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1. | Front matter Pages I - VII |
RESEARCH ARTICLE | |
2. | Postural Orthostatic Tachycardia Syndrome in Pediatric Patients with Celiac Disease and Relationship with Tissue Transglutaminase Antibody Levels and HLA Tissue Group Elif Erolu, Esra Polat doi: 10.14744/hnhj.2020.04557 Pages 211 - 214 INTRODUCTION: Celiac disease is an autoimmune disease triggered by gluten in cereals. Many other system involvements may occur in Celiac disease. One of them is the autonomic nervous system. The role of autoimmunity in the etiology of postural orthostatic tachycardia syndrome (POTS) is also discussed recently. In this study, we aimed to investigate the presence of POTS and its relationship with serum antibody levels and HLA tissue group in patients with newly diagnosed Celiac disease and gluten-free diet not yet started. METHODS: Active standing test was applied to patients with the Celiac disease with orthostatic symptoms. POTS diagnosis was made for those who had orthostatic complaints for six months and who were found to be positive for the active standing test and who have not systemic disease and anemia. RESULTS: POTS positivity was found in 16 patients (34%) out of 47 patients who met the inclusion criteria. In POTS positive patients, female gender (62.5%) was higher than male gender (37.5) (p=0.023). POTS was positive in 13 (41%) of 31 patients with anti-Tg IgA levels above 200 U/ml and POTS positive in three (18%) of 16 patients with anti-Tg IgA levels below 200 U/ml (p=0.04). Twenty-one patients had HLADQ2, four patients had HLADQ8, 15 patients had HLADQ2 and HLADQ8 positivity. Out of the15 patients who were found to be HLADQ2 and HLADQ8 positive, nine patients (65%) were POTS positive, out of the 21 patients who were found to be HLADQ2 positive, seven patients had POTS positivity (33%) (p=0.04). DISCUSSION AND CONCLUSION: In our study, we showed that POTS frequency increased with an increase in the Anti-Tg IgA level and HLADQ2 and DQ8 association. This supports that POTS is an autoimmune disease. The presence of POTS should be kept in mind in the presence of orthostatic symptoms in pediatric celiac disease. |
3. | The Effects of Epiretinal Membrane on the Treatment of Diabetic Macular Edema with Intravitreal Ranibizumab Yalçın Karaküçük, Süleyman Okudan doi: 10.14744/hnhj.2019.09226 Pages 215 - 220 INTRODUCTION: This study aimed to compare the response to ranibizumab therapy in naive diabetic macular edema (DME) patients with and without an epiretinal membrane (ERM). METHODS: A retrospective chart review was performed on 71 eyes in 71 DME patients. The patients were divided into a DME without ERM [ERM (-)] group (n=34) and DME with ERM [ERM (+)] group (n=37). Best-corrected visual acuity (BCVA), central macular thickness (CMT) and subfoveal choroidal thickness (SFCT) were evaluated. RESULTS: There were no significant differences in age or gender distribution between the patients in the ERM (-) and ERM (+) groups (p=0.052, p=0.96, respectively). In both groups, CMT showed a significant decrease during the first, second and third months (p<0.01 for each in both groups). Therefore, BCVA increased in both groups and made significant gains from the second month (p=0.044 in the ERM (-) group and p=0.006 in the ERM (+) group). CMT and BCVA values did not differ significantly between the ERM (-) and ERM (+) groups in the baseline, first month, second month or third month. In the ERM (-) group, SFCT values decreased significantly as compared to baseline in the first month, second month and third month (p=0.001, p<0.001, p<0.001, respectively). In the ERM (+) group, the first month SFCT value did not change significantly (p=0.389), but it decreased significantly in the second month and third month as compared to baseline (p<0.001, p<0.001, respectively). DISCUSSION AND CONCLUSION: Based on studying patients for three months, we determined that a series of three monthly injections of ranibizumab ensured a statistically significant improvement in visual acuity and a decrease in CMT and SFCT in diabetic patients with or without ERM. |
4. | Evaluation of Correlation between Clinical and Magnetic Resonance Findings of Patellar Chondromalacia Deniz Özel, Mustafa Çağlar Kır, Mehmet Öncü doi: 10.14744/hnhj.2020.82504 Pages 221 - 225 INTRODUCTION: To evaluate the correlation between clinical appearance and magnetic resonance imaging features of chondromalacia that can determine the knee magnetic resonance indication and to define a novel chondral status indicator. METHODS: This study was performed between May 2017 and February 2019. If the knee pain was suggestive for the presence of chondromalacia clinically, then VAS and Kujala AKPS were noted. For MRI evaluation, a patellar cartilage score (PCS) was defined to evaluate the mean patellar thickness (MPT) and MRI grading together. RESULTS: Advanced chondromalacia was more common among females (p<0.01). There was a positive correlation between age and MRI grading and the correlation coefficient was calculated to be 0.56. The highest correlation coefficient obtained with PCS in comparing PCS, MCT (mean cartilage thickness) and MRI grading for the clinical relationship. To define advanced chondromalacia with VAS and AKPS cut-off values calculated to be 3 and 80 in ROC analysis. AKPS was a superior clinical indicator for advanced chondromalacia compared with VAS. The other demographic findings, such as age and gender relations, were concordant with the literature. DISCUSSION AND CONCLUSION: A potentially better method was defined to combine VAS with functional measurements, such as AKPS, to determine a knee status may be indicative of MRI evaluation. As a novel perspective, PCS was the best indicator of the chondral clinical status that consists of both the mean patellar thickness and magnetic resonance grading. |
5. | Our 10 years’ Experience in Testicular Tumors Senad Kalkan, Selahattin Çalışkan doi: 10.14744/hnhj.2020.68095 Pages 226 - 228 INTRODUCTION: Testicular cancer is usually seen among young men and has lower incidence when compared with other urologic malignancies. This study aims to share the results of testicular cancer during the last ten years. METHODS: In this study, the patients who underwent orchiectomy in our unit between January 2009 and January 2019 were reviewed retrospectively. Age of the patients, the laboratory results and pathological reports were recorded. The patients who were diagnosed as benign tumor and inflammation were excluded from this study. RESULTS: There were 131 patients in the present study. The patients’ age was between 21 and 90, with a mean age of 37.16+12.18 years. The germ cell tumor was reported in 125 patients. The remaining of the six patients had a sex-cord stromal tumor (n=3), liposarcoma (n=2) and lymphoma (n=1). Of these 125 patients, seminomas were seen in 39.2% and nonseminomatous germ cell tumor in 60.8% of the patients. Mixed germ cell tumor was reported in 65 (85.52%) patients; embryonal carcinoma was detected in seven (9.21%) patients. Four (5.26%) patients were diagnosed as a teratoma. DISCUSSION AND CONCLUSION: Most of the patients had germ cell tumors. Mixed germ cell tumor was the commonest tumor and followed by seminoma. |
6. | Long Term Visual Outcomes of Uveitis Associated with Behcet’s Disease Selim Bölükbaşı, Yılmaz Özyazgan doi: 10.14744/hnhj.2020.94557 Pages 229 - 233 INTRODUCTION: To compare the visual prognosis of patients with Behcet’s uveitis who presented after 1977-1987 and 2000-2010. METHODS: In this observational, retrospective study, 382 eyes of the 200 patients (48 female and 152 male) were included. Patients who visited the clinic between 1977 and 1987 were classified into Group 1, and patients who visited between 2000 and 2010 into Group 2. Group 1 consisted of 194 eyes (100 patients), and Group 2 consisted of 188 eyes (100 patients). Best corrected visual acuity (BCVA) measurements, biomicroscopic and fundoscopic examinations, gender, age of onset of uveitis, numbers of ocular attacks per year from the onset of ocular disease, immunosuppressive drugs and ocular complications were noted by medical records. Grade of uveitis was noted at the first and last visit. RESULTS: In this study, 76% of the patients were male and 24% of the patients were female. Bilateral ocular involvement was in 91%. The mean age of onset of uveitis was 29 years. Mean ocular attack number was 4.21 in Group 1 and 3.25 in Group 2. Kaplan Meier survival analysis estimated the risk of losing useful vision (BCVA>0.1) at the last visit for Group 1 and Group 2 as 64.50% and 48.81% (Log Rank: 11.44, p<0.001). Mean last visit grade was 3.24 in Group 1 and 2.47 in Group 2 (p<0.001). Mean last BCVA was 0.41 in Group 1 and 0.65 in Group 2 (p<0.001). DISCUSSION AND CONCLUSION: There was a trend for a better visual prognosis in patients who presented after 2000 due to following-up ocular attacks closer and using azathioprine, cyclosporin A and new treatment agents for severe posterior uveitis. |
7. | Does the Surgical Technique Affect the Results of Partial Nephrectomy Performed for Renal Cell Carcinoma? Single-center 'MIC' Score and 'Trifecta' Results Abdurrahman İnkaya, Ahmet Tahra, Resul Sobay, Eyüp Veli Küçük, Uğur Boylu doi: 10.14744/hnhj.2018.32559 Pages 234 - 240 INTRODUCTION: To report the MIC scores and trifecta rates in patients who underwent partial nephrectomy with open (OPN), laparoscopic (LPN) and robot-assisted techniques (RPN) due to kidney tumor. METHODS: Demographic characteristics, tumor characteristics, peri-and post-operative data and complications of the patients who underwent OPN (n=58), LPN (n=32) and RPN (n=126) between 2007 and August 2018 due to kidney tumor and histopathological features were evaluated retrospectively in this study. To report oncological and functional outcomes of nephron-sparing surgery for renal tumors, MIC (surgical margin negativity, ischemia duration less than 20 minutes and lack of complication) and Trifecta (surgical margin negativity, perioperative complications and glomerular filtration rate (GFR) >90% protection rate) were used. RESULTS: RPN was superior to OPN technique in hospitalization and estimated bleeding. Transfusion rate and all complications were similar in all three techniques. Although OPN had shorter operation time and ischemia time, there was a higher amount of blood loss and hospital stay. No significant difference was found between all three techniques for surgical margin positivity and >90% preservation of GFR. The mean duration of warm ischemia was 23.6 minutes with the longest LPN, followed by a mean of 18.4 minutes with an RPN and a mean of 16.6 minutes with OPN (p=0.003). It was significantly longer. Our MIC score was 79% in OPN, 71% in LPN and 81.7% in RPN (p=0.04). Our Trifectaoranes were 87% in OPN, 87.5% in LPN and 93.6% in RPN (p=0.128). DISCUSSION AND CONCLUSION: Both the 'MIC score system 'and the 'Trifecta' system are easy to use and reproducible systems for reporting partial nephrectomy results for renal tumors. Robot-assisted partial nephrectomy is the most powerful alternative technique for open partial nephrectomy with low complication rates, shorter operation time, similar ischemia durations and oncologic outcomes. |
8. | Dermatological Findings in Female and Male Fibromyalgia Patients Müge Kepekçi, Berna Ürkmez, Emre Araz, Özgür Taşpınar, Murat Erdugan, Ilteriş Ahmet Şentürk doi: 10.14744/hnhj.2018.98705 Pages 241 - 245 INTRODUCTION: Fibromyalgia syndrome (FMS) is a chronic disease characterized by widespread musculoskeletal pain and hypersensitivity at some points of the body. Our study aims to investigate whether there is a difference between male and female FMS patients and male and female healthy volunteers concerning dermatological findings. METHODS: Sixty female and 60 male patients, who were diagnosed with FMS, were included in the study group; 60 female and 60 male healthy volunteers were included in the control group in this study. Fibromyalgia Impact Questionnaire and the Beck Depression Inventory were applied to all participants at the time of admission. All participants were examined by a dermatologist, and dermatological diagnoses were recorded. The results of the patients in both groups were compared and statistically analyzed. RESULTS: In the examination of dermatological diagnoses, it was found that the incidence of lichen simplex chronicus was significantly higher in female FMS patients than in healthy female participants (p=0.006). DISCUSSION AND CONCLUSION: Based on the results of this study, our findings suggest that dermatological examination in patients with FMS should be given more importance within a holistic examination approach. |
9. | The Effects of Anti-HBs Antibodies Passed through Transplacental Route on Immunization Induced by HBV Vaccine and Natural Course of Passively Transmitted HBs Antibodies Enver Atay, Aysu Say doi: 10.14744/hnhj.2020.69335 Pages 246 - 249 INTRODUCTION: Hepatitis B infection is an important infection that concerns public health. In this study, we aimed to evaluate whether anti-Hbs antibodies born from mothers who are immune to hepatitis B virus with natural or vaccination and passed from mother to baby transplacentally affect the natural course of these passive anti-HBs antibody titers. METHODS: In this study, 68 healthy term newborn babies were included. The immune status of the mothers of these newborn babies was evaluated. Babies were divided into three groups. Group 1, babies whose mothers were positive for AntiHBs antibody, anti-HBS titers were evaluated consecutively at 0, 1, 3, 6 and 8 months without HBV vaccine. In Group 2, babies whose mothers were positive for anti-HBs antibody were vaccinated with HBV vaccine at 0.1 and 6 months, and these babies were examined for anti-HBS titers at 0.1, 3, 6 and 8 months. In Group 3, babies whose mothers were negative of anti-HBs antibody were vaccinated with HBV vaccine at 0, 1 and 6 months, and babies were examined at 0.1, 3, 6 and 8 months. RESULTS: Group 1 consisted of 22 babies, Group 2 consisted of 24 babies and Group 3 consisted of 22 babies. Percentages of anti-HBs titers falling below <10 mIU/mL at 1, 3, 6 and 8 months were found to be 40.9%, 50%, 59.09%, and 100% of non-vaccinated babies whose mothers were positive for anti-HBs antibody. DISCUSSION AND CONCLUSION: We found that the antibody response to HBV vaccine administered to infants with passive antibodies was similar to the antibody response in mothers vaccinated with their mothers HBsAg (-), anti-HBs (-), anti-HBcIgM (-) and the same vaccine calendar. Thus, it was found that anti-HBs antibodies that started this transplacentalntal pathway did not affect the antibody response produced by the HBV vaccine administered at 0, 1 and 6 months. |
10. | The Role of TNF-alpha and IL-10 Cytokines in Degenerative Lumbar Spinal Stenosis Mustafa Efendioğlu, Emine Emel Koçman doi: 10.14744/hnhj.2020.81488 Pages 250 - 253 INTRODUCTION: In this study, we investigated Tumor Necrosis Factor-α (TNF-α)/Interleukin -10 (IL-10) (inflammatory/anti-inflammatory) cytokine balance in patients diagnosed with degenerative Lumbar Spinal Stenosis (LSS). METHODS: Blood samples obtained from patients and control subjects were centrifuged at the Haydarpaşa Numune Training and Research Hospital Immunology Laboratory and stored at -20°C. Human TNF-alpha and IL-10 cytokines were studied manually with an Enzyme-linked immunosorbent assay (ELISA) method using Boster brand 96-well ELISA kits. RESULTS: TNF -alpha values of the patient group were found to be statistically significantly higher than the control group (p=0.004; p<0.05) and IL-10 values of the patient group were statistically significantly higher than the control group (p=0.017; p<0.05). DISCUSSION AND CONCLUSION: Our findings suggest that TNF-alpha and IL-10 cytokine levels increased together in degenerative LSS cases. The inflammatory process of the disease is trying to be balanced with an anti-inflammatory response |
11. | The Fabry Family Determined as a Result of the Screening of the Transplanted Patients: A Single-Center Screening Özgür Can, Süleyman Baş, Melike Betül Öğütmen doi: 10.14744/hnhj.2018.81904 Pages 254 - 258 INTRODUCTION: Fabry disease (FD) is an X-linked lysosomal storage disorder that arises from a decreased activity of α-galactosidase A. With this study, we evaluated an FD family, which was detected after the screen of transplanted patients. METHODS: We were able to screen 200 transplanted patients at the University of Health Science, Haydarpasa Numune Training and Research Center. α-Gal A activity was used for screening of the male patients. Gene analysis was performed for all female transplanted patients. RESULTS: Among 200 patients, one 35 years old female patient had a genetic mutation, which was c.376A>G (p=S126G) heterozygous. She received a renal kidney from her sister in 2015. Genetic analysis of this female donor also revealed the same genetic variation. Starting with this index patient, we communicate with available 38 family members. Among these family members, the genetic analysis was performed to 22 family members. Twelve and 10 family members had negative and positive results, respectively. We could not communicate with 12 family members. Only one male family member had positive result and was the nephew of the index case. DISCUSSION AND CONCLUSION: Eleven family members had positive results for genetic analysis. An 87 years old aunt showed the asymptomatic nature of the disease. Again, the family had only one male member with the mutation. |
12. | The Neuroectodermal Subtypes of Chiari Malformation: Long-term Results Ramazan Sarı, Fatih Han Bolukbaşı, Recep Başaran, Mustafa Efendioğlu, Nejat Işık doi: 10.14744/hnhj.2020.05658 Pages 259 - 265 INTRODUCTION: Chiari malformations (CMs) are a heterogeneous group of disorders defined by anatomic anomalies of the cerebellum, brainstem, and craniovertebral junction (CVJ). This study aims to establish the de-mographic and clinical features, incidence, surgical procedures, and outcomes in large series of CMs, to investi-gate whether CM-0 is a subgroup of CM, Chiari 1 and 1.5 are different pathologies. METHODS: In this study, all of the patients were evaluated and operated on for CM between 1985 and 2016. The patients were grouped into various subtypes. Demographic data, additional diseases, clinical features, surgical procedures, complications and outcomes were recorded. RESULTS: In this study, 55 patients who underwent various surgical procedures were evaluated. Their mean age was 0.72±1.17. We detected 26 cases of CM-2 (47.3%), 16 cases of CM-3 (29.1%) and 13 cases of CM-4 (23.6%). When Chiari subtypes were compared, there were statistically significant differences in additional dis-eases, symptom duration, neuro examination, complication rate and hospital stay. DISCUSSION AND CONCLUSION: The findings obtained in this study suggest that the long hospital stay, the presence of SM and short symptom duration are associated with worse outcomes. The dura repair is the most important stage of surgery. Dural tear (CSF fistule) increases the complication rate and mean hospital stay and also causes the worse outcome. Therefore, the surgeon should spend more time on dura repair. |
13. | Combination or Alone? Which one is the Best in Premature Ejaculation Treatment? Aykut Buğra Şentürk, Ali Haydar Yılmaz, Basri Çakıroğlu, Muhammet Yaytokgil, Cemil Aydın, Musa Ekici, Serdar Aykan, Mustafa Sungur doi: 10.14744/hnhj.2018.87699 Pages 266 - 270 INTRODUCTION: To compare the effectiveness of tadalafil alone and in combination with dapoxetine in patients with premature ejaculation. METHODS: In this study, 120 patients treated at the urology clinic for premature ejaculation were evaluated prospectively. IELT and IIEF forms of patients were filled before this study, and their urological examinations were performed. Patients that were being treated were divided into two groups. Patients in group 1 received only 5 mg tadalafil, whereas patients in group 2 received a combination of dapoxetine 30 mg and tadalafil 5 mg. RESULTS: After the treatment, group 1 mean IEFF scores were 25.12±2.49, and mean IELT scores were 7.35±4.37 seconds. There was a statistically significant increase in both parameters (p<0.001). After the treatment, group 2 mean IEFF scores were 27.37±2.46, and mean IELT scores were 9.07±4.20 seconds. There was a statistically significant increase in both parameters (p<0.001). DISCUSSION AND CONCLUSION: Use of dapoxetine in combination with tadalafil instead of using tadalafil alone in the treatment of premature ejaculation will increase treatment success. |
14. | Transperitoneal Laparoscopic Repair of the Retrocaval Ureter: Our Single-Center Experience Serdar Aykan, Ahmet Ürkmez, Musab Ali Kutluhan, Mustafa Zafer Temiz, Atilla Semerciöz, Ahmet Yaser Müslümanoğlu doi: 10.14744/hnhj.2018.91259 Pages 271 - 278 INTRODUCTION: We aimed to describe our experience in transperitoneal laparoscopic repair of retrocaval ureter (RCU) in this study. METHODS: Between February 2010 and February 2017, five patients (1 female and 4 males) who underwent laparoscopic repair with the diagnosis of RCU in our department were included in this study. Patients’ mean age was 27 (range 20–32 years). All patients were pre-operatively evaluated using ultrasonography (US) followed by contrast-enhanced computed tomography (CT) intravenous pyelography (IVP). After CT diagnosis of RCU, all patients underwent diuretic renography examination with 99mTc-DTPA. Laparoscopic surgery was performed by the transperitoneal approach using the three-dimensional (3D) vision system in two and two-dimensional vision system (2D) in three patients. RESULTS: All operations were completed laparoscopically without conversion to open surgery. Mean operation time was 168.5±9.89 minutes. Operation time of two patients in whom 3D a vision system was used was shorter (155 and 165 minutes) comparing to others in whom 2D vision systems used. Blood loss was less than 50 mL in all patients. Obliterated ureteric segments were excised in four patients. Four patients were symptom-free after surgery and had regression of hydronephrosis in their kidneys. In one of the cases, there was no resolution of hydronephrosis postoperatively. DISCUSSION AND CONCLUSION: Careful dissection along the planes with good tissue respect and good hemostasis during each step are the key to success for laparoscopic repair of RCU. Pure laparoscopic treatment of RCU seems feasible and technically reliable. At the same, time using a 3D vision system, if available would be preferable because of the dissection and intracorporeal suturing advantages. |
15. | Prophylactic Effects of Verapamil in Testicular Ischemia-reperfusion Damage in Rats Zülfü Sertkaya, Metin Ishak Öztürk, Orhan Koca, Mehmet Akyüz, Gülistan Gümrükçü, Muhammet İhsan Karaman doi: 10.14744/hnhj.2018.72324 Pages 279 - 283 INTRODUCTION: Testicular torsion, migration of neutrophils to the ischemic region and the formation of free oxygen radicals are important factors in the occurrence of ischemia-reperfusion damage in testes. Verapamil HCl is a phenylalkylamine derivative of the L-type voltage-dependent calcium channel blocker. In our study, we evaluated the prophylactic effects of the Verapamil in testicular ischemia-reperfusion damage. METHODS: Twenty-one, eight weeks old adult, male Wistar-Albino rats were randomly divided into three groups as follows: Sham, I/R, I/R+Verapamil HCl. In Sham and I/R groups, saline was injected intraperitoneally at the second hour; in I/R+Verapamil HCl group, Verapamil was injected intraperitoneal at the second hour. Spermatogenic functions were evaluated according to Johnsen criteria, and then, average scores were calculated. P<0.05 was statistically significant. RESULTS: We compared all histopathological and molecular parameters derived from all groups. Average levels of inflammation mediators (TNF-α and IL-1β) were calculated. In the early period, compared with the Sham group, TNF-α levels increased statistically significant in theI/R group, which did not receive any medical treatment. Also, we saw that Verapamil HCl treatment avoided an increase in TNF-α level and provided the same levels as the Sham group. Glutathione peroxidase (GPx), which is antioxidant in tissue levels, significantly decreased in theI/R group, which did not receive Verapamil HCl as compared with the Sham group. Verapamil HCl avoided this situation. Although GPx expression scores were higher in the I/R group than the Sham group, Verapamil HCl treatment takes these scores to the same levels as in the Sham group. For spermatogenesis, there was no statistically significant difference between groups according to Johnsen scoring system. DISCUSSION AND CONCLUSION: I/R generated by T/D, in the early period, causes an increase of inflammation mediators in blood. It resulted in an increase in GPx activity, which decreased anti- oxidant capacity in tissue, and it has no effect to spermatogenesis parameters in four hours period. Verapamil HCl reduces damage in testicular I/R. |
16. | Evaluation of the patients with Congenital Rikets Enver Atay doi: 10.14744/hnhj.2020.79847 Pages 284 - 287 INTRODUCTION: The present study aims to evaluate the clinical findings and biochemical properties of the patients who were followed up in the neonatal intensive care unit due to congenital rickets. METHODS: The data of patients who were followed up in our neonatal intensive care unit between March 2015 and March 2020 due to congenital rickets were analyzed retrospectively from the patient’s files and registration forms. The findings of physical examination and biochemical tests of the patients were recorded at the time of admission. RESULTS: Six patients were included in this study. Four of the patients were girls. The mean age of application was 19±6 days. All patients were admitted with convulsion. The average calcium at the first application was 5.5±0.7 mg/dL; ionized calcium 0.7±0.02 mmol/L; phosphorus 6.9±1.2 mg/dL; alkaline phosphatase 747±148 U/L; parathyroid hormone 265±40 pg/mL and mean 25-OH vitamin D 3.4±0.4 ng/mL. All cases were hospitalized and treated and diagnosed with congenital rickets. DISCUSSION AND CONCLUSION: Despite vitamin D prophylaxis, rickets can still be seen in our country. With this study, we aimed to draw attention to the significance of vitamin D prophylaxis. |
17. | The Management of Gallbladder and Extrahepatic Biliary Duct Injuries Mikail Çakır, Okan Murat Aktürk doi: 10.14744/hnhj.2020.45220 Pages 288 - 291 INTRODUCTION: Injury of the biliary system is rare. They can be divided into traumatic biliary injuries and iatrogenic biliary injuries. In this study, extrahepatic bile duct and gall bladder injuries and treatment methods and complications were reviewed in the general surgery clinic. METHODS: The files of the patients who were operated in the general surgery service of our hospital for extra-hepatic bile ducts and gallbladder trauma were examined in a retrospective cohort study. In addition to iatrogenic and traumatic injuries of the gallbladder, traumatic and iatrogenic injuries due to ERCP, laparoscopic interventions, Bismuth Strasberg classifications, repairs and complications of these injuries were examined. RESULTS: A total of 13 non-hepatic biliary injuries were detected, four of which were in the gallbladder. 75% (3/4) of gallbladder injuries arose from abdominal trauma. The leading cause of common hepatic canal and choledochal injuries was iatrogenic. These injuries may occur during ERCP or cholecystectomy. In iatrogenic biliary tract injuries, 80% primary repair and drain placement were performed without a major complication. DISCUSSION AND CONCLUSION: The vast majority of gallbladder injuries are due to abdominal trauma. They are most commonly seen in piercing and firearm injuries. The most common cause of non-liver biliary tract injuries is iatrogenic injuries. Traumatic injuries of the common hepatic canal and the choledochus are rare and rarely represent in isolation. |
18. | Evaluation of Clinical and Demographical Characteristics of the Patients who Admitted to the Pediatric Emergency Department of a University Hospital Esra Türe, Erdal Erarslan, Abdullah Yazar, Fatih Akın, Dursun Odabaş doi: 10.14744/hnhj.2019.68552 Pages 292 - 299 INTRODUCTION: This study aims to evaluate the admissions to our pediatric emergency department, the diagnoses, the follow-ups and treatments, contributing to plannings to be organized for timely and appropriate interventions. METHODS: In this study, 46756 patients who admitted to the pediatric emergency department of our hospital as an outpatient or via ambulance were included to be evaluated retrospectively by age range, gender, time of admission, frequency of admissions by months, the complaint of emergency department admission, the diagnosis made and whether they were hospitalized in an inpatient ward. RESULTS: In this study, 54% of the patients were male and the rest of the patients were female. Evaluated by seasons, it was determined that the maximum number of admissions, in descending order, were in winter and spring months, and the minimum number of admissions, however, were in summer and autumn months. During the day, the busiest time of the pediatric emergency department was between 16: 00 - 00: 00. The most commonly made diagnosis in the pediatric emergency department in all months during the whole year was determined to be upper respiratory tract infection (34.9%, n: 16060), followed by lower respiratory tract infections with a rate of 19.5%. Among all patients, the number of cases for which a forensic report was issued, however, was determined to be 1.5%. The hospitalization rate of all patients was determined to be 10.7%. 3099 (61.8%) of a total of 5013 hospitalized patients were hospitalized in the pediatric emergency department observation unit, where their treatments were completed. DISCUSSION AND CONCLUSION: Pediatric emergency departments, which will serve under appropriate conditions and opportunities, by which unnecessary admissions and hospitalizations will be reduced, and in which shorter observations will be made, would be able to provide services of better quality, reduce the number of unnecessary tests and allow effective intervention. |
19. | Evaluation of Relationship between Alzheimer's Disease and Red Cell Distribution Volume (RDW) Mustafa Ülker, Buse Çağla Arı doi: 10.14744/hnhj.2018.09821 Pages 300 - 302 INTRODUCTION: Alzheimer's disease (AD) is a chronic degenerative disease of the central nervous system (CNS) that occurs with neuronal and synapse loss, progressive progression and may lead to impaired cognitive functioning, self-care deficits, and behavioral disorders. Red blood cell distribution width (RDW) is a numerical measure of the variation of the sizes of circulating erythrocytes in the circulation. It has been shown in some studies that increased RDW may affect the cerebrovascular pathology and may have a predisposing role in the development of AD. In this study, we aimed to compare the RDW values of patients with AD and healthy controls. Patients and healthy volunteers followed up in our outpatient clinics of our hospital between 2014-2018 were included in our hospital. METHODS: A total of 98 individuals, including 49 AD diagnosed as AD in Erenkoy Mental Neurologic Disease Hospital outpatient clinic and 49 healthy controls, applied between 2014-2018, were enrolled in this study. Patients who had coronary heart disease, congestive heart failure, diabetes, hypo or hyperthyroidism, malignancy, chronic renal failure, chronic liver disease and hematologic disease were excluded from this study. Venous blood samples were taken from the median cubital vein. RDW values were estimated by the hospital hemogram measurement devices. SD/MCVx100% equation was also used for checking the RDW measurements. RESULTS: The mean age of AD patients was 77.3± 8.5 and 73.6±12.0 in the control group with a statistically significant intergroup difference (p=0.020). There was no significant intergroup difference concerning gender (Male/Female, 21/28 in an AD group and 22/27 in the control group (p=0.839). There was no statistical difference between groups concerning RDW values. RDW distribution rates were 14.5±1.5 in AD and 14.7±1.9 in the control groups (p=0.206). The average MMSE score was 16 (8-23) in the AD group. DISCUSSION AND CONCLUSION: Although we could not find any significant relationship between AD and RDW, because of its potential effects on AD, and the presence of studies with contrasting results, these results should be confirmed by studies performed with a higher number of patients. |
20. | Evaluation of Geriatric Patients Hospitalized for Toxic Hepatitis in a University Hospital Pınar Tosun Taşar, Ömer Karaşahin, Murat Furkan Vural, Hakan Dursun doi: 10.14744/hnhj.2020.54765 Pages 303 - 307 INTRODUCTION: Toxic hepatitis is a common condition that causes impaired liver function. In the geriatric population, factors that further increase the existing risk of toxic hepatitis include an age-related physiological decline in liver function, polypharmacy and the use of herbal products as natural remedies for health problems. This study aims to investigate the causes of toxic hepatitis and comorbid clinical conditions in patients aged 65 years and over who were hospitalized for toxic hepatitis. METHODS: Data were collected by retrospective analysis of the medical records of 15 patients aged 65 years and older who were treated for toxic hepatitis in the geriatric ward of a university hospital between January 2019 and December 2019. RESULTS: The mean age of the patients was 69.53±7.22, and 73.3% (n=11) were women. The most common chronic comorbidity was hypertension (46.7%). The most common suspected etiological factor for toxic hepatitis was an edible plant from the genus Ferula that is cultivated in the wild in Erzurum and its vicinity (locally known as çaşır otu). None of the patients developed fulminant hepatic failure or acute tubular necrosis during follow-up. All 15 patients in this study recovered and were discharged. DISCUSSION AND CONCLUSION: The geriatric population is at risk for toxic hepatitis due to age-related physiological changes, polypharmacy, higher rates of chronic disease, and more frequent use of herbal medicines. |
21. | Prevalence of Myocardial Bridge and Possible Associated Variables with Coexisting Coronary Atherosclerosis and Acute Coronary Syndrome Alper Kepez, Ashok Paudel, Osman Yesildağ, Bülent Mutlu doi: 10.14744/hnhj.2018.60590 Pages 308 - 313 INTRODUCTION: The present study aims to evaluate the prevalence of myocardial bridging (MB) and investigate patient and bridge-related factors that may be associated with an increased tendency for atherosclerosis and acute coronary syndrome. METHODS: Consecutive coronary angiography recordings that were recorded between 01/01/2013 and 01/01/2016 were retrospectively evaluated in this study. Data of consecutive patients with MB were obtained from patient files. Patients with MB were grouped according to the presence of significant atherosclerosis in any coronary artery and the presence of significant atherosclerosis proximal to bridge. Patients with isolated MB were also sub-grouped according to their presentation with the acute coronary syndrome. Demographic, clinical and angiographic parameters were compared between groups. RESULTS: There were a total of 75 patients with MB, with an overall prevalence rate of 1.07%. MB patients without coexisting significant atherosclerotic lesion had longer bridge length and more severe stenosis rate (21.4±9.9 mm vs. 17.2±7.6 mm, p=0.045; 73.0±12.5% vs. 65.6±13.0%, p=0.015, respectively). Diabetes mellitus was the only risk factor that was more prevalent in MB patients with significant coexisting atherosclerotic lesions. MB segment of patients with proximal significant atherosclerosis was significantly shorter compared with the length of patients without significant proximal atherosclerosis (16.0±7.4 mm vs 20.7±9.5 mm, p=0.05). The presentation as an acute coronary syndrome was more prevalent in patients with significant atherosclerosis compared to patients with isolated MB (68.8% vs. 46.5%, p=0.045). There was no significant discriminative variable for presentation as acute coronary syndrome in patients with isolated MB. DISCUSSION AND CONCLUSION: The prevalence rate of MB in our study is in agreement with the previous angiographic studies reported from Turkey. Coexisting atherosclerotic lesions seem to be primarily involved in the pathogenesis of acute coronary syndrome and ischemic symptoms that had necessitated coronary angiography. |
CASE REPORT | |
22. | Extraperitoneal Laparoscopic Radical Prostatectomy with Handheld Articulating Laparoscopic Instruments Driven by Robotic Technology Serdar Aykan, Ahmet Yaser Müslümanoğlu doi: 10.14744/hnhj.2018.62207 Pages 314 - 316 Robotic-assisted radical prostatectomy (RARP) is a popular current minimally invasive surgical treatment option for organ-confined prostate cancer (PCa). The benefits of RARP concerning fully articulating robotic arms and three-dimension (3D) vision are widely accepted. However, the cost of the RARP is the main limitation. Laparoscopic radical prostatectomy (LRP) has been still in usage for its minimally invasive features, but it is a very complex procedure, has negative effects on surgeons’ ergonomics, and has a limited vision on 2D. At his point, LRP with articulating devices and 3D vision is logical. We here reported an extraperitoneal LRP case with articulating laparoscopic instruments (Kymerax®, Terumo, Hatagaya, Tokyo, Japan) with the 3D visualizing system (Viking Systems, La Jolla; CA). To our knowledge, this is the first extraperitoeneal LRP using this set, in the literature. |