Comparison of the anatomic femoral and the transtibial tunnel technique in the arthroscopic anterior cruciate ligament reconstruction
Nasuhi Altay 1, Kutsi Tuncer 2, Mehmet Köse 2, Ahmet Emre Paksoy 2
1 Department of Orthopaedic and Traumatology, Erzurum Regional Education and Research Hospital, 2 Department of Orthopaedic and Traumatology, Medical Faculty, Ataturk University, Erzurum, Turkey
DOI: 10.4328/ACAM.20450 Received: 2020-12-22 Accepted: 2022-04-08 Published Online: 2022-10-27 Printed: 2022-12-01 Ann Clin Anal Med 2022;13(12):1296-1300
Corresponding Author: Nasuhi Altay, Department of Orthopaedic and Traumatology, Erzurum Regional Education and Research Hospital, Erzurum, Turkey. E-mail: email@example.com P: +90 537 592 68 86 Corresponding Author ORCID ID: https://orcid.org/0000-0002-5518-3938
Aim: In this study, we aimed to compare the functional results of the transtibial tunnel (TT) and anatomic femoral tunnel (AFT) technique in arthroscopic single-bundle anterior cruciate ligament reconstruction.
Material and Methods: We performed arthroscopic single-bundle anterior cruciate ligament reconstruction with autogenous hamstring tendons in 40 patients using the transtibial tunnel technique and 43 patients using the anatomic femoral tunnel technique. We used radiological X-Ray and MR imaging. We evaluated patients on physical examination before and after surgery using Anterior-drawer, Lachman and Pivot-shift tests and Tegner, Lysholm and International Knee Documentation Committee (IKDC) functional scoring systems.
Results: Among the patients included in the study, 95.2% (n = 79) were male and 4.8% (n = 4) were female. The mean age of the patients was 30,4 years. In fifty (59.5%) patients, the right knee was affected, in thirty-three (40.5%) patients, the left knee was affected. We followed our patients for an average of 18.9 months. Tegner, Lysholm and IKDC scores are similar in both techniques before and after the surgery. Compared to pre-surgery, significant improvement was observed in the Anterior drawer and Lachman tests of the patients in whom we used the anatomical femoral tunnel technique, while no significant difference was found between the two techniques in the Pivot shift test.
Discussion: The location of the tunnels is one of the most important factors affecting the outcome of the ACL reconstruction. The TT technique is an easier and shorter surgical method. In the TT technique, the location of the tibial tunnel determines the placement of the femoral tunnel. Surgical and learning times are longer in the AFT technique. In the AFT technique, the femoral tunnel is drilled independently of the tibial tunnel position, which makes it possible to place the graft in the center of the femoral footprint. Although both techniques show similar functional results, the AFT technique significantly increases anteroposterior and rotational stability. Accordingly, rehabilitation and return to sports are earlier in the anatomic femoral tunnel technique. It is possible to say that the anatomic femoral tunnel technique is superior, considering the patient satisfaction and the rate of returning to the pre-surgical activity level.
Keywords: Cruciate Ligament, Single Bundle, Anatomic Tunnel, Transtibial Tunnel, Arthroscopic Repair
Histopathological evaluation of H. pylori and brucellosis relationship
Hakan Sezgin Sayiner 1, Sezgin Barutcu 2, Sefer Aslan 3, Bilge Aydın Turk 4, Aysun Gurbuzcan 5, Sadik Akgun 6
1 Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Adıyaman University, Adıyaman, 2 Department of Gastroenterology, Faculty of Medicine, Gaziantep University, Gaziantep, 3 Department of İnternal Diseases, Adiyaman Education Research Hospital, Adıyaman, 4 Department of Pathology, Faculty of Medicine, Adıyaman University, Adıyaman, 5 Department of İnternal Diseases, Harran State Hospital, Sanliurfa, 6 Department of Microbiology, Faculty of Medicine, Adıyaman University, Adıyaman, Turkey
DOI: 10.4328/ACAM.21287 Received: 2022-06-26 Accepted: 2022-10-20 Published Online: 2022-10-31 Printed: 2022-12-01 Ann Clin Anal Med 2022;13(12):1301-1304
Corresponding Author: Sefer Aslan, Department of Internal Medicine, Adıyaman Training and Research Hospital, 02100, Adıyaman, Turkey. E-mail: firstname.lastname@example.org P: +90 505 220 27 03 Corresponding Author ORCID ID: https://orcid.org/0000-0002-5926-5375
Aim: Helicobacter pylori (HP) is a common infection that can increase the pH of the stomach. Situations in which stomach protection is removed cause an increase in susceptibility to brucellosis.
Material and Methods: Pathological examination results of our patients who underwent gastroscopy and gastric biopsy with the diagnosis of retrospective brucellosis and the control group, who were not diagnosed with brucellosis, were included in the study. In the period from 01.07.2012 to 01.07.2019, the pathology investigation results of 39 patients diagnosed with brucellosis through Brucella agglutination or with 1/160 and above on Brucella coombs agglutination test were compared with 113 control group patients.
Results: There was no significant difference (P <0,185) in HP positivity between the two groups. A significant decrease (P<0,007) was determined in terms of lymphoid aggregation between the brucellosis HP- positive and the control group with HP- positive patients.
Discussion: HP was not found to be significant as a facilitating factor in terms of brucellosis, however, a negative correlation was determined in terms of lymphoid aggregation (MALT lymphoma precursor) in the brucellosis patient group.
Keywords: Brucellosis, H. pylori, Intestinal Metaplasia, Lymphoid Aggregate
The effect of cerium oxide on erythrocyte deformability in ischemia- reperfusion injury in rats administered sevoflurane
Aydın Tunçay 1, Volkan Şıvgın 2, Faruk Metin Çomu 3, Ayşegül Küçük 4, Aycan Özdemirkan 2, Işın Güneş 5, Mustafa Arslan 2
1 Department of Cardiovascular Surgery, Medical Faculty, Erciyes University, Kayseri, 2 Department of Anesthesiology and Reanimation, Medical Faculty, Gazi University, Ankara, 3 Department of Physiology, Medical Faculty, Kırıkkale University, Kırıkkale, 4 Department of Physiology, Medical Faculty, Kutahya Health Sciences University, Kutahya, 5 Department of Anesthesiology and Reanimation, Medical Faculty, Erciyes University, Kayseri, Turkey
DOI: 10.4328/ACAM.21301 Received: 2022-07-04 Accepted: 2022-08-08 Published Online: 2022-08-11 Printed: 2022-12-01 Ann Clin Anal Med 2022;13(12):1305-1308
Corresponding Author: Mustafa Arslan, Department of Anesthesiology and Reanimation, Medical Faculty, Gazi University, 06510, Ankara, Turkey. E-mail: email@example.com P: +90 533 422 85 77 Corresponding Author ORCID ID: https://orcid.org/0000-0003-4882-5063
Aim: Ischemia-reperfusion (IR) injury is a common problem in vascular surgery. Acute IR damage observed in the lower extremities, especially in aortic surgery, occurs following temporary cross-clamping of the abdominal aorta. Disruption in blood rheology disrupts microvascular blood flow, leading to exacerbation of microangiopathy. It is known that drugs used for anesthesia affect blood rheology, which is affected by many factors. Therefore, we aimed to investigate the effects of cerium oxide on erythrocyte deformability before sevoflurane anesthesia in rats with lower extremity IR.
Material and Methods: After approval by the ethics committee, 30 rats were randomly divided into 5 groups. Control (group C), IR (group IR), IR-cerium oxide (group IRCO), IR-sevoflurane (group IRS), IR-cerium oxide-sevoflurane (group IRCOS). Infrarenal abdominal aorta and atraumatic microvascular clamp were placed in IR groups 30 minutes after intraperitoneal cerium oxide was administered at a dose of 0.5 mg / kg. One hundred and twenty minutes later, the clamp was removed and reperfused for 120 minutes. Sevoflurane was applied at a rate of 2.3% at 4 L/min and 100% oxygen during IR for the minimum alveolar concentration to be 1 for rats. All rats were administered intraperitoneal ketamine (100 mg/kg) and euthanasia was performed by taking blood from the abdominal aorta. Erythrocytes were obtained from heparinized whole blood samples. Deformability measurements were made in erythrocyte suspensions in phosphate-buffered saline. A constant flow filtrometer system was used for the measurement of erythrocyte deformability and relative resistance was calculated.
Results: Erythrocyte deformability index was found to be significantly different between the groups (p=0.002). Compared to the control group, the erythrocyte deformability index was significantly higher in IR and IRS groups (p<0.0001, p=0.003, respectively). In the IRCO and IRCOS groups, the erythrocyte deformability index was found to decrease significantly compared to the IR group (p=0.008, p=0.025, respectively). The erythrocyte deformability index was similar in Group C and in the IRCO and IRCOS groups (p=0.453, p=0.120, respectively).
Discussion: We determined that cerium oxide administered intraperitoneally 30 minutes before ischemia in rats corrects the erythrocyte deformability deteriorated in IR-generated rats. We also found that cerium oxide had beneficial effects by reversing undesirable effects of IR. Further studies with larger volumes are required to support our promising results
Keywords: Ischemia-Reperfusion, Cerium Oxide, Sevoflurane, Erythrocyte Deformability, Rat
Association between tumor markers (CA125, CA15-3) and homozygous sickle cell anemia
Gamze Hande Kavvasoglu 1, Barış Kavvasoglu 2, Hasan Kaya 3
1 Department of Internal Medicine, Hatay Education and Research Hospital, 2 Department of Cardiology, Hatay Education and Research Hospital, 3 Department of Internal Medicine, Mustafa Kemal University, Hatay, Turkey
DOI: 10.4328/ACAM.21303 Received: 2022-07-03 Accepted: 2022-09-05 Published Online: 2022-09-13 Printed: 2022-12-01 Ann Clin Anal Med 2022;13(12):1309-1313
Corresponding Author: Gamze Hande Kavvasoglu, Department of Internal Medicine, Hatay Education and Research Hospital, Hatay, Turkey. E-mail: firstname.lastname@example.org P: +90 532 504 47 94 Corresponding Author ORCID ID: https://orcid.org/0000-0001-7558-0714
Aim: Sickle Cell Anemia (SCA) is a systemic and chronic inflammatory disease and is one of the most common hemoglobinopathies in the world and in our country. Cancer antigen 15-3 (CA15-3) and cancer antigen (CA125) have an important place in cancer screening, treatment follow-up and disease follow-up today. However, it has been shown that it may be high in some diseases other than these purposes. In this study, we also planned to determine the relationship between tumor markers and patients with SCA, which is a chronic inflammatory and ischemic disease.
Material and Methods: Patients over the age of 18 who were diagnosed with homozygous SCA and followed up in the Department of Internal Diseases of Hatay Mustafa Kemal University Health Practice and Research Hospital and applied to the outpatient clinic were included in the study. Height, weight, body mass index (BMI) and waist circumference of all patients were measured. Echocardiographic examination was performed. Blood samples were collected from the patients to study CA125 and CA15-3 on appropriate days and conditions.
Results: A total of 34 patients, 19 female and 15 male, and 35 healthy volunteers, 16 female and 19 male, were included in the study. In the echocardiographic examinations, the ejection fraction was normal in the control and SCA groups, and no signs of pericardial effusion were found. The mean CA15-3 of the patients with SCA was 56.42±23.73 U/ml, the mean of CA15-3 of the control group was 9.99±4.62 U/ml, and there was a statistically significant difference (p=0,001). The median CA125 value of patients with SCA was calculated as 5.95 U/ml, while the highest was 99 U/ml and the lowest was 1.8 U/ml. While the median CA125 value of the control group was calculated as 6 U/ml, the highest measurement was 17.8 U/ml and the lowest measurement was 0.7 U/ml. There was no any statistically significant difference between the groups.
Discussion: Although the CA15-3 level was high in patients with SCA, the CA125 level was normal. We think that CA15-3 level is important in understanding the pathophysiology and mechanism of SCA and in terms of follow-up. Our study should be supported by studies with large patient participation.
Keywords: Sickle Cell Anemia, CA125, CA15-3
Factors contributing to the development of pneumothorax and mortality in patients with COVID-19
Bulent Ozturk 1, Muharrem Cakmak 2, Ahmet Sızlanan 2
1 Department of Thoracic Surgery, Gazi Yasargil Education and Research Hospital, Diyarbakir, 2 Department of Thoracic Surgery, Faculty of Medicine, Fırat University, Elazig, Turkey
DOI: 10.4328/ACAM.21305 Received: 2022-07-04 Accepted: 2022-08-08 Published Online: 2022-08-11 Printed: 2022-12-01 Ann Clin Anal Med 2022;13(12):1314-1318
Corresponding Author: Muharrem Cakmak, Department of Thoracic Surgery, Faculty of Medicine, Fırat University, Elazig, Turkey. E-mail: email@example.com P: +90 533 301 68 97 F: +90 424 233 35 55 Corresponding Author ORCID ID: https://orcid.org/0000-0002-9504-2689
Aim: Secondary spontaneous pneumothorax is caused by underlying lung disease, while barotraumatic pneumothorax results from mechanical ventilation. SARS-CoV2 (COVID-19) is a disease that is transmitted through droplets and affects many organs such as the lungs, brain, kidney, and liver. The lungs are the most affected organ and have the greatest influence on mortality. In SARS-CoV2 infection, progression of consolidations and expansion towards the upper lobes, the development of pleural or pericardial fluid, the development of lymphadenopathy, the presence of bronchiectasis, the development of cavitation, and pneumothorax are poor prognostic factors. In our study, we aimed to compare factors contributing to the development of pneumothorax in 29 patients who developed pneumothorax during the treatment of COVID-19 infection and follow-up.
Material and Methods: Age, gender, habits, co-morbid diseases, clinical, radiological, laboratory, treatment, mortality and morbidity results of 29 patients who developed pneumothorax during the treatment and follow-up of COVID-19 infection were evaluated. Patients were divided into two groups as deceased (Group1) and surviving (Group 2) patients. The results of the groups were compared.
Results: We found that mean age, lymphocyte elevation, mechanical ventilator applications, length of stay in the intensive care unit, and complication development after thoracostomy were more significant in Group 1 than in Group 2 (p<0.05), whereas gender, pneumothorax localization, blood group, Rh differences, and smoking were not significant (p>0.05).
Discussion: Although the number and ratio of the comparison criteria included in the study were in favor of Group 1, certain parameters were statistically significant. However, the development of pneumothorax is an important cause of mortality in SARS-CoV2 patients.
Keywords: Pneumothorax, Respiratory System, SARS-CoV2
The effect of intraperitoneal irrigation with saline at body temperature on post-cesarean section pain
Seda Kır, Tayfur Çift, Süleyman Serkan Karaşin
Department of Obstetrics and Gynecology, Health Sciences University, Bursa Yüksek İhtisas Training and Research Hospital, Bursa, Turkey
DOI: 10.4328/ACAM.21306 Received: 2022-07-05 Accepted: 2022-08-15 Published Online: 2022-08-24 Printed: 2022-12-01 Ann Clin Anal Med 2022;13(12):1319-1323
Corresponding Author: Süleyman Serkan Karaşin, Mimarsinan District, Emniyet Street, Bursa Yüksek İhtisas Training and Research Hospital, 16310, Yıldırım, Bursa, Turkey. E-mail: firstname.lastname@example.org P: +90 544 430 95 50 Corresponding Author ORCID ID: https://orcid.org/0000-0002-4837-5114
Aim: This study aimed to compare the effect of intraperitoneal irrigation with saline at body temperature and drying with a sponge on pain and other early morbidities after cesarean section.
Material and Methods: This prospective observational study was included 347 patients between November 2020 and January 2021. We designed two groups of patients whose abdomen was washed with saline or dried with a sponge during a cesarean section. The saline used was heated in sterile blood and fluid warmer, and the temperature was measured with a sterile mercury thermometer. Parameters such as VAS scores of the patients at specific periods, 6th, and 24th-hour Hb-Wbc values, and gas discharge time were compared.
Results: The leukocyte value after 24 hours of cesarean was significantly lower, and the 24th-hour VAS score was higher in the group that was washed with isotonic and compared with the group that was dried with a sponge. In patients who had their first cesarean section, the 2nd-hour VAS score was lower in the saline-washed group than in the group cleaned with a sponge. In patients with previous cesarean section, the rate of flatulence at postoperative day 0 was significantly higher in the group that was washed with isotonic compared to the group that was dried with a sponge. The VAS score after 24 hours was also significantly higher.
Discussion: It may be beneficial to clean with intraperitoneal saline irrigation or a sponge to reduce postoperative pain and return early bowel movements, especially in patients with previous surgery and possible intraabdominal adhesions.
Keywords: Cesarean Section, Pain, Postoperative, Peritoneal Lavage
Contribution of vitamin D and calcium-sensing receptors methylation to the risk of colorectal cancer in Saudi patients
Meaad I. Fallatah, Ayat B. Al-Ghafari, Maryam H. Al-Zahrani
Department of Biochemistry, Faculty of Science, King Abdulaziz University, Jeddah, Saudi Arabia
DOI: 10.4328/ACAM.21329 Received: 2022-07-26 Accepted: 2022-10-20 Published Online: 2022-10-28 Printed: 2022-12-01 Ann Clin Anal Med 2022;13(12):1324-1328
Corresponding Author: Ayat Badr Al-Ghafari, Department of Biochemistry, Faculty of Science, King Abdulaziz University, P.O. Box, 23815, Jeddah, Saudi Arabia. E-mail: email@example.com P: +96 650 468 65 49 Corresponding Author ORCID ID: https://orcid.org/0000-0001-9156-4263
Aim: Colorectal cancer (CRC) is one of the most common cancers worldwide. It results from an interaction between genetic and epigenetic alterations with micronutrients. Vitamin D, via the vitamin D receptor (VDR) and calcium sensing receptor (CaSR), stimulates several hallmarks of cancer. This study aimed to measure the methylation status of VDR and CaSR in CRC patients and correlate them with other clinicopathological parameters to identify their role as diagnostic biomarkers.
Material and Methods: The study was performed on 108 participants (CRC patients and controls). RT-PCR was used to measure the expression of VDR and CaSR mRNAs, whereas pyrosequencing was used to identify the methylation status of the promoter using DNA samples.
Results: The expression results showed that neither VDR expression nor CaSR expression had a significant correlation with CRC risk. However, the promoters of VDR and CaSR were highly hypomethylated in CRC patients (the fold change was -7.09 for VDR and -4 for CaSR).
Discussion: Although VDR and CaSR had a strong correlation with cancers, the results showed that they might not be promising diagnostic markers for CRC. However, more experiments on larger sample size are needed to elucidate the correlation between promoter methylation modification and CRC carcinogenesis.
Keywords: Colorectal Cancer, VDR Promoter Methylation, CaSR Promoter Methylation
The role of the delta neutrophil index in predicting 28-day mortality and thrombolytic treatment indications in pulmonary embolism
Adil Emre Gezer 1, Fatih Ahmet Kahraman 2, Melih Çamcı 2
1 Department of Emergency Medicine, Pursaklar State Hospital, 2 Department of Emergency Medicine, Ankara City Hospital, Ankara Yıldırım Beyazıt University, Ankara, Turkey
DOI: 10.4328/ACAM.21333 Received: 2022-08-01 Accepted: 2022-09-05 Published Online: 2022-10-11 Printed: 2022-12-01 Ann Clin Anal Med 2022;13(12):1329-1333
Corresponding Author: Melih Çamcı, Üniversiteler Mahallesi, 1604. Cadde, No: 9, Çankaya, Ankara, Turkey. E-mail: firstname.lastname@example.org P: +90 505 883 91 81 Corresponding Author ORCID ID: https://orcid.org/0000-0003-4797-0816
Aim: The aim of this study is to determine whether delta neutrophil index (DNI) values have an effect on predicting 28-day mortality and thrombolytic indications in patients with pulmonary embolism (PE).
Material and Methods: In our study, the age, gender, history of chronic diseases, the laboratory findings (WBC, RDW, DNI, Urea, Creatinine, pH, Lactate), the localization of the pulmonary embolus/emboli, the observed symptoms, whether the thrombolytic therapy was given in the emergency room, 28-day mortality status of 311 patients who were diagnosed with PE in the emergency department and met the inclusion criteria, were recorded and analyzed.
Results: A significant difference was found in the age distribution of the evaluated patients who survived and died in the 28-day follow-up period. When the biochemical parameters were evaluated according to the presence of 28-day mortality, WBC, NEU, LYM, LYM%, EOS, RBC, HGB, RDW, DNI, Urea, D-dimer, Troponin and CRP were found to be statistically significantly different between the two groups. It was found that as the DNI value increased, there was an increase in the 28-day mortality rate.
Discussion: An increase in DNI, especially in the inflammatory processes, suggests that it will also increase during PE. DNI values obtained as part of a complete blood count can be easily estimated without an additional cost or a time burden. We predict that an increased DNI value is useful as a marker in estimating 28-day mortality in patients with acute PE, a disease with high mortality and morbidity.
Keywords: Pulmonary Embolism, Emergency Department, Delta Neutrophil Index (DNI), Mortality
The effect of ABO blood types and mean platelet volume on mortality in COVID-19 patients in ICU
Kübra Taşkın 1, Cansu Akın 2, Dilek Erdoğan Arı 3, Hulya Yilmaz Ak 1, Tahsin Şimşek 1, Özlem Sezen 1, Kemal Saracoglu 1
1 Department of Anesthesiology and Reanimation, Kartal Dr. Lütfi Kırdar City Hospital, 2 Department of Anesthesiology and Reanimation, Fatih Sultan Mehmet Training and Research Hospital, 3 Department of Anesthesiology and Reanimation, Acibadem Kozyatagı Hospital, Istanbul, Turkey
DOI: 10.4328/ACAM.21339 Received: 2022-08-03 Accepted: 2022-11-09 Published Online: 2022-11-15 Printed: 2022-12-01 Ann Clin Anal Med 2022;13(12):1334-1338
Corresponding Author: Kübra Taşkın, Department of Anesthesiology and Reanimation, Kartal Dr. Lütfi Kırdar City Hospital, 34740, Kartal, İstanbul, Turkey. E-mail: email@example.com P: +90 534 644 81 34 Corresponding Author ORCID ID: https://orcid.org/0000-0002-7023-4748
Aim: In COVID-19 infection, it is known that there are some risk factors such as age, gender, chronic disease and laboratory findings, and these factors increase morbidity and mortality. Within the scope of the study, it is aimed to evaluate the relationship between blood type and platelet indices and mortality in COVID-19 patients followed in the intensive care unit, since there are limited data on MPV levels of COVID-19 patients in the literature.
Material and Methods: After ethics committee approval, data on 322 COVID-19 patients who were followed up in the intensive care unit between March 1 and June 30, 2021 were retrospectively analyzed. Demographic data, comorbidities and mean platelet volume (MPV) measured in the complete blood count of the patients, mechanical ventilation status and type of intensive care discharge were recorded.
Results: When the patients were grouped as A Rh-positive (n=138) and non-A Rh-positive (n=183) patients according to their blood type, it was found that statistically higher mortality developed in A Rh-positive patients. MPV was found to be a good predictor of mortality. The threshold with the best sensitivity and specificity for MPV was calculated as 9.4 (sensitivity=77.0%, specificity=69.1%, negative predictive value (NPV)=44.8%, positive predictive value (PPV)=90.3%). According to the cut-off value, when patients with low MPV (MPV≤9.4, n=105) were compared with those with high MPV (MPV>9.4, n=216), statistically more deaths occurred in those with high MPV.
Discussion: In our study, it was concluded that COVID-19 disease is associated with ABO blood types and MPV. Blood type A and high MPV values were found to carry a higher risk for COVID-19 disease and severity and were associated with mortality.
Keywords: COVID-19, ABO Blood Types, Mean Platelet Volume, Mortality
Fonseca anamnestic index and temporomandibular disorder analysis in random patients
Cagri Koyal, Hatice Lamia Elif Sagesen, Sezgi Cinel Sahin
Department of Prosthodontics, Faculty of Dentistry, Pamukkale University, Denizli, Turkey
DOI: 10.4328/ACAM.21340 Received: 2022-08-04 Accepted: 2022-09-05 Published Online: 2022-11-28 Printed: 2022-12-01 Ann Clin Anal Med 2022;13(12):1339-1344
Corresponding Author: Çağrı Koyal, Department of Prosthodontics, Faculty of Dentistry, Pamukkale University, Camlaralti Mahallesi, Suleyman Demirel Cd., No: 95, 20160, Pamukkale, Denizli, Turkey. E-mail: firstname.lastname@example.org P: +90 258 296 17 37 / +90 506 327 31 32 F:+90 258 296 17 63 Corresponding Author ORCID ID: https://orcid.org/0000-0002-3500-4031
Aim: Temporomandibular disorders (TMDs) have frequently been encountered in the general population over past years. It is aimed to evaluate the presence of the TMD using the Fonseca Anamnestic Index (FAI).
Material and Methods: Individuals included in the study were aged 18 and over without known TMD, who applied to the prosthodontics clinic. The study included 120 volunteers, 61 male (50.98%) and 59 female (46.93%) participants. The mean age was 48.91±18.3 years. Intraoral findings and the presence/severity of TMDs of participants were evaluated with the FAI. The data from intraoral findings were collected and analyzed using descriptive statistical methods. The significance was evaluated at p<0.05 and p<0.001 levels.
Results: TMD was not observed in 43.33% (n=52) of the participants. Mild TMD was detected in 43.33% (n=52) of patients, moderate TMD in 8.33% (n=10), and severe TMD in 4.99% (n=6). While there was no significant difference between TMD severity levels and age (p=0.238), there was a significant relationship with gender (p=0.01). No correlation was found between FAI score and age (r=-0.078; p<0.40). While no pathological findings were present in 33.3% of patients, tooth wear was the most common intraoral finding (50.83%). A significant relationship was found between the presence of linea alba and TMD severity (p=0.001).
Discussion: FAI is a trustworthy diagnostic tool in clinical practice, which should be preferred to detect the severity of early stage TMD-related symptoms in individuals.
Keywords: Intraoral finding; Temporomandibular Joint, Temporomandibular Disorders, Fonseca Anamnestic Index
Can hemorrhoid surgery restore erectile dysfunction caused by hemorrhoids?
Ersan Eroglu 1, Yusuf Ilker Comez 2
1 Department of General Surgery, 2 Department of Urology, Memorial Bahcelievler Hospital, Istanbul, Turkey
DOI: 10.4328/ACAM.21341 Received: 2022-08-05 Accepted: 2022-09-17 Published Online: 2022-09-21 Printed: 2022-12-01 Ann Clin Anal Med 2022;13(12):1345-1348
Corresponding Author: Ersan Eroglu, Department of General Surgery, Memorial Bahcelievler Hospital, Bahçelievler Merkez, Adnan Kahveci Blv., No: 227, 34180, Bahçelievler, İstanbul, Turkey. E-mail: email@example.com P: +90 212 408 45 45 Corresponding Author ORCID ID: https://orcid.org/0000-0002-6654-185X
Aim: Erectile dysfunction (ED) may accompany hemorrhoidal pain. In this study, we aimed to investigate whether hemorrhoid surgery restores erectile function.
Material and Methods: Sexually active 88 male patients aged between 24-82 years and scheduled for hemorrhoid surgery were included in the study. Patients’ demographic data such as age, weight, height and body mass index (BMI), comorbidities, previous surgery, smoking and drug use status were recorded. The preoperative and postoperative International Prostate Symptom Score (I-PSS) and International Index of Erectile Function 5 (IIEF-5) scores were recorded and compared. Doppler-assisted hemorrhoid surgery was performed in all patients. All participants were instructed not to take any medication for ED during the follow-up period. Patients were followed up for 6 months.
Results: The mean age of the patients was 41.77±9.31 (24-82) years. The mean BMI value was calculated as 27.33±3.28 kg/m2. The mean preoperative I-PSS score was found as 3.05±1.60 and the mean postoperative I-PSS score was found as 3.01±1.53. No statistically significant difference was found between the pre- and postoperative I-PSS score values (p=0.317). The mean preoperative IIEF-5 score was found as 20.44±2.16 and the mean postoperative IIEF-5 score was found as 21.06±1.93. There was a significantly significant difference between the mean pre- and postoperative IIEF-5 scores (p<0.001).
Discussion: Our results revealed that there was a significant improvement in ED following hemorrhoid surgery, suggesting a potential relationship between hemorrhoids and erectile dysfunction. However, further, more comprehensive prospective studies are needed to reveal these associations.
Keywords: Haemorrhoids, Haemorrhoid Surgery, Erectile Dysfunction, I-PSS, IIEF-5
Cell-free dna methylation evaluation in patients with thyroid diseases
Guner Begum Cilgin 1, Ozge Caglar Cil 2, Atilla Uslu 3, Akin Cayir 4
1 Canakkale Onsekiz Mart University, Institute of Health Sciences, Canakkale, 2 Department of Head and Neck Surgery- Otorhinolaryngology, Faculty of Medicine, Canakkale Onsekiz Mart University, Canakkale, 3 Department of Physiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, 4 Department of Health Services, Canakkale Onsekiz Mart University, Canakkale, Turkey
DOI: 10.4328/ACAM.21344 Received: 2022-08-09 Accepted: 2022-09-17 Published Online: 2022-11-14 Printed: 2022-12-01 Ann Clin Anal Med 2022;13(12):1349-1353
Corresponding Author: Ozge Caglar Cil, Çanakkale Onsekiz Mart University, Health Services Vocational College, 17100, Çanakkale, Turkey. E-mail: firstname.lastname@example.org P: +90 286 218 00 18 Corresponding Author ORCID ID: https://orcid.org/0000-0001-8737-2891
Aim: The main aim of the study was to evaluate the DNA 5-methylcytosine (m5C) level, measured in circulating cell-free DNA (ccfDNA) as a distinct feature of thyroid gland-related disorders, including thyroiditis, benign nodule, and malignant nodule.
Material and Methods: The study included 75 patients with 30 benign nodules, 30 thyroiditis, and 15 thyroid cancers; 19 subjects were evaluated as a control group. We collected peripheral blood samples from three disease groups and the controls, and then separated the plasma from the whole blood. We measured m5C in ccfDNA purified from plasma samples of patients and healthy individuals.
Results: The level of m5C, measured in thyroiditis patients was significantly different from those measured in the control group, malignant and benign patients. We observed hypomethylation in benign and malignant patients when compared with the control group. However, there was no significant difference between the malignant patients and the control group and between the benign patients and the control group. After comparison of disease groups, we observed that there was no statistically significant difference between benign and malignant patients. We observed a statistically significant difference between thyroiditis and malignant patients (p<0.01) and between thyroiditis and benign patients (p=0.001).
Discussion: Very few studies have reported that DNA methylation is an epigenetic mechanism in thyroiditis patients. Here, we reported that the level of m5C of ccfDNA could be used as a biomarker for thyroiditis. Further studies are required with the higher number of malign and benign patients to investigate the differences between patients with nodules and healthy individuals.
Keywords: Thyroid diseases, Epigenetic, DNA Methylation, Circulating Cell-Free DNA, Cancer, Thyroiditis
Investigation of the efficacy of carotid artery doppler USG in evaluating patients admitted to the emergency department with syncope
Kübra Selçok 1, Hüseyin Cahit Halhallı 2, Serkan Yılmaz 3, Bora Kalaycıoğlu 4, Emrah Çelik 5
1 Department of Emergency Medicine, Soma State Hospital, Manisa, 2 Department of Emergency Medicine, Health Sciences University, Kocaeli Derince Training and Research Hospital, Kocaeli, 3 Department of Emergency Medicine, Kocaeli University, Medical Faculty Hospital, Kocaeli, 4 Department of Radyology, İzmir Seka State Hospital, İzmir, 5 Department of Emergency Medicine, Health Sciences University, Kocaeli Derince Training and Research Hospital, Kocaeli, Turkey
DOI: 10.4328/ACAM.21349 Received: 2022-10-10 Accepted: 2022-11-11 Published Online: 2022-11-15 Printed: 2022-12-01 Ann Clin Anal Med 2022;13(12):1354-1358
Corresponding Author: Kübra Selçok, Department of Emergency Medicine, Manisa State Hospital, Manisa, Turkey. E-mail: email@example.com P: +90 554 513 43 61 Corresponding Author ORCID ID: https://orcid.org/0000-0002-1470-0345
Aim: In our study, we aimed to investigate the effectiveness of carotid artery doppler ultrasonography (CADU), which is a non-invasive and radiation-free method, as a tool in the differential diagnosis of patients with syncope of primary unknown etiology.
Material and Methods: In this prospective and single-center study, patients aged≥18 years admitted to the emergency department of a tertiary hospital with syncope were included. CADU examinations were performed by two emergency physicians and two experienced emergency residents. Patients were evaluated and scored on the basis of the San Francisco Syncope Rule (SFSR) system. Statistical significance was set at p<0.05.
Results: Among the 140 patients included, those with syncope of unknown origin demonstrated higher rates of previous heart failures, significantly elevated levels of BNP, positively correlated with the SFSR score. Furthermore, 25 of the patients were readmitted within 1 month and these patients had significantly higher rates of bilateral carotid artery stenosis. Therefore, using higher cut-off values for measuring carotid stenosis leads to increased specificity when evaluating readmission. This indicated that CADU can be used for ruling out the need for readmission.
Discussion: CADU is an important imaging test in revealing pathological conditions in patients with syncope of unknown etiology and can provide significant results in identifying and excluding patients who could be readmitted within a month. Most studies aim to directly identify the cause of syncope; however, there are limited data to guide clinicians in evaluating and ruling out readmission.
Keywords: Emergency Department, Diagnostic, Doppler Ultrasonography, Carotid Artery, Syncope
Effect of low-dose ketamine on fetal oxidative stress: A randomized trial
Mehmet Aksoy 1, 2, Gamze Nur Cımıllı Senocak 2, 3, Esra Laloglu 4, Ayse Nur Aksoy 2, 5, Aysenur Dostbıl 1, 2
1 Department of Anesthesiology and Reanimation, Faculty of Medicine, Ataturk University, 2 Anesthesiology Clinical Research Office, Ataturk University, 3 Department of Obstetrics and Gynecology, Faculty of Medicine, Ataturk University, 4 Department of Biochemistry, Faculty of Medicine, Ataturk University, 5 Department of Obstetrics and Gynecology, University of Health Sciences, Erzurum Regional Training and Research Hospital, Erzurum, Türkiye
DOI: 10.4328/ACAM.21350 Received: 2022-08-09 Accepted: 2022-09-17 Published Online: 2022-09-23 Printed: 2022-12-01 Ann Clin Anal Med 2022;13(12):1359-1363
Corresponding Author: Mehmet Aksoy, Department of Anesthesiology and Reanimation, Faculty of Medicine, Ataturk University, 25240, Erzurum, Türkiye. E-mail: firstname.lastname@example.org P: +90 505 819 35 26 F: +90 442 236 09 68 Corresponding Author ORCID ID: https://orcid.org/0000-0003-0867-8660
Aim: In this study, we aimed to investigate the effect of preoperative low-dose (0.3 mg/kg) intravenous (IV) ketamine administration on fetal oxidative stress markers including Superoxide Dismutase (SOD), Glutathione Peroxidase (GPx), Malondialdehyde (MDA), and Ischemia-modified albumin (IMA) in patients undergoing cesarean section with combined spinal epidural anesthesia (CSEA).
Material and Methods: A total of 60 parturients aged 18–45 years, and undergoing elective cesarean section with CSEA were included. Two groups (n=30, for each group) were formed by randomization. Before the CSEA procedure, the ketamine group received an IV of 0.3 mg/kg ketamine diluted with 10 ml normal saline and the control group received an IV10 ml normal saline. Then, CSEA was performed using 1.8 ml 0.5% isobaric bupivacaine (9 mg) and 15 µg fentanyl. Immediately after delivery, the umbilical cord was doubly clamped, and a 5 ml of cord blood sample was drawn for biochemical analysis of fetal oxidative stress markers. The socio-demographic, anesthetic characteristics, and biochemical analysis results of the participants were recorded. The results were compared with appropriate statistical methods.
Results: There were no significant differences between the groups in terms of socio-demographic and anesthetic characteristics. Also, both groups had similar values in terms of cord blood GPx, MDA, SOD, and IMA levels.
Discussion: Preoperative low-dose IV ketamine administration has no influence on cord blood oxidative stress markers.
Keywords: Ketamine, Cord blood; Oxidant, Antioxidant, Cesarean Section, Anesthesia
Effects of sleeve gastrectomy surgery on electrocardiographic ventricular arrhythmia markers
Mehmet Inanir 1, Tolga Memioglu 1, Fatih Yilmaz 2, Hayati Eren 3, Kenan Toprak 4, Neriman Sengul 5
1 Department of Cardiology, Faculty of Medicine, Bolu Abant Izzet Baysal University, Bolu, 2 Department of Cardiology, University of Health Sciences, Kartal Kosuyolu High Specialty Training and Research Hospital, Istanbul, 3 Department of Cardiology, Elbistan State Hospital, Kahramanmaraş, 4 Department of Cardiology, Siverek State Hospital, Sanliurfa, 5 Department of Gastrointestinal Surgery, Faculty of Medicine, Bolu Abant Izzet Baysal University, Bolu, Turkey
DOI: 10.4328/ACAM.21355 Received: 2022-08-11 Accepted: 2022-09-21 Published Online: 2022-09-25 Printed: 2022-12-01 Ann Clin Anal Med 2022;13(12):1364-1367
Corresponding Author: Mehmet Inanir, Department of Cardiology, Faculty of Medical, Bolu Abant Izzet Baysal University, Bolu, Turkey. E-mail: email@example.com P: +90 374 253 46 56 F: +90 374 254 66 00 Corresponding Author ORCID ID: https://orcid.org/0000-0003-1784-3584
Aim: Severely obese patients are known to be at risk of malignant arrhythmias. The frequency of ventricular arrhythmia and sudden death is increasing in morbidly obese patients. Ventricular depolarization and repolarization parameters on the electrocardiogram can predict mortality and morbidity. Electrocardiographic (ECG) markers of ventricular depolarization and repolarization parameters like QT, QTc, QTd, QTdc, JT, JTc and Tp-e intervals and Tp-e/QT, Tp-e/QTc, Tp-e/JT and Tp-e/JTc ratios were evaluated before and after sleeve gastrectomy surgery.
Material and Methods: ECG recordings of 35 (24 females and 11 males) morbid obese patients without evident cardiovascular disease were analyzed before and 20.3±9.6 (6-36) months after sleeve gastric surgery. QT, QRS, JT, and Tp-e intervals were measured. QTc, QTd, QTdc, and JTc intervals and Tp-e/QT, Tp-e/QTc, Tp-e/JT and Tp-e/JTc ratios were calculated.
Results: Body mass index (48.29±7.65 to 31.38±4.94 kg/m2, p<0.001), QTc interval (405.6±17.3 to 389.2±16.6 milisecond (ms), p<0.001), QTd (27.5±12.4 to 18.3±9.0 ms, p<0.001), QTdc (30.7±14.4 to 19.1±9.1 ms, p<0.001), JTc interval (315.0±19.0 to 301.2±20.4 ms, p=0.001), Tp-e interval (81.6±7.8 to 69.5±9.3 ms, p<0.001), Tp-e/QT ratio (0.22±0.03 to 0.19±0.02, p<0.001), Tp-e/QTc ratio (0.20±0.02 to 0.18±0.02, p<0.001), Tp-e/JT ratio (0.29±0.04 to 0.24±0.03, p<0.001) and Tp-e/JTc ratio (0.26±0.03 to 0.23±0.03, p<0.001) were significantly decreased after sleeve gastrectomy surgery.
Discussion: QTc, QTd, QTdc, JTc, and Tp-e intervals and Tp-e/QT, Tp-e/QTc, Tp-e/JT and Tp-e/JTc ratios, which are potential ECG ventricular arrhythmia predictors were significantly decreased. Therefore weight reduction with sleeve gastrectomy surgery may be associated with decreased malign arrhythmia tendency and sudden cardiac death.
Keywords: Morbid Obesity, Sleeve Gastrectomy Surgery, Tp-e Interval, Tp-e/JTc Ratio, Ventricular Arrhythmia
Factors affecting mortality and morbidity in patients with sternum fracture
Yeliz Gul 1, Muharrem Cakmak 2, Siyami Aydin 2, Evrim Gul 3
1 Department of Radiology, Faculty of Medicine, Health Science University, Fethi Sekin Education and Research Hospital, 2 Department of Thoracic Surgery, Faculty of Medicine, Firat University, 3 Department of Emergency, Faculty of Medicine, Firat University, Elazig, Turkey
DOI: 10.4328/ACAM.21362 Received: 2022-08-17 Accepted: 2022-09-21 Published Online: 2022-09-26 Printed: 2022-12-01 Ann Clin Anal Med 2022;13(12):1368-1372
Corresponding Author: Evrim Gul, Emergency Department, Faculty of Medicine, Firat University, Elazig, Turkey. E-mail: firstname.lastname@example.org P: +90 424 233 35 55 F: +90 424 233 35 55 Corresponding Author ORCID ID: https://orcid.org/0000-0001-9049-5446
Aim: Closed sternal fractures are deceleration injuries that occur as a result of blunt trauma. In these fractures, cardiac and great vessel injury probability is higher than that of other blunt traumas. Since they are caused by high-energy traumas, they can be accompanied by internal organ injury, chest wall injury, and head and spine traumas. Clinical findings can be very different according to other organ injuries and concomitant pathologies. In our study, we aimed to evaluate the outcomes of patients with post-traumatic sternal fracture.
Material and Methods: Files of 348 patients with sternal fractures presenting to the emergency department and thoracic surgery clinic between 2011 and 2020 were evaluated retrospectively. The patients were divided into two groups as group 1 (patients with sternal fractures and other organ injuries (non-isolated sternal fractures)) and group 2 (isolated sternal fractures).
Results: When the demographic distributions of the patients were evaluated, gender and etiological differences were not significant between the groups. In terms of concomitant pathologies, rib fracture, lung contusion, pneumothorax, and hemothorax were the most common in Group 1 patients, while skin abrasion was observed in Group 2. Concomitant organ injuries were most common in the liver and spleen in Group 1 patients, while there was no concomitant pathology in Group 2. CWIS was 2 in 252 of Group 1 patients, and the mean ISS was 20.07 ± 6.51. On the other hand, CWIS was 1 in all Group 2 patients, and the mean ISS was 7.90 ± 8.64. Group 1 ISS values were statistically significant compared to Group 2. Concomitant pathology or organ injury is the cause of increased mortality and morbidity in patients with sternum fractures.
Discussion: The chest wall injury scoring system is a guide for surgery in those patients. The injury severity score, on the other hand, increases in direct proportion to the severity of the trauma and should be considered an effective parameter for demonstrating the severity of the injury.
Keywords: Morbidity, Mortality, Trauma, Sternal Fracture
Evaluation of the effects of 3D mapping ablation on atrial conduction times in patients with paroxysmal atrial fibrillation
İbrahim Dönmez, Tolga Memioğlu, Emrah Acar, Fatma Erdem
Department of Cardiology, Faculty of Medicine, Abant Izzet Baysal University, Bolu, Turkey
DOI: 10.4328/ACAM.21367 Received: 2022-08-23 Accepted: 2022-10-20 Published Online: 2022-11-17 Printed: 2022-12-01 Ann Clin Anal Med 2022;13(12):1373-1377
Corresponding Author: İbrahim Dönmez, Department of Cardiology, Faculty of Medicine, Abant Izzet Baysal University, 14280, Golkoy, Bolu, Turkey. E-mail: email@example.com P: +90 374 253 46 56 Corresponding Author ORCID ID: https://orcid.org/0000-0002-6913-9073
Aim: Atrial fibrillation (AF) causes structural, electrical, and cellular remodeling in the atrium. Evaluation of intra- and interatrial conduction time, indicates structural and electrical remodeling in the atrium. This study aimed to evaluate the effect of pulmonary vein isolation applied with radiofrequency ablation (RF) therapy on intra- and interatrial conduction time and to investigate the structural and electrically remodeling after treatment.
Material and Methods: Fifty-two patients with symptomatic PAF despite at least one antiarrhythmic drug and without structural heart disease were included in the study. Two patients were excluded because of complications developed during and after the operation. Fifty patients (28 female; mean age: 51.68 ± 11.731; mean left atrial diameter: 36.79 ± 4.318) who underwent CARTO® 3D pulmonary vein isolation applied with the RF ablation system were followed-up. Intra- and inter-atrial electromechanical delay was measured in all patients using tissue doppler echocardiography before and three months after RF ablation.
Results: All intra- and interatrial conduction times were significantly decreased 3 months after RF ablation procedure (PA lateral p = 0.022; PA septum p = 0.002; PA tricuspid p = 0.019, interatrial conduction delay p= 0,012, intra-atrial conduction delay p = 0.029).
Discussion: The results of our study suggest that providing stable sinus rhythm with RF ablation may slow down, stop or even improve structural remodeling at substrate level secondary to AF even in patients with paroxysmal AF who did not yet develop atrial fibrosis and permanent structural changes.
Keywords: Pulmonary Vein Isolation, Radiofrequency Ablation, Atrial Conduction Time, Tissue Doppler Echocardiography
The clinical significance of neutrophil to lymphocyte ratio in incarcerated inguinal hernia in patients over 65
Emrah Akin 1, Kayhan Ozdemir 2, Necattin Firat 1, Merve Yigit 2, Emre Gonullu 2, Recayi Capoglu 2, Fatih Altintoprak 1
1 Department of General Surgery, Faculty of Medicine, Sakarya University, 2 Department of General Surgery, Faculty of Medicine, Sakarya University, Research and Educational Hospital, Sakarya, Turkey
DOI: 10.4328/ACAM.21369 Received: 2022-08-25 Accepted: 2022-09-25 Published Online: 2022-09-27 Printed: 2022-12-01 Ann Clin Anal Med 2022;13(12):1378-1382
Corresponding Author: Emrah Akin, Department of General Surgery, Faculty of Medicine, Sakarya University, Adapazari, Sakarya. E-mail: firstname.lastname@example.org P: +90 264 888 40 00 F: +90 0264 275 91 92 Corresponding Author ORCID ID: https://orcid.org/0000-0003-0224-3834
Aim: Morbidity and mortality rates increase in the presence of an incarcerated inguinal hernia in geriatric patients. The study aims to determine two parameters that can be used to predict ischemia in elderly patients.
Material and Methods: The records of patients over 65 years of age who were operated on in emergency conditions with the diagnosis of incarcerated inguinal hernia were retrospectively analyzed. The patients were divided into non-resection (Group 1) and resection (Group 2) groups. The groups were evaluated in terms of demographic features, American Society of Anesthesiology score, white blood cell numbers, neutrophil percentage, neutrophil/lymphocyte ratio, mean platelet volume, hernia sac content, hernia type, length of hospital stay, and complication rates.
Results: The study included 183 patients. One hundred fifty-six of the patients were male (85.3%), 27 patients were female (14.7%), and the mean age of the patients was 75.4 ± 5.3 years (66-90). The neutrophil/lymphocyte ratio value was determined as 3.1 (0.62-3.9) in the non-resection group and 3.2 (0.7-16.4) in the resection group. There was no statistically significant difference between the groups in terms of neutrophil/lymphocyte ratio values (p> 0.05). In Group 2, mean platelet volume, hospital stay, and complication rates were statistically higher.
Discussion: Although the preoperative neutrophil/lymphocyte ratio is not useful in predicting the presence of ischemia in incarcerated inguinal hernias in elderly patients, mean platelet volume may be useful in predicting the presence of ischemia and indication of resection.
Keywords: Hernia, Small Bowel, Mean Platelet Volume, Geriatric
Importance of systemic inflammation and hematological indices in gastric cancer staging
Server Sezgin Uludag 1, Ergin Erginoz 2, Ahmet Necati Sanli 1, Nazim Gures 2, Kagan Zengin 1, Mehmet Faik Ozcelik 1
1 Department of General Surgery, Faculty of Medicine, Istanbul University Cerrahpasa, Istanbul, 2 Department of General Surgery, Balıkesir Atatürk City Hospital, Balıkesir, Turkey
DOI: 10.4328/ACAM.21377 Received: 2022-09-06 Accepted: 2022-10-26 Published Online: 2022-11-08 Printed: 2022-12-01 Ann Clin Anal Med 2022;13(12):1383-1387
Corresponding Author: Ergin Erginoz, Department of General Surgery, Faculty of Medicine, Istanbul University, Cerrahpaşa Mah. Kocamustafapaşa Cad. No:34/E Fatih, Istanbul, Turkey. E-mail: email@example.com P: +90 533 493 36 76 Corresponding Author ORCID ID: https://orcid.org/0000-0002-8349-3298
Aim: In this study, we aimed to assess whether preoperative C-reactive protein (CRP), hematological parameters, and indices can predict the stage of patients with gastric cancer.
Material and Methods: Five hundred and thirty-six patients with gastric cancer (stages I–III) were enrolled as case series analyses in this study.
Results: Patients with adenocarcinoma were older, leukocyte and albumin levels were lower, and CRP values were higher than in signet ring cell carcinoma patients. There was a statistically significant difference between the two pathological subgroups in terms of gender and tumor stages. Platelet (PLT) and PLT/lymphocyte ratios were found to be high in the advanced stage TNM Classification of Malignant Tumors (TNM) stage 3A, 3B, and 3C. The incidence of adenocarcinoma was found to be higher in the early stage compared to the late stage.
Discussion: Preoperative high CRP, low leukocyte, and albumin levels in patients with gastric cancer may be an indicator to distinguish signet ring cell carcinoma from adenocarcinoma. The preoperative high platelet and PLT/lymphocyte ratio may be useful predictive factors for differentiating in patients with stage 1A, 1B, 2A, and 2B and stage 3A, 3B, and 3C in gastric cancer.
Keywords: Gastric Cancer, C-reactive Protein, Platelet, Lymphocyte, Platelet/Lymphocyte Ratio
Endotracheal intubation practice from a pediatric emergency clinic of a tertiary hospital in Turkey
Alper Çiçek 1, Emel Berksoy 1, Pelin Elibol 2, Gülşah Demir 1, Şefika Bardak 1, Tuğçe Nalbant 3, Gamze Gökalp 3
1 Department of Pediatric Emergency Medicine, Faculty of Medicine, University of Health Sciences, Izmir Tepecik Education and Research Hospital, 2 Department of Pediatric Emergency Medicine, Faculty of Medicine, Ege University, 3 Department of Pediatric Emergency Medicine, Faculty of Medicine, Izmir Kâtip Celebi University, Izmir, Turkey
DOI: 10.4328/ACAM.21381 Received: 2022-09-06 Accepted: 2022-11-07 Published Online: 2022-11-16 Printed: 2022-12-01 Ann Clin Anal Med 2022;13(12):1388-1392
Corresponding Author: Alper Çiçek, University of Health Sciences, Izmir Tepecik Education and Research Hospital, Guney Neighbourhood, 1140/1 Street, No:1, Konak, Izmir, Turkey. E-mail: firstname.lastname@example.org P: +90 505 006 23 23 F: +90 232 433 07 56 Corresponding Author ORCID ID: https://orcid.org/0000-0001-5017-4525
Aim: Airway management has primary importance to provide optimal ventilation and oxygenation in emergency services.
Material and Methods: In the study, the resuscitation room records of patients aged 0-18 years in the pediatric emergency room of Healt Sciences University, Tepecik Education and Research Hospital between January 2017 and January 2020. We evaluated the patients who were admitted to the resuscitation room and underwent emergency or rapid sequential intubation. We compared the time elapsed from admission to the emergency room until the time of successful tracheal intubation in the resuscitation room.
Results: The mean age of 111 patients in the study was 14.47 months (3.93-42.27), 65 (58.6%) of them were boys and 46 (41.1%) of them were girls. Nine (8.1%) patients were resuscitated outside the hospital and it continued in the resuscitation room. Successful tracheal intubation was achieved in 95 (85.5%) patients after the first attempt. Sedative or neuromuscular blocker agents were given to 71 (63.9%) patients before intubation and cardiopulmonary resuscitation was performed in only one of them. When the time elapsed from the time of admission until the patient was taken to the resuscitation room, vascular access was provided and successful intubation was achieved, there was no significant difference between working hours and out of working hours.
Discussion: The intubation procedure, besides being a life-saving intervention, requires attention and care in terms of its risks and timing. It is very important to carry out the tracheal intubation procedure on time and the records should be kept properly and completely during the procedure.
Keywords: Airway Management, Pediatric Emergency, Tracheal Intubation
The relationship between expressed emotion and treatment resistance in patients with major depression
Fatih Baz 1, Erdoğdu Akça 2, Mesut Yıldız 1
1 Department of Psychiatry, Faculty of Medicine, Marmara University, 2 Department of Psychiatry, Marmara University, Pendik Research and Training Hospital, Istanbul, Turkey
DOI: 10.4328/ACAM.21387 Received: 2022-09-09 Accepted: 2022-10-26 Published Online: 2022-11-12 Printed: 2022-12-01 Ann Clin Anal Med 2022;13(12):1393-1398
Corresponding Author: Mesut Yıldız, Department of Psychiatry, Faculty of Medicine, Marmara University, Istanbul, Turkey. E-mail: email@example.com P: +90 505 891 43 63 Corresponding Author ORCID ID: https://orcid.org/0000-0002-6965-370X
Aim: Expressed emotion (EE) is associated with relapse in major depression. However, past research on its relationship with treatment resistance is limited. In this study, we aimed to investigate whether there is any difference in terms of EE between treatment-resistant depression (TRD) and non-resistant depression (non-TRD) patients, and the relationship between the clinical characteristics of depression and EE.
Material and Methods: The study included 50 patients with TRD, 50 patients with non-TRD and the relatives of these 100 patients. All patients were given the Quick Inventory of Depressive Symptomatology Self-Report Form (QIDS_SR16) and Level of Expressed Emotion (LEE) Scale. Furthermore, the Expressed Emotion (EE) Scale was applied to the relatives of the patients to determine the level of EE.
Results: LEE total score (p = 0.020) and EE total score (p <0.001) were found to be significantly higher in the TRD group. There was a positive correlation between the QIDS-SR16 total score and total EE and LEE scores and all subscale scores (p <0.05). Regression analysis revealed that the QIDS total score (0.394) and male gender (0.219) were associated with the total score of EE. The LEE total score was predicted by QIDS total score (0.370), and the higher education level of the close relative (0.219).
Discussion: Besides its limitations, the present study is the first study comparing the expressed emotion between TRD and non-resistant major depression patients. Prospective studies with a large sample size are needed regarding how expressed emotion affects the severity of the disease and its clinical course.
Keywords: Expressed Emotion, Major Depression, Treatment Resistance
Comparison of the effect of electroconvulsive therapy performed by administering propofol with and without rocuronium
Oguzhan Kursun, Ayse Mızrak Arslan, Elzem Sen, Lutfiye Pirbudak
Department of Anesthesiology and Reanimation, Faculty of Medicine, University of Gaziantep, Gaziantep, Turkey
DOI: 10.4328/ACAM.21395 Received: 2022-09-18 Accepted: 2022-10-26 Published Online: 2022-11-12 Printed: 2022-12-01 Ann Clin Anal Med 2022;13(12):1399-1403
Corresponding Author: Elzem Sen, Department of Anesthesiology and Reanimation, Faculty of Medicine, University of Gaziantep, 27310, Gaziantep, Turkey. E-mail: firstname.lastname@example.org P: +90 532 784 21 51 F: +90 342 360 39 98 Corresponding Author ORCID ID: https://orcid.org/0000-0003-3001-7324
Aim: In this study, we aimed to compare groups in terms of cardiovascular changes and side effects by administering propofol to patients in the control group and propofol and rocuronium bromide to patients in the study group during electroconvulsive therapy.
Material and Methods: Eighty-four patients with ASA I-II schizophrenia, major depression and bipolar disease were included in the study. Heart rate, MAP (mmHg) and ECG of the patients were recorded both before induction and at the end of convulsion. Patients in the R group (n = 42) were administered with 2% lidocaine IV 0,5 mg / kg, propofol IV 1-2 mg / kg and rocuronium IV 0,2 mg / kg for induction. Patients in the P group (n = 42) were given 2% lidocaine IV 0,5 mg / kg and propofol IV 1-2 mg / kg only for induction.
Results: Pd values before induction were statistically lower than Pd values after ECT in both P and R groups. In both patients in the P group and the R group, the post-ECT values for HR were statistically higher than the pre-induction values. Pre-induction MAP values were statistically lower than post-ECT MAP values in both P and R groups.
Discussion: In ECT, when we compare the application of propofol and rocuronium with the application of propofol without muscle relaxants, propofol as an anesthetic agent provided an adequate and safe anesthesia with rapid recovery and a minimal side effect profile except for postoperative temporary myalgia in these patients.
Keywords: ECT, Propofol, Rocuronium
Evaluation of pediatricians’ awareness of traditional and complementary medicine
Fatma Sargın 1, İnci Kara 2
1 Department of Pediatrics, Konya Beyhekim Training and Research Hospital, 2 Department of Anesthesiology and Reanimation, Faculty of Medicine, Selcuk University, Konya, Turkey
DOI: 10.4328/ACAM.21397 Received: 2022-09-19 Accepted: 2022-10-28 Published Online: 2022-11-11 Printed: 2022-12-01 Ann Clin Anal Med 2022;13(12):1404-1408
Corresponding Author: Fatma Sargın, Department of Pediatrics, Konya Beyhekim Training and Research Hospital, Konya, Turkey. E-mail: email@example.com P: +90 533 726 32 29 Corresponding Author ORCID ID: https://orcid.org/0000-0002-4514-1857
Aim: Today, the use of Traditional and Complementary Medicine (T&CM) methods in adults and children is increasing day by day in many countries. This situation makes clinicians’ level of knowledge about T&CM even more important. In our study, we aimed to evaluate the awareness of pediatricians about T&CM applications.
Material and Methods: The survey was delivered electronically to 300 pediatricians, of whom 184 completed the survey completely. The survey consisted of a total of 15 questions, and the demographic characteristics of the participants, their level of knowledge about T&CM, their thoughts on T&CM applications in clinical practice, and the future of T&CM training were evaluated.
Results: 47.7% of the surveyed pediatricians were male and 54.3% were female. While only 9.8% of the participants stated that they received training on T&CM, 71.7% stated that they planned to receive training. Only 20.7% of the participants reported their knowledge level about T&CM as moderate and above. While the participants reported phytotherapy (39.4%) as the T&CM method they had the most knowledge about, acupuncture (31.8%) and Cupping Therapy / Hijama Therapy (23.5%) followed phytotherapy. 49.2% of the participants who suggested T&CM in their clinical practice described the level of knowledge about T&CM as moderate and above (p<0.001). 74.6% of the participants who recommend T&CM in their clinical practice state that they recommend it to their patients to support the immune system.
Discussion: Consequently, it is obvious that the level of knowledge about T&CM is not at the desired level for pediatricians and they have not received any training on T&CM at any stage of their education, except for individual training efforts. In practice, almost all pediatricians encounter at least one T&CM application or recommend it without realizing it or not. For this reason, we believe that the dissemination of T&CM training and integration into medical education will be appropriate for both clinicians’ and patients’ safety.
Keywords: Attitude, Behavior, Knowledge, Pediatricians, Traditional and Complementary Medicine
Lactate and D-Dimer levels in acute pulmonary embolism and COVID-19
Mehmet Cagri Goktekın, Mustafa Yılmaz
Department of Emergency Medicine, Faculty of Medicine, Fırat University, Elazığ, Turkey
DOI: 10.4328/ACAM.21398 Received: 2022-09-19 Accepted: 2022-10-28 Published Online: 2022-11-02 Printed: 2022-12-01 Ann Clin Anal Med 2022;13(12):1409-1413
Corresponding Author: Mehmet Cagri Goktekın, Department of Emergency Medicine, Faculty of Medicine, Fırat University, 23200, Elazig, Turkey. E-mail: firstname.lastname@example.org P: +90 424 237 00 00 Corresponding Author ORCID ID: https://orcid.org/0000-0001-7911-8965
Aim: This study aimed to compare clinical data and laboratory results in patients examined for suspected pulmonary embolism (PE) in the emergency department based on three groups: patients with coronavirus disease-2019 (COVID-19), patients with PE and patients with both COVID-19 and PE.
Material and Methods: This retrospective study was approved by the local ethics committee of the university. Patients included in the study were divided into three groups: Group 1, consisting of COVID-19-polymerase chain reaction (PCR) (negative) and PE (positive) patients; Group 2, consisting of COVID-19-PCR (positive) and PE (negative) patients, and Group 3, consisting of COVID-19-PCR (positive) and PE (positive) patients.
Results: The three patient groups included in the study had no difference in terms of age (p = 0.916) or sex. The laboratory results of the groups were compared using the Kruskal–Wallis test, which showed significant differences in the levels of white blood cells (p = 0.005), lymphocytes (p < 0.001), neutrophils (p = 0.016), D-Dimer (p < 0.001) and lactate (p = 0.001). Receiver operating characteristic curve analysis with a cut-off value of >2590 for D-Dimer showed 71.43% specificity and 78% sensitivity in differentiating Group 1 from Group 2, and with a cut-off value of >3640, it had 80% specificity and 81.82% sensitivity in differentiating Group 3 from Group 2.
Discussion: COVID-19 leads to increased incidence of PE. In addition to clinical data, D-Dimer and lactate levels can be used in the differentiation of these patients.
Keywords: COVID-19, D-Dimer, Lactate, Pulmonary Embolism
Assessment of left ventricular functions with myocardial performance index in coronary slow flow phenomenon
İsa Ardahanlı 1, Onur Akgun 2, Murat Özmen 3, Rafig Gurbanov 4, Olgica Mihaljevic 5
1 Department of Cardiology, Faculty of Medicine, Seyh Edebali University, Bilecik, Turkey, 2 Department of Cardiology, Ankara Training and Research Hospital, Ankara, Turkey, 3 Department of Cardiology, Erzurum City Hospital, Erzurum, Turkey, 4 Department of Bioengineering, Faculty of Engineering, Seyh Edebali University, Bilecik, Turkey, 5 Department of Pathophysiology, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
DOI: 10.4328/ACAM.21406 Received: 2022-09-21 Accepted: 2022-10-29 Published Online: 2022-11-08 Printed: 2022-12-01 Ann Clin Anal Med 2022;13(12):1414-1418
Corresponding Author: İsa Ardahanlı, Pelitözü Location, Fatih Sultan Mehmet Boulevard, No:25/A, 11040, Bilecik, Turkey. E-mail: email@example.com P: +90 533 576 83 25 F: +90 228 202 33 66 Corresponding Author ORCID ID: https://orcid.org/0000-0002-9309-803X
Aim: Coronary slow flow phenomenon (CSFP) is the delayed filling and emptying of contrast agents in the coronary arteries without angiographically significant stenosis. The impact of CSFP on left ventricular (LV) functions is unclear. The myocardial performance index (MPI) is an index that permits the evaluation of LV systolic and diastolic functions together. In this study, we aimed to evaluate how LV systolic and diastolic functions are affected by the use of MPI in patients with CSFP.
Material and Methods: The study included 53 patients (28 men and 25 women) who were found to have CSFP on coronary angiography, and 53 age and gender-matched individuals (30 men and 23 women) with normal coronary arteries. Isovolumetric contraction time (IVCT), isovolumetric relaxation time (IVRT) and ejection time (ET) were measured for all participants included in the study with the help of the tissue Doppler technique. MPI values were calculated with the IVCT+IVRT/ET formula and the results were compared between groups.
Results: The mean age of the study group was 54.4 ± 9.9 years. In the CSFP group, the MPI was significantly higher (0.56 ± 0.09 vs 0.51 ± 0.09, p = 0.016), IVRT was longer (75.30 ± 11.83 vs 69.47 ± 15.89 ms, p = 0. 035), and ET was shorter (257.51 ± 30.98 vs 270.04 ± 21.4 ms, p = 0.017). IVCT was similar between groups (67.34 ±12.74 vs. 68.72 ± 13.42 ms, p = 0.588). LVEF, Mitral E and mitral A wave, E’, A’, and E/A were similar in both groups.
Discussion: Our study results demonstrated that conventional diastolic and systolic parameters were not affected in CSFP and MPI was impaired. We think that MPI should be measured together with other routine echocardiographic measurements when evaluating whether the left ventricular function is affected by CSFP.
Keywords: Coronary Slow Flow, Myocardial Performance Index, Left Ventricular Functions