Is lactate level beneficial in triage of non-traumatic emergencies?
Pınar Hanife Kara Cetinbilek 1, Özkan Erarslan 2, Shikha Tandon 3, Serhat Akay 1, Erden Erol Unluer 1
1 Department of Emergency Medicine, University of Health Sciences, Izmir Bozyaka Education and Research Hospital, Izmir, Turkey, 2 Department of Emergency Medicine, Cizre State Hospital, Sırnak, Turkey, 3 Department of Emergency Medicine, Fortis Hospital Mohali, Punjab, India
DOI: 10.4328/ACAM.21334 Received: 2022-07-31 Accepted: 2023-06-05 Published Online: 2023-06-27 Printed: 2023-10-01 Ann Clin Anal Med 2023;14(10):864-868
Corresponding Author: Pınar Hanife Kara Cetinbilek, Department of Emergency Medicine, University of Health Sciences, Bozyaka Egitim ve Arastirma Hastanesi. 35170, Karabağlar, Izmir, Turkey. E-mail: email@example.com P: +90 505 939 76 00 F: +90 232 261 44 44 Corresponding Author ORCID ID: https://orcid.org/0000-0003-1261-4272
This study was approved by the Ethics Committee of University of Health Sciences Izmir Bozyaka Education and Research Hospital (Date: 2018-07-26, No: 03)
Aim: In this study, we aimed to investigate if blood lactate levels, which have been proven to be effective in trauma triage, can serve as a guide in the triage of nontraumatic yellow and red zone (urgent and very urgent) zone patients.
Material and Methods: The relationship between venous blood lactate level and triage categories was investigated retrospectively in 1060 yellow and red zone patients who visited the emergency department between 19.02.2019 and 07.03.2019.
Results: The mean lactate level was significantly higher in patients categorized as red (very urgent) compared to patients categorized as yellow (urgent) (3.04±2.32 vs.1.93±1.08 mmol/L) (p<0.05, p=0.001). A lactate level >2 mmol/L could distinguish between red and yellow categories with a sensitivity of 64.15% and a specificity of 68.74% (p<0.05) respectively.
Discussion: Although the lactate level in the red zone is significantly higher than in the yellow zone, we do not consider it appropriate to use this parameter on non-traumatic triage decisions due to its low sensitivity and specificity.
Keywords: Emergency Medicine, Lactate, Triage
Evaluation of outpatient COVID-19 patients’ readmissions to the emergency department
Meral Yıldırım 1, Gülşah Çıkrıkçı Işık 2, Tuba Şafak 3, Emine Emektar 2, Yunsur Çevık 2
1 Department of Emergency Medicine, Ankara Atatürk Sanatorium Training and Research Hospital, 2 Department of Emergency Medicine, University of Health Sciences, Ankara Atatürk Sanatorium Training and Research Hospital, 3 Department of Emergency Medicine, Ankara Etlik City Hospital, Ankara, Turkey
DOI: 10.4328/ACAM.21630 Received: 2023-01-31 Accepted: 2023-03-12 Published Online: 2023-06-20 Printed: 2023-10-01 Ann Clin Anal Med 2023;14(10):869-872
Corresponding Author: Gülşah Çıkrıkçı Işık, Department of Emergency Medicine, University of Health Sciences, Ankara Atatürk Sanatorium Training and Research Hospital, Ankara, Turkey. E-mail: firstname.lastname@example.org P: +90 505 587 34 36 Corresponding Author ORCID ID: https://orcid.org/0000-0002-6067-7051
This study was approved by the Ethics Committee of Keçiören Training and Research Hospital (Date: 2021-04-13, No: 2012-KAEK-15/2279)
Aim: In this study, we aimed to analyze variables regarding emergency department (ED) readmissions of COVID-19 patients who were treated as outpatients.
Material and Methods: This is a retrospective observational study. COVID-19 PCR- positive patients treated on an outpatient basis who were admitted to the ED during the treatment period or in the first week of the post-treatment period were analyzed. Demographic findings, complaints, comorbidities, vital parameters, laboratory, radiologic findings, and outcomes were analyzed by using the data registration system of the hospital.
Results: A total of 505 patients were evaluated, with the median age of 57 and 45% were female. Fever (%73), cough and dyspnea (%56 each) were the most common complaints. Two-thirds of the patients had two or more comorbidities. There was significant progress in radiologic and laboratory findings. Forty-one percent were hospitalized in inpatient clinics, and 15% in intensive care units on readmission to the ED. Fifty-one patients died.
Discussion: In COVID-19 patients with mild symptoms and favorable laboratory and radiological findings on index admission, followed up as outpatients, the disease might progress rapidly and readmission to ED, need for hospitalization and even death may occur. Thus, close follow-up of patients and being alert to new symptoms and signs that may develop is necessary.
Keywords: COVID-19, Emergency Department, Readmission
Retrospective evaluation of 3% NaCl treatment in patients with symptomatic hyponatremia in the emergency department
Enver Özçete, Bahadır Arslan
Department of Emergency Medicine, Faculty of Medicine, Ege University, Izmir, Turkey
DOI: 10.4328/ACAM.21724 Received: 2023-04-13 Accepted: 2023-07-17 Published Online: 2023-07-22 Printed: 2023-10-01 Ann Clin Anal Med 2023;14(10):873-878
Corresponding Author: Enver Özçete, Department Of Emergency Medicine, Faculty of Medicine, Ege University, Izmir, Turkey. E-mail: email@example.com P: +90 505 594 39 36 Corresponding Author ORCID ID: https://orcid.org/0000-0002-1685-2369
This study was approved by the Ethics Committee of Ege University (Date: 2023-01-13, No: 23-1T/41)
Aim: As the most common electrolyte disorder in the Emergency Department, hyponatremia is a serious medical condition associated with a high risk of morbidity and mortality. Hypertonic saline is an effective treatment for symptomatic hyponatremia. This study aims to determine the effective variables in serum sodium elevation and overcorrection with 3% NaCl treatment in patients with symptomatic hyponatremia in the emergency department.
Material and Methods: In this study, we conducted a retrospective analysis of the efficacy of 3% NaCl treatment in symptomatic hyponatremic patients over 18 years of age. We described patients’ characteristics and outcome variables.
Results: In our study, 582 patient files were reviewed. In total, 270 patients were excluded from the study. Ultimately, 312 patients were included in our study. The mean baseline sNa in the patients was 116±4.5 mmol/L. The most common Hypertonic 3% NaCl treatment was Rapid Intermittent Bolus with a rate of 64.4%. A minimum of 5 mmol/l increase in serum Na was observed in 36.5% of patients following the first treatment. In any period, 20.5% of patients had a rise in sNa of more than 10 mmol/L within the first 24 h.
Discussion: For treating symptomatic hyponatremia with 3% NaCl, a target serum Na of 125 mmol/L may be used along with a 5 mmol/L increase in serum Na. In the prevention of excessive serum Na elevation, 3% NaCl treatment in a volume smaller than baseline serum Na levels < 125 mmol/L may be considered.
Keywords: Hyponatremia, Hypertonic Saline, Emergency Department
Mapping the most problematic functions in chronic low back pain patients: Analysis of the patient-specific functional scale
Tuğçe Özen 1, Tuğba Kuru Çolak 1, İlker Çolak 2, Necati Tatarlı 3
1 Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Marmara University, 2 Department of Orthopaedics and Traumatology, Maltepe Medical Park Hospital, 3 Department of Neurosurgery, Kartal Dr. Lütfi Kırdar City Hospital, Istanbul, Turkey
DOI: 10.4328/ACAM.21740 Received: 2023-04-25 Accepted: 2023-05-30 Published Online: 2023-06-27 Printed: 2023-10-01 Ann Clin Anal Med 2023;14(10):879-884
Corresponding Author: Tuğçe Özen, Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Marmara University, Maltepe, Istanbul, Turkey. E-mail: firstname.lastname@example.org P: +90 216 777 57 00 Corresponding Author ORCID ID: https://orcid.org/0000-0003-0611-6752
This study was approved by the Ethics Committee of Marmara University Faculty of Health Sciences (Date: 2023-02-23, No: 28)
Aim: Difficulty in functioning is one of the reasons by patients with low back pain (LBP) seek help. The purpose was to identify the problematic functions of chronic LBP patients using the Patient-Specific Functional Scale (PSFS) based on the International Classification of Functioning, Disability and Health (ICF) and investigate the related factors with the PSFS scores.
Material and Methods: One-hundred LBP patients were included. The responses obtained from PSFS were linked to the ICF categories based on the linking procedure. Patient reported outcome measures (PROMs) and physical measurements were used for clinical assessment. Correlations were analyzed with Spearman’s rho correlation.
Results: The identified 327 meaningful concepts were linked to 28 different 2ndlevel and 40 different 3rd level ICF categories. PSFS was found to correlate with the pain level during activity, perceived disability, and some domains of the health-related quality of life (p<0.05), while kinesiophobia and emotional status did not correlate with PSFS scores (p>0.05). Among physical tests, flexibility measurements correlated with PSFS scores (p<0.05).
Discussion: Chronic LBP patients reported various functions. The content analyses showed the need for an extension of the ICF core sets for LBP. This study also revealed that not all PROMs and physical outcomes are able to reflect the difficulty level of the problematic activities. Assessment with PSFS may be beneficial for individually tailored treatment programs.
Keywords: Low Back Pain, ICF, PSFS, Rehabilitation
The effects of the COVID-19 pandemic on microbiology-immunology publications: Bibliometric analysis and visualization
Yağmur Ekenoğlu Merdan 1, Okan Aydoğan 2, Selim Merdan 3
1 Department of Medical Microbiology, Faculty of Medicine, Biruni University, 2 Department of Medical Microbiology, Faculty of Medicine, Istanbul Medipol University, 3 Department of Flow Cytometri Laboratory, Ümraniye Training and Research Hospital, Istanbul, Turkey
DOI: 10.4328/ACAM.21745 Received: 2023-04-27 Accepted: 2023-06-05 Published Online: 2023-07-03 Printed: 2023-10-01 Ann Clin Anal Med 2023;14(10):885-890
Corresponding Author: Okan Aydoğan, Department of Medical Microbiology, Faculty of Medicine, Istanbul Medipol University, Istanbul, Turkey. E-mail: email@example.com P: 444 85 44 Corresponding Author ORCID ID: https://orcid.org/0000-0001-7275-8724
Aim: The aim of this study is to visualize the most cited publications, the most frequently used keywords, and the topics studied in the field of “Microbiology-Immunology” before and during the pandemic and to reveal the differences between the two periods.
Material and Methods: Studies registered in the Scopus database and published in the field of “Microbiology-Immunology” in 2019 and 2022 were included in the study. Data analysis was performed using Microsoft Excel and VOSviewer program. In the keyword analysis, the most recently published and the top 2000 most cited publications in 2019 and 2022 were evaluated.
Results: The most frequently used keywords in the most recent publications in 2019 were “Medicago truncatula”, “malaria” and “immunotherapy”, while the most cited keywords were “inflammation”,”microbiome” and “immunotherapy”. In 2019, it was determined that most studies were on immunotherapy. In 2022, the top three most frequently used keywords in the most recently published publications were “malaria”, “neuroinflammation” and “inflammation”, while the most cited publications were “COVID-19”, “SARS-CoV-2” and “vaccination”. As a result of the keyword analysis, it was determined that the most frequently published topics and the most cited topics were different from each other in the analysis of current studies in 2022.
Discussion: Since our study reveals the changes in the literature related to our field, we think that it will be a guide in planning new studies. We believe that periodic repetition of bibliometric analyses and keyword mapping studies will contribute to the quantitative and qualitative development of scientific productivity in our field.
Keywords: Bibliometric Analysis, Keyword Mapping, Scientometrics, Bibliometric Visualization, VOSviewer
Opioid-free anesthesia with nociception monitoring in bariatric surgery:
Is it effective enough?
Tugcehan Sezer Akman 1, Zahide Doganay 2, Hale Kefeli Celik 3
1 Department of Anesthesiology and Reanimation, Alaca State Hospital, Çorum, 2 Department of Anesthesiology and Reanimation, Kastamonu University, Kastamonu, 3 Department of Anesthesiology and Reanimation, University of Health Sciences Samsun Training and Research Hospital, Samsun, Turkey
DOI: 10.4328/ACAM.21753 Received: 2023-05-11 Accepted: 2023-06-12 Published Online: 2023-07-03 Printed: 2023-10-01 Ann Clin Anal Med 2023;14(10):891-896
Corresponding Author: Tugcehan Sezer Akman, Department of Anesthesiology and Reanimation, Alaca State Hospital, Alaca, Çorum, Turkey. E-mail: firstname.lastname@example.org P: +90 530 540 67 90 Corresponding Author ORCID ID: https://orcid.org/0000-0003-4135-8407
This study was approved by the Ethics Committee of Samsun Health Sciences University Training and Research Hospital (Date: 2020-06-16, No: KAEK 2020/5/1)
Aim: In this study, we aimed to compare the effectiveness of an opioid-free anesthesia method with Nociception Level (NOL) Index monitoring to provide intraoperative analgesia control in laparoscopic bariatric surgeries and its effect on the risk of postoperative nausea and vomiting and the need for antiemetics and analgesics with the opioid-based anesthesia.
Material and Methods: Forty patients who underwent laparoscopic bariatric surgery were classified into two groups: those who received opioid-based anesthesia (OA) and those who received opioid-free anesthesia (OFA). Intraoperative NOL index values and additional analgesia requirements were noted. Additional analgesia was administered when the postoperative Visual Analogue Scale (VAS) score was ≥3, an antiemetic drug was administered when the nausea-vomiting score was ≥ 2, and their amounts were noted.
Results: There were no significant differences between the groups in terms of NOL values (p>0.05) and maximum-minimum NOL values (69.55 ± 8.52 vs. 74.50 ± 8.46, 0 vs. 0, p>0.05). Similarities were found between intraoperative and postoperative additional analgesia, VAS score, nausea-vomiting score, and antiemetic drug consumption (p>0.05). Tramadol consumption in the first postoperative 24 hours was significantly higher in the OA group (150.0 ± 48.7 mg vs. 110.0 ± 44.7, p= 0.012).
Discussion: Opioid-free anesthesia with intraoperative nociception monitoring can be safely applied in bariatric surgery patients.
Keywords: Obesity, Bariatric Anesthesia, Opioid-Free Anesthesia, Nociception
Are pan-immune inflammation-value, systemic inflammatory response index clinically useful to predict in patients with chronic spontaneous urticaria?
Huseyin Erdal 1, Fatma Esra Gunaydin 2
1 Department of Medical Genetics, Faculty of Medicine, Aksaray University, Aksaray, 2 Deparment of Allergy and Immunology, Ordu University Training and Research Hospital, Ordu, Turkey
DOI: 10.4328/ACAM.21799 Received: 2023-06-19 Accepted: 2023-07-31 Published Online: 2023-08-08 Printed: 2023-10-01 Ann Clin Anal Med 2023;14(10):897-900
Corresponding Author: Huseyin Erdal, Department of Medical Genetics, Faculty of Medicine, Aksaray University, Aksaray, Turkey. E-mail: email@example.com P: +90 543 414 08 15 Corresponding Author ORCID ID: https://orcid.org/0000-0003-0786-5077
This study was approved by the Ethics Committee of Ordu University (Date: 2023-03-31, No: 2023/86)
Aim: Recent studies show that the immune inflammatory response plays an important role in chronic spontaneous urticaria (CSU). The aim of the study was to examine whether pan-immune inflammation value (PIV) and systemic inflammatory response index (SII) are effective in predicting CSU.
Material and Methods: Sixty-five patients and 65 healthy controls followed in the Allergy and Immunology Clinics of Ordu University Training and Research Hospital were included in this retrospective study.
Results: Neutrophil and lymphocyte, MPV, PDW, PCT and CRP levels were statistically significant between the patient and healthy controls (p<0.05). A statistically significant difference was found in PLR, dNLR, SIRI and PIV indices between the groups (p<0.05). We concluded that SIRI and PIV could be novel cost-effective biomarkers in patients with CSU.
Discussion: SIRI and PIV levels were statistically significant in patients with CSU. SIRI and PIV are newly designed indexes that are accepted as easily calculable and comprehensive indicators of immune response and systemic inflammation. Inflammatory indices can be an inexpensive, practical and safe indicator of the inflammatory state in patients with CSU.
Keywords: Chronic Spontaneous Urticaria, Inflammation, Systemic Inflammatory Response Index, Pan-Immune-Inflammation Value
Effect of parenteral morphine on overall survival in patients with lung cancer
Suna Kavurgacı 1, Pınar Akın Kabalak 1, Derya Kızılgöz 1, Yasemin Söyler 1, İrem Turan 2, Ülkü Yılmaz 1
1 Department of Interventional Pulmonology, 2 Department of Interventional Thoracic Surgery, Ankara Atatürk Sanatorium Training and Research Hospital, Ankara, Turkey
DOI: 10.4328/ACAM.21804 Received: 2023-06-28 Accepted: 2023-08-07 Published Online: 2023-08-18 Printed: 2023-10-01 Ann Clin Anal Med 2023;14(10):901-905
Corresponding Author: Suna Kavurgacı, Department of Interventional Pulmonology, Ankara Atatürk Sanatorium Training and Research Hospital, 06280, Keçiören, Ankara, Turkey. E-mail: firstname.lastname@example.org P: +90 505 931 22 18 Corresponding Author ORCID ID: https://orcid.org/0000-0002-5856-4891
This study was approved by the Ethics Committee of Ankara Atatürk Sanatoryum Training and Research Hospital (Date: 2021-10-21, No: 10)
Aim: Terminal-stage cancer patients often receive parenteral morphine treatment (PMT) to relieve various symptoms associated with the progression or adverse events associated with cancer. Our study was aimed at a retrospective evaluation of the survival of patients with terminal-stage lung cancer who received inpatient PMT due to pain and dyspnea palliation.
Material and Methods: We carried out a retrospective analysis of 52 terminal-stage lung cancer patients who received PMT at our hospital. The patients were divided into three groups according to the indications for PMT: Group A (uncontrolled dyspnea; n = 23), Group B (pain; n = 22), Group C (both shortness of breath and pain; n = 7).
Results: Of the total, 23 (44.2%) received morphine for dyspnea, 22 (42.3%) for pain and seven (13.5%) for both. A good subjective response (“no symptoms” or “mild symptom”) was documented in 46 patients (88.4%), poor response in four patients (7.4%) and no response in two patients (3.8%). The median survival time from the onset of PMT was 85 days (range 54–117 days). The study found dyspnea and pain to be indications for PMT in terminal-stage lung cancer patients, with dyspnea being the main indication for PMT. Patients in Group A (shortness of breath) required lower doses of morphine than in Group B (uncontrolled pain), although the survival time from the onset of PMT was significantly shorter in patients with dyspnea (Group A) than in patients without dyspnea (Group B).
Discussion: Further studies are required to facilitate the effective and appropriate use of PMT in terminal-stage lung cancer patients. Dyspnea was the major indication for PMT in terminal-stage lung cancer patients, and the survival time was considerably limited in this group.
Keywords: Morphine, Palliative Care, Survival
Emergency and elective approaches to femoral hernias
Alper Varman, Selman Alkan
Department of General Surgery, Meram School of Medicine, Necmettin Erbakan University, Konya, Turkey
DOI: 10.4328/ACAM.21864 Received: 2023-08-12 Accepted: 2023-09-25 Published Online: 2023-09-30 Printed: 2023-10-01 Ann Clin Anal Med 2023;14(10):906-909
Corresponding Author: Alper Varman, Department of General Surgery, Meram School of Medicine, Necmettin Erbakan University, 42080, Selçuklu, Konya, Turkey. E-mail: email@example.com P: +90 554 818 23 34 Corresponding Author ORCID ID: https://orcid.org/0000-0002-8111-6333
This study was approved by the Ethics Committee of Necmettin Erbakan University Meram Medical Faculty (Date: 2023-07-21, No: 2023/4523)
Aim: Femoral hernias often occur with incarceration, resulting in obstruction and strangulation. They usually require emergency surgical intervention and sometimes bowel resection may be required. The aim of this study is to compare the surgical results of femoral hernia cases in emergency or elective conditions.
Material and Methods: The medical files of 38 patients who underwent surgery in January 2015- March 2022 with the diagnosis of femoral hernia at the general surgery service at Necmettin Erbakan University Meram Medical Faculty Hospital were retrospectively examined. Demographic data, party-relevant information, surgical technique, content of sac, length of hospital stay, recurrence and complications according to the last polyclinic were retrieved from the patient files and electronic database.
Results: The gender distribution of the cases was 81.6% (n=31) females and 11.5% (n=7) males. The mean age was 45.74±16.11 years. The complication rate among the groups was significantly higher in those undergoing emergency surgery (p=0.014). No significant difference was found between the two groups in terms of the side of hernia (p=0.671).
Discussion: Femoral hernia is more common in women. There are different repair techniques. More extensive prospective research is needed to compare surgical techniques and outcomes.
Keywords: Femoral Hernia, Elective Surgery, Emergency Surgery
Difficult airway awareness of physicians with specialty training in medicine
Aslı Mete Yıldız 1, İlknur Hatice Akbudak 1, Barış Demirci 1, Selvinaz Yüksel Tanrıverdi 2
1 Department of Anesthesiology and Reanimation, Faculty of Medicine, Pamukkale University, 2 Department of Anesthesiology and Reanimation, Faculty of Medicine, Denizli State Hospital, Denizli, Turkey
DOI: 10.4328/ACAM.21868 Received: 2023-08-14 Accepted: 2023-09-25 Published Online: 2023-09-28 Printed: 2023-10-01 Ann Clin Anal Med 2023;14(10):910-914
Corresponding Author: Aslı Mete Yıldız, Department of Anesthesiology and Reanimation, Faculty of Medicine, Pamukkale University, Turkey. E-mail: firstname.lastname@example.org P: +90 530 932 23 34 Corresponding Author ORCID ID: https://orcid.org/0000-0002-5621-7407
This study was approved by the Ethics Committee of Pamukkale University (Date: 2022-06-28, No: E-60116787-020-333909)
Aim: Today, many physicians with specialization training in medicine need to intervene in emergency situations in patients whose airway is predicted to be difficult. In the new time, many new equipment is used to intervene in difficult airways. Being aware of and using these technologies is difficult or frightening for most physicians. This study was conducted to determine the awareness of physicians who are less likely to encounter patients with difficult airways, who are outside the department of anesthesiology and reanimation.
Material and Methods: This study was a survey study conducted by asking 15 questions about difficult airway management to 150 physicians who received specialization training in the internal and surgical departments of Pamukkale University Faculty of Medicine. Their approaches to the difficult airway and their awareness ofn this issue, as well as and their responses to the applications in emergency situations related to the patients who were predicted to have a difficult airway were evaluated.
Results: If the main results are summarized; as a result, the majority of the participants (76%) had practical experience in using the airway. In difficult airway situations, the majority of the participants (71.3%) preferred to use the general airway method as the first choice. Regarding the first person to be asked for help, the majority of the participants (59.3%) stated that they would call the assistant of the anesthesia department. The situation of refraining from intubation is related to gender, and female participants experienced this situation more frequently than male participants (p=0.016). Among participants specializing in internal medicine, the use of the general airway method was significantly lower than the use of the Laryngeal Mask Airway (LMA) and was similar to the use of intubation. In contrast, those specializing in surgical medicine used the general airway method significantly more frequently than the LMA, while the use of intubation was similar (p=0.003). Those with knowledge of the Mallampati score preferred the LMA significantly more frequently, followed by the airway method and intubation. Being a woman female gender increases the risk of abstaining from intubation by 2.56 times, while not working as a general practitioner increases the risk by 2.22 times.
Disccussion: Anticipating the difficulties that may occur in airway control is vital for safe ventilation. In our study, we evaluated the approaches to difficult airway and their awareness of this issue of physicians who received specialization training in medicine apart from the department of anesthesiology and reanimation. Our findings showed that most of the residents had insufficient knowledge and experience in difficult airway management. All findings emphasizes the importance of interdisciplinary training and presents residents’ understanding of difficult airway management and shows that they need more training and they need to gain more experience in this regard. The results of our study show that residency students from many different clinical branches actually need an interdisciplinary education.
Keywords: Difficult Airway, Airway Awareness, Awareness of Physicians
The effect of anesthetic agents used in oocyte collection on intracytoplasmic sperm injection results in patients treated for infertility due to male factor
Necmiye Ay 1, Gulsemin Çiçek 2, Duygu Akyol 1 , Nadiye Koroglu 3, Gonca Yetkin Yıldırım 4, Ibrahim Polat 5, Ziya Salihoglu 6
1 Department of Anesthesiology and Reanimation, Başakşehir Cam and Sakura City Hospital, Istanbul, 2 Department of Histology and Embryology, Faculty of Medicine, Necmettin Erbakan University, Konya, 3 Department of Gynecology and Obstetrics, Acıbadem Mehmet Ali Aydınlar University Acıbadem Atakent Hospital, Istanbul, 4 Department of Gynecology and Obstetrics, Medipol Mega University Hospital, Istanbul, 5 Department of Gynecology and Obstetrics, Basakşehir Cam and Sakura City Hospital, Istanbul, 6 Department of Anesthesiology and Reanimation, Faculty of Medicine, Istanbul University, Haseki Institute of Cardiology, Istanbul, Turkey
DOI: 10.4328/ACAM.21871 Received: 2023-08-15 Accepted: 2023-09-16 Published Online: 2023-09-21 Printed: 2023-10-01 Ann Clin Anal Med 2023;14(10):915-919
Corresponding Author: Necmiye Ay, Department of Anesthesiology and Reanimation, Başakşehir Cam and Sakura City Hospital, 34480, Başakşehir, Istanbul, Turkey. E-mail: email@example.com P: +90 533 496 44 41 Corresponding Author ORCID ID: https://orcid.org/0000-0003-1787-7522
This study was approved by the Ethics Committee of Bakırköy Dr. Sadi Konuk Training and Research Hospital (Date: 2019-10-28, No: 2019-21-07)
Aim: Different anesthetic methods and agents are used for transvaginal oocyte retrieval procedures (TORP) in assisted reproductive techniques (ART). In our study, we evaluated prospectively the effect of propofol and thiopental sodium during TORP on intracytoplasmic sperm injection (ICSI) results in the spouses of patients with male factor indication.
Material and Methods: The study was approved by the ethics committee with Protocol No. 2019-21-07 on dated October 28, 2019. Sixty female patients who underwent TORP for intracytoplasmic sperm injection were included in the study. Anesthesia was randomized into two groups according to propofol (GP) or thiopental sodium (GT) used for induction and maintenance anesthesia. Patients’ demographic data, effects of the anesthetic drug used on hemodynamics and nausea and vomiting, laboratory parameters including fertilization rate, cleavage rate, optimal embryo rate and implantation rate, and pregnancy outcomes were recorded.
Results: Sixty patients, including the propofol group (n:30) and the thiopental sodium group (n:30), were evaluated. Mean age, body mass index and motile sperm count were similar in both groups. Mean arterial pressures and nausea and vomiting rates were lower in GP (p<0.05). Although intracytoplasmic sperm injection, pronucleus, MII oocyte values were statistically significantly higher in GP, B-HCG and clinical pregnancy outcomes were similar in both groups.
Discussion: Our findings revealed that propofol and thiopental sodium, the anesthetic agents used in transvaginal oocyte collection procedure before ICSI treatment, had similar effects on clinical pregnancy. The results of our study are similar to many studies in the literature.
Keywords: Anesthetic Agents, Assisted Reproductive Techniques, Transvaginal Oocyte Retrieval Procedures, Pregnancy
Dual trigger does not improve the results of in vitro fertilization cycles in POSEIDON group 3: A retrospective cohort study
Gonul Ozer 1, Sevinc Ozmen 2
1 Department of Obstetrics and Gynecology, Faculty of Medicine, Uskudar University, 2 Department of in Vitro Fertilization, Medipol University, Medipol Mega Hospital, Istanbul, Turkey
DOI: 10.4328/ACAM.21873 Received: 2023-08-15 Accepted: 2023-09-16 Published Online: 2023-09-30 Printed: 2023-10-01 Ann Clin Anal Med 2023;14(10):920-924
Corresponding Author: Gonul Ozer, Department of Obstetrics and Gynecology, Faculty of Medicine, Uskudar University, 34764, Umraniye, Istanbul, Turkey. E-mail: firstname.lastname@example.org P: +90 532 694 55 49 Corresponding Author ORCID ID: https://orcid.org/0000-0003-2900-8623
This study was approved by the Ethics Committee of Medipol University (Date: 2021-12-27, No: E-10840098-772.02-6688)
Aim: The aim of this study is to find out how the combined use of a gonadotropin-releasing hormone agonist (GnRH-a) and human chorionic gonadotropin (hCG) affects the success of IVF in women younger than 35 with diminished ovarian reserve (POSEIDON 3).
Material and Methods: This retrospective study included a total of 386 cycles in which embryo transfer occurred: 105 in the dual trigger group and 281 in the r-hCG trigger group. The two groups were compared regarding patient demographics, IVF cycle characteristics, and pregnancy outcomes.
Results: Demographic characteristics were similar in both groups. When the r-hCG and dual-trigger groups’ cycles were compared, the number of retrieved oocytes, the number of metaphase II oocytes, the rates of fertilization and implantation, the number of embryos transferred, and the number of embryos frozen were all the same. When comparing the cycle characteristics of the r-hCG and dual-trigger groups, the retrieved oocytes, metaphase II oocytes, fertilization rates, implantation rates, number of embryos transferred, and number of cryopreserved embryos were similar. The implantation (46.6% vs. 47.6%, p=0.855), biochemical miscarriage (4.6% vs. 4.8%, 0.955), clinical miscarriage (7.8% vs. 6.7%, p=0.700), and ongoing pregnancy (34.2% vs. 36.2%, p=0.710) rates were similar. There were no statistically significant differences between the two groups.
Discussion: This study compared dual trigger and r-hCG trigger in women under 35 with diminished ovarian reserve for IVF outcomes. While some research suggested dual trigger benefits, this study found no significant differences in IVF cycle results or pregnancy outcomes between the groups. The limitations of the study include its retrospective design and small sample size. Further well-designed research is needed to recommend routine dual trigger usage for such patients.
Keywords: Dual Trigger, hCG Trigger, Diminished Ovarian Reserve, Pregnancy Outcomes
Differences and effects on heart rate variability regarding time-domain parameters and frontal QRS-T angle in irritable bowel syndrome with diarrhea or constipation
Onur Akhan 1, Tuncay Guzel 2, Mehmet Kis 3, Mustafa Dogdus 4, Enver Avci 5
1 Department of Cardiology, Bilecik Training and Research Hospital, Bilecik, 2 Department of Cardiology, Gazi Yasargil Training and Research Hospital, Diyarbakir, 3 Department of Cardiology, Faculty of Medicine, Dokuz Eylul University, Izmir, 4 Department of Cardiology, Medical Point Hospital, Izmir, 5 Department of Gastroenterology, Medova Hospital, Konya, Turkey
DOI: 10.4328/ACAM.21874 Received: 2023-08-15 Accepted: 2023-09-18 Published Online: 2023-09-27 Printed: 2023-10-01 Ann Clin Anal Med 2023;14(10):925-930
Corresponding Author: Onur Akhan, Department of Cardiology, Bilecik Training and Research Hospital, Bilecik, Turkey. E-mail: email@example.com P: +90 535 594 33 55 Corresponding Author ORCID ID: https://orcid.org/0000-0003-4440-9599
This study was approved by the Ethics Committee of Bilecik Seyh Edebali University (Date: 2023-05-18, No: E-10333602-050.04.01-181790)
Aim: Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder associated with autonomic nervous system (ANS) abnormalities. The primary aim is to examine heart rate variability (HRV) in IBS patients and identify differences between diarrhea (IBS-D) and constipation-predominant (IBS-C) subtypes with time-domain (T-D) parameters linked to parasympathetic nervous system (PNS) activity using 24-hour Holter electrocardiography (ECG). The secondary aim is to determine if ANS dysregularities affect frontal QRS-T angle f(QRS-T) and ECG features.
Material and Methods: The patients with palpitation symptoms who had a 24-hour Holter ECG evaluation at our clinic from January 2019 to December 2022 were reviewed retrospectively. Twenty-fıve patients with IBS-D, 25 with IBS-C, and 50 healthy controls were included.
Results: According to univariate logistic regression, the PR interval, 24-hour minimum heart rate (minHR), rMMSSD, pNN50, and SDNN index are predictors of IBS. In multivariate logistic regression analysis, only the 24-Hour minHR and SDNN index remained significant as an independent predictor of IBS. Based on the Scatter-Plot, 12% of the variation in the 24-hour minHR was connected to the SDDN index. IBS had a moderate negative association with minHR and SDNN index, a weak negative correlation with rMMSSD and pNN50, and a weak positive correlation with PR interval. The IBS predictability of the PR interval, 24-Hour minHR, rMMSSD, pNN50, and SDNN index was also determined using ROC analysis.
Discussion: We found that T-D parameters were adversely affected in IBS, irrespective of subtype. PR intervals were longer in IBS than controls; however, the f(QRS-T) angle did not differ between the subtypes.
Keywords: Irritable Bowel Syndrome, Frontal Qrs-T Angle, Time-Domain Parameters, Electrocardiography, Ambulatory Holter Electrocardiography
Frequency and clinical features of cockroach sensitivity in atopic children
Ozge Atay, Mehmet Şirin Kaya, Melike Ocak, Demet Can
Department of Pediatric Immunology and Allergy, Dr. Behçet Uz Child Disease and Pediatric Surgery Training and Research Hospital, Izmir, Turkey
DOI: 10.4328/ACAM.21875 Received: 2023-09-18 Accepted: 2023-08-16 Published Online: 2023-09-27 Printed: 2023-10-01 Ann Clin Anal Med 2023;14(10):931-934
Corresponding Author: Ozge Atay, Department of Pediatric Immunology and Allergy, Dr. Behçet Uz Child Disease And Pediatric Surgery Training And Research Hospital, Izmir, Turkey. E-mail: firstname.lastname@example.org P: +90 533 547 35 79 Corresponding Author ORCID ID: https://orcid.org/0000-0002-7673-3601
This study was approved by the Non-interventional Clinical Research Ethics Committee of Izmir Katip Çelebi University (Date: 2023-05-18, No: 0224)
Aim: Blattella germanica (Bg) is the most common type of cockroach in Turkey. Although Bg is most commonly associated with respiratory allergic diseases in pediatric patients, it may cause a variety of allergic diseases. The aim of this study was to determine the prevalence of Bg in atopic children and to evaluate the clinical and laboratory findings in these patients.
Material and Methods: This study was conducted in the Pediatric Allergy outpatient clinic of Dr. Behcet Uz Pediatrics and Surgery Training and Research Hospital between 15.03.2022 and 10.04.2023. We analyzed children aged 2-18 years who underwent skin prick testing for aeroallergens, due to the presence of allergic disease symptoms. Next, we determined the prevalence, clinical and laboratory findings of Bg sensitization.
Results: Bg sensitivity was detected in 74 (5.45%) of 1358 atopic patients. The median age of Bg-sensitive patients was 8 (min-max:4-17), 33 (44.6%) of them were girls. Bg monosensitization was significantly more frequent in patients with cockroaches in their homes compared to those without (8.1% vs. 2.7%, p=0.012). Despite being told about household precautions, more than half of the patients had not performed any indoor pest control.
Discussion: Our study is the most comprehensive current study on cockroach sensitization and clinical findings in Turkish children. Measures against aeroallergens are often difficult to implement. However, household measures for Bg can facilitate the treatment of atopic diseases. Therefore, it would be useful to identify Bg-sensitized patients and take simple and effective measures such as indoor pest control.
Keywords: Allergy, Asthma, Allergic Rhinitis, Children, Cockroach
Can biochemical markers help in the differential diagnosis of pheochromacytoma-adrenocortical adenoma
Yasemin Emur Gunay 1, Irfan Nuhoglu 2, Ahmet Enes Damcı 3, Serdar Karakullukcu 4, Özlem Kanburoglu Meletlı 2, Hülya Coskun 2, Ozge Ucuncu 2, Muhammet Cüneyt Bilginer 2, Mustafa Kocak 2
1 Department of Endocrinology and Metabolism, Giresun Training and Research Hospital, Giresun, 2 Department of Endocrinology and Metabolism, Faculty of Medicine, Karadeniz Technical University, Trabzon, 3 Department of Internal Medicine, Espiye State Hospital, Giresun, 4 Department of Public Health, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey
DOI: 10.4328/ACAM.21879 Received: 2023-08-18 Accepted: 2023-09-18 Published Online: 2023-09-27 Printed: 2023-10-01 Ann Clin Anal Med 2023;14(10):935-938
Corresponding Author: Yasemin Emur Gunay, Department of Endocrinology and Metabolism, Giresun Training and Research Hospital, Giresun, Turkey. E-mail: email@example.com P: +90 533 039 12 90 F: +90 454 310 20 20 Corresponding Author ORCID ID: https://orcid.org/0000-0002-0645-2070
This study was approved by the Ethics Committee of Faculty of Medicine, Karadeniz Technical University (Date: 2022-06-30, No: 2022/125)
Aim: In this study, we aimed to investigate the usability of biochemical parameters in differentiating pheochromocytoma and nonfunctional adrenocortical adenomas.
Material and Methods: This study was conducted retrospectively by comparing 49 patients who underwent adrenalectomy and were pathologically diagnosed with ‘pheochromocytoma’ with 60 age- and sex-matched controls with nonfunctional adrenocortical adenomas between January 2000 and June 2022. Hematological markers such as neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), RDW, and MPV were compared between groups.
HALP score was calculated with the formula including hemoglobin (g/dl), albumin (g/L), lymphocyte (x103 /µl) and thrombocyte (x103 /µl) values [HALP score: Hemoglobin(g/dl)X albumin (g/L) )X lymphocyte (x103 /µl)/ platelet (x103 /µl)]. HALP scores were compared between groups. At the same time, the effectuality of the HALP score in the differential diagnosis of pheochromocytoma was evaluated.
Results: While NLR and PLR values were statistically higher in pheochromocytoma patients compared to nonfunctional adenoma patients (p=0.009; p<0.001, respectively), HALP values were significantly low (p<0.001). There was no statistically significant difference in RDW and MPV values (p=0.072; p=0.509). When the diagnostic decision-making in predicting pheochromocytoma disease was examined by ROC curve analysis, it was found that the AUC values of the initial HALP, albumin, hemoglobin, and lymphocyte parameters were statistically significant.
Discussion: It was observed that biochemical parameters such as NLR, PLR, and HALP scores differed significantly in differentiating pheochromocytomas from nonfunctional ACAs. This difference was thought to be due to a severe inflammatory response in pheochromocytoma.
Keywords: Pheochromocytoma, Adrenocortical Adenomas, Halp Score
Contribution of alkaline phosphatase in the detection of “Superscan” finding in bone scintigraphy
Seyit Ahmet Ertürk
Department of Nuclear Medicine, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey
DOI: 10.4328/ACAM.21881 Received: 2023-08-17 Accepted: 2023-09-18 Published Online: 2023-09-28 Printed: 2023-10-01 Ann Clin Anal Med 2023;14(10):939-942
Corresponding Author: Seyit Ahmet Ertürk, Department of Nuclear Medicine, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey. E-mail: firstname.lastname@example.org P: +90 462 377 30 00 Corresponding Author ORCID ID: https://orcid.org/0000-0002-6030-9662
This study was approved by the Noninterventional Clinical Research Ethics Committee of Sancaktepe Sehit Prof. Dr. Ilhan Varank Training and Research Hospital (Date: 2023-03-08, No: 49)
Aim: Distant osteoblastic bone metastases are frequent manifestations of prostate cancer. Widespread bone metastases can occasionally give rise to uniform distribution of “Tc99m methylene diphosphonate” resulting in a nearly normal appearance on the bone scintigraphy. This situaition is defined as superscan, a finding that can be seen in some malignancies and some metabolic diseases. We think that alkaline phosphatase values, may be a parameter that can prevent erroneous evaluation in prostate cancer patients with extensive bone metastasis,”superscan” finding that can cause an appearance similar to normal bone scintigraphy. This study aimed to investigate the relationship between alkaline phosphatase levels and the superscan finding during the evaluation of bone scintigraphy images.
Material and Methods: Prostate cancer patients who underwent bone scintigraphy in our unit between 2014 and 2022 were retrospectively scanned and those reported as “superscan” were selected. The relationship between serum ALP levels and the “Superscan” finding was evaluated and ROC analysis was performed.
Results: When the bone scintigraphy images of the patients were evaluated, 12 had normal scintigraphy and 12 had superscan findings. While the mean ALP levels of the patients with superscan appearance in the bone scintigraphy were 515.17±476.71, the mean ALP levels of the patients whose bone scintigraphy was reported as normal were calculated as 83.58±25.41 (p=0.005).
Discussion: ALP levels in patients who were reported as superscan during bone scintigraphy were found to be statistically significantly higher than in patients whose bone scintigraphy was reported as normal. Therefore, evaluation of ALP levels while reporting bone scintigraphy examinations by nuclear medicine specialists can greatly prevent false negative results in patients.
Keywords: Prostate Cancer, Bone Scintigraphy, Alkaline Phosphatase, Superscan, Bone Metastases
The correlation between cardiac troponin I land ischemic stroke severity using the national institutes of health stroke scale
Soukri Chatzı Chatıp 1, Ömer Faruk Demir 2, Nezih Kavak 3
1 Department of Emergency, Afşin Public Hospital, Kahramanmaraş, 2 Department of Emergency, Dışkapı Yıldırım Beyazıt Research and Training Hospital, Ankara, 3 Department of Emergency, Etlik City Hospital, Ankara, Türkiye
DOI: 10.4328/ACAM.21897 Received: 2023-08-23 Accepted: 2023-09-25 Published Online: 2023-09-28 Printed: 2023-10-01 Ann Clin Anal Med 2023;14(10):943-947
Corresponding Author: Soukri Chatzı Chatıp, Department of Emergency, Afşin Public Hospital, Kahramanmaraş, Türkiye. E-mail: email@example.com P: +90 537 893 95 31 Corresponding Author ORCID ID: https://orcid.org/0009-0000-1955-3420
This study was approved by the Ethics Committee of Dışkapı Yıldırım Beyazıt Research and Training Hospital (Date: 2018-04-16, No: 2018-49-13)
Aim: The aim of this study is to explore the correlation between cardiac troponin I (cTnI) levels and the National Institutes of Health Stroke Scale (NIHSS) in acute ischemic stroke (AIS) patients as well as to determine the significance of cTnI levels in predicting the prognosis of AIS patients.
Material and Methods: A retrospective analysis was conducted on patients diagnosed with AIS who presented to the Emergency Department of Ankara Dışkapı Yıldırım Beyazıt Research and Training hospital between February and June 2018 and had their cTnI levels assessed. Both the cTnI levels and NIHSS scores of these patients were documented.
Results: A total of 151 patients were evaluated. The mortality rate for patients with normal cTnI levels was 1.69% (2 out of 118 patients), while those with elevated cTnI levels had a mortality rate of 32.25% (p=0.001). Of those with normal cTnI levels, 10.92% required intensive care unit (ICU) admission, compared to 40.62% with elevated cTnI levels (p=0.002). The average NIHSS scores for patients with normal and high cTnI levels were 5.83±5.80 and 12.56±7.55, respectively.
Discussion: The results of this study indicate that elevated cTnI levels in AIS patients are associated with a worse prognosis, higher necessity for ICU admission, and increased mortality rates. It is believed that evaluating cTnI levels, a readily available test in AIS patients, will guide clinicians in assessing the patient’s prognosis.
Keywords: Stroke, Cardiac Troponin I, National Institutes of Health Stroke Scale
Short-term effect of latanoprostene bunod monotherapy on reducing intraocular pressure and altering macular microvasculature
Kemal Bayrakçeken 1, Hasan Akgöz 2
1 Department of Ophthalmology, Faculty of Medicine, Erzincan Binali Yildirim University, Erzincan, 2 Department of Ophthalmology, Erzurum Regional Training and Research Hospital, Erzurum, Turkey
DOI: 10.4328/ACAM.21900 Received: 2023-08-24 Accepted: 2023-09-25 Published Online: 2023-09-27 Printed: 2023-10-01 Ann Clin Anal Med 2023;14(10):948-951
Corresponding Author: Kemal Bayrakçeken, Department of Ophthalmology, Faculty of Medicine, Erzincan Binali Yildirim University, Erzincan, Turkey. E-mail: firstname.lastname@example.org P: +90 505 944 19 44 Corresponding Author ORCID ID: https://orcid.org/0000-0001-9550-1358
This study was approved by the Ethics Committee of Erzincan Binali Yıldırım University (Date: 2023-04-27, No: 2023/09-1)
Aim: In this study, we aimed to evaluate the effect of topical latanoprostene bunod (LBN) 0.024% on early intraocular pressure (IOP) and macular microvasculature.
Material and Methods: This retrospective study included 46 eyes of 46 treatment-naive participants with primary open-angle glaucoma disease (POAG) who were initiated on topical LBN 0.024%. IOP values of the patients were compared before and the first month after treatment. Macular and ganglion cell complex thicknesses were evaluated using optical coherence tomography (OCT), and macular vessel density parameters were evaluated using OCT angiography (OCTA). Pre-and post-treatment findings were compared with the paired-sample t-test.
Results: At the time of the first presentation, the mean IOP value of the patients was 26.20±2.84 mmHg. After administration of LBN 0.024%, the mean follow-up IOP value decreased to 14.93±2.25 mmHg in the first month (p=0.00). When OCTA images taken before and the first month after treatment were compared, it was determined that the early treatment diabetic retinopathy study (ETDRS) value for the outer nasal section significantly increased (p=0.042). There was no significant difference in the remaining parameters showing macular vessel density.
Discussion: LBN 0.024% is a topical ocular hypotensive agent effective in lowering IOP in the early period in patients with POAG.
Keywords: Glaucoma, Latanoprostene Bunod, Nitric Oxide, Optical Coherence Tomography Angiography
Impact of copper intrauterine devices on sexual function: A prospective comparative study within the same cohort of Turkish women
Department of Obstetrics and Gynecology, Avcılar Murat Kölük State Hospital, Istanbul, Turkey
DOI: 10.4328/ACAM.21902 Received: 2023-08-25 Accepted: 2023-09-29 Published Online: 2023-09-30 Printed: 2023-10-01 Ann Clin Anal Med 2023;14(10):952-955
Corresponding Author: Adil Barut, Department of Obstetrics and Gynecology, Avcılar Murat Kölük State Hospital, Istanbul, Turkey. E-mail: email@example.com P: +90 532 552 95 35 Corresponding Author ORCID ID: https://orcid.org/0000-0003-0146-0474
This study was approved by the Ethics Committee of Sadi Konuk Training and Research Hospital (Date: 2019-04-22, No: 219-08-25)
Aim: This study sought to examine whether and to what extent copper intrauterine devices (CuIUD) were associated with adverse effects on women’s sexual function, assessed at three time points, immediately before use, and 1 and 3 months after deployment
Material and Methods: This prospective study included 207 consecutive women who had presented to the Department of Gynecology. Data included age, number of parities, delivery methods, education status, and history of vaginal discharge and abnormal uterine bleeding. Immediately before and one and three months after deployment, participants were asked to complete the Female Sexual Function Index (FSFI).
Results: The mean age of 207 women was 34.2±6.4 years. At baseline, the incidence of sexual dysfunction was 41.1%, which increased significantly to 47.3% compared with baseline and final assessments (43. 3%). Scores of sexual desire and sexual arousal were significantly lower a month later than at baseline and 3 months later. Pain scores also increased significantly following implantation, both at 1 and 3 months.
Discussion: It is not surprising that implantation of a CuIUD would be associated with decreased sexual function, sexual desire, sexual arousal, and increased pain in the early period. This is because most women with a CuIUD still have fears of becoming pregnant and experience increased levels of pain due to an implanted CuIUD, both keeping them from being sexually activity. In the course of time, both fears and pain regress, allowing sexual function to return to pre-implantation levels.
Keywords: Incidence of Sexual Dysfunction, Copper Intrauterine Device, Sexual Pain
Investigation of the contribution of viscoelastic polymer gel pad usage to the accuracy of magnetic resonance elastography measurements: A preliminary study
Levent Karakaş 1, Süheyl Poçan 2
1 Department of Radiology, Health Sciences University, Istanbul Gaziosmanpasa Training and Research Hospital, 2 Department of Radiology, Faculty of Medicine, Nisantasi University, Istanbul, Turkey
DOI: 10.4328/ACAM.21918 Received: 2023-08-28 Accepted: 2023-09-28 Published Online: 2023-09-30 Printed: 2023-10-01 Ann Clin Anal Med 2023;14(10):956-960
Corresponding Author: Levent Karakaş, Department of Radiology, Health Sciences University, Istanbul Gaziosmanpasa Training and Research Hospital, Istanbul, Turkey. E-mail: firstname.lastname@example.org P: +90 507 260 86 70 Corresponding Author ORCID ID: https://orcid.org/0000-0001-5485-9337
This study was approved by the Ethics Committee of Istanbul Nisantası University and BHTCLINIC Istanbul Tema Hospital (Date: 2022-06-29, No: 2022/27-3)
Aim: The aim of this study was to investigate whether the use of a gel pad contributes to the calculation of stiffness in elastography examination and thus to its diagnostic value by measuring the magnetic resonance elasticity values of relatively curved body parts, such as the knee joint.
Material and Methods: Our study was performed using a data series of 52 knee joint magnetic resonance images obtained from 45 patients were examined. The examinations were performed on elastography images obtained using extra drivers in addition to the standard examination performed with a 3 Tesla magnetic resonance device. Patients who appeared normal with no radiological abnormalities during and after the acquisition of conventional images were included in the study. In the elastographic evaluation performed on the tendon in these normal cases, measurements were taken at different locations of the tendon, with and without a gel pad, and the stiffness values were statistically analyzed.
Results: In examinations with the gel pad, stiffness values were in a more homogeneous range, the standard deviation was lower ±77, and stiffness values from the same location were correlated (p<0,05), while in examinations without the gel pad, the standard deviation was larger ±112 and stiffness values were more inconsistent.
Discussion: As a result, it was concluded that the use of gel pads in magnetic resonance elastography, especially for curved body surfaces, contributes to the accuracy of stiffness value measurement and increases the reliability of the evaluation.
Keywords: Active Driver, Elastography, Gel Pad, Magnetic Resonance, Passive Driver, Stiffness