Supplement 2 2023
Comparison of adnexal torsion in premenopausal and postmenopausal women and risk of malignancy
Osman Balci, Hasan Energin
Department of Obstetrics and Gynecology, Faculty of Meram Medicine, Necmettin Erbakan University, Konya, Turkey
DOI: 10.4328/ACAM.21165 Received: 2022-03-29 Accepted: 2022-06-06 Published Online: 2023-07-21 Printed: 2023-09-25 Ann Clin Anal Med 2023;14(Suppl 2):S125-129
Corresponding Author: Hasan Energin, Department of Obstetrics and Gynecology, Faculty of Meram Medicine, Necmettin Erbakan University, 42080, Meram, Konya, Turkey. E-mail: email@example.com P: +90 553 061 90 41 F: +90 332 223 61 81 Corresponding Author ORCID ID: https://orcid.org/0000-0003-4089-403X
This study was approved by the Ethics Committee of Necmettin Erbakan University (Date: 2023-07-07, No: 4424)
Aim: Adnexal torsion is one of the rare causes of lower abdominal pain, however, it is a common gynecological surgical emergency. Its prevalence is 2.7%. The incidence of torsion may be lower in post-menopausal women because of decreased risk of benign ovarian cysts and benign teratomas. Adnexal masses in post-menopausal patients are more likely to be malignant. However, there is not enough study to know precisely the risk of malignancy in post-menopausal patients with adnexal torsion.
Material and Methods: This study was carried out in a tertiary center in Turkey. The study retrospectively analyzed 380 patients presented to our clinic with abdominal pain between January 2005 and January 2020 and underwent surgery for adnexal torsion.
Results: The data were collected from patients records at a tertiary center in Turkey over a 15-year period. Three hundred eighty patients underwent surgery for adnexal torsion; 288 patients were premenopausal and 92 patients were postmenopausal. Fourteen ovarian malignancies and 11 borderline serous and mucinous tumors were reported; 11 (11.9%) ovarian malignancies were reported in post-menopausal patients and 3 (1.1%) d in premenopausal patients. There were 6 serous cystadenocarcinoma, 4 mucinous cystadenocarcinoma, and 4 granulosa cell tumors that had been reported as malignancy histopathologic subtype.
Discussion: There is a longer delay in postmenopausal adnexal patients’ treatment since postmenopausal adnexal torsion is an uncommon and unexpected gynecological emergency. Malignancy prevalence is high in the postmenopausal group, and surgeons should suspect malignancy in post-menopausal adnexal torsion patients.
Keywords: Adnexal Torsion, Detorsion, Ovarian Malignancy
The influence of coccyx morphology on ganglion impar block treatment results in chronic coccydynia
Samet Sancar Kaya 1, Şeref Çelik 2, Erkan Yavuz Akçaboy 2, Hamit Göksu 3, Müge Baran 4, Şaziye Şahin 2
1 Department of Pain Medicine, Adıyaman University Training and Research Hospital, Adıyaman, 2 Department of Pain Medicine, University of Health Sciences, Ankara City Hospital, Ankara, 3 Department of Pain Medicine, University of Health Sciences, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, 4 Department of Pain Medicine, Ağrı Training and Research Hospital, Ağrı, Turkey
DOI: 10.4328/ACAM.21734 Received: 2023-04-26 Accepted: 2023-06-05 Published Online: 2023-06-20 Printed: 2023-09-25 Ann Clin Anal Med 2023;14(Suppl 2):S130-134
Corresponding Author: Samet Sancar Kaya, Deparment of Pain Medicine, Adıyaman University Training and Research Hospital, 02100, Ziyaretpayamlı, Adıyaman, Turkey. E-mail: firstname.lastname@example.org P: +90 505 753 60 59 Corresponding Author ORCID ID: https://orcid.org/0000-0003-4819-1128
This study was approved by the Ethics Committee of Ankara City Hospital (Date: 2022-01-26, No: E1-22-2338)
Aim: Coccydynia is usually managed conservatively; however, ganglion impar block (GIB) can be performed in patients who do not respond to conservative treatments. In this study, we aimed to investigate the effect of coccyx morphology on outcomes of GIB in coccydynia.
Material and Methods: A retrospective study included 101 patients with coccydynia who failed to respond to conservative treatments and underwent GIB. Patients were categorized as normal (Type 1), or abnormal (Type 2, 3, 4, and 5) based on the modified Postacchini and Massobrio classification. Pain scores before and after the injection at 1 and 3 months were compared. A more than 50% reduction in visual analogue scale (VAS) scores was defined as significant pain relief.
Results: According to the Postacchini-Massobrio classification, 42 patients had a normal coccyx (Group I) and 59 had an abnormal coccyx (Group II). VAS scores in both groups had improved significantly from baseline at 1 and 3 months (p <0.05). There were significantly greater decreases in VAS scores in the 1st and 3rd months in Group II than in Group I (p < 0.001). The 1st month VAS and 3rd month VAS scores were higher in the patient group without trauma history than in the patient group with trauma history (p = 0.008, and p = 0.040, respectively).
Discussion: GIB is safe and effective for the management of coccydynia. History of trauma and type of coccyx in patients with chronic coccydynia seem to affect treatment outcomes.
Keywords: Coccydynia, Ganglion Impar Block, Coccydynia Treatment, Coccyx Morphology, Postacchini-Massobrio Classification
Elizabethkingia meningoseptica: A new cause of ventilator-associated pneumonia in pediatric intensive care unit
Gultac Evren 1, Senem Akgul 2
1 Department of Pediatric Intensive Care Unit, 2 Department of Medical Microbiology, Manisa City Hospital, Manisa, Turkey
DOI: 10.4328/ACAM.21770 Received: 2023-06-01 Accepted: 2023-07-03 Published Online: 2023-07-10 Printed: 2023-09-25 Ann Clin Anal Med 2023;14(Suppl 2):S135-139
Corresponding Author: Gultac Evren, Department of Pediatric Intensive Care Unit, Manisa City Hospital, Manisa, Turkey. E-mail: email@example.com P: +90 505 210 25 47 Corresponding Author ORCID ID: https://orcid.org/0000-0002-0614-0894
This study was approved by the Ethics Committee of Bakırçay University (Date: 2022-10-05, No:720/2022-GOA)
Aim: Ventilator-associated pneumonia (VAP) is diagnosed by detecting bacterial microorganisms in addition to purulent tracheal secretions, fever, respiratory distress, leukocytes in the tracheal aspirate, and radiological findings of pneumonia in patients on mechanical ventilation for more than 48 hours. The objective of this study was to determine the effects of E. meningoseptica bacteria and other agents, which are infrequently detected in tertiary pediatric intensive care units, on clinical findings, demographic characteristics, and mortality in patients with VAP.
Material and Methods: In this retrospective study, patients who were intubated in a tertiary pediatric intensive care unit (PICU) and diagnosed with ventilator-associated pneumonia according to CDC criteria between 2021 and 2022 were evaluated. The study included 42 patients who met all inclusion criteria.
Results: The 42 participants in the study were diagnosed with VAP based on CDC criteria and positive microbiological test results. The average age of the patients was 38,5 months, and the bmales predominated. Nine patients had E. meningoseptica isolated from them. Eight of the forty-two patients included in the investigation perished, and three of them had VAP. Mechanical ventilation time (p = 0.017) and PICU hospitalization time (p = 0.017) were both prolonged in the E. meningoseptica-isolated group.
Discussion: In recent years, the prevalence of E. meningoseptica infection in pediatric intensive care units has increased rapidly. This infection causes fatal opportunistic infections in patients receiving broad-spectrum antibiotics, followed by central venous catheters, duration of mechanical ventilation, and length of PICU stay.
Keywords: Ventilator-Associated Pneumonia, Elizabethkingia Meningoseptica, Antibiotics, Pediatric Intensive Care Unit
Effect of tocilizumab treatment on intubation and mortality rates in patients with severe COVID-19: A retrospective cross-sectional study
Kubilay Issever 1, Mehmet Emir Arman 2, Deniz Cekic 3, Ahmed Cihad Genc 4, Ahmed Bilal Genc 5, Ali Muhtaroglu 6, Selcuk Yaylaci 7
1 Department of Internal Medicine, Faculty of Medicine, Giresun University, Giresun, 2 Department of General Practitioner, Sakarya University Research and Educational Hospital, Sakarya, 3 Department of Internal Medicine, Sakarya University Research and Educational Hospital, Sakarya, 4 Department of Internal Medicine, Sakarya University Research and Educational Hospital, Sakarya, 5 Department of Internal Medicine, Faculty of Medicine, Sakarya University, Sakarya, 6 Department of General Surgery, Faculty of Medicine, Giresun University, Giresun, 7 Department of Internal Medicine, Faculty of Medicine, Sakarya University, Sakarya, Turkey
DOI: 10.4328/ACAM.21833 Received: 2023-07-27 Accepted: 2023-08-28 Published Online: 2023-09-06 Printed: 2023-09-25 Ann Clin Anal Med 2023;14(Suppl 2):S140-145
Corresponding Author: Kubilay Issever, Department of Internal Medicine, Faculty of Medicine, Giresun University, Merkez, Giresun, Turkey. E-mail: firstname.lastname@example.org P: +90 531 381 74 75 Corresponding Author ORCID ID: https://orcid.org/0000-0002-1376-1488
This study was approved by the Ethics Committee of Sakarya University Medical Faculty (Date: 2021-05-29, No: E-71522473-050.01.04-32203-320)
Aim: COVID-19 has impacted all health facilities worldwide since 2020. Thus, finding curative treatments is vital, especially for patients with severe disease. In this study, we aimed to evaluate the curative potential of Tocilizumab in patients with severe COVID-19.
Material and Methods: Retrospectively, we analyzed the files of 154 patients treated in the intensive care units (ICU) between October 2020 and October 2021. Tocilizumab was administered to the patients before intubation as soon as the signs of the severe disease were noticed. The groups were compared as “tocilizumab” (Group T) vs. “non-tocilizumab” (Group NT).
Results: No significant age and gender differences were found between the tocilizumab and non-tocilizumab groups. Intubation (31.2% vs. 45.5%) and mortality rates (33.8% vs. 45.5%) were lower in the tocilizumab group, but the difference was not statistically significant (p>0.05). Group T was more frequently treated with glucocorticoids, while this group contained fewer patients with diabetes mellitus and chronic kidney failure (p=0.01 and 0.004, respectively). Correlation analysis revealed a slightly and moderately positive correlation of mortality and intubation with CPAP (Continuous Positive Airway Pressure) therapy, uric acid, AST (Aspartate Aminotransferase), creatine kinase (CK), lactate dehydrogenase (LDH), troponin I, Vitamin D, and interleukin-6 (IL-6) (p=0.000, 0.001, 0.032, 0.015, 0.000, 0.000, 0.004, and 0.002, respectively).
Discussion: Our results revealed that Tocilizumab might prevent intubation and death if administered early in patients with severe COVID-19.
Keywords: Tocilizumab, COVID-19, Mortality, Intubation
Two-stage revision of infected knee replacement in patients with antibiotic-loaded spacer
Kemal Kayaokay 1, Kemal Aktuğlu 2
1 Department of Orthopaedics and Traumatology, Izmir Katip Çelebi University, Atatürk Research and Training Hospital, 2 Department of Orthopaedics and Traumatology, Ege University, Izmir, Turkey
DOI: 10.4328/ACAM.21841 Received: 2023-08-02 Accepted: 2023-09-06 Published Online: 2023-09-21 Printed: 2023-09-25 Ann Clin Anal Med 2023;14(Suppl 2):S146-149
Corresponding Author: Kemal Kayaokay, Department of Orthopaedics and Traumatology, Izmir Katip Çelebi University, Atatürk Research and Training Hospital, 35150, Karabağlar, Izmir, Turkey. E-mail: email@example.com P: +90 532 201 16 11 Corresponding Author ORCID ID: https://orcid.org/0000-0003-1655-0587
This study was approved by the Non-Interventional Clinical Research Ethics Committee of Izmir Katip Celebi University (Date: 2023-04-27, No: 0199)
Aim: Prosthetic infections after total knee arthroplasty (TKA) are the most important cause of early failure in TKA, despite advances in diagnosis and treatment. In our study, we aimed to evaluate the results of a two-stage total knee arthroplasty using an antibiotic-loaded spacer.
Material and Methods: Two-stage revision was performed in all patients who were diagnosed with infected TKA. A prefabricated antibiotic-loaded articulating polymethylmethacrylate spacer or a vancomycin + gentamicin-loaded spacer to fill the gap was placed following debridement and irrigation. The patients were evaluated in terms of laboratory, clinical and radiographic findings at postoperative months 1, 3, 6 and in the following months. The recorded American Knee Society (AKS) Knee Scores of the patients before surgery and at the final follow-up were included in the evaluation.
Results: The mean patient age was 71.38 (range: 56-85) years. Culture was positive in 10 (47.6%) and negative in 11 (52.4%) of the 21 patients. The mean time from the most recent surgery (primary or revision) until removal of the prosthetic implant was 30.38 months (range: 0.5-96 months) and the mean time between the first and second stages was 6.2 months (range: 3-16 months). The mean AKS knee score increased from 39.1 points (range: 31-48) prior to the first stage to 74.95 points (range: 63-86) after the second stage (p<0.001).
Discussion: The two-step revision arthroplasty technique is a reliable and effective method in the treatment of infected TKA. The use of antibiotic-loaded spacers gives satisfactory results in increasing joint range of motion(ROM).
Keywords: Antibiotic-Loaded Spacer, Periprosthetic Joint Infection, Total Knee Arthroplasty
Effect of clinical characteristics on terminal ileum length in right hemicolectomy for primary right colon adenocarcinoma
Yunushan Furkan Aydoğdu 1, Emre Gülçek 2, Çağrı Büyükkasap 3, Hasan Bostancı 3, Osman Yüksel 3
1 Department of General Surgery, Bandırma Research and Training Hospital, Balıkesir, 2 Department of General Surgery, Polatlı Duatepe State Hospital, Ankara, 3 Department of General Surgery, Faculty of Medicine, Gazi University, Ankara, Turkey
DOI: 10.4328/ACAM.21845 Received: 2023-08-06 Accepted: 2023-09-06 Published Online: 2023-09-13 Printed: 2023-09-25 Ann Clin Anal Med 2023;14(Suppl 2):S150-153
Corresponding Author: Yunushan Furkan Aydoğdu, Department of General Surgery, Bandırma Training and Research Hospital Balıkesir, Turkey. E-mail: firstname.lastname@example.org P: +90 537 561 66 81 Corresponding Author ORCID ID: https://orcid.org/0000-0002-2418-2393
This study was approved by the Ethics Committee of Gazi University Faculty of Medicine (Date: 2023-01-23, No: 079)
Aim: Although the severity of diarrhea, the number of defecations, disturbances in the absorption of bile salts in right hemicolectomy theoretically depend on the resected length of the terminal ileum, there is no international guideline on how much the terminal ileum can be resected. The aim of this study was to determine the length of the ileum removed in patients undergoing right hemicolectomy for primary right colon adenocarcinoma and to evaluate whether surgical urgency, tumor localization and patient characteristics affect the length of the ileum.
Material and Methods: We evaluated 145 patients who underwent right hemicolectomy for primary colon adenocarcinoma.
Results: The median resected ileum length of the patients included in the study was 6 cm (min:2-max:73). When ileum lengths were evaluated by subgroups according to T stage (p=0.005) and N stage (p=0.005), there was a significant relationship between them. When N stages were also evaluated, there was no significant relationship between N0-N1 stages, while there was a significant difference in ileum lengths between N1-N2 (p=0.008) and N0-N2 (p=0.001) stages.
Discussion: In this descriptive study, we investigated the factors that may explain the variability of ileum length in patients who underwent right hemicolectomy for primary right colon adenocarcinoma, with the idea that the length of the ileum resected during surgery does not have a certain standard.
Keywords: Right Colon Adenocarcinoma, Terminal Ileum, Tumor Invasion, Regional Lymph Nodes, Distant Metastases
Evaluation of age-related surgery in congenital scoliosis
Dilek Arslan, Osman Fikret Sönmez
Department of Neurosurgery, Health Sciences University, Izmir Tepecik Training and Research Hospital, Izmir, Turkey
DOI: 10.4328/ACAM.21851 Received: 2023-08-09 Accepted: 2023-09-12 Published Online: 2023-09-21 Printed: 2023-09-25 Ann Clin Anal Med 2023;14(Suppl 2):S154-159
Corresponding Author: Dilek Arslan, Department of Neurosurgery, Health Sciences University, Izmir Tepecik Training and Research Hospital, Konak, Izmir, Turkey. E-mail: email@example.com P: +90 532 397 85 50 Corresponding Author ORCID ID: https://orcid.org/0000-0001-7463-4389
This study was approved by the Ethics Committee of University of Health Sciences Izmir Tepecik Training and Research Hospital (Date: 2023-05-04, No: 2023/03-48)
Aim: In deformity surgeries performed on pediatric, adolescent and adult patients with congenital scoliosis, age-related goals, techniques and results change. In this study, we aimed to guide patient management and surgical planning and avoid possible complications in 5 pediatric (0-12 years), 5 adolescent (13-19 years) and 5 adult (>20 years) patients operated for congenital scoliosis.
Material and Methods: A retrospective review of patients operated for congenital scoliosis between 2017 and 2022 in a single center was performed. The characteristics and measurement values of 15 congenital scoliosis patients who were operated using bilateral pedicle screw system were compared in relation to age. Scoliosis Research Society 22-question questionnaire was applied.
Results: The length of hospital stay of the pediatric group was statistically higher than of the adult group (p=0.021). There was no significant difference in the SRS-22 questionnaire of the groups. According to intragroup comparisons, the final postoperative values of the pediatric and adolescent groups were statistically lower than the preoperative values (p=0.001; p=0.042). The amount of decrease in thoracic kyphosis values in the pediatric group was statistically higher than in the adult group (p=0.038).
Discussion: Congenital scoliosis is a complex spinal problem associated with many abnormal findings. When a surgeon decides to perform congenital scoliosis surgery, the more important criterion than the patient’s age is the severity of the segmentation defect present in the patient. In proportion to the damage caused by the deformity to the patient’s quality of life, it should be decided whether to perform the surgery or to delay surgery.
Keywords: Adult Congenital Scoliosis, Adolescent Congenital Scoliosis, Pediatric Congenital Scoliosis, Congenital Scoliosis, Surgical Technique
Demographics and inflammatory features correlate in lumbar disc hernia
Department of Neurosurgery, Memorial Hospital, Istanbul, Turkey
DOI: 10.4328/ACAM.21858 Received: 2023-08-11 Accepted: 2023-09-12 Published Online: 2023-09-18 Printed: 2023-09-25 Ann Clin Anal Med 2023;14(Suppl 2):S160-164
Corresponding Author: Mahmut Özden, Department of Neurosurgery, Memorial Hospital, Bahcelievler, 34180, Istanbul, Turkey. E-mail: firstname.lastname@example.org P: +90 532 227 32 07 Corresponding Author ORCID ID: https://orcid.org/0000-0003-2441-0015
This study was approved by the Ethics Committee of Memorial Bahcelievler Hospital (Date: 2023-01-05, No: 74)
Aim: In patients with lumbar disc hernia, the demographic and inflammatory factors that are mutually associated with each other and radicular pain are not entirely clear. This study aimed to determine these correlations.
Material and Methods: This retrospective investigation evaluated 124 lumbar disc hernia patients selected according to detailed inclusion and exclusion criteria to minimize bias factors. The study determined the patient’s demographic and clinical features, comorbid diseases, pain intensity, disc hernia side and levels, extent of paresis, and inflammatory indices (neutrophil-to-lymphocyte and platelet-to-lymphocyte ratio). Pain intensity was assessed with Visual Analogue Scale (VAS) scores. Inflammation indices are calculated from blood counts. NCSS (Number Cruncher Statistical System, 2020, USA) software was utilized for statistical analysis.
Results: Patient’s age, extent of paresis, and disc hernia side correlated with pain intensities. Patients with disc hernias at the L1-L2 and L5-S1 levels had shorter preoperative pain duration than the cohort’s median pain duration, while the reverse was true for L2-L3 and L4-L5 level disc hernias. Twelve patients (9.7%) had comorbid diabetes, demonstrating a lower reduction of immediate postoperative pain. There was a slight negative correlation between the neutrophil-to-lymphocyte ratio and the preoperative pain duration.
Discussion: This current study provides additional insights regarding demographics, anatomy, and inflammatory components of disc hernia.
Keywords: Lumbar Disc Hernia, Microdiscectomy, Demographics, Inflammation
Comparison of suicide attempt cases admitted to emergency services during COVID-19 and before
Mehmet Göktuğ Efgan, Osman Sezer Çınaroğlu, Umut Payza, Efe Kanter, Serkan Bilgin
Department of Emergency Medicine, Izmir Katip Celebi University, Ataturk Training and Research Hospital, Izmir, Turkey
DOI: 10.4328/ACAM.21867 Received: 2023-08-13 Accepted: 2023-09-16 Published Online: 2023-09-21 Printed: 2023-09-25 Ann Clin Anal Med 2023;14(Suppl 2):S165-170
Corresponding Author: Mehmet Göktuğ Efgan, Department of Emergency Medicine, Izmir Katip Celebi University, Ataturk Training and Research Hospital, Izmir, Turkey. E-mail: email@example.com P: +90 232 243 43 43 F: +90 232 243 15 30 Corresponding Author ORCID ID: https://orcid.org/0000-0002-0794-1239
This study was approved by the Non-Invasive Clinical Research Ethics Committee of Izmir Katip Çelebi University (Date: 2022-06-16, No: 0309)
Aim: COVID-19 infection did not remain isolated in China, where it originated, but spread all over the world and caused a pandemic. It is known that people’s mental health may deteriorate in situations such as pandemics that create a global impact. Deterioration in people’s mental health can affect the number and general characteristics of suicide attempt cases admitted to the emergency department. The aim of this study was to compare the number of suicide attempts in the emergency department in two periods before and during COVID-19.
Material and Methods: The study was planned as a retrospective, observational study. Suicide attempt cases admitted to our emergency department 2 years before and 2 years during COVID-19 infection were analyzed. Patients were divided into two groups.
Results: A total of 900 patients were included in the study. The mean age was 41.44±14.97 years. The number of admissions before COVID-19 infection was higher. Statistically significant differences were found between both groups in marital status, previous diagnosis of psychiatric illness, educational status and age.
Discussion: The number of patients admitted to our emergency department with suicide attempts decreased in the 2-year period following the pandemic. Statistically significant changes were found in patient characteristics. Especially patients who were single, unemployed and had a history of depressive mood disorder presented to the emergency department with suicide attempts more frequently during COVID-19. We argue that preventive and preventive health services should be expanded in epidemic situations such as pandemics.
Keywords: COVID-19, Suicide, Emergency Department
Relationship between perceived stress level with menstruation symptoms and quality of life in women
Aybüke Ersin, Sena Öndeş
Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Istanbul Atlas University, Istanbul, Turkey
DOI: 10.4328/ACAM.21870 Received: 2023-08-14 Accepted: 2023-09-16 Published Online: 2023-09-21 Printed: 2023-09-25 Ann Clin Anal Med 2023;14(Suppl 2):S171-175
Corresponding Author: Sena Öndeş, Department of Physiotherapy and Rehabilitation, Faculty of Medicine, Atlas University, 34408, Istanbul, Turkey. E-mail: firstname.lastname@example.org P: +90 538 709 45 35 Corresponding Author ORCID ID: https://orcid.org/0000-0002-9715-3083
This study was approved by the Non-Interventional Scientific Research Ethics Committee Istanbul Atlas University (Date: 2022-03-30, No: E-22686390-050.01.04-13570)
Aim: The aim of the study is to investigate the relationship between perceived stress level, menstrual symptoms and quality of life in women aged between 18-50 years.
Material and Methods: This study was carried out with the participation of 172 volunteers. The Perceived Stress Scale was used to evaluate the stress levels of the participants, the Menstruation Symptom Scale was used to evaluate the menstrual symptoms, and the Short Form-36 was used to evaluate the quality of life. Simple Linear Regression Analysis was used to examine the effects of demographic characteristics of the participants on menstrual symptoms, and Pearson’s or Spearman’s Correlation Analyzes were performed in accordance with the distribution of the data to determine the relationship between perceived stress level, menstrual symptoms, and quality of life.
Results: The results of our study show that smoking increases menstrual symptoms (p=0.022). Perceived stress level was found to be correlated with all sub-parameters of the Menstruation Symptom Scale at a low level (p<0.05). It was found that there was a moderate and negative correlation with all Short Form-36 sub-parameters, except for the Short Form-36 physical function sub-parameter (p<0.05).
Discussion: Our study showed that menstrual symptoms tend to increase as the perceived stress level in women increases. In addition, it has been revealed that the increase in stress level and menstrual symptoms negatively affects the quality of life of women. According to the results of our study, it is recommended that future studies examine the effects of stress reduction practices on women’s menstrual symptoms and quality of life.
Keywords: Perceived Stress Level, Menstruation Symptoms, Quality of Life
The role of PAPP-A and free B-HCG, which are among the first trimester tests, in predicting pregnancy complications
Fatih Şahin 1, Fatma Yazıcı Yılmaz 2
1 Department of Obstetrics and Gynecology, Prof. Dr. Cemil Tascıoglu City Hospital, Istanbul, 2 Department of Obstetrics and Gynecology, Private Clinic, Ankara, Turkey
DOI: 10.4328/ACAM.21877 Received: 2023-08-16 Accepted: 2023-09-18 Published Online: 2023-09-23 Printed: 2023-09-25 Ann Clin Anal Med 2023;14(Suppl 2):S176-179
Corresponding Author: Fatih Şahin, Department of Obstetrics and Gynecology, Prof. Dr. Cemil Tascıoglu City Hospital, Istanbul, Turkey. E-mail: email@example.com P: +90 544 743 01 67 F: +90 212 230 35 35 Corresponding Author ORCID ID: https://orcid.org/0000-0002-1621-5896
This study was approved by the Ethics Committee of Sişli Etfal Training and Research Hospital (Date: 2014-09-02, No: 356)
Aim: In our study, we aimed to evaluate the predictive value of first-trimester maternal serum PAPP-A (Pregnancy Associated Plasma Protein-A) and B-HCG (human chorionic gonadotropin) levels in predicting pregnancy complications.
Material and Methods: The study included 489 singleton pregnancies undergoing first-trimester screening at the antenatal clinic, with perinatal records examined both before and after birth. Cases with PAPP-A <0.4 MoM and B-HCG <0.5 MoM values were investigated for associations with miscarriage, ectopic pregnancy, fetal death, preeclampsia, gestational diabetes mellitus (GDM), intrauterine growth restriction (IUGR), small for gestational age (SGA), large for gestational age (LGA), preterm labor, premature rupture of membrane (PROM), preterm premature membrane rupture (PPROM), cholestasis, and newborn requirements.
Results: In our study, patients with low PAPP-A values had a 2.6 times higher prevalence of preeclampsia, while in the B-HCG group, the prevalence was 2 times higher. Additionally, there was no significant association between the high-risk group and GDM, SGA, IUGR, and PROM.
Discussion: It has been observed that PAPP-A and HCG levels examined in the first trimester are associated with adverse pregnancy outcomes in the later weeks of pregnancy.
Keywords: PAPP-A, B-HCG, Obstetric Ultrasound
Genetic spectrum of familial hypertriglyceridemia from the southeastern region of Turkey
Ayse Ergul Bozaci 1, Aysel Tekmenuray Ünal 2, Fatma Demirbaş 3, İbrahim Taş 1, Mehmet Nuri Ozbek 4
1 Department of Pediatric Metabolism, Diyarbakır Children’s Hospital, 2 Department of Medical Genetics, Gaziyasargil Research and Training Hospital, 3 Department of Pediatric Gastroenterology and Hepatology, Diyarbakır Children’s Hospital, 4 Department of Pediatric Endocrinology, Gaziyasargil Research and Training Hospital, Diyarbakir, Turkey
DOI: 10.4328/ACAM.21880 Received: 2023-08-17 Accepted: 2023-09-21 Published Online: 2023-09-23 Printed: 2023-09-25 Ann Clin Anal Med 2023;14(Suppl 2):S180-185
Corresponding Author: Ayse Ergul Bozaci, Department of Pediatric Metabolism, Diyarbakır Children’s Hospital, Diyarbakir, Turkey. E-mail: firstname.lastname@example.org P: +90 236 229 26 00 Corresponding Author ORCID ID: https://orcid.org/0000-0002-9783-1016
This study was approved by the Ethics Committee of Diyarbakır Gazi Yaşargil Research and Training Hospital (Date: 2021-12-31, No: 966)
Aim: The disorders of lipid metabolism that cause primary hypertriglyceridemia result from genetic defects in triglyceride synthesis and metabolism. Although primary causes are rare in hypertriglyceridemia, they should be considered in severe hypertriglyceridemia cases. Identified genetic mutations are LPL, APOC2, APOA5, LMF1 and GPIHBP1 mutations.
Material and Methods: This descriptive cross-sectional study was conducted in Diyarbakir Children’s Hospital pediatric metabolism clinic on 60 patients from 41 unrelated families who were followed and diagnosed with severe hypertriglyceridemia based on clinical presentation, neurological parameters, biochemical measurements, and molecular analysis. The LPL, APOC2, APOA5, LMF1, GPIHBP1 genes were sequenced in 60 patients. Patients with initial triglyceride levels >885mg/dL were included in the study. Patients with a secondary cause were excluded from the study.
Results: Rare DNA sequence variants were identified in 49 patients (81.66%), including variants LPL (n=15), APOC2 (n=32), and APOA5 (n=2). No mutations were found in 11 patients (21%). The mean initial triglyceride level was 4322.8±4483mg/dL. Acute pancreatitis occurred in 38.33% (n=23) of the patients. The incidence of eruptive xanthoma was 28.33%, organomegaly was 23.33%, and failure to thrive was 21.66%. 69.23% of the patients with failure to thrive were patients with pancreatitis. Two different variants, c.55+6T>G and c.55+1G>C were detected in the APOC2 gene, seven different variants one of which is novel, c.557G>A, c.953A>G, c.296T>C, c.662T>C, c.1262G>A, c.644G>A and c.679G>C, were detected in the LPL gene, and two different variants one of which is novel, c.334_399dup65bp and c.16_39del24bp were detected in the APOA5 gene. Six patients were homozygous for both c.557G>A and c.953A>G variants.
Discussion: The frequency of mutations in APOC2 was 50%, LPL was 25% and APOA5 was %3.33. The relatively high prevalence of APOC2 mutations in our cohort may be due to regional frequency. The development of new therapeutic options for this rare disease requires awareness and screening among these patients. These findings highlight the need for molecular analysis in patients with severe HTG. It is anticipated to guide future individualized therapeutic strategies.
Keywords: Hypertriglyceridemia, Lipoprotein Lipase, APOC2, Acute Pancreatitis
Key variables in managing femoral pathological fractures and search for objective parameters for decision-making
Hüseyin Kaya, Arman Vahabi, Dündar Sabah
Department of Orthopedics and Traumatology, Faculty of Medicine, Ege University, Izmir, Turkey
DOI: 10.4328/ACAM.21884 Received: 2023-08-18 Accepted: 2023-09-20 Published Online: 2023-09-23 Printed: 2023-09-25 Ann Clin Anal Med 2023;14(Suppl 2):S186-191
Corresponding Author: Arman Vahabi, Department of Orthopedics and Traumatology, Faculty of Medicine, Ege University, Izmir, Turkey. E-mail: email@example.com P: +90 530 876 03 31 Corresponding Author ORCID ID: https://orcid.org/0000-0002-8937-6658
This study was approved by the Ethics Committee of Ege University Faculty of Medicine (Date: 2021-10-15, No: 21-10T/4)
Aim: Bone invasion in advanced cancers represents later stages and requires individualized treatment strategies based on patient related variables. The objective of this study is to ascertain the significance of age, location, serum levels of Ca, urea, albumin, and accordingly calculated MEP (Metastatic Early Prognostic) score, in planning the treatment of femoral impending and pathological fractures. The secondary aim was to compare complication rates between osteosynthesis and prosthetic replacement and to place this analysis on the time axis.
Material and Methods: This retrospective cohort was conducted at a tertiary care hospital with a dedicated orthopedic oncology team. The database search was performed for surgically treated femoral pathological/impending fractures between 2010 and 2020. Demographic data, mortality, fracture location, levels of Ca, urea, albumin, and follow-up X-rays were collected. Surgical procedures were categorized as prosthetic replacement or osteosynthesis for comparative analysis. Complications and the necessity of secondary interventions were noted accordingly.
Results: A total of 109 patients met the inclusion criteria. The average follow-up period was 9.1 months, with a mean survival time of 12.96 months. High serum urea levels, low albumin levels, high calcium levels were associated with increased one-year mortality. Osteosynthesis procedures had a higher need for secondary surgeries compared to prosthetic reconstruction. A threshold of one year has shown to be the critical limit before mechanical complications related to osteosynthesis occur.
Discussion: Secondary surgery rates were higher in the fixation group with survival exceeding one year, suggesting a greater consideration for prosthetic replacement in that group. Markers such as urea, albumin, and calcium levels can provide insights into mortality rates when evaluating surgical treatment options.
Keywords: Metastatic Bone Disease, Bone Metastasis, Orthopaedic Oncology, MEP Score, Mortality, Life Expectancy
The impact of parity on sexual function in Somali women: A prospective study
Adil Barut, Deka Omer Mohamud
Department of Obstetrics and Gynaecology, Somali-Mogadishu Recep Tayyip Erdoğan Research and Training Hospital, Mogadishu, Somalia
DOI: 10.4328/ACAM.21886 Received: 2023-08-21 Accepted: 2023-09-21 Published Online: 2023-09-23 Printed: 2023-09-25 Ann Clin Anal Med 2023;14(Suppl 2):S192-196
Corresponding Author: Adil Barut, Department of Obstetrics and Gynaecology, Somali-Mogadishu Recep Tayyip Erdoğan Research and Training Hospital, Mogadishu, Somalia. E-mail: firstname.lastname@example.org P: +252 610267232 Corresponding Author ORCID ID: https://orcid.org/0000-0002-1121-4923
This study was approved by the Ethics Committee of Mogadishu Somali Turkey Training and Research Hospital (Date: 2022-05-09, No: MSTH/10163/09.05.2022/558)
Aim: Childbirth is considered a celebrated and respected event in almost all societies, particularly in developing and underdeveloped countries. This study aimed to document the sexual problems of Somali women in multiparous or grand multiparous women.
Material and Methods: This prospective study included 363 consecutive women who had presented to the Department of Gynaecology. Data included age, number of parities, delivery method, education, and residence area. The participants were asked to complete the Female Sexual Function Index (FSFI).
Results: Of the 363 participating women, 12.1%, 16.8%, 34.7% and 36.4% were classified as nulliparous, primiparous, multiparous (2-4 deliveries) and grand multiparous women, respectively. The overall mean age was 30.1±7.8 years. The overall incidence of sexual dysfunction was 57.3%, 38.6%, 54.1%, 61.2%, and 65.9% among nulliparous, primiparous, multiparous (2-4 deliveries), and grand multiparous women, respectively.
Total FSFI and orgasm scores were significantly higher among nulliparous, primiparous, and multiparous (2-4 deliveries) women than among grand multiparous women (p<0.05). In addition, grand multiparous women had a significantly higher incidence of sexual dysfunction as compared with nulliparous women (65.9% vs 38.6%, p=0.014). Grand multiparous status showed a significant inverse association with the orgasm score. Multiparous (2-4 deliveries) and grand multiparous status had significant associations with sexual dysfunction (OR:2.05, p=0.045; OR:3.07, p=0.002, respectively).
Discussion: Our findings showed an incremental rise in the incidence of sexual dysfunction through the forms of parity from nulliparity to grand multiparity, with the latter showing a significant difference from the former.
Keywords: Multiparous Women, Grand Multiparous Women, Sexual Dysfunction, Somalia
Incidental bilateral synchronous invasive breast cancer in a patient with low back pain
Berrin Papila Kundaktepe 1, Vedat Durgun 1, Ergin Erginoz 1, Meltem Pekpak 2, Sennur Ilvan 3
1 Department of General Surgery, 2 Department of Internal Medicine, 3 Department of Pathology, Cerrahpasa School of Medicine, Istanbul University, Istanbul, Turkey
DOI: 10.4328/ACAM.20890 Received: 2021-10-09 Accepted: 2021-11-27 Published Online: 2023-09-23 Printed: 2023-09-25 Ann Clin Anal Med 2023;14(Suppl 2):S197-199
Corresponding Author: Berrin Papila Kundaktepe, Department of General Surgery, Cerrahpaşa Tıp Fakültesi Yerleşkesi, İstanbul Üniversitesi, Kocamustafapaşa Caddesi, No:53, 34098, Fatih, İstanbul, Turkey. E-mail: email@example.com P: +90 532 493 34 74 Corresponding Author ORCID ID: https://orcid.org/0000-0003-4394-3976
Bilateral synchronous invasive breast cancer is rare with an incidence of less than 3%. In the majority of the patients, the contralateral breast tumor is often diagnosed when noticing the lesion in the other breast during the physical examination due to a mass. Infrequently, the patient may be totally asymptomatic, as seen in this presented case. In this report, we present a rare case presenting with low back pain, which was then incidentally diagnosed as bilateral breast carcinoma.
Keywords: Invasive Ductal Carcinoma, Bilateral Breast Cancer, Synchronous Tumor
Gaucher disease and SARS-CoV-2 infection: A case report
Nafiye Urgancı 1, Nazan Dalgıc 2, Dilek Guller 1, Merve Usta 1
1 Department of Pediatric Gastroenterology, 2 Department of Pediatrics Infectious Diseases, Health Sciences University, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
DOI: 10.4328/ACAM.21229 Received: 2022-05-15 Accepted: 2023-04-29 Published Online: 2023-08-08 Printed: 2023-09-25 Ann Clin Anal Med 2023;14(Suppl 2):S200-202
Corresponding Author: Nafiye Urganci, Department of Pediatric Gastroenterology, Health Sciences University, Sisli Hamidiye Etfal Training and Research Hospital, Sariyer, Istanbul, Turkey. E-mail: firstname.lastname@example.org P: +90 212 338 63 00 F: +90 212 338 63 00 Corresponding Author ORCID ID: https://orcid.org/0000-0003-4854-507X
Gaucher disease is an autosomal recessive genetic disorder, caused by deficiency of the lysosomal enzyme, glucocerebrosidase, which leads to an accumulation of glucosylceramide in macrophages. It causes splenomegaly, hepatomegaly, cytopenia, and bone lesions associated with infiltration of bone marrow, spleen, and liver by Gaucher cells. A new coronavirus named severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) causing severe acute respiratory disease, emerged in China in December 2019. Most of the infected children appear to be asymptomatic or have a milder clinical course in contrast with adults. Herein, we report a pediatric case of Gaucher disease with SARS-CoV-2 infection.
Keywords: Gaucher, SARS-CoV-2, Enzyme Therapy
Reconstruction with hamstring autograft of atraumatic simultaneous ruptures of the bilateral quadriceps tendons: A novel technique
Burak Kuscu 1, Fatih Dogar 2, Duran Topak 2, Yakup Ekinci 3, Kaan Gürbüz 3
1 Department of Orthopaedics and Traumatology, Kahramanmaras Pazarcık State Hospital, Kahramanmaras, 2 Department of Orthopedics and Traumatology, Faculty of Medicine, Kahramanmaras Sutcu Imam University, Kahramanmaras, 3 Department of Orthopaedics and Traumatology, Kayseri City Education and Research Hospital, Kayseri, Turkey
DOI: 10.4328/ACAM.21569 Received: 2023-01-01 Accepted: 2023-04-29 Published Online: 2023-05-04 Printed: 2023-09-25 Ann Clin Anal Med 2023;14(Suppl 2):S203-206
Corresponding Author: Burak Kuscu, Department of Orthopaedics and Traumatology, Kahramanmaras Pazarcık State Hospital, 46700, Pazarcık, Kahramanmaras, Turkey. E-mail: email@example.com P: +90 507 192 73 13 Corresponding Author ORCID ID: https://orcid.org/0000-0002-1082-2206
Bilateral spontaneous quadriceps tendon rupture is a very uncommon phenomenon recorded in a few cases, but unilateral traumatic quadriceps tendon rupture is a rather common orthopedic pathology. In addition, it is related to systemic (e.g., diabetes mellitus, hyperparathyroidism, gout, pseudogout, obesity, steroid usage) and autoimmune diseases as well as most chronic renal failure (CRF). The occurrence of bilateral atraumatic simultaneous quadriceps tendon ruptures in CRF is most likely associated with the duration of renal disease and the duration of dialysis. Here we present an atraumatic spontaneous rupture of both quadriceps tendons with tendon hamstring autograft in a previously diagnosed male patient with CRF repaired using a novel reconstruction technique. This technique, which we use in quadriceps tendon repair, is an easy and effective method that shows excellent results in early rehabilitation and knee joint movements and prevent early re-rupture.
Keywords: Quadriceps Tendon, Rupture, Reconstruction, Chronic Renal Failure, Novel Technique
Aortic valve replacement due to infective endocarditis in a 24-week pregnant patient
Ali Akdogan 1, Ahmet Coskun Ozdemır 2, Engin Erturk 1
1 Department of Anaesthesiology and Intensive Care, 2 Department of Cardiovascular Surgery, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey
DOI: 10.4328/ACAM.21696 Received: 2023-03-18 Accepted: 2023-05-05 Published Online: 2023-05-14 Printed: 2023-09-25 Ann Clin Anal Med 2023;14(Suppl 2):S207-209
Corresponding Author: Ali Akdogan, Department of Anaesthesiology and Intensive Care, Faculty of Medicine, Karadeniz Technical University, 61080, Trabzon, Turkey. E-mail: firstname.lastname@example.org P: +90 462 377 57 41 F: +90 462 325 53 98 Corresponding Author ORCID ID: https://orcid.org/0000-0001-7592-3844
Infective endocarditis in pregnant women is mostly associated with a history of rheumatic or congenital heart disease and is very rare. Surgical mortality is high both for the mother and the fetus. In most cases, infective endocarditis in pregnancy has a subacute course and includes the mitral valve, but it may also rarely involve the aortic valve, as in our case. Hypothermia and rewarming during the cardiopulmonary bypass period may trigger fetal hypoxia and uterine contraction in these patients, which may adversely affect both the mother and the fetus. We present a 28-year-old female patient with extensive vegetations on the aortic valve due to infective endocarditis, who applied to the emergency department with complaints of dyspnea and consciousness at the 22nd week of her pregnancy.
Keywords: Cardiopulmonary Bypass, Infective Endocarditis, Aortic Valve Replacement, Pregnancy, Pulsatile Flow
Genetic and immunological biomarkers in the diagnosis of pulmonary tuberculosis: A literature review for miRNA and cytokine characterization
Umit Karadeli 1, Meliha Merve Cicekliyurt 1,2
1 Department of Medical System Biology, School of Graduate Studies, 2 Department of Medical Biology, Faculty of Medicine, Canakkale Onsekiz Mart University, Canakkale, Turkey
DOI: 10.4328/ACAM.21502 Received: 2022-11-20 Accepted: 2022-12-31 Published Online: 2023-05-05 Printed: 2023-09-25 Ann Clin Anal Med 2023;14(Suppl 2):S210-214
Corresponding Author: Meliha Merve Cicekliyurt, Department of Medical Biology, Faculty of Medicine, Canakkale Onsekiz Mart University, 17100, Canakkale, Turkey. E-mail: email@example.com P:+90 286 218 0018 F: +90 286 218 37 38 Corresponding Author ORCID ID: https://orcid.org/0000-0003-4303-9717
There is a sensitive interaction in the relationship between the Mycobacterium tuberculosis that causes tuberculosis disease (TB) and its host. This interaction significantly affects the course of the infection. Unfortunately, scientific studies continue without slowing down this disease, which remains popular among the infectious diseases with the highest mortality rate. Although the importance of genetics and the immune system in the host-bacteria relationship is emphasized, immunopathological events still need to be fully elucidated.
The molecular events between Mycobacterium tuberculosis and the host dictate the course of infection. Different expression levels of miRNAs in this infection continue until the polarization of macrophages. In addition, studies have shown that miRNAs also affect cytokine release in this cellular immune process.
This review aimed to reveal how M. tuberculosis affects the course of host miRNAs during active infection and how cytokine levels change due to this interaction by reviewing the recent literature. This study will discuss the implications of using miRNA profiles and cytokine levels as biomarkers for the onset, maintenance, and termination of active TB.
Keywords: Cytokine, Immunity, miRNA, Pro-Inflammation,Tuberculosis