumatic small bowel perforation between 2005 and 2013 were examined. Age, gender, complaints, duration of symptoms, comorbid disease(s), perforation location, length of stay in hospital, etiology, surgical treatment, morbidity, and mortality data were recorded. Patients were divided into two groups, survivors and non-survivors, and their features were compared.
Results: The mean age of the patients was 51.3±19.9 years. Signs of peritoneal irritation were present in 22(73.3%) patients. In surgical exploration, generalized purulent peritonitis was observed in 14(46.6%) patients, while localized peritonitis was observed in the others. Bowel resection was performed in 27(90%) patients, while primary suture was performed in only 3(10%) patients. A diverting ileostomy was performed in 18(60%) patients. Mortality was observed in 9 (30%) patients. Duration of the symptoms and multiple perforations were significantly higher in non-survivors.
Conclusion: A delay in diagnosis and presence of multiple perforations are the most important causes of mortality. Every effort should be made to avoid delay in diagnosis; however, once the diagnosis is delayed, especially in patients with multiple perforations, extensive surgery such as bowel resection and ileostomy should not be avoided.
Keywords: Non-Traumatic, small bowel perforation, diagnosis, management
Evaluation of biofilm formation activity of standard microorganism strains
Uğur Tutar, Cem Çelik, Mehmet Ataş, Tutku Tunç, Mustafa Gökhan Gözel
J Clin Exp Invest 2015;6(2):135-139.
https://doi.org/10.5799/ahinjs.01.2015.02.0504
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Objective: Biofilm is a structure formed by a group of microorganisms. Bacteria in the biofilm lead to much more serious problems in medical and industrial terms when compared to their planktonic forms. In this sense, it is important to know about the biofilm activities of the microorganisms. The ability of certain microorganism strains to form biofilms was shown, and the importance of this subject was tried to be emphasized in this study.
Methods: Fifteen bacteria and two yeast standard strains were used in the study. Microtiter plate method was used in order to determine the biofilm production capacities of standard strains. Biofilm formations were assessed as “nonadherent =0,weakly adherent = I, moderately adherent = II and strongly adherent =III.”
Results: Biofilm formation was observed in all of the 17 standard strains following the study carried out. Among standard microorganisms, Pseudomonas aeruginosa, Staphylococcus aureus, Corynebacterium pseudotuberculosis and Neisseria sicca created a strong biofilm.
Conclusion: It is known that biofilms formed by microorganisms lead to negative consequences in human health. Therefore it’s important to study on understanding biofilm formations. We believe that the biofilm formation data of the standard microorganisms we provide in our study will contribute to the researchers to conduct researches on this subject and the literature related to the subject.
Keywords: Biofilm, microtiter plate method, antimicrobial resistance, standard strain
Epidemiological and clinical data of patients with spinal cord injury: Five-year experience of our center
Burhan Fatih Koçyiğit, Serdar Mazlum Akaltun, Özlem Altındağ, Ali Aydeniz, Savaş Gürsoy, Ali Gür
J Clin Exp Invest 2015;6(2):140-143.
https://doi.org/10.5799/ahinjs.01.2015.02.0505
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Objective: We aimed to present epidemiological and clinical data on spinal cord injury (SCI) patients who were rehabilitated at our hospital to define etiological factors and high risk groups.
Methods: Data on 174 SCI patients rehabilitated between January 2009 and October 2014 in our hospital were retrospectively evaluated. Patient age, sex, etiology of injury, injury level (cervical, thoracic, lumbar), total number of rehabilitation sessions, spinal operation status, functional groups according to the American Spinal Injury Association (ASIA) Scale were recorded.
Results: In total, 105 of the patients were male and 69 were female. The mean age of patients was 36.61 ± 16.16 years. Traffic accidents were the most common cause of injury (n=45, 25.9%), followed by falls from height (n=39, 22.4%). The most common injury was thoracic spine injury (n=95, 54.6%), followed by lumbar spine injuries (n=48, 27.6%). Traffic accidents were significant mechanism for thoracic spine injuries (p=0.007). Ineffective neurosurgery had a significant relation with lumbar spine injuries (p<0.001).
Conclusion: The most of the SCIs we observed were preventable. Comprehensive identification of the epidemiologic, clinic and demographic features of SCIs contributes to define most common etiological factors, high risk groups, thereby making it possible to pay personal and communal attention to precautions for SCIs.
Keywords: Spinal cord injury, epidemiology, etiology
Comparison of clinical characteristics of the elderly and very elderly patients in the medical intensive care unit
Mehmet Köş, Hafize Titiz, Birgül Öneç, Tuba Soysal, Ali Kutlucan, Yusuf Aydın, Leyla Kutlucan
J Clin Exp Invest 2015;6(2):144-149.
https://doi.org/10.5799/ahinjs.01.2015.02.0506
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Objective: The increase in the mean age of the general population is reflected in the patient populations who are in need of intensive care. Increasing number of comorbidities with age is also an important issue to be considered in the management of these patients. We evaluated clinical and laboratory features of the elderly (65-79 years) and very elderly (≥80 years) patients in our medical intensive care unit (ICU).
Methods: The clinical and laboratory data of intensive care patients aged 65 and over were retrospectively analyzed. Comorbidities were commented with 19 disease-weighted Charlson Comorbidity Index (CCI).
Results: 231 elderly and 216 very elderly patients were included in this study. Pulmonary diseases were the most prevalent primary cause of admission to ICU in both groups. The most common comorbidities were hypertension and heart failure in both groups. Number of patients whose CCI scores>3 were higher in very elderly patients group than in elderly patients group. While there was no difference in terms of median ICU-survival between two groups in general, when 30 days and longer intensive care follow-ups were evaluated, it was found 81.0 (95% CI: 48.8-113.2) days and 41.0 (95% CI: 36.6- 45.4) days in the elderly and very elderly patients respectively (p = 0.009).
Conclusion: We concluded that, age is not the main factor affecting the ICU-survival in patient over 65 years old in intensive care unit. However, increasing age may be associated with short survival at prolonged hospitalizations in ICU.
Keywords: İntensive care unit, aged, survival
Our anesthesia practices outside the operation room: Evaluation of 528 patients
Muhammed Bilal Çeğin, Lokman Soyoral, Nureddin Yüzkat, Mehmet KIlıç, Nurettin Kurt, Uğur Göktaş
J Clin Exp Invest 2015;6(2):150-153.
https://doi.org/10.5799/ahinjs.01.2015.02.0507
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Objective: In this research, we aimed to present the latest data of a medical faculty's outpatient anesthesia applications.
Methods: The patients of the adult and pediatric cardiology, gastroenterology and radiology departments, applied with anesthesia outside of the operation room, were examined. The cases were analyzed in terms of age, sex, ASA, appliance and recovery duration, intensive care need, smoking history.
Results: 528 patients were administered with anesthesia during outpatient anesthesia applications. 336 (64%) of the patients were women and 192 (36%) of them were men. The mean ages of all the patients were 29.6±20.6year. years in outpatient anesthesia. The mean anesthesia administration duration of all the patients were defined as 22.57±11.76 min. The shortest processing time took place during gastroscopy (13.2±8.66min) and the longest processing time took place during balloon valvuloplasty (67.9±18.4). The mean recovery duration was found as 10.1±7.26min.
Conclusion: The outpatient anesthesia applications are similar to the applications in operation rooms in terms of the risks. The anesthesiologist should carry out a good preoperative evaluation for the increasing number of outpatient anesthesia applications and appropriate physical conditions should be provided.
Keywords: Outside anesthesia, recovery, operative risk
The comparison of mean platelet volume and other hemogram results in patients with carpal tunnel syndrome
Mehmet Uçar, Fatih Vatansever, Nermin Tanık, Mehtap Aykaç Çebiçci, Serap Tomruk Sütbeyaz, Ümit Sarp, Kaan Gürbüz
J Clin Exp Invest 2015;6(2):154-158.
https://doi.org/10.5799/ahinjs.01.2015.02.0508
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Objective: Carpal tunnel syndrome (CTS) is formed by the compression of median nerve passes under the level of the transverse carpal ligament at the level of the wrist. CTS is the most common type of entrapment neuropathy. Mostly underlying cause of this entrapment is unknown. Mean platelet volume (MPV), is an important indicator in a positive direction for platelet activation and function. In this study, increased thrombocyte activation due to increased mean thrombocyte volume is whether an important indicator for CTS diagnosis or not was researched.
Methods: In this study, 418 patients diagnosed with CTS and 120 controls were enrolled, including 538 people. In both groups, demographic data, and hemoglobin (HGB), mean corpuscular volume (MCV), red cell distribution width (RDW), platelet count (PLT), MPV, platelet distribution width (PDW) parameters were evaluated.
Results: The mean HGB, MCV values were significantly lower in the CTS group than those of controls(p <0.001). RDW, PDW values were statistically higher in the CTS group (p <0.001). The mean MPV was significantly different between groups (p <0.005). The mean PLT did not reach statistically significant difference between groups (p = 0,484).
Conclusion: The results of our study demonstrated that the increased MPV and PDW values and other related hemogram parameters (HGB, MCV, RDW) may provide useful information in the diagnosis and be predictive in patients with CTS.
Keywords: Carpal Tunnel Syndrome, Mean Platelet Volume, Platelet Count
Comparison of sirolimus-eluting stent versus polyzene-F polymer-coated stent in terms of early inflammatory response and long term outcomes
Murat Yüksel, Zeki Şimşek, Göksel Açar, Ulaankhuu Batgerel, Hacı Murat Güneş, Ali Metin Esen, Mehmet Muhsin Türkmen
J Clin Exp Invest 2015;6(2):159-164.
https://doi.org/10.5799/ahinjs.01.2015.02.0509
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Objective: The intra-coronary stents provided great benefit after percutaneous transluminal coronary angioplasty (PTCA); however, high in-stent restenosis rates, even up to 25-30%, is the the main concern. Cytotoxic drug-eluting stents were developed to overcome this challenge. Whereas, they interfered vessel healing and endothelization process which led to increased risk of stent thrombosis. A bioinert molecule, polyzene-F(PzF), was applied to the surface of a new generation stent to provide anti-inflammatory and anti-thrombogenic property. We aimed to compare the sirolimus-eluting stent with PzF-coated cobalt-chrome stent in terms of early inflammatory response and long-term major adverse cardiac events (MACE) rates.
Methods: Stable coronary artery disease patients treated with PzF-coated cobalt-chrome stent formed the 1st group (n=19), and those received sirolimus-eluting stent (n=13) formed the 2nd group. Serum hsCRP and IL-6 levels were measured before percutaneous coronary intervention (pre-PCI), and after 1st and 10th days (post-PCI 1, and post-PCI 10, respectively) of PCI. The patients were followed-up to 1 year in terms of MACE experience.
Results: The study groups were comparable in terms of pre-PCI, post-PCI-1 and post-PCI-10 serum hsCRP and IL-6 levels. Four of 19 patients (21%) in the 1st group and 1 of 13 patients (8%) in the 2nd group experienced MACE during 1-year follow-up; whereas this difference was not statistically significant (p=0.26).
Conclusion: Although, the PzF-coated cobalt-chrome stent was claimed to have lower anti-inflammatory and anti-thrombogenic properties, we showed similar inflammatory response and long-term MACE rates compared to sirolimus-eluting stent. Prospective, randomized, large scale studies are needed to clarify this issue.
Keywords: Coronary artery disease, in-stent restenosis, polyzene-F, sirolimus-eluting stent, stent thrombosis
Investigation of SLC6A4 gene expression in autism spectrum disorders
Elif Funda Şener, Keziban Korkmaz, Didem Behice Öztop, Gökmen Zararsız, Yusuf Özkul
J Clin Exp Invest 2015;6(2):165-169.
https://doi.org/10.5799/ahinjs.01.2015.02.0510
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Objective: Autism is defined as a complex neurodevelopmental disorder. Genetics plays a major role in the etiology of autism spectrum disorders (ASD). The role of the serotonin in the development of autism has been widely investigated. SLC6A4 gene (SERT or 5-HT) has an important role reuptaking of serotonin. Because of this, our study examined the expression level of SLC6A4 gene in autism patients.
Methods: Thirty-four patients (26 male, 8 female) who diagnosed as autism firstly according to DSM-V criteria in the Department of child psychiatry, Erciyes University Medical Faculty and healthy 23 controls (16 male, 7 female) were enrolled in this study. Total RNA was isolated from peripheral blood samples using TRIzol. Quantitative Real-time PCR (qRT-PCR) was performed to detect SLC6A4 gene expression.
Results: SLC6A4 gene expression was found statistically significant and low in autism group compared with controls (p=0,027).
Conclusion: The low gene expression in the patient group implied that there is an abnormality of serotonin reuptake. According to our results, we suggest that much more studies may be planned with the expression and methylation profile of this gene combined with gene polymorphisms especially affecting the expression in larger sample sizes.
Keywords: Autism, Expression, Gene, Serotonin, SLC6A4
The efficacy of percutaneous nephrostomy performed by using combined ultrasonography and fluoroscopy: Retrospective analysis of 87 cases
Emre Kaçar, Çınar Balçık, Ebru Ünlü, İbrahim Keleş, Mustafa Karalar, Ömer Fatih Nas, Rukan Karaca
J Clin Exp Invest 2015;6(2):170-174.
https://doi.org/10.5799/ahinjs.01.2015.02.0511
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Objective: We aimed to evaluate the efficacy of the percutaneous nephrostomy (PN) performed by using combined ultrasonography (USG) and fluoroscopy.
Methods: Eighty-seven patients (48 female, 39 male; mean age, 58.2; range, 19-91) who underwent 106 PN procedures performed by using USG and fluoroscopy combination between July 2011 and May 2015 were retrospectively analyzed. The technical success was considered if nephrostomy catheter was placed within renal pelvis and functioned spontaneously. All patients received preprocedural prophylactic antibiotic and preprocedural coagulation parameters and platelet count were tested in all patients routinely. The procedural complications are classified as major, minor and catheter-related. The technical success rates and complication rates of the PN procedure were calculated.
Results: PN was performed for benign causes in 47 patients (54%) and for malignant causes in 40 patients (46%). A total of 106 nephrostomies were performed in 101 kidneys (95.1%) with dilated systems and in 5 kidneys (4.9%) with non-dilated systems. The technical success rate of PN was 98.1% (104/106 PN procedures). Major complication was not observed in any patients. Transient hematuria as a minor complication was seen in 11 patients (12.6%). Catheter dislodgement occurred in 11 patients (12.6%).
Conclusion: The PN performed by using combined USG and fluoroscopy is effective and reliable procedure in urinary decompression and diversion with high success and low complication rates.
Keywords: Percutaneous nephrostomy, ultrasonography, fluoroscopy, complications
The relationship of burnout with job satisfaction and suicide ideation among anesthesiologists
Süreyya Özkan, Emine Uzlaş Karaman, Nalan Öztürk, Filiz Akın Ahun, Nazan Has Selmi
J Clin Exp Invest 2015;6(2):175-182.
https://doi.org/10.5799/ahinjs.01.2015.02.0512
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Objective: In this research, it was aimed to determine the relationship between the level of burnout of anesthesiologists with job satisfaction and suicide ideation.
Methods: 109 anesthesiologists working in education and research, university, private and public hospitals in Istanbul, Ankara, Bursa, Izmir, Kütahya, Denizli, Antalya, Samsun, Bolu, Rize, Erzurum, Amasya, Gaziantep, Şanlıurfa, Ağri, Iğdir, Mus were included in the study. Sociodemographic data form, Minnesota Job Satisfaction Scale, Maslach Burnout Inventory Scale and Suicidal Ideation Scale were used to collect data in research. Descriptive statistics and statistical analysis of study, correlation and regression analysis tests were used.
Results: The level of emotional burnout and reduced personal accomplishment of anesthesiologists was found to reduce the overall level of satisfaction of feeling (ß = -0,380) (ß = -0,292), and the level of depersonalization to affect the overall level of satisfaction (p=0,432). Also there is a relationship between emotional burnout, depersonalization, reduced personal accomplishment and suicide ideation (p˂0,001). It was found that the level of emotional burnout of anesthesiologists to increase levels of suicide ideation (ß = 1,286).
Conclusion: In our study, it was concluded that burnout among anesthesiologists has a relationship between job satisfaction and suicide ideation. It was determined that emotional exhaustion and reduced personal accomplishment diminish the overall level of satisfaction. Moreover it was concluded that emotional burnout increased suicide ideation.
Keywords: Anesthesiology, job satisfaction, suicide
A rare cause of postnasal drip and nasal obstruction: Isolated sphenochoanal polyp
Önder Akdeniz, Davut Akduman, Mehmet Haksever, Fevzi Solmaz, Ercan Gündoğdu
J Clin Exp Invest 2015;6(2):183-185.
https://doi.org/10.5799/ahinjs.01.2015.02.0513
Case Report
[Abstract]
[PDF]
ABSTRACT
Choanal polyps are benign solitary masses, arising within the sinus and protruding into nasal cavity. The nomenclature is made according to the sinus that it is originated from. Sphenochoanal polyp (SCP) is quite rare, originates from sphenoid sinus, passes through the sphenoethmoid recess and elongates to nasopharynx and oropharynx. It may be confused with antrochoanal polyps on anterior rhinoscopy. Radiological examination with computerized tomography and nasal endoscopy are important in the differentiation of these two types of choanal polyps. Endoscopic approach for the complete removal of the SCP including its mucosa of the site of origin is extremely safe, which has minimal risk of recurrence. Herein we report a 30 years-old male patient with SCP, which was removed via endoscopic transnasal surgery. He had no recurrence at postoperative 9 months of follow-up.
Keywords: Nasal obstruction, nasal polyp, paranasal sinus disease, nasal surgical procedure
Phrenic nerve blocage with spinal anesthesia for laparoscopic Nissen fundoplication
Murat Dursun, Funda Erdoğdu, Yücel Gültekin, Şükrü Salih Toprak
J Clin Exp Invest 2015;6(2):186-188.
https://doi.org/10.5799/ahinjs.01.2015.02.0514
Case Report
[Abstract]
[PDF]
ABSTRACT
In this case, we describe a patient having laparoscopic Nissen fundoplication (LNF) under spinal anesthesia with phrenic nerve blockade. It’s emphasized that in this type of operations, spinal anesthesia may be an alternative method rather the general anesthesia and the resulting shoulder pain in laparoscopic surgery performed under spinal anesthesia can be prevented by phrenic nerve blockade.
Keywords: Nissen, laparoscopic, spinal, phrenic nerve
Mucosal melanosis associated with chemoembolization
Ali Alkan, Dılşa Mızrak, Seçkin Özgül, Güngör Utkan
J Clin Exp Invest 2015;6(2):189-191.
https://doi.org/10.5799/ahinjs.01.2015.02.0515
Case Report
[Abstract]
[PDF]
ABSTRACT
Mucosal lesions due to underlying disease or drug toxicity, are important part of oncology practice. Patient with a diagnosis of hepatocellular carcinoma was treated with chemoembolisation. She presented with new onset of mucosal hyperpigmented lesion all through her oral cavity. Biopsy was consistent with mucosal melanosis, which was associated with the chemotherapeutics used in the chemoembolisation procedure. Lesion progressively improved without any treatment. Here we present an mucosal melanosis experience after chemoembolisation.
Keywords: Mucosal melanosis, hyperpigmentation, adriamycin, chemoembolization
Isolated right aortic arch: Antenatal evaluation
Ali Babacan, Yaşam Kemal Akpak, Nuri Kaya, İlhami Gül, Murat Muhcu, Ercüment Müngen, Selami Süleymanoğlu
J Clin Exp Invest 2015;6(2):192-195.
https://doi.org/10.5799/ahinjs.01.2015.02.0516
Case Report
[Abstract]
[PDF]
ABSTRACT
Aortic arch abnormalities are the least frequently prenatally diagnosed congenital cardiac abnormalities. Right aortic arch (RAA) identified in prenatal period is associated frequently with other cardiac/non-cardiac malformations, notably tracheal or esophageal compression and microdeletions 22q11. Intrauterine and postnatal survey of the fetus depends on these anomalies and their effects. Aortic arc variations, particularly RAA, can be diagnosed accurately by fetal echocardiography. Elaborated fetal cardiac and extracardiac evaluation should be undertaken in all cases of RAA by using Doppler ultrasound. Also cytogenetic testing for 22q11 microdeletions should be considered carefully. Nonetheless, it should be kept in mind that isolated RAA has a good prognosis, and in the majority of the patients, it is an asymptomatic vascular variant with a relatively low risk for chromosomal anomaly. In this paper with this case, we aim to evaluate the prenatal findings, associated conditions and prognosis of prenatally detected RAA anomalies in the light of literatures.
Keywords: Anatomic variation, aortic arch anomaly, congenital heart abnormalities, fetal echocardiography, prenatal diagnosis
Ethical uncertainty in a patient in the terminal period: Eighth catheter
Nureddin Yüzkat, Muhammed Bilal Çeğin, Lokman Soyoral, Uğur Göktaş, Burhab Özkan
J Clin Exp Invest 2015;6(2):196-198.
https://doi.org/10.5799/ahinjs.01.2015.02.0517
Case Report
[Abstract]
[PDF]
ABSTRACT
Intensive care units are units where patients, who have the need for life support that may benefit from observation and treatment, are monitored. With these characteristics, decrease in risk of death and providence of early recovery have been a source of hope for patients and their families. In these units, most commonly the critically ill patients, who require organ failure treatment, are treated. Additionally, intensive care units environment are the places where ethical issues may be encountered in the treatment of critically ill patients. Health care workers are faced with a number of ethical issues; even they may be in the position of decision maker sometimes. In such cases, importance of the ethical concepts and, values and opinions of the people appears. In this article, ethical uncertainties of catheter insertion of a case that is at terminal period, staying at intensive care unit, has multi-catheterization (7 units) and a new catheter had to be inserted, are criticized.
Keywords: Ethical uncertainty, intensive care unit, patients, terminal period
Tooth in the bronchus: Importance of the history taking and chest X-ray
Fatih Battal, Hakan Aylanç, Gökhan Berktuğ Bahadır, Mustafa Tekin, Şule Yıldırım
J Clin Exp Invest 2015;6(2):199-201.
https://doi.org/10.5799/ahinjs.01.2015.02.0518
Case Report
[Abstract]
[PDF]
ABSTRACT
One of the rare causes of chronic cough in children is foreign body aspiration. Nine years old girl presented with a history of cough persisting for the last 6 months. Although it was expressed that she had swallowed her tooth, she was prescribed drugs for pneumonia and asthma but did not have any diagnostic work-up. On physical examination there was expiratory wheezing on right hemithorax and also breath sounds were decreased on right. Laboratory was unremarkable except for mild leukocytosis. In the chest X-ray there was an opacity of peribronchiolar area. Patient was diagnosed as foreign body aspiration. Bronchoscopy was performed by department of pediatric surgery. A molar tooth was removed from right bronchus. There was not any problem in the follow-up of the patient. This case report emphasized the importance of history, physical examination and chest X-ray in evaluation of schoolchild with chronic cough once again.
Keywords: Foreign body aspiration, children, tooth, chronic cough
Clinical applications of cellular therapy products
Serpil Yanbakan
J Clin Exp Invest 2015;6(2):202-208.
https://doi.org/10.5799/ahinjs.01.2015.02.0519
Review
[Abstract]
[PDF]
ABSTRACT
Adult stem cells have the potential to differentiate into multiple cell types and have usage about lots of regenerative medicine research fields. Especially bone marrow-derived mesenchymal stem cells have a wide range of case presentation. New discoveries about stem cell biology will progress new options about cellular therapy products and isolation of different stem cell types will increase hope for treatment of important illness such as Parkinson’s disease, diabetes, malign brain tumors. It is the aim of this review is to present an overview of the current status of stem cell researches in different clinical applications for experimental and therapeutic purposes in our country.
Keywords: Bone marrow, mesenchymal stem cells, stem cell researches