Management of chest trauma; tube thoracostomy: A feasible option
Muhammad Ayub Jat 1, Abdul Mutalib Almadawy 2
1 Department of Surgery, Faculty of Medicine, Northern Border University, 2 Department of Specialist Thoracic Surgeon, Ministry of Health, Northern Medical Tower, Arar, Saudi Arabia
DOI: 10.4328/ACAM.21648 Received: 2023-05-23 Accepted: 2023-07-03 Published Online: 2023-07-10 Printed: 2023-11-01 Ann Clin Anal Med 2023;14(11):961-965
Corresponding Author: Muhammad Ayoob Jat, Department of Surgery, Faculty of Medicine, Northern Border University, 1321, Arar, Saudi Arabia. E-mail: firstname.lastname@example.org P: +966 535 213 066 Corresponding Author ORCID ID: https://orcid.org/0000-0001-7671-0314
This study was approved by the Ethics Committee of Northern Border University (Date: 2020-10-20, No: 10/42/H)
Aim: In this study, we aimed to determine the safety and feasibility of tube thoracostomy in the management of chest trauma and its impact on patient outcomes.
Material and Methods: This retrospective study was conducted at the Department of Surgery, Northern Medical Tower, in Arar Kingdom of Saudi Arabia for 2 years from January 2019 to December 2020. Inclusion criteria were patients who presented to the Emergency Department with chest trauma due to a motor car accident (MCA), history of falls, history of assault, etc., and they were hemodynamically stable. Exclusion criteria were hemodynamically unstable patients with obvious signs of thoracotomy. Records of all patients with chest trauma were retrieved from files. The variables of the study were the demographic data, the mechanism of trauma, the clinical assessment of patients, the duration of the chest tube, length of stay in the hospital, complications, and clinical outcomes.
Result: This study included 365 patients with chest trauma, 329 (90.14 %) males and 36 (9.86%) females with a ratio of M 9:1 F. The age of the patients ranged from 12 to 70 years with a mean age of (41.15 ± 1.5) years. Road traffic accidents were the commonest mechanism in 300 (82.19%) patients with blunt chest trauma and a stab wound in penetrating chest trauma. Head and neck injuries were the most common associated injuries. Tube thoracostomy under local anesthesia was done in 98 (27%) patients, while 267 (73%) patients were managed conservatively.
Discussion: Tube thoracostomy is a safe and feasible option in the management of chest trauma with better patient outcomes. Chest trauma resulting from road traffic accidents remains the major mechanism of chest injury among young males and active age groups.
Keywords: Chest Trauma, Rib Fracture, Tube Thoracostomy, Pneumothorax, Hemothorax
Effects of iloprost and n-acetylcysteine on ischemia-reperfusion injury and thiol/disulfide hemostasis in rats
Yasin Alper Yildiz 1, Fatih Altintoprak 2, Fehmi Celebi 2, Volkan Oter 3, Gozde Cakırsoy Cakar 4, Hayrullah Yazar 5, Hüseyin Cakiroglu 6, Ali Muhtaroğlu 7
1 Department of General Surgery, Faculty of Medicine, Kastamonu University, Kastamonu, 2 Department of General Surgery, Faculty of Medicine, Sakarya University, Sakarya, 3 Department of Gastroenterological Surgery, Faculty of Medicine, Ankara City Hospital, Ankara, 4 Department of Pathology, Faculty of Medicine, Sakarya University Research and Educational Hospital, Sakarya, 5 Department of Biochemistry, Faculty of Medicine, Sakarya University Research and Educational Hospital, Sakarya, 6 Experimental Medicine Researchand Application Center, Faculty of Medicine, Sakarya University, Sakarya, 7 Department of General Surgery, Faculty of Medicine, Giresun University , Giresun, Turkey
DOI: 10.4328/ACAM.21658 Received: 2023-02-19 Accepted: 2023-07-03 Published Online: 2023-08-02 Printed: 2023-11-01 Ann Clin Anal Med 2023;14(11):966-970
Corresponding Author:Yasin Alper Yıldız, Department of General Surgery, Faculty of Medicine, Kastamonu University, Kastamonu, Turkey. E-mail: email@example.com P: +90 534 953 06 28 Corresponding Author ORCID ID: https://orcid.org/0000-0002-6348-1927
This study was approved by the Local Ethics Committee of Sakarya University Animal Experiments (Date: 2018-09-05, No: 24)
Aim: Intestinal ischemia occurs after partial or complete obstruction of the intestinal arterial blood flow, and reperfusion injury following the restoration of blood flow. Intestinal ischemia-reperfusion [IIR] damage can cause multiple organ failure and death.
In our study, we aimed to observe the effect of ilioprost and N-acetylcysteine on ischemia-reperfusion injury and to show the effect of the Thiol disulfide mechanism in this area.
Material and Methods: Thirty Sprague Dawley rats were divided into five groups of six animals each: sham, IIR, IIR+IL, IIR+NAC and IIR+NAC+IL. Intestinal samples and blood were collected after completion of the sham or IIR protocol. Small-bowel samples were evaluated according to the Chiu score. Thiol/disulfide [DS] hemostasis was followed using a novel series of serum biomarkers. Serum concentrations of total thiol, native thiol and disulfide were also determined.
Results: The average Chiu score was lower in the IIR + NAC group than in both the IIR and the IIR + IL group, but the differences were not statistically significant. The score in the sham group was significantly lower than those of the other four groups. The level of reduced thiol and the native thiol/total thiol [NT/TT] ratios were higher in groups treated with NAC, IL or both. In the latter groups, oxidized thiol, DS/TT and DS/NT ratios were lower than in the IIR group but the differences between the three treatment groups were not statistically significant.
Discussion: The addition of IL to NAC was not more protective than NAC alone in a rat model of IIR injury. Our results suggest that markers of thiol-DS hemostasis can be used as indicators of antioxidant mechanisms in IIR injury.
Keywords: Ischaemia-Reperfusion Injury, Disulphide, Thiol, Iloprost
Diagnostic and prognostic value of scd163 levels in upper gastrointestinal bleeding
Melis Dorter 1, Utku Murat Kalafat 2, Busra Bildik 3, Doganay Can 4, Serkan Dogan 2, Kader Irak 5, Basar Cander 2, Ramazan Guven 4
1 Department of Emergency Medicine, Koc University Hospital, Istanbul, 2 Department of Emergency Medicine, University of Health Science, Kanuni Sultan Suleyman Training and Research Hospital, Istanbul, 3 Departmen of Emergency Medicine, Karabuk University Training and Research Hospital, Karabuk, 4 Department of Emergency Medicine, Ministry of Health Basaksehir Cam and Sakura City Hospital, Istanbul, 5 Department of Gastroenterolog, Ministry of Health Basaksehir Cam and Sakura City Hospital, Istanbul, Turkey
DOI: 10.4328/ACAM.21697 Received: 2023-04-01 Accepted: 2023-05-17 Published Online: 2023-07-04 Printed: 2023-11-01 Ann Clin Anal Med 2023;14(11):971-975
Corresponding Author: Melis Dorter, Department of Emergency Medicine, Koc University Hospital, Istanbul, Turkey. E-mail: firstname.lastname@example.org P: +90 530 304 88 06 Corresponding Author ORCID ID: https://orcid.org/0000-0001-6958-6052
This study was approved by the Ethics Committee of Health Sciences University and Istanbul Kanuni Sultan Süleyman Training and Research Hospital (Date: 2019-05-16, No: KAEK/2019.06.154)
Aim: Upper gastrointestinal endoscopy (an invasive procedure) is the gold standard for diagnosing patients with suspected upper gastrointestinal bleeding. In this study, oOur aim is to determine the value of sCD163 in upper gastrointestinal bleeding.
Material and Methods: In this single-center,e cross-sectional, prospective study, we aimed to evaluate the value of sCD163 as a non-invasive marker for diagnosing and predicting upper gastrointestinal bleeding. Patients aged ≥18 years who underwent endoscopy for suspected upper gastrointestinal bleeding and presented at the emergency department of Kanuni Sultan Suleyman Training and Research Hospital in the University of Istanbul Health Science were included in the study. Statistical analysis was conducted using the SPSS Statistics 26.0 program (IBM Inc., New York, USA). The study was conducted between January 8, 2019 and January 4, 2020 with 75 participants. Of these, 41 patients had upper gastrointestinal bleeding, and 34 were healthy volunteers.
Results: In the patient group, Glasgow-–Blatchford scores and sCD163 values were calculated for those with and without bleeding-related findings. Notably, the patient group had statistically significantly higher sCD163 levels than the healthy volunteer group healthy volunteers (p < 0.05).
Discussion: sCD163 may be a useful biomarker for diagnosing upper gastrointestinal bleeding and identifying the clinical process.
Keywords: Gastrointestinal Bleeding, sCD163, Scoring, Endoscopy
An outbreak of septic arthritis after arthroscopic reconstruction of the anterior cruciate ligament
Güliz Evik 1, Gülcan Türkmen 2, Fatma Bozdağ 3, Mehmet Çolak 4, Gülden Ersöz 5
1 Department of Infectious Diseases, Faculty of Medicine, Mersin University, 2 Department of Nursing, Mersin University Hospital, 3 Department of Public Health, Faculty of Medicine, Mersin University, 4 Department of Orthopaedics and Traumatology, Faculty of Medicine, Mersin University, 5 Department of Infectious Diseases, Faculty of Medicine, Mersin University, Mersin, Turkey
DOI: 10.4328/ACAM.21699 Received: 2023-03-22 Accepted: 2023-05-05 Published Online: 2023-08-05 Printed: 2023-11-01 Ann Clin Anal Med 2023;14(11):976-980
Corresponding Author: Güliz Evik, Department of Infectious Diseases, Faculty of Medicine, Mersin University, 33343, Mersin, Turkey. E-mail: email@example.com P: +90 536 557 09 33 Corresponding Author ORCID ID: https://orcid.org/0000-0003-2125-3536
This study was approved by the Clinical Research Ethics Committee of Mersin University (Date: 2022-02-23, No: 148)
Aim: Acute septic arthritis after arthroscopic posterior cruciate ligament (PCL) reconstruction is uncommon but is a very critical complication. Properly sterilized surgical instruments are the most important step in preventing infection. After arthroscopic anterior cruciate ligament surgery, a cluster of 6 joint-bursa infection cases was seen in our unit. The aim of this study was to determine the socio-demographic and clinical practices that may be associated with the development of infection in the surgical site after arthroscopic cruciate ligament surgery.
Material and Methods: This was a cross-sectional study of SSIs developing after arthroscopic anterior cruciate ligament surgery in 2018 in a University Hospital. Environmental and surgical equipment samples were taken. ATP bioluminescence test was performed on these samples. When a high-risk status was detected, surveillance cultures were performed.
Results: A total of 15 procedures meeting the inclusion and exclusion criteria were evaluated. Six patients were considered to have infections, while 9 were infection-free. An examination of the surgery lists showed that 6 of the 7 patients with infection represented the first arthroscopic procedure of the day. An inquiry regarding personnel of the surgery room showed that a newly appointed nurse made a modification in the decontamination procedure of the surgical equipment.
Discussion: Incomplete sterilization of surgical equipment and environmental contamination can lead to serious infection.
Keywords: Arthroscopic Surgery, Anterior Cruciate Ligament, Septic Arthritis, Outbreak
Clinicopathological roles of Vasobin-2 in colorectal cancers
Suat Benek 1, Ayşegül İsal Arslan 2, Kasım Çağlayan 3, Mehmet Zengin 1, Fatih Rüştü Polat 1, Tamer Sağıroğlu 1
1 Department of General Surgery, Faculty of Medicine, Tekirdağ Namık Kemal University, Tekirdağ, 2 Department of Pathology, Faculty of Medicine, Tekirdağ Namık Kemal University, Tekirdağ, 3 Department of Pathology, Ankara Training and Research Hospital, Ankara, Turkey
DOI: 10.4328/ACAM.21705 Received: 2023-03-29 Accepted: 2023-06-21 Published Online: 2023-08-03 Printed: 2023-11-01 Ann Clin Anal Med 2023;14(11):981-985
Corresponding Author: Suat Benek, Department of General Surgery, Faculty of Medicine, Tekirdağ Namık Kemal University, Tekirdağ, Turkey. E-mail: firstname.lastname@example.org P: +90 507 559 88 09 Corresponding Author ORCID ID: https://orcid.org/0000-0003-0774-7695
This study was approved by the Ethics Committee of Tekirdağ Namık Kemal University (Date: 2021-04-27, No: 2021.123.04.18)
Aim: Vasohibin-2(VASH2) is a pro-angiogenic molecule synthesized from mononuclear cells. The biological characteristics of colorectal cancer (CRC) cells and their microenvironment are not known yet. In the present study, the purpose was to investigate the clinicopathological roles of VASH2 in colorectal cancers.
Material and Methods: Three-micron sections were made for Immunohistochemistry (IHC) Analysis of the paraffin block tissues of 159 patients who underwent curative surgery for CRC. Immunohistochemical staining was performed with anti-CD34 and anti-D2-40’ and anti-Vasohibin-2 antibodies as lymphatic vessel markers on vascular endothelial cells. The density of newly formed vessels in the peripheral stroma of the tumor with CD34 and D240 and the presence of VASH-2 were investigated in these vessels.
Results: It was determined in the relationship analysis of the variables that VASH2 positivity showed a positive relationship with tumor diameter (p<0.05). No significant relationships were detected with other prognostic factors. Advanced age, perineural invasion (PNI), and pathological stage were the parameters that predicted survival in the Cox Regression Analysis, in which many variables were included (p<0.05), and VASH2 positivity showed negative predictive characteristics together with CD 34 positivity (p<0.05). No relationship was detected between VASH2 expression levels and CD34 and D-240 in cancer stroma and paracancerous tissue. VASH2 expression was significantly lower in cancer stroma and VASH2, CD34, and D-240 levels were higher in paracancerous tissue; however, no relationship was detected in this respect.
Discussion: In the present study, a significant relationship was detected between VASH2 and tumor diameter. However, no statistically significant differences associated with prognosis were detected. Further studies of its other roles in the tumor microenvironment as well as the pro-angiogenic characteristics of VASH2 will help to reveal the effects of this molecule in cancer angiogenesis.
Keywords: Angiogenesis Stimulating Agents, Endothelial Cells, Immunohistochemistry, Vasohibin
Investigation of oxygen saturation levels in respiratory system diseases in the covid-19 pandemic
Gülbin Aydoğdu Umaç 1, Arife Erdogan 2, Fatma Ezgi Can 3
1 Department of Manisa Provincial Ambulance Service Chief Physician, Manisa, 2 Department of Emergency Medicine, Faculty of Medicine, Izmir Bakırçay University Cigli Regional Training Hospital, İzmir, 3 Department of Biostatistics, Faculty of Medicine, İzmir Katip Çelebi University, İzmir, Turkey
DOI: 10.4328/ACAM.21722 Received: 2023-04-10 Accepted: 2023-06-16 Published Online: 2023-07-03 Printed: 2023-11-01 Ann Clin Anal Med 2023;14(11):986-989
Corresponding Author: Arife Erdogan, Department of Emergency Medicine, Faculty of Medicine, Izmir Bakırçay University Cigli Regional Training Hospital, İzmir, Turkey. E-mail: email@example.com P: +90 531 343 97 31 Corresponding Author ORCID ID: https://orcid.org/0000-0003-2488-2012
This study was approved by the Ethics Committee of Izmir Bakircay Unıversity (Date: 2023-02-01, No: 869/849)
Aim: In the Covid-19 pandemic, it is seen that patients remain hypoxic in the long term and their SpO2 values decrease. The aim of this study was to evaluate the SpO2 levels in cases transported to the hospital by 112 ambulance and to investigate the correlation of the data results with respiratory system diseases and COPD patients, which is the group most frequently transported to the hospital.
Material and Methods: We examined the SpO2 values of patients who were transported by 112 emergency ambulance with shortness of breath during the long period of the pandemic. We examined 270,753 patients who were transported between March-September 2020, 2021, 2022. The patients were divided into two groups according to the degree of saturation: saturation between 86-90% and below 85%.
Results: We statistically analyzed the saturation levels of the patients by year and month. There was no statistically significant relationship in terms of the number of transported cases by years and months in patients with a saturation below 85% (p=0.908). There was a significant correlation between years and months in patients with 86-90% saturation (p=0.029). There was a statistically significant relationship between the saturation levels of the cases carried by years (p=0.017). In 2021-2022, the percentage of patients with both saturation below 85% and between 86-90% increased compared to 2020 (p=0.003; p=0.015).
Discussion: According to the results of the study, the low oxygen levels of the patients who were transported to the hospital with shortness of breath increased in the 1st and 2nd years compared to the beginning of the pandemic.
Keywords: Long COVID-19 Syndrome, Dyspnea, Hypoxemia, Pulse Oximetry
Investigation of peripheral natural killer cell activity in recurrent miscarriages of unknown cause
Elnare Alyazova 1, Gulchin Babayeva 2, Mehmet Cengiz Çolakoğlu 2, Jule Eriç Horasanlı 2
1 Department of Gynecology and Obstetrics, Meram Faculty of Medicine, Medova Hospital, 2 Department of Gynecology and Obstetrics, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey
DOI: 10.4328/ACAM.21747 Received: 2023-05-02 Accepted: 2023-06-12 Published Online: 2023-07-04 Printed: 2023-11-01 Ann Clin Anal Med 2023;14(11):990-994
Corresponding Author: Jule Eriç Horasanlı, Department of Gynecology and Obstetrics, Meram Faculty of Medicine, Necmettin Erbakan University, Konya,Turkey. E-mail: firstname.lastname@example.org P: +90 555 479 33 94 Corresponding Author ORCID ID: https://orcid.org/0000-0002-8738-7126
This study was approved by the Ethics Committee of Necmettin Erbakan University, Medical Faculty (Date: 2022-11-06, No: 2020/2889)
Aim: Recent studies on alloimmune factors have shown that Natural Killer (NK) cells may have a role in the implantation and maintenance of pregnancy. It is unclear precisely what kind of relationship exists between uterine and peripheral blood NK cells. Our study aims to investigate the relationship between pNK cells and recurrent pregnancy loss.
Material and Methods: Among the patients who applied to the outpatient clinic at University Hospital, retrospectively, women with two or more pregnancy losses constituted the RM group, and women with two or more live births and no miscarriage formed the control group. Two or more miscarriages before 20 weeks of gestation were accepted as the criterion to consider a case of recurrent pregnancy loss.
Results: To investigate the etiology of miscarriage in RM patients, parameters associated with the cytotoxicity of pNK cells in women with RM and control fertile women were evaluated. Although the median pNK activity level was relatively higher in the recurrent low group compared to the control group, there was no significant difference between the groups in our study (p=0.448).
Discussion: The present study found no significant difference in the percentages of CD56+dim and CD56+bright pNK cells between the patient group with unexplained RM and the healthy fertile control group. There was also no significant difference in CD8 and CD158a expressions in pNK cells between the patient group with unexplained RM and the healthy fertile control group.
Keywords: Peripheral Natural Killer Cell , Recurrent Miscarriages
Clinical features and outcomes of pediatric ocular traumas
Hasan Burhanettin Kapti, Aslihan Uzun, Asena Keles Sahin
Department of Ophthalmology, Faculty of Medicine, Ordu University, Ordu, Turkey
DOI: 10.4328/ACAM.21750 Received: 2023-05-07 Accepted: 2023-06-21 Published Online: 2023-07-08 Printed: 2023-11-01 Ann Clin Anal Med 2023;14(11):995-999
Corresponding Author: Aslihan Uzun, Department of Ophthalmology, Ordu University, Training and Research Hospital, Altinordu, Ordu, Turkey. E-mail: email@example.com P: +90 537 023 21 17 (Corresponding Author ORCID ID: https://orcid.org/0000-0002-5787-3879
This study was approved by the Ethics Committee of Ordu University (Date: 2022-10-27, No: 2022-241)
Aim: In this study, we aimed to evaluate clinical features and outcomes of pediatric ocular traumas in a tertiary hospital.
Material and Methods: Medical records of children under 18 years who underwent surgery for pediatric ocular trauma between January 2018 and December 2021 were reviewed. Ocular traumas were classified according to the Birmingham Eye Trauma Terminology system.
Results: The study included 19 patients (13 males and 6 females). The mean age was 9.83±5.02 (1-17) years. The mean follow-up was 4.7±3.7 (1-12) months. Injuries were caused by sharp objects [glass (57%), wires (28.5%), and knife (14.5%)] in 6 patients, and 5 children had blunt trauma. The types of traumas were open globe (52.6%), closed globe (15.8%), eyelid laceration (15.8%), closed globe injury with eyelid laceration (10.5%) and upper canalicular laceration (5.3%). Penetrating injury was detected in 7 children and globe rupture was detected in 2 patients. One patient had an intraocular foreign body. The mean interval between trauma and surgery was 6.2±11.2 (1-48) hours. Preoperative and postoperative BCVAs were 0.38±0.43 and 0.55±0.19, respectively. A corneal scar was observed in 6 eyes, iris deformity was found in 3 eyes, persistent hypotonia occurred in 1 eye and proliferative vitreoretinopathy developed in 1 eye.
Discussion: Children who needed surgery for ocular trauma had open globe injuries, notably glass-induced penetrating eye lesions. Pediatric eye injuries may cause persistent ophthalmologic sequelae and visual loss despite proper treatment. Hence, preventing eye injuries in youngsters may prevent lifelong vision loss better than treating them thereafter.
Keywords: Blunt Trauma, Eye Injuries, Open Globe Injury, Pediatric Ocular Trauma
Analysis of the characteristics and complications of mesiodens with cone beam computed tomography: A retrospective study
Kevser Kolçakoğlu 1, Eda Nur Güzeldemirci 2, Gizem Doğan Okur 1, Esra Kızılcı 1
1 Department of Pedodontics, Faculty of Dentistry, Erciyes University, Kayseri, 2 Department of Private Kardent Oral and Dental Health Center, Ankara, Turkey
DOI: 10.4328/ACAM.21751 Received: 2023-05-08 Accepted: 2023-06-20 Published Online: 2023-08-02 Printed: 2023-11-01 Ann Clin Anal Med 2023;14(11):1000-1005
Corresponding Author: Kevser Kolçakoğlu, Department of Pedodontics, Faculty of Dentistry, Erciyes University, 38000, Kayseri, Turkey. E-mail: firstname.lastname@example.org P: +90 539 257 41 07 Corresponding Author ORCID ID: https://orcid.org/0000-0003-2596-8678
This study was approved by the Clinical Research Ethics Committee of Erciyes University (Date: 2023-03-29, No: 199)
Aim: The aim of this study was to investigate the three-dimensional characteristics of mesiodens with Cone-beam Computed Tomography (CBCT) and to analyze the eruption status, direction, shape and complications of mesiodens in pediatric patients.
Material and Methods: In the study, 473 children between the ages of 7-14 years who were diagnosed with mesiodens from the patients who applied to Erciyes University Pediatric Dentistry Department for dental examination between 2012-2020 were evaluated retrospectively. CBCT images of 122 mesiodens from 94 patients who met the inclusion criteria were analyzed. Demographic indicators, the number of mesiodens, crown shape, position, mesiodens eruption status, eruption direction, and dentition stages of the patient were recorded in patients with mesiodens. Clinical complications caused by mesiodens (diastema, eruption delay, rotation, hyperplastic follicle, cyst, root resorption) and their positions in the sagittal, frontal and axial planes were classified.
Results: The mean age of patients with mesiodens was 8.75(%1.92) years and 22 (%23.40) of the patients were female and 72 (%76.60) were male. The percentages of patients with 1 and 2 mesiodens were 70.21, 29.79%, respectively. None of the patients had three or more mesiodentes. Of the 122 mesiodentes examined, 95 were conical and conical mesiodens was the most common (77.90%). When the directions of the mesiodens were examined according to their shapes, it was seen that the conical mesiodentes were positioned more inverted (n=30) and those with tubercles were positioned vertically (n=15) (p<0.05). Type 3 mesiodens (impacted and in contact with the central incisor) (n=65,53.30%), evaluated in the sagittal plane, was found to cause more rotation (p<0.05).
Discussion: Mesiodentes are difficult to diagnose, especially when they are impacted, and can be overlooked in routine clinical dental examinations. In cases where they are not diagnosed, they can cause orthodontic problems. It is necessary to increase the awareness of dentists about mesiodens, especially when examining pediatric patients.
Keywords: Cbct, Mesiodens, Characteristics
Could the subvastus approach be the first choice in total knee arthroplasty?
Mehmet Fevzi Cakmak, Levent Horoz
Department of Orthopedics and Traumatology, Faculty of Medicine, Kirsehir Ahi Evran University, Kirsehir, Turkey
DOI: 10.4328/ACAM.21759 Received: 2023-05-17 Accepted: 2023-06-20 Published Online: 2023-08-08 Printed: 2023-11-01 Ann Clin Anal Med 2023;14(11):1006-1010
Corresponding Author: Mehmet Fevzi Cakmak, Department of Orthopedics and Traumatology, Faculty of Medicine, Kirsehir Ahi Evran University, Kirsehir, Turkey. E-mail: email@example.com P: +90 532 207 97 59 Corresponding Author ORCID ID: https://orcid.org/0000-0001-9338-8232
This study was approved by the Ethics Committee of Kirsehir Ahi Evran University (Date: 2023-03-07, No: 2023-05/30)
Aim: Total knee replacement procedures are widely used in advanced cases of knee osteoarthritis. Medial parapatellar arthrotomy is one of the most commonly used approaches in total knee replacement. As an alternative to this approach, the subvastus approaches have been developed. The purpose of this study is to compare medial parapatellar and subvastus approaches.
Material and Methods: The study population was the archive of the orthopedics and traumatology clinic of a third-level hospital. This is a retrospective study. The study was conducted with 288 participants, including 147 MPPs and 141 SV. Range of motion, pain scores, and functional scores of the patients were recorded. The GENESIS II TKR system was performed for all participants.
Results: No significant difference was observed in terms of age, BMI values, and the operated side among the patients. No significant difference was found in KSS values between groups at the 12th week and first-year measurements. However, there were statistically significant differences observed in OKS measurements on the third and tenth days. A significant difference was observed in VAS values measured on the first and third postoperative days. The study groups were analyzed in terms of developing complications. According to the findings, no complications were observed in 136 participants in the MPP group and 129 participants in the SV group.
Discussion: Our study concluded that the SV approach should not be the first choice for TKR due to its limitations.
Keywords: Total Knee Replacement, Medial Parapatellar Arthrotomy, Subvastus Approach, Continuous Passive Motion, Range of Motion, Visual Analogue Scale
Can platelet-rich plasma be as effective as corticosteroids in the treatment of frozen shoulder in rats? Experimental animal study
Javid Mohammadzadeh Azarabadi 1, Shahla Vahidfar 2, Ekin Kaya Şimşek 1, Duygu Türkbey Şimşek 3
1 Department of Orthopedics and Traumatology, Faculty of Medicine, Baskent University, 2 Department of Physical Medicine and Rehabilitation, Lokman Hekim Demetevler Medical Center, 3 Department of Pathology, Gülhane Training and Research Hospital, Ankara, Turkey
DOI: 10.4328/ACAM.21771 Received: 2023-05-30 Accepted: 2023-07-31 Published Online: 2023-08-05 Printed: 2023-11-01 Ann Clin Anal Med 2023;14(11):1011-1014
Corresponding Author: Javid Mohammadzadeh Azarabadi, Department of Orthopedics and Traumatology, Faculty of Medicine, Baskent University, Ankara, Turkey. E-mail: firstname.lastname@example.org P: +90 538 038 79 83 Corresponding Author ORCID ID: https://orcid.org/0000-0003-2393-3535
This study was approved by the Ethics Committee of Başkent University Medical and Health Sciences Research Board and Experimental Animals (Date: 2017-01-30, No: 17/02)
Aim: Frozen shoulder is an important health problem that causes significant socio-economic losses as it affects daily life. Its etiopathogenesis has not been fully elucidated. A long recovery period leads to new searches for treatment. In the treatment of frozen shoulder, corticosteroids (CS) and platelet-rich plasma (PRP) are applied, among other options. The aim of this study is to compare the effectiveness of CS and PRP in frozen shoulder.
Material and Methods: A secondary frozen shoulder model was created in rats. At the end of the eight-week waiting period, the shoulder joint was released. The rats, divided into three groups, were injected intraarticularly with saline in the first group, CS in the second group, and PRP in the third group. After a two-week waiting period, the shoulder joint range of motion of the sacrificed rats was measured. The joint capsule was evaluated histologically for synovial inflammation, type 3 collagen, capillary proliferation, subscapular bursa adhesion and fibrosis.
Result: CS and PRP application did not affect the range of motion of the joint. A significant increase in synovial inflammation a decrease in fibrosis, type 3 collagen deposition, subscapular bursa adhesion were revealed. It was observed that vascular proliferation did not change.
Discussion: CS and PRP treatment yielded similar results in the frozen shoulder animal model. While both of these treatments do not affect the range of motion of the joint, they reverse the pathological changes in a frozen shoulder.
Keywords: Frozen Shoulder, Corticosteroid, Platelet-Rich Plasma, Joint Range of Motion
Seromucinous borderline tumor of the ovary: Correlation of MRI findings with literature
Department of Radiology, University of Health Sciences, Tepecik Education and Research Hospital Center, Izmir, Turkey
DOI: 10.4328/ACAM.21773 Received: 2023-06-01 Accepted: 2023-07-10 Published Online: 2023-07-22 Printed: 2023-11-01 Ann Clin Anal Med 2023;14(11):1015-1019
Corresponding Author: Ebru Hasbay, Department of Radiology, Faculty of Medicine, Tepecik Education and Research Hospital Center, Izmir, Turkey. E-mail: email@example.com P: +90 506 269 62 52 Corresponding Author ORCID ID: https://orcid.org/0000-0001-6288-3169
This study was approved by the Ethics Committee of Health Sciences University Tepecik Training and Research Hospital (Date: 2023-06-06, No: 2023/05-08)
Aim: The aim of this study was to describe magnetic resonance imaging (MRI) findings of ovarian seromucinous borderline tumor (SMBT) and compare the findings with the literature.
Material and Methods: This retrospective study examined 13 patients (15 lesions) with seromucinous borderline tumors in terms of size, configuration, signal intensity (SI), and accompanying ovarian endometriosis. An experienced abdominal radiologist evaluated the MRI findings of SMBT.
Results: On MRI, 15 lesions were found. The mean age of the patients was 48.2±13.5 years. Their mean size was 150.1±68.4 mm. SMBTs appeared as complex cystic-solid masses. T2-weighted SI of the solid portion was hyperintense in almost all of the tumors. Endometriosis was present in 10 patients (66.7%). Asid was detected in 15.4% (n=2) of the patients, while peritoneal dissemination was evident in 30.8% (n=4) of the patients.
Discussion: More than half of tumors were accompanied by endometriosis. High T2-weighted SI of the solid portion could be a specific feature of ovarian SMBTs.
Keywords: Magnetic Resonance Imaging, Neoplasm, Ovary, Seromucinous Tumor, Endometriosis
High doses of methylprednisolone in patients with severe COVID-19 infection
Ahmed Farhan 1, Saira Kanwal 1, Arslan Ahmad 1, Syed Muneeb Ali 2, Naveed Ullah Khan 3
1 Department of General Medıcıne, 2 Department of Critical Care Medicine, 3 Department of Neurology, Pakistan Institute of Medical Sciences, Islamabad, Pakistan
DOI: 10.4328/ACAM.21774 Received: 2023-06-13 Accepted: 2023-07-17 Published Online: 2023-08-01 Printed: 2023-11-01 Ann Clin Anal Med 2023;14(11):1020-1024
Corresponding Author: Saira Kanwal, Department of General Medıcıne, Pakistan Institute of Medical Sciences, Islamabad, Pakistan. E-mail: firstname.lastname@example.org P: +92 321 248 34 51 Corresponding Author ORCID ID: https://orcid.org/0000-0002-7444-219X
This study was approved by the Ethics Committee of Shaheed Zulfiqar Ali Bhutto Medical University (Date: 2021-04-28, No: F.1-1/2015/ERB/SZABMU/771)
Aim: Hypoxemia caused by lung injury is a typical feature of SARS- CoV-2 Pneumonia. Although corticosteroids are not the definite treatment for this condition, they have proven to be effective in some cases. In this study, we aimed to determine if high doses of methylprednisolone are safe and effective in patients suffering from severe SARS-COV-2 pneumonia.
Material and Methods: In all, 78 patients were enrolled in the study. The randomized double-blinded study involved half of the patients receiving methylprednisolone and half receiving a placebo. The primary outcome, calculated by comparing the percentage of in-hospital deaths between the two groups, was not statistically significant. In the Methylprednisolone group, patients had decreased lung compliance, increased oxygen demand, and an increased risk of infections, as measured by procalcitonin levels.
Results: A total of 78 patients were divided equally to get a placebo or pulse methylprednisolone in this double-blinded, randomized control trial. The study included 64.1% (50) female participants and 35.9% (28) male participants. Serum Ferritin levels were significantly increased in the placebo group in comparison to the methylprednisolone group. Procalcitonin was increased in the methylprednisolone group. The requirement for oxygen inhalation was lower in the placebo group. The total hospital stays, and days spent on mechanical ventilation were longer in patients who survived.
Discussion: Methylprednisolone use in severe COVID-19 infections did not improve survival compared to placebo. Furthermore, methylprednisolone significantly increased the risk of infection.
Keywords: SARS-COV-2 Infection, Methylprednisolone, Mechanical Ventilation
Evaluating the diagnostic efficacy of secretoneurin in ıdentifying heart failure among dyspneic patients in the emergency department
Tahir Talat Yurttaş 1, Ali Cankut Tatliparmak 2, Sarper Yilmaz 3, Asım Bedri Erdem 4, Özgür Dikme 4, Özlem Dikme 4
1 Department of Emergency Medicine, Faculty of Medicine, Istanbul Yeni Yuzyil University, 2 Department of Emergency Medicine, Faculty of Medicine, Uskudar University, 3 Department of Emergency Medicine, Faculty of Medicine, Istanbul Dr. Lutfi Kirdar City Hospital, 4 Department of Emergency Medicine, Faculty of Medicine, Istanbul Training and Research Hospital, Istanbul, Turkey
DOI: 10.4328/ACAM.21783 Received: 2023-06-07 Accepted: 2023-07-10 Published Online: 2023-07-15 Printed: 2023-11-01 Ann Clin Anal Med 2023;14(11):1025-1028
Corresponding Author: Ali Cankut Tatliparmak, Department of Emergency Medicine, Faculty of Medicine, Uskudar University, Istanbul, Turkey. E-mail: email@example.com P: +90 216 400 22 22 Corresponding Author ORCID ID: https://orcid.org/0000-0002-6729-5021
This study was approved by the Ethics Committee of Health Sciences University Istanbul Training and Research Hospital Ethics Committee (Date: 2021-06-04, No: 2864)
Aim: The accurate and timely diagnosis of heart failure is crucial for optimal patient management. This study aimed to evaluate the diagnostic potential of secretoneurin, a novel biomarker, in patients presenting with dyspnea to the emergency department.
Material and Methods: The study included 51 patients, 19 of whom were diagnosed with heart failure, and 32 patients without heart failure. Secretoneurin levels were measured and compared with established biomarkers, N-terminal pro-brain natriuretic peptide (NT-proBNP) and high sensitivity cardiac troponin-t (hs-cTnT), for diagnostic utility.
Results: The study findings revealed a significant elevation of secretoneurin levels in heart failure patients compared to those without heart failure (p<0.001). In addition, secretoneurin exhibited moderate discriminative properties (AUROC: 0.643, 95% CI: 0.457 – 0.828) when differentiating heart failure from non-heart failure patients. However, NT-proBNP (AUROC: 0.864, 95% CI: 0.739 – 0.99) and hs-cTnT (AUROC: 0.759, 95% CI: 0.596 – 0.922) demonstrated superior diagnostic performance.
Discussion: Secretoneurin is promising as a potential diagnostic biomarker for heart failure, with elevated levels observed in heart failure patients. Further investigations are warranted to determine its precise role and potential contribution as part of a comprehensive diagnostic approach.
Keywords: Secretoneurin, Heart Failure, Dyspnea, Diagnostic Biomarker, Emergency Department.
Comparison of anxiety and patient satisfaction before and after elective hysterectomy under general or spinal anesthesia: A questionnaire study
Mustafa Levent Cetın 1, Ali Akdogan 2, Davut Dohman 2
1 Department of Anesthesiology and Critical Care, Bursa City Training and Research Hospital, Bursa, 2 Department of Anesthesiology and Critical Care, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey
DOI: 10.4328/ACAM.21787 Received: 2023-06-09 Accepted: 2023-07-31 Published Online: 2023-08-08 Printed: 2023-11-01 Ann Clin Anal Med 2023;14(11):1029-1033
Corresponding Author: Ali Akdogan, Department of Anesthesiology and Intensive Care, Faculty of Medicine, Karadeniz Technical University, 61080, Trabzon, Turkey. E-mail: firstname.lastname@example.org P: +90 462 377 58 98 F: +90 462 325 53 98 Corresponding Author ORCID ID: https://orcid.org/0000-0001-7592-3844
This study was approved by the Ethics Committee of Karadeniz Technical University (Date: 2010-10-21, No: 2010/56)
Aim: One of the most important purposes of preoperative assessment is to reduce anxiety. Anxiety has a negative effect on anesthesia, operation and post-operative healing. It was aimed to this study find out the causes of anxiety related to anesthesia, measure preoperative anxiety levels, and determine the relationship between anxiety and patient satisfaction in elective hysterectomy procedures.
Material and Methods: After obtaining informed consent, 101 volunteer patients aged 18-65 years who were going to undergo elective hysterectomy surgery were included in the study. Patients were asked demographic variables, the first three causes of anxiety related to anesthesia, to respond to State-Trait Anxiety Inventory [STAI] I and II tests and complete QoR-40 test.
Results: While preoperative STAI I values were higher than STAI II, postoperative STAI I values were found to be decreased. It was seen that the patients’ anxiety level was too high during the preoperative period. It was found that the causes of preoperative anxiety related to anesthesia were oversleeping after surgery, post-operative pain, nausea and vomiting. No relationship between preoperative anxiety and postoperative patient satisfaction was found.
Discussion: In this study, it was observed that being older, having given birth before, being single, and increased anxiety in patients who underwent spinal anesthesia. In addition, it was found that there was no significant change in anxiety level according to education level, number of children, occupation, and history of surgery.
Keywords: Anxiety, Hysterectomy, Patient Satisfaction, Anesthesia
Is vitamın D level related to bilateral lateral epicondylitis?
Haluk Yaka 1, Cumali Yılmaz 2, Hasan Rüzgar 2, Tahsin Sami Çolak 2, Ahmet Fevzi Kekeç 2, Mustafa Özer 2
1 Department of Orthopaedics & Traumatology, Konya City Hospital, 2 Department of Orthopaedics and Traumatology, Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey
DOI: 10.4328/ACAM.21793 Received: 2023-06-15 Accepted: 2023-07-17 Published Online: 2023-07-22 Printed: 2023-11-01 Ann Clin Anal Med 2023;14(11):1034-1037
Corresponding Author: Haluk Yaka, Department of Orthopaedics and Traumatology, Konya City Hospital, 42020, Karatay, Konya, Turkey. E-mail: email@example.com P: +90 554 615 39 26 Corresponding Author ORCID ID: https://orcid.org/0000-0001-7461-7298
This study was approved by the Ethics Committee of Necmettin Erbakan University (Date: 2022-03-04, No: 2022/3672)
Aim: This study aimed to examine the relationship between unilateral lateral epicondylitis (ULE), bilateral lateral epicondylitis (BLE), and vitamin D levels.
Material and Methods: Between January 2016 and January 2021, 112 ULE patients (67 men, 45 women, mean age 45.55±10.75 years), 90 BLE patients (47 men, 43 women, mean age 44.93±9.76 years), and 134 patients determined as the control group (47 men, 43 women, mean age 44.93±9.76 years) were included in the study. The three groups were compared in terms of vitamin D levels.
Results: The mean vitamin D level was 24.87±8.45 ng/ml in the control group, 16.67±8.08 ng/ml in the ULE group, and 12.2±5.71ng/ml in the BLE group. There was a significant difference in vitamin D levels between the control and ULE group, the control and BLE group, and the ULE and BLE group (p<0.001, p<0.001, p=0.014, respectively).
Discussion: Vitamin D levels of patients with bilateral lateral epicondylitis were significantly lower than those with unilateral lateral epicondylitis. This study shows that low vitamin D may be one of the etiological factors of lateral epicondylitis and may cause bilateral lateral epicondylitis at lower values.
Keywords: Vitamin D, Lateral Epicondylitis, ECRB, Elbow Pain
A Scientometric analysis of resuscitative endovascular balloon occlusion of the aorta (reboa) articles: Where do we stand?
Serkan Günay, Ahmet Öztürk, Ali Kemal Erenler
Department of Emergency Medicine, Hitit University, Erol Olçok Education and Research Hospital, Çorum, Turkey
DOI: 10.4328/ACAM.21819 Received: 2023-07-12 Accepted: 2023-08-14 Published Online: 2023-08-18 Printed: 2023-11-01 Ann Clin Anal Med 2023;14(11):1038-1043
Corresponding Author: Serkan Günay, Department of Emergency Medicine, Hitit University, Erol Olçok Education and Research Hospital, 19200, Çorum, Turkey. E-mail: firstname.lastname@example.org P: +90 530 401 26 16 Corresponding Author ORCID ID: https://orcid.org/0000-0002-8343-0916
Aim: The aim of this study is to reach the data related to resuscitative endovascular balloon occlusion of the aorta (REBOA) through the Web of Science database, to make a scientometrics analysis of the data and to guide the researchers.
Material and Methods: All articles related to REBOA were reviewed on the Web of Science database. Articles were ranked according to the top 10 most published countries. All articles were analyzed through the database. In addition, the top 20 journals in which the most articles were published were listed according to their publication numbers. All articles were analyzed according to article type and subject headings. Abstracts of the top 10 most cited articles were prepared.
Results: The country with the most publications on REBOA was the United States (US). When we examine the journals that publish the most REBOA articles, the Journal of Trauma and Acute Care Surgery ranks first with 130 publications. Most of the 419 articles were found to have been published in the original article type. It has been observed that the studies have mostly focused on the clinical use of REBOA.
Discussion: There is a need for more comprehensive studies on the use of REBOA and its complications.
Keywords: REBOA, Scientometric Analysis, Journals
In vitro evaluation of the cytotoxic effects of alkasite restorative material on human dental pulp stem cells
Tugba Elgun 1, Belen Sırınoglu Capan 2, Canan Duman 3, Nazli Ece Gungor Orduerı 4
1 Department of Medical Biology, Faculty of Medicine, Biruni University, Istanbul, 2 Department of Pediatric Dentistry, Faculty of Dentistry, Istanbul University–Cerrahpaşa, Istanbul, 3 Department of Pediatric Dentistry, Faculty of Dentistry, Istanbul Atlas University, Istanbul, 4 Department of Histology and Embryology, Faculty of Medicine, Biruni University, Istanbul, Turkey
DOI: 10.4328/ACAM.21846 Received: 2023-08-05 Accepted: 2023-09-06 Published Online: 2023-09-12 Printed: 2023-11-01 Ann Clin Anal Med 2023;14(11):1044-1048
Corresponding Author: Tugba Elgun, Department of Medical Biology, Faculty of Medicine, Biruni University, Istanbul, Turkey. E-mail: email@example.com P: +90 505 316 37 63 Corresponding Author ORCID ID: https://orcid.org/0000-0002-1311-6892
This study was approved by the Ethics Committee of Biruni University (Date: 2019-11-07, No: 2019/34-12)
Aim: The clinical suitability of restorative dental materials is determined by evaluating their biocompatibility, and physical and chemical properties. The present study examined the cytotoxic effects of three different dental restorative materials on human dental pulp stem cells (DPSCs).
Material and Methods: In this study, composite, high-viscosity glass ionomer cement (HVGIC), and an alkasite were used. In total, 12 samples of each material were prepared for cytotoxicity assays. Cytotoxic effects were determined by considering biomaterial releases. Cell viability and proliferation were observed and analyzed at intervals of 24 and 72 hours using both the methyl-thiazole-diphenyl-tetrazolium (MTT) and xCELLigence cytotoxicity assays. Data were calculated using the RTCA-DP integrated software of the xCELLigence system and the GraphPad Prism 9.1.1 program. Data from the proliferation experiments were statistically evaluated using the Two-way ANOVA test.
Results: Alkasite exhibited the highest cytotoxicity, whereas HVGIC and composite did not exhibit any significant difference compared with the control. There was no difference between the two time points in the cytotoxicity of composite and alkasite in the MTT assay. However, the cytotoxicity of HVGIC was higher at 72-hours than at 24-hours. Similar results were obtained with both assays. Although alkasite exhibited higher cytotoxicity than composite and HVGIC, all materials exerted slightly cytotoxic effects (60%–90% cell viability) on DPSCs.
Discussion: Considering its aesthetic, and mechanical properties, alkasite can be clinically preferred instead of other materials in cavities that are not close to the dental pulp.
Keywords: Alkasite, Composite, Glass Ionomer Cement, Cytotoxicity, Dental Pulp
Confirmation of anatomical proximities in endoscopic sinus surgery with computer tomography: A cadaveric study
Rukiye Ozcelik Erdem 1, Mehmet Akif Dundar 2, Mitat Arıcıgil 2, Hamdi Arbag 2
1 Department of Otorhinolaryngology, Dr. Vefa Tanır Ilgın State Hospital, 2 Department of Otorhinolaryngology, Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey
DOI: 10.4328/ACAM.21997 Received: 2023-09-26 Accepted: 2023-10-28 Published Online: 2023-10-30 Printed: 2023-11-01 Ann Clin Anal Med 2023;14(11):1049-1053
Corresponding Author: Rukiye Ozcelik Erdem, Department of Otorhinolaryngology, Dr. Vefa Tanır Ilgın State Hospital, Konya, Turkey. E-mail: firstname.lastname@example.org P: +90 553 080 05 14 Corresponding Author ORCID ID: https://orcid.org/0000-0001-5087-4652
This study was approved by the Ethics Committee of Necmettin Erbakan University (Date: 2016-10-07, No: 2016/687)
Aim: The aim of this study was to investigate the confirmation of anatomical proximities between endoscopic sinus surgery with computer tomography.
Material and Methods: This study was done on 5 fresh frozen cadaver heads between May 2017 to June 2018. High-resolution computed tomography (HRCT) was taken before the operations. Firstly uncinectomy was done. Then all stages of functional endoscopic sinus surgery (FESS), which contains anterior-posterior ethmoidectomy, dissection of the sphenoid sinus and frontal recess, and maxillary sinusotomy were performed from anterior to posterior. Distances between each other landmarks and distances to the nasal vestibule were measured during the surgery. All measurements taken during dissection were measured on the coronal, axial, and sagittal section HRCT. Dissection data were compared with radiological data.
Results: As a result of comparing the radiological data and dissection data, there was no significant difference between the data obtained from the sagittal section and the dissection data. A significant difference (P=0.03) was found between the dissection and radiological evaluation in the coronal section except for the measurements of SO-UT (p=0.853) and MP-SA (p=0.972), and in the axial section except for the measurements of the SO-C (p=0.579) and MP-SA (p=1).
Discussion: Measurements obtained in the paranasal sinus CT can be used during FESS. While the data obtained in the sagittal section are suitable for the operation plan and can be used directly, the coronal and axial section are not.
Keywords: Endoscopic Surgical Procedure, Multidetector Computed Tomography, Nasal Sinuses
Effectiveness of beta-blockers with neurocardiogenic syncope
Meltem Yiğit, Arif Ruhi Özyürek, Zülal Ülger, Ertürk Levent
Department of Child Health and Diseases, Faculty of Medicine, Ege University, Izmir, Turkey
DOI: 10.4328/ACAM.22003 Received: 2023-10-04 Accepted: 2023-10-30 Published Online: 2023-10-30 Printed: 2023-11-01 Ann Clin Anal Med 2023;14(11):1054-1058
Corresponding Author: Meltem Yiğit, Department of Child Health and Diseases, Faculty of Medicine, Ege University, Izmir, Turkey. E-mail: email@example.com P: +90 532 256 46 03 Corresponding Author ORCID ID: https://orcid.org/0009-0009-8568-3675
This study was approved by the Ethics Committee of Izmir Bakırçay University (Date: 2023-10-18, No: 1231/1211)
Aim: Syncope is a condition characterized by sudden and temporary loss of consciousness, accompanied by a loss of postural tone. In its pathophysiology, there can be a sudden drop in cerebral blood flow, alterations in the composition of the blood reaching the brain, or psychological causes. The aim of this study is to search the etiologies of syncope in children and evaluate the effectiveness of ß-blocker treatment in cases with neurocardiogenic syncope.
Material and Methods: The study included 51 patients admitted to our hospital with syncope complaints over a period of 18 months. Patients were evaluated by history, physical examination, laboratory tests, Electrocardiography (ECG), 24-hour holter monitoring, tilt test and EEG. Patients with a positive tilt test were divided into two subgroups. One group was given ß-blocker treatment, and the other group was given only recommendations.
Results: The tilt test was positive in 23 (45,09%) of 51 patients presenting with syncope complaints. Metoprolol was administered to 11(21,56%) of the patients. Metoprolol was used as a ß-blocker for 6 months. Conservative treatment was administered to 12 (23.52%) of them. The group not given ß-blockers was advised to take enough water and salt, not to stand for long periods of time, raise the head of the bed by 20°, and not to get up suddenly from the bed or from where they were sitting. When the syncope recurrence was questioned at the end of the 1-year follow-up after treatment or offers, no recurrence of syncope was observed in patients who received or did not receive treatment.
Discussion: The tilt test is the only noninvasive test used in the definitive diagnosis of neurocardiogenic syncope and should be performed in doubtful cases to clarify the diagnosis. In the treatment and follow-up of patients with vasovagal syncope, it should be taken into consideration that some precautions before drug therapy may be sufficient. These suggestions are not to stand for a long time, to ensure adequate water intake, not fasting, to raise the head of the bed 20 degrees, and not to get up suddenly from the bed or sitting position. There are no difference between the two groups in terms of recurrence of syncope. ß-blocker treatment has no effect on the recurrence of neurocardiogenic syncope.
Keywords: Tilt Test, Syncope, Neurocardiogenic Syncope, Electrocardiogram