Thyroid surgery: comparison between ultrasonic scalpel-SonoSurg and classic clamp and tie technique
Kalin Nicolaev Vidinov, Tanio Ivanov Sechanov
J Clin Exp Invest 2015;6(3):209-213.
https://doi.org/10.5799/ahinjs.01.2015.03.0520
Research Article
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ABSTRACT
Objective: The purpose of this prospective study was to evaluate the efficacy and safety in the application of ultrasonic scalpel compared to conventional operative technique in open surgery of the thyroid gland.
Methods: The study included 100 patients operated between May 2013 and August 2013. Patients were divided into two groups - 50 patients were operated using SonoSurg® and 50 patients were operated using classic “clamp and Tie” technique. We evaluated and compared the outcome between the two groups.
Results: Both groups had a similar distribution in the demographic features such as gender, age, functional activity and malignant diseases of the thyroid gland. When comparing the results, we found a significant reduction in the duration of surgery in patients operated with SonoSurg® (SST group) (72 ± 20 min vs 100 ± 32 min, p = 0.01). There was no difference for fluid in the vacuum drainage during the first 24 hrs. Hospital stay of patients in both groups was similar - an average of 3 days stay into the clinic.
Conclusion: Our results showed that "ultrasonic scalpel” is an effective, easy to use and completely reliable method for achieving hemostasis with visible advantages over classical operational technique.
Keywords: Total thyroidectomy, ultrasonic scalpel, clamp and tie technique
Relationships between anthropometric measurements, leptin and IGF-1 levels in Turkish healthy newborns
Sacide Karakaş, Ayfer Metin Tellioğlu, Güzel Dişçigil, Aslıhan Büyüköztürk Karul, Münevver Kaynak
J Clin Exp Invest 2015;6(3):214-219.
https://doi.org/10.5799/ahinjs.01.2015.03.0521
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Objective: The aim of the present study is to determine anthropometric measurements of a group of healthy newborns and evaluate their association with the serum levels of leptin and insulin-like growth factor 1(IGF-1).
Methods: Extremity lengths, skinfold thickness, body circumference measurements of 113 heathy newborns were taken by appropriate methods. Of the total 113 newborns, 55 were male and 58 were female. Serum leptin and IGF-1 levels were measured.
Results: Leptin levels had moderately positive correlations with body mass index (BMI), weight and suprailiac skinfold thickness (p<0.05). There was no significant relationship between anthropometric measurements and IGF-1 levels (p>0.05).
Conclusion: Anthropometric measurements of newborns will be of guidance for the growth and development of their future life.
Keywords: Anthropometry, newborn, leptin, insulin-like growth factor 1(IGF-1)
Treatment of nonseptic bursitis with endoscopic surgery
Azad Yıldırım, Ahmet Kapukaya, Yılmaz Mertsoy, Şehmus Yiğit, Mehmet Akif Çaçan
J Clin Exp Invest 2015;6(3):220-223.
https://doi.org/10.5799/ahinjs.01.2015.03.0522
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Objective: The aim of this study was to show that endoscopic surgery is a simple and acceptable method for various problems associated with wounds, range of motion and that such surgery ensures an early return to work after treatment of nonresponding nonseptic bursitis.
Methods: Thirty-two patients with nonseptic bursitis caused by repeated minor trauma that did not respond to medical treatment from 2008 to 2012 were included in this study. Radiographic [anteroposterior and lateral], ultrasound, macro and microscopic analyses of drainage liquid and aerobic and anaerobic cultures were obtained from the patients for the diagnosis.
Results: The mean age was 40.8 years. Fifteen patients had prepatellar bursitis, 13 had olecranon bursitis and 4 had ankle bursitis. Two patients had a history of falling on their knee. The other patients had a history of repetitive stimulation .The mean follow up period was 2.6 years [range. 2-5 years] and no medical complications occurred after the endoscopic surgery; such as scarring, loss of sensation and infection. One recurrence in response to medical treatment was observed.
Conclusion: Endoscopic bursectomy is a short and acceptable procedure with excellent results in terms of returning to work early and minimal wound related problems.
Keywords: Endoscopy, bursitis, treatment
Laparoscopic appendectomy for perforated appendicitis in children: Is intraperitoneal drainage necessary?
Mithat Gunaydin, Dilek Demirel, Ferit Bernay, Ender Ariturk, Unal Bicakci, Burak Tander
J Clin Exp Invest 2015;6(3):224-227.
https://doi.org/10.5799/ahinjs.01.2015.03.0523
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Objective: In this study, our aim is to evaluate the necessity of intraperitoneal drainage in perforated appendicitis.
Methods: 510 pediatric patients [246 laparoscopic (LA) and 264 open (OA)] underwent appendectomy between 2007 and 2014. 275 of them were perforated appendicitis (106 LA, 169 OA). The patients were retrospectively evaluated in terms of age, sex, symptoms, length of hospital stay (LOHS), antibiotherapy, postoperative nasogastric tube placement and intraperitoneal drainage, follow-up period, intraoperative and postoperative complications.
Results: Statistically significant differences were observed between laparoscopic perforated appendicitis (71 male, 35 female; median 9.5 years) and open perforated appendicitis (108 male, 61 female; median 9 years) groups in terms of placement of nasogastric tube (102/106 vs.169/169) (p=0.021), length of hospital stay (1.67± 0.11 days vs. 2.34± 0.09 days) (p<0.001), intraperitoneal drainage (32/106 vs. 138/169), (p<0.001), duration of intraperitoneal drainage (1.66± 0.28 vs. 4.21± 0.2 days) and LOHS (5.82± 0.3 vs. 4.23± 0.6 days) respectively (p <0.001). There was no significant difference between the two groups in terms of development of intra-abdominal abscess (10/106 vs. 9/169), (p=0.144), surgical site infection (2/106 vs. 8/169), (p=0.187) and development of adhesive intestinal obstruction (1/106 vs. 9/169) (p=0.053).
Conclusion: Laparoscopic access reduces the necessity for drainage and shortens duration of nasogastric tube and length of hospital stay.
Keywords: Laparoscopic appendectomy, perforated appendicitis, intraperitoneal drainage
Analysis of the effects of hospitalization on fine hand functions compared to gross grip in patients with rheumatoid arthritis
Zeynep Tuna, Deran Oskay, Derya Onbulak, Rıdvan Mercan
J Clin Exp Invest 2015;6(3):228-232.
https://doi.org/10.5799/ahinjs.01.2015.03.0524
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Objective: Hospitalization process causes a variety of physical problems. The decrease of hand use in daily life during hospitalization brings hand dysfunction to mind in inpatients. The aim of this study is to compare the hand functions of hospitalized patients with Rheumatoid Arthritis (RA) to outpatients in detail.
Methods: Grip and pinch strengths of both hospitalized patients in rheumatology service and outpatients on the routine control day were measured. In addition, 9-Hole Peg Test was performed and the disability level was determined by the Turkish version of Michigan Hand Outcomes Questionnaire (MHOQ).
Results: While grip strength and MHOQ scores were similar (p>0.05) in both groups, all three pinch strengths (lateral, bipod, tripod) and 9HPT scores were lower (p<0.05) in hospitalized patients.
Conclusion: Consequently, besides disease activity, hospitalization process also impairs fine hand functions in rheumatological patients. Evaluation of fine hand functions and appropriate rehabilitative interventions may prevent further disability in hospitalized patients.
Keywords: Rheumatoid arthritis, rheumatoid hand, hand functions, dexterity, hospitalization
Nosocomial infections and risk factors in intensive care unit of a university hospital
Zuhal Yesilbag, Aslı Karadeniz, Seniha Basaran, Fatih Oner Kaya
J Clin Exp Invest 2015;6(3):233-239.
https://doi.org/10.5799/ahinjs.01.2015.03.0525
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Objective: The aim of this study is to evaluate nosocomial infections (NIs) in intensive care unit (ICU) in terms of site of infection, distribution of pathogens and risk factors for developing infection.
Methods: 80 patients staying for more than 48 hours in the ICU were included in the study. Epidemiologic characteristics of the patients, invasive procedures and other risk factors were noted. Cultures, identification of isolates and antibiotic susceptibility tests were made by standard microbiologic methods.
Results: Of 56 patients who have developed NIs, 26 (50%) had pneumonia, 15 (28.8%) had bloodstream infections and 6 (11.5%) had urinary tract infections. Klebsiella pneumoniae (23.5%), Pseudomonas aeruginosa (19.6%), and Acinetobacter spp. (15.6%) were the most frequently isolated microorganisms, respectively. For Klebsiella pneumoniae isolates, extended spectrum beta lactamase (ESBL) rate was 91.6%, carbapenem resistance rate was 15.6% and for Pseudomonas aeruginosa and Acinetobacter spp. carbapenem resistance rates were 60% and 100% respectively. Hemodialysis, enteral nutrition, total parenteral nutrition and prolonged hospitalization for more than 10 days were determined as independent risk factors for developing NI. Additionally Acute Physiology and Chronic Health Evaluation (APACHE) II score, length of ICU stay and lenght of hospital stay before ICU were found to be high in the NI group.
Conclusion: Pneumonia is the most common NI and carbapenem resistance in Gram-negative bacilli was remarkably high in our ICU. It was considered that infection control measures must be applied carefully, invasive procedures should be used in correct indications and we should avoid long-term hospitalization if unnecessary.
Keywords: Intensive care unit, nosocomial infections, carbapenem resistance
Factors affecting mortality in patients with burns
Halil Erbiş, Ibrahim Aliosmanoglu, Bunyamin Ozturk, Burak Veli Ülger, Huseyin Timucin, Mehmet Akif Turkoglu, Veli Vural
J Clin Exp Invest 2015;6(3):240-243.
https://doi.org/10.5799/ahinjs.01.2015.03.0526
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Objective: The increase in life quality and expectancy causes an increase in the elderly population. Improvements in burn treatment resulted in decreased mortality in children and young adults but in elderly patients burns are still an important trauma that should be handed differently than other age groups. The aim of this study was to evaluate the factors effecting mortality in patients with burns over 45 years old.
Methods: Fifty-eight patients over 45 years of age, who were treated in our burns unit in the last 3 years were included in our study. Their age, burn percentage and depth, coexisting diseases and mortality rates were examined retrospectively.
Results: The average age of surviving patients was 57.4 years while it was 70 years for nonsurviving patients (p=0.002). The width of burn area was 21.1 % in surviving and 50 % in nonsurviving patients (p<0.01). The effect of additional coexistent diseases on mortality was significant (p=0.001). The most common reasons of mortality were sepsis and congestive heart failure.
Conclusion: We found out that the age, percentage of burns and coexistent diseases had a negative effect on success of treatment and mortality. Mortality rates will decrease in these cases with careful follow-up and a multidisciplinary approach.
Keywords: burns, coexisting, mortality, elderly patient
Comparison of propofol and ketofol in minor gynecologic interventions
Yasemin Işık, Zehra Kurdoğlu, Uğur Göktaş, İsmail Kati, Dilara Sözen
J Clin Exp Invest 2015;6(3):244-249.
https://doi.org/10.5799/ahinjs.01.2015.03.0527
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Objective: Outpatient anesthesia requires a safe anesthetic method and an anesthetic agent that provides a rapid anesthesia depth and hemodynamic stability. To provide an uneventfully recovery, the anesthetic must also be rapidly metabolized, and its metabolites should not accumulate in the body. This study compared sedo-analgesia effects, recovery times, postoperative complications, Modified Aldrete Scale, Visual Analog Scores, and patient and surgeon satisfaction between propofol and ketofol, administered as anesthetics during the probe curettage procedure.
Methods: A total of 60 female patients included in the study. Group P was administered 2 mg/kg of propofol and a 1 μg/kg intravenous bolus of fentanyl for induction and 100 μg/kg/min of propofol for maintenance. Group K was administered a 600 µg/kg IV bolus of ketofol for induction and 100 µg/kg/min of ketofol for maintenance. Additional fentanyl (50 µg) was administered to Group P, and 25 µg/kg/min of ketofol was administered to Group K according to autonomic and hemodynamic responses.
Results: Demographic data of the 2 groups were similar. A significant decrease in hemodynamic values was detected in patients in Group P after induction. No change in these values was detected during or after induction in Group K. The additional analgesia requirement was 66.6% in Group P. Nausea was detected in 2 patients in Group K. Additionally, hallucination was detected in 2 patients in Group K. Patient and surgeon satisfaction were complete in both groups.
Conclusion: According to our findings, ketofol anesthesia may be a good option in uterine curettage, patients recover quickly and comfortably, and ketofol both provides sufficient analgesia for the minor surgical intervention and reduces complications.
Keywords: Ketofol, propofol, sedo-analgesia, uterine curettage
Individual features and contraceptive attitudes of women who had unintended pregnancy
Ebru Ersoy, Yetkin Karasu, Esra Yaşar Çelik, Ali Özgür Ersoy, Aytekin Tokmak, Yasemin Taşçı
J Clin Exp Invest 2015;6(3):250-255.
https://doi.org/10.5799/ahinjs.01.2015.03.0528
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Objective: To explore preconceptional family planning attitudes in patients who delivered at term and causes of unplanned pregnancies. To explore contraception preferences in these patients.
Methods: This study was conducted in Zekai Tahir Burak Teaching and Research Hospital between September 2013 and February 2014. A questionnaire was administered face to face (n=475). Demographic findings, level of education, family type, level of income, preconceptional planning, preconceptional and postpartum contraception preferences were questioned. These data were recorded with neonatal outcomes.
Results: Three hundred sixty five (76.8%) patients stated that they preconceptionally planned their pregnancies. There were 110 (23.2%) women who defined their gestation as unplanned. The frequency of preconceptionally planned pregnancies were higher in nulliparous women (88.4%) than multiparous women (67.9%) (p<0.001). There was no significant difference between planned and unplanned pregnancies with respect to financial income, infant’s birth weight, and hemoglobin levels at delivery. However, educational level of the patients were significantly lower in patients with unplanned pregnancy (p<0.001). The time interval since last pregnancy was longer in patients with unplanned pregnancy and they were more motivated to use any kind of postpartum contraception (p<0.001). In planned pregnancies, the frequency of preconceptional gynecologic examination and using folic acid supplements were 32.9% and 16%, respectively.
Conclusion: In our study, it was noticed that educational level of the women was a prominent factor on whether the pregnancy was planned or not. Family planning trainings must be structured according to the educational level of the couples and awareness about family planning must be increased.
Keywords: Contraception; unplanned pregnancy; conception
Comparison of cannulated screw and dynamic hip screw for the treatment of femoral neck fractures
Mehmet Gem, Emin Özkul, Celil Alemdar, Ahmet Kapukaya, Hüseyin Arslan, Ramazan Atiç
J Clin Exp Invest 2015;6(3):256-262.
https://doi.org/10.5799/ahinjs.01.2015.03.0529
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Objective: We aimed to compare the results of surgeries for intracapsular femoral neck fractures with cannulated screws(CS) and dynamic hip screw(DHS), due to lack of evidence which implant for internal fixation of femoral neck fractures is better .
Methods: In our clinic between September 2005 and November 2009, 38 patients were operated with intracapsular transcervical fracture of collum femoris between17 to 65 years of age. Eighteen were operated with DHS(47.4%) and 20 were operated with CS fixation(52.6%).
Results: 16 patients (42.1%) were female and 22 (57.9%) were male and the mean age was 37.13 (17-65) years. The mean duration of follow-up was 18.05 (2-57) months. 26 patients were operated in 1st -3rd day (68.4%), 9 patients were operated in 4 to 7 day (23.7%), 3 patients were operated in after 7th day (7.9%). In the DHS group, 9 (50%) patients had avascular necrosis (AVN), 6 (33.3%) patients had implant failure, 3 (16.7%) patients had delayed union, 5 (27.8%) patients had nonunion, 1 (5.6%) patient had infection, and 1 (5.6%) patient had myositis ossificans. According to the criteria of Salvati Wilson hip joint assessment, in the DHS group 8 patients (44.4%) were very good, 5 patients (27.8%) were good, 5 patients (27.8%) were moderate. Salvati score was evaluated as average of 28 points (16-40). İn the CS group, 8 (40%) patients had AVN, 1 (5%) had delayed union, 3 (15%) of the cases had nonunion and 1 (5%) patients infection was detected. According to the criteria of the Salvati-Wilson, in the CS group13 (65%) of them are very good, 5 (25%) were good, 2 (10%) were assessed as moderate. Salvati score was evaluated as average of 33 points (18-40). In the CS group none of the patients had implant failure, in the DHS group 6 patients had implant failure (33.3%) (p<0,05).
Conclusion: Except for the high rate of implant failure detection in the DHS group method, no significant difference between complications and functional results between two groups.
Keywords: femoral neck fractures, dynamic hip screw, cannulated screw
Long term results of trabeculectomy surgery
Ferhat Evliyaoğlu, Çetin Akpolat, Muhammet Mustafa Kurt
J Clin Exp Invest 2015;6(3):263-268.
https://doi.org/10.5799/ahinjs.01.2015.03.0530
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Objective: Evaluation of long-term results of primary trabeculectomy operation
Methods: The cases that are followed up with diagnosis of glaucoma in Okmeydanı Training and Research Hospital Eye Clinic between January 2000 and December 2001 were evaluated retrospectively. All of the cases, despite maximum therapy, have high intraocular pressure (IOP), undergone primary trabeculectomy operation, are followed at least 6 months and regularly followed through 10 years were included in this study. IOP with or without medical treatment 18mmg or less than 18 mmHg accepted as successful. IOL pressure measured with applanation tonometry.
Results: 89 eyes of 70 cases were included in this study. The cases included in the study, 42 male (60%), and 28 (40%) were female. The mean age was 63.65±12.18 years. Preoperative intraocular pressure determined as 30.36 ± 3.2 mmHg. In the follow up examination mean intra ocular pressure was 15.31 ± 1.2 mmHg at 1st month, 15.47± 1.1mmHg at 3rd month, 15.02±1.8 mmHg at 6th month, 15.34± 2.1 mmHg at 1styear, 15.82 ± 2.1mmHg at 2nd year, 17.06 ± 2.3mmHg at 5th year and 18.02 ± 2.2 mmHg at 10th year. Statistical analysis of these data showed significant decreased of intra ocular pressure in the post operative period in compare to the preoperative period, 1st month, 3rd month, 6thmonth, 1st year, 2nd year, 5th year an 10th year (p < 0.01). The follow-up period in the study was 91.10 ± 40.15 months (6-120 months).
Conclusion: Primary trabeculectomy can be considered as an alternative treatment procedure especially in patients who does not use drugs regularly and unable to attend regular medical examination.
Keywords: Glaucoma, intra ocular pressure, trabeculectomy
Three years of distribution of intestinal parasites in an Education and Research Hospital: A retrospective study
Bayram Pektaş, Ayşegül Aksoy Gökmen, Aşkın İnci, Aziz Alper Biten, Recep Keşli, Temel Ülker
J Clin Exp Invest 2015;6(3):269-273.
https://doi.org/10.5799/ahinjs.01.2015.03.0531
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Objective: In this study, we aimed to evaluate the patients who applied to various clinics in our hospital with gastrointestinal complaints in terms of intestinal parasites, retrospectively.
Methods: Totally 41967 stool samples of patients applied to Parasitology laboratory in Konya Education and Research Hospital in January 2010-December 2012 were investigated under microscope after multiplexing by native lugol and formol ethyl acetate method. Trichrome dying was performed to the suspected samples. The stool samples, in which Entamoeba histolytica /E.dispar cannot be differentiated, were investigated by ELISA method in order to identify adhesin antigens.
Results: Intestinal parasite was determined in 2145 (5.11%) of 41.967 patients who applied to our laboratory in 3 years. 39.4%, 44.3% and 16.2% of positive patients were 0-15, 16-50 and >50 years old, respectively. Blastocyctis hominis, Entamoeba spp and Giardia intestinalis were found in 59.9%, 25% and 13.7% of the positive samples, respectively. Entamoeba spp and Giardia intestinalis were found most frequently in 0-15 years old patients, while Blastocyctis hominis was found most frequently in 15-49 years old patients. There was a statistically significant difference between these parasites and age groups (p<0.01). The distribution of the positive cases among the years was found as 6.8% in 2010, 5.4% in 2011, 3.3% in 2012 and there was a statistically significant difference between the years (p<0.01).
Conclusion: According to our results, the frequency of parasite infection still maintains its importance, although the frequency was decreased compared to previous years.
Keywords: Intestinal parasites, prevalence, Konya
In vitro investigation of effects of commercially available food and fabric paints in different colors, on Methicillin-resistant Staphylococcus aureus and Pseudomonas aeruginosa
Julide Sedef Göçmen, Burcu Bozdoğan, Mehmet Emin Bozdoğan, Şener Colak, Aykut Kılıç, Elif Sungur
J Clin Exp Invest 2015;6(3):274-278.
https://doi.org/10.5799/ahinjs.01.2015.03.0532
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Objective: The aim of this study to determine, the antibacterial effects of red, blue, green and yellow fabric and nutrient dyes, which were commonly used in our daily life on Methicillin Resistant Staphylococcus aureus (MRSA) and Pseudomonas aeruginosa with different concentration.
Methods: Serial dilutions of commercially available green, red, yellow, and blue fabric and food dyes in sterile saline were prepared. One milliliter from each concentration of dyes was splitted into the tubes.
McFarland 0.5 standard were used to adjust the turbidity of bacterial suspensions of P. aeruginosa and S. aureus standard strains. This suspension of each strain dispensed 100 microliters to all food and fabric dyes concentrations and incubated at 37°C. After overnight incubation 1 microliter suspension from each tube is plated on Mueller Hinton agar to determine bactericidal with sterile disposable loop. After incubation of these plates at 37°C for 18 - 24 hours, colonies were counted.
Results: Green, yellow and red colors of fabric and food dyes were inhibited MRSA, and they showed significantly less effect against P. aeruginosa. However, blue fabric and food dye antibacterial affects, were greater than other colors against MRSA and also against P. aeruginosa.
Conclusion: In this study, we determined that inhibition effect of food and fabric dyes, on bacterial growth can be variable belong to the color and concentration of dye. Our in vitro findings were indicated that colors of dyes can be a factor to inhibit bacterial contamination and true color choice will be helpful for painting especially high risk places for bacterial contamination.
Keywords: food dye, fabric dye, methicillin resistant Staphylococcus aureus, Pseudomonas aeruginosa
The change of antibiotic resistance profiles over the years in Pseudomonas aeruginosa and Acinetobacter baumannii strains isolated from intensive care units
M. Cem Şirin, Neval Ağuş, Nisel Yılmaz, Yeşer Karaca Derici, Sevgi Yılmaz Hancı, Arzu Bayram, Pınar Şamlıoğlu
J Clin Exp Invest 2015;6(3):279-285.
https://doi.org/10.5799/ahinjs.01.2015.03.0533
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Objective: The aim of this study was to determine the antibiotic resistance profiles of Pseudomonas aeruginosa and Acinetobacter baumanniistrains isolated from patients in our hospital intensive care units (ICUs) between the years 2011-2014 and to investigate the changes of these profiles over the years.
Methods: Identification and antibiotic susceptibility testing of the strains were performed by automated system. Cefoperazone-sulbactam and tigecycline susceptibility was determined by disk diffusion method. Imipenem, meropenem and colistin resistance was confirmed by E-test method. Chi-square and Fisher's exact test were used to compare the antibiotic susceptibilities statistically.
Results: The highest resistance rates were determined for imipenem (50.2%), meropenem (51.9%) and piperacillin-tazobactam (64.0%) in P. aeruginosa strains (n=722). The changes in the rates of antibiotic resistance were not statistically significant in P. aeruginosa strains between the years 2011 and 2014. The decrease in gentamicin, amikacin and trimethoprim-sulfamethoxazole resistance and the increase in cefoperazone-sulbactam and tigecycline resistance was found to be statistically significant in A. baumannii strains (n=1044) between the years 2011 and 2014. The increase in imipenem and meropenem resistance was found to be statistically significant between the years 2012 and 2013. Piperacillin-tazobactam, ceftazidime, cefepime, imipenem and meropenem resistances in A. baumannii strains were found to be over 95% in all the years. Colistin was found to be the most effective antimicrobial agent for both bacteria.
Conclusion: The determination of considerably high antibiotic resistance rates in P. aeruginosa and A. baumannii strains isolated from our hospital ICUs has indicated that rational antibiotic use policies and more effective infection control programs should be applied along with monitoring the antibiotic susceptibility profiles constantly.
Keywords: Pseudomonas aeruginosa, Acinetobacter baumannii, intensive care units, antibiotic resistance
Effect of the reverse redistribution pattern on the left ventricular ejection fraction in the Tc-99m MIBI SPECT myocardial perfusion scintigraphy
Bekir Taşdemir, Zeki Dostbil, Murat Yüksel, İlhan Sezgin
J Clin Exp Invest 2015;6(3):286-290.
https://doi.org/10.5799/ahinjs.01.2015.03.0534
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Objective: The causes and prognostic significance of the reverse redistribution pattern (RRP) is not clear yet. In this study, we aimed to evaluate the RRP effect on the left ventricular ejection fraction (EF).
Methods: Imaging of the patients whose technetium-99m sestamibi myocardial perfusion scintigraphy was carried out and reported as normal were retrospectively examined. One-day protocol and/or pharmacologic stress testing applied patients were excluded. 21 patients with RRP met the inclusion criteria. All of these patients were included in the study as RRP group. Randomly selected 21 patients with non-RRP were included in the study as control group. Transient ischemic dilation (TID) scores and EF values were automatically calculated with the Quantitative Gated SPECT (QGS) program.
Results: While a statistically significant difference was not found between the RRP and control groups in terms of age, sex, hypertension, family history, hyperlipidemia, and diabetes (p>0.05), there was a statistically significant difference in terms of smoking (p=0.019). TID scores in the RRP group were significantly lower compared to the control group (p<0.001). In addition, a statistically significant decrease was determined in the EF values in the rest images compared to the stress images in the RRP group (p=0.002). Furthermore, this decrease was significantly higher than in the control group (p= 0.034).
Conclusion: The results related to the TID scores and EF values are suggesting the existence of an ischemic cause in the background of the RRP. Additionally, the relationship found between smoking and RRP may be associated with the tachycardia and / or coronary spasm-inducing effect of smoking.
Keywords: Sestamibi, myocardial perfusion, reverse redistribution, reverse distribution, reverse perfusion
Retrospective evaluation of low birth weight infants that monitored in neonatal intensive care unit of an university
Fesih Aktar, İlyas Yolbaş, İlhan Tan, Sabahattin Ertuğrul, Mehmet Şah İpek, Kamil Yılmaz, Muhammed Nurullah Sabaz
J Clin Exp Invest 2015;6(3):291-295.
https://doi.org/10.5799/ahinjs.01.2015.03.0535
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Objective: Preterm neonates were approximately 70% of total low birth weight infants in developed countries. The aim of this study is to evaluate the low birth weight neonates who were hospitalized in the neonatal unit of our hospital between the years 2010-2011, retrospectively.
Methods: 626 infants that born with under 2500 gram were enrolled to the study. Family history, natal, prenatal, postnatal, maternal and demographic features and risk factors were recorded retrospectively.
Results: Mother giving birth age was 21-35 years, gestational age was at 33 weeks and birth weight was found 2001-2500 gram mostly and the mortality rate was found 29.7% in our study. Maternal age, multipl pregnancy ratio, place of birth, birth presentation, duration of hospitalization, causes of premature birth and mortality rate is found statistically significant difference between low birth weight infants when comparing with birth weight (p<0.05). The most common cause of premature birth was preeclampsia-eclampsia in all infants while oligohydramnios was mostly found in ≤1000 gram infants. Respiratory distress and convulsion in the 2001-2500 g infants, hyperbilirubinemia in the 1501-2000 gram infants and required mechanical ventilation in the ≤1000 gram infants were found significantly higher (p<0.05).
Conclusion: Improving the educational level of the society, ensuring adequate prenatal monitoring, establishment of appropriate and adequate neonatal intensive care unit, following out delivery of premature at neonatal intensive care unit centers, appropriate transporting should be done, identifying the common risks such as sepsis and respiratory distress syndrome for mortality causes and taken measures againts them are serious importance for the prevention of premature birth.
Keywords: Newborn, low birth weight, demographic features, prevention
Prolidase activity in major depressive disorder
Süleyman Demir, Aslıhan Okan İbiloğlu, Mehmet Güneş, Mahmut Bulut, Abdullah Atli, Mehmet Cemal Kaya, İbrahim Kaplan, Aytekin Sır
J Clin Exp Invest 2015;6(3):296-300.
https://doi.org/10.5799/ahinjs.01.2015.03.0536
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Objective: Prolidase enzyme, which exists in plasma, brain and various organs, is a cytosolic exopeptidase, that divisor the imidodipeptides with carboxyl terminal position of proline and hydroxyproline. The aim of the present study was to investigate serum prolidase activity level in major depressive disorder (MDD).
Methods: This study included 22 patients with MDD as the study group, and 26 healthy subjects without any psychiatric disorders as the control group. Each patient underwent a detailed diagnostic evaluation by experienced psychiatrists. The sociodemographic information form given to both patients and the control subjects, while Hamilton Depression Scale Scoring (HDS), Hamilton Anxiety Scale Scoring (HAS), Clinical Global Impression Scoring (CGI) applied to patients. Blood samples were obtained for biochemical analyses.
Results: The mean age of the patient group was 31.3±10.1 years old, whereas the mean age of the control group was 32.3±8.8 years old. The mean duration of the education for the patient group was 8.1±6.2 years, whereas for the control group was 10.2±3.8 years. There was no significant differences in terms of the mean age of participants and the mean duration of the education between two groups (p>0.05). The level of prolidase activity of patient group was 510.3±480.8 U/L, whereas the level of prolidase activity of control group was 457.8±386.0 U/L. No significant difference was observed in serum prolidase activity between patient and the control groups (p>0.05).
Conclusion: In our study similar level of prolidase activity was found in MDD and healthy subjects. We suggest that this finding may be an evidence indicating that MDD and bipolar depression may be different clinical entities.
Keywords: Major depressive disorder, prolidase activity, etiology
Treatment of congenital radial head dislocation with a computer-assisted hexapod external fixator: A case report
Özgür Karakoyun, Mehmet Fatih Erol, Mesut Karıksız
J Clin Exp Invest 2015;6(3):301-305.
https://doi.org/10.5799/ahinjs.01.2015.03.0537
Case Report
[Abstract]
[PDF]
ABSTRACT
Congenital dislocation of the radial head (CDRH), a congenital anomaly of the elbow, can cause symptoms such as joint stiffness, snapping, locking, or pain, however the diagnosis is sometimes made incidentally from x-rays. The treatment goal is to ameliorate the symptoms and obtain a joint with a full range of motion. This paper presents a case of unilateral CDRH that was asymptomatic until adolescence, when locking and snapping developed. Several treatment options are described in the literature. Although the conventional and computer-assisted external fixator systems are used in several clinical pictures such as extremity deformities, joint contractures and fixation of acute fractures etc a computer-assisted external fixator system has not been used for CDRH. We successfully performed ulnar dorsal translation and a lengthening osteotomy with a computer-assisted external fixator to reduce the radial head indirectly and had satisfactory functional and clinical results.
Keywords: Radial head, congenital dislocation, hexapod external fixator
Conservatively treated isolated capitatum fracture: Case report
Mehmet Fatih Erol, Özgür Karakoyun
J Clin Exp Invest 2015;6(3):306-308.
https://doi.org/10.5799/ahinjs.01.2015.03.0538
Case Report
[Abstract]
[PDF]
ABSTRACT
Capitatum fractures contributes 1% of all carpal bone fractures. Isolated fracture of capitatum is a rare entity which is seen in the literature as case reports. Any delay in diagnosis can cause complications such as nonunion, avascular necrosis, malunion and secondary arthrosis. We present in this paper the early result of the conservative treatment of an isolated nondisplaced capitatum fracture which was diagnosed late and emphasize the importance of the diagnosis and treatment of capitatum fracture.
Keywords: capitatum, fracture, conservative treatment
A razor blade in the gastrointestinal system
Ertuğrul Altınbilek, Derya Öztürk, Yusuf Altunöz, Güleser Akpınar, Banu Karakuş, İbrahim İkizceli, Cemil Kavalcı, Elif Çelikel
J Clin Exp Invest 2015;6(3):309-311.
https://doi.org/10.5799/ahinjs.01.2015.03.0539
Case Report
[Abstract]
[PDF]
ABSTRACT
Swallowing of a foreign object is the second most common endoscopic emergency after gastrointestinal bleeding. We aimed to report a case of razor blade swallowing that presented with abdominal pain. A 33-year-old man was brought to the emergency department by his relatives with the complaint of abdominal pain that had started after swallowing a razor blade 1 day earlier. His past history was notable for schizoaffective disorder. A plain abdominal radiogram showed multiple appearances consistent with metallic, shiny foreign objects (razor blade) at multiple levels.
Keywords: Razor blade, emergency, schizoaffective disorder
Diffuse fatal infantile hemangioendothelioma in an infant liver: Case report
Serkan Şenol, Asım Yörük, İhsan Kuru, Asuman Kıral, Gizem Ersoy
J Clin Exp Invest 2015;6(3):312-314.
https://doi.org/10.5799/ahinjs.01.2015.03.0540
Case Report
[Abstract]
[PDF]
ABSTRACT
Infantile hemangioendothelioma is a rare tumor in the liver in children under 3 years of age. It is usually incidentally detected but may also occur with liver enlargement. Herein a case of neonatal infantile hemangioendothelioma in liver with hepatosplenomegaly and respiratory-circulatory failure resulting in monitoring is presented with literature.
Keywords: Infant, liver, fatal, infantile hemangioendothelioma
Laryngeal inflammatory myofibroblastic tumor: A rare case
Gülay Bulut, Ayşe Öter Almalı, Remzi Erten, İrfan Bayram, Mahfuz Turan, Mehmet Deniz Bulut
J Clin Exp Invest 2015;6(3):315-317.
https://doi.org/10.5799/ahinjs.01.2015.03.0541
Case Report
[Abstract]
[PDF]
ABSTRACT
Inflammatory myofibroblastic tumor is a borderline neoplasm with uncertain malignant potential. The most frequent site of localization is the lungs. The localization in larynx in the head-neck area is rather rare. The 11-year-old female patient had the symptom of hoarse voice, which had been continuing for three years. The laryngoscopy performed showed a polypoid tissue with a wide base, which involved the left vocal cord at full length. The polypoid tissue was completely excised. The histopathological examination performed demonstrated several myofibroblasts with intranuclear pseudo-inclusions, which were surrounded by mixed inflammatory infiltrates in a myxoid stroma. No significant atypia, mitosis and necrosis were observed. The immunochemistry stains were positive for Vimentin, ALK and EMA in neoplastic cells. Alcian blue stain was positive in the myxoid stroma. The case was diagnosed with laryngeal inflammatory myofibroblastic tumor in the light of histopathological and immunohistochemical findings. Laryngeal inflammatory myofibroblastic tumor, a rare entity, should definitely be distinguished from malignant laryngeal tumors. Accurate diagnosis ensures that unnecessary and aggressive treatment methods are avoided and complete, organ-salvaging resection adequate for the inflammatory myofibroblastic tumor be conducted.
Keywords: Inflammatory myofibroblastic tumor, immunohistochemistry, larynx
Primary squamous cell carcinoma of breast presenting with symptoms of breast abscess
Mani Habibi, Onur Özener, Barış Rafet Karakaş, Arsenal Sezgin Alikanoğlu, Nurullah Bulbuller
J Clin Exp Invest 2015;6(3):318-320.
https://doi.org/10.5799/ahinjs.01.2015.03.0542
Case Report
[Abstract]
[PDF]
ABSTRACT
Although breast abscess is a common inflammatory breast disease, there are rare cases that were found to be associated with malignancy. Primary squamous cell carcinoma of breast (PSCCB) is an example of this. Only a very limited number of PSCCB patients presented with an abscess are reported in the literature. Although rarely seen, postmenopausal women presented with symptoms of breast abscess and exhibiting a poor response to treatment, the possibility of (PSCCB) disease should always be considered in the differential diagnosis.
Keywords: Abscess, breast, squamous cell carcinoma
Mania associated with paliperidone treatment in schizophrenia: A case report
Süleyman Demir, Aslıhan Okan İbiloğlu, Mehmet Cemal Kaya, Mehmet Güneş
J Clin Exp Invest 2015;6(3):321-323.
https://doi.org/10.5799/ahinjs.01.2015.03.0543
Case Report
[Abstract]
[PDF]
ABSTRACT
Paliperidone is an atypical antipsychotic drug used to treat schizophrenia. Paliperidone can cause some rare side effects during treatment. Despite many publications of mania and hypomania induced by antipsychotics, mania cases induced by paliperidone are few in the literature. In this case a schizophrenia patient showing symptoms of mania during usage of paliperidone with a dose of 9 mg/day in which the symptoms rapidly disappeared after discontinuation of paliperidone and initiation of aripiprazole was reported. Clinicians should be aware of that Paliperidone treatment may trigger mania symptoms.
Keywords: Paliperidone, schizophrenia, mania
Child health in case of emergency
Attila Alp Gözübüyük, Ensar Duras, Hüseyin Dağ, Emine Türkkan, Vefik Arıca
J Clin Exp Invest 2015;6(3):324-330.
https://doi.org/10.5799/ahinjs.01.2015.03.0544
Review
[Abstract]
[PDF]
ABSTRACT
In the Stockholm Declaration, it states that " The emergency in terms of medicine is characterized by the acute and unforeseeable imbalance between the capacity and sources of the medicine profession within a certain period of time and the requirement of people affected by the emergency situation or people whose health are under threat." Since potential exposure from the inner and outer stimulus is higher for the organism that is developing in physiological and psychological sense, childhood period is a risky period without considering causation. All of the risks cover the child, family and society. In risk evaluation, live, protection, development and participation rights of child shall be basis in humane and legal sense. Considering the fact that child is the subject of the social life, the damages that may happen should be realized before creating domino effect and injuries should be treated and they should be prevented with precautions that are the dynamo of themselves. Convention on the rights of children gives right to all of us in particular to pediatricians like us to warn and remind states of their duties in the event of failure to abide by these rights to protect the children from risky situations. Reasonable and practical approaches shall be produced with evaluations conducted in the scope of the health, security and education in case of emergency.
Keywords: Extraordinary, immigration, child, war, disaster
Oxidative stress and its impacts on intracellular lipids, proteins and DNA
Oğuzhan Özcan, Hüseyin Erdal, Gökhan Çakırca, Zafer Yönden
J Clin Exp Invest 2015;6(3):331-336.
https://doi.org/10.5799/ahinjs.01.2015.03.0545
Review
[Abstract]
[PDF]
ABSTRACT
Oxidative stress is described as disturbed oxidative balance between increased reactive oxygen species such as hydroxyl radical (OH•), superoxide radical (O2−), hydrogen peroxide (H2O2) which occurs during normal cellular metabolism and decreased antioxidants which have scavenging effects on free radicals. Reactive oxygen species resulted from increased oxidative stress attacks on to the double bonds of lipids, proteins and DNA bases, removing one hydrogen atom from structure and initiate to oxidative chain reactions. This process leads to cellular damage and death damaging intracellular macromolecules such as lipids, proteins and DNA. The damage of free radicals is detected measuring oxidative products such as malondialdehyde (MDA), protein carbonyl (PCO) and 8-hydroxyguanine derivatives (8-OHG, 8-hidroksi-2′-deoksiguanozin) in body fluids and various tissues.
Although considerable amount of studies in this field, the effects of oxidative stress on cellular structures still remain unknown. In this review, we aimed to evaluate the biochemical aspects of oxidative stress, antioxidant systems and their mechanism of actions and oxidative products.
Keywords: Oxidative stress, protein carbonyl, malondialdehyde, 8-hydroxyguanine