Cerrahi Tıp Bilimleri Bölümü Koleksiyonu

Bu koleksiyon için kalıcı URI

https://hdl.handle.net/20.500.12899/36

Listeleniyor 1 - 20 / 44

IS BODY MASS INDEX AND OBESITY SURGERY MORTALITY SCORE IMPORTANT IN PERIOPERATIVE COMPLICATIONS OF LAPAROSCOPIC SLEEVE GASTRECTOMY BEFORE DISCHARGE?
(13.01.2021) Kanat,B.H.
ABSTRACT - Background: Morbid obesity surgery and related complications have increased with time. Aim: To evaluate the relationship between perioperative complications before discharge and preoperative body mass index and obesity surgery mortality score in laparoscopic sleeve gastrectomy. Method: 1617 patients who met the inclusion criteria were evaluated retrospectively. The patients were examined in terms of demographic data, presence of comorbidities, whether there were complications or not, type of complications and obesity surgery mortality score. Results: Complications were seen in 40 patients (2.5%) and mortality wasn’t seen in the early postoperative period before discharge. The mean age of patients with complications was 36.3±10.02 years (19-57) and without complications 34.12±9.54 (15–64) years. The preoperative mean BMI values of patients with and without complications were 45.05±3.93 (40–57) kg/m2 and 44.8±3.49 (35–67) kg/m2 respectively. According to BMI groups 40–45 kg/m2 , 45–50 kg/m2 and 50 and over, there was not any statistical significance seen in three groups in terms of complication positivity and major-minor complication rates. There was not any statistical significance seen between the patients with and without major-minor complications and obesity surgery mortality score. Conclusion: There was not any relation between perioperative laparoscopic sleeve gastrectomy complication rates before discharge and BMI and obesity surgery mortality scores
Managing ileus due to phytobezoars: Our clinical experience
(04.05.2020) Kanat,B.H.
Aim: We aimed to evaluate our phytobezoar cases who were followed up and treated due to mechanical obstruction in our clinic. Materials and Methods: The files of acute abdomen or ileus patients who were followed up in the Elazığ Training and Research Hospital General Surgery Clinic between January 2013 and January 2018 were evaluated retrospectively. Patients whose data were not available and who were followed up and treated for non-phytobezoar ileus and acute abdomen were excluded from the study. Nine patients meeting the inclusion criteria were reviewed retrospectively. Demographic data (age, gender) of the patients, previous surgical histories, comorbidites, whether there is gastric or intestinal bezoar, treatment options and complications were recorded. Numerical data are given as median (minimum - maximum values); categorical data are given as n (%) for statistical evaluation. Results: Three of the patients were female (33.4%) and 6 were male (66.7%).The median age of all patients was 71(25–78) years. Seven of the patient had previous surgical intervention history (77.8%) (5 had gastric surgery and 2 had other abdominal surgery history), 2 (22.2%) had no previous surgical intervention history. Two of the patients (22.2%) whom endoscopic intervention was performed for with gastric bezoar, operated for intestinal obstruction due to migration of gastric bezoar.One of the patients (11.1%) whom had no surgical intervention history had primary intestinal bezoar and one (11.1%) had concomitant intestinal bezoar with gastric bezoar. Conclusion: Mechanical obstruciton due to bezoars, must be kept in mind in patients who had perivous gastric surgery history and habitual eating disorders.Not only the exploration of the target area but also whole exploration must be done.Close follow up for migration is important for the gastric bezoars after endoscopic interventions
Effect of preoperative radiotherapy and emergent surgery on conversion in laparoscopic colorectal surgery: A retrospective cohort study
(30.05.2020) Kanat,B.H.
Aim: The effects of preoperative radiotherapy and emergent surgery on conversion in laparoscopic colorectal surgery is not clear. We therefore aimed to determine the effects of neoadjuvant radiotherapy and emergent surgery on conversion. Methods: The data of 67 patients, who were operated for familial adenomatosis polyposis coli, colon, and rectum malignant neoplasms by the same surgical team between October 2016 and January 2018 were evaluated retrospectively. Among them, fifty-five laparoscopically finished or converted to open surgery cases were included in the study. The exclusion criteria included cases which began as open surgery, history of previous colorectal surgery for benign or malignant diseases, morbid obesity (body mass index >40 kg/m2 ) and missing data. Demographic values (age, gender), localization of tumor, whether it was an emergent or elective surgery, history of preoperative chemotherapy and radiotherapy, and causes of conversion were evaluated. Results: Among 55 patients, 35 were male (63.6%) and 20 were female 20 (36.4%), with a mean age of 58.4 (13.4) (22 – 80) years. Mean ages of conversion and laparoscopically finished cases were 62.86 (8.91) (53 – 73) and 57.71 (13.84) (22 – 80) years, respectively (P=0,216). The reason for operation was right colon cancer in three patients (5.5%), left colon cancer in six (10.9%), rectum cancer in thirty-seven (67.3%), rectosigmoid junction cancer in five (9.1%) and adenocancer due to familial adenomatous polyposis coli in four patients (7.3%). In seven patients (12.7%), the need for conversion to open surgery arose. Among 55 patients, 47 patients were operated electively (85.5%) and 8 were operated under emergent conditions (14.5%). Of the 7 conversion patients, 5 were operated under emergent conditions and 2 were operated electively (P<0,001). This result showed that conversion rates were higher in emergent surgery patients. Neoadjuvant radiotherapy wasn’t administered to 38 patients (69.1%) (chemotherapy was administered alone to 3 of the patients and 35 patients were not treated with any neoadjuvant therapy), and neoadjuvant chemoradiotherapy combination was administered to 17 patients (39.1%). Among 7 conversion patients, 1 had been administered neoadjuvant radiotherapy while 6 had not (P=0.308). This result showed no statistical differences between patients to whom preoperative radiotherapy were and were not administered. Conclusion: Laparoscopic colorectal surgery can be performed as successfully as conventional open surgery under elective conditions. Preoperative radiotherapy is not related to conversion
Sinovac vaccination and the course of COVID-19 disease in hospitalized patients in Turkey
(King Faisal Specialist Hospital and Research Centre, 2022) Acun Delen, Leman; Öterkuş, Mesut
BACKGROUND: The Alpha variant of SARS-CoV-2 has a higher transmission rate than the first variant identified. The efficacy of vaccines is affected by the characteristics of SARS-CoV-2 variants. OBJECTIVE: Investigate the relationship of vaccination and virus variant on the course of the disease in patients who were hospitalized with a diagnosis of COVID-19. DESIGN: Retrospective, cohort study SETTING: Tertiary health institution PATIENTS AND METHODS: The study included patients older than the age of 18 years who were hospitalized in a COVID-19 service or the intensive care unit with a diagnosis of COVID-19 between 1 January 2021 and 30 April 2021. Demographic characteristics, vaccination and the Alpha virus variant status, comorbidities, and information about hospitalization were obtained from the hospital automation system and patient files. MAIN OUTCOME MEASURES: Vaccination rate and relationship with course of disease. SAMPLE SIZE: 608 RESULTS: Most of the patients (n=482, 79.3%) were admitted to the COVID-19 service. More of the COVID-19 service patients had the Alpha variant than the patients admitted to ICU (P<.009). The Alpha variant was also more common in younger patients (P<.001). There was no relationship between the Alpha virus and comorbid diseases such as diabetes mellitus and hypertension. Mortality was lower in the patients who had received a second dose of the Sinovac vaccine (P=.004) compared with unvaccinated patients. CONCLUSION: Although the Alpha variant spreads faster, it has a milder course. If only the Sinovac vaccine is available, we recommend that the two doses of the Sinovac vaccine be administered. LIMITATIONS: Our study is single-center and did not include pregnant and pediatric patients. CONFLICT OF INTEREST: None.
Deep learning model developed by multiparametric MRI in differential diagnosis of parotid gland tumors
(Springer, 2022) Gündüz, Emrah; Alçin, Ömer Faruk; Kızılay, Ahmet; Yıldırım, İsmail Okan
Purpose: To create a new artificial intelligence approach based on deep learning (DL) from multiparametric MRI in the differential diagnosis of common parotid tumors. Methods: Parotid tumors were classified using the InceptionResNetV2 DL model and majority voting approach with MRI images of 123 patients. The study was conducted in three stages. At stage I, the classification of the control, pleomorphic adenoma, Warthin tumor and malignant tumor (MT) groups was examined, and two approaches in which MRI sequences were given in combined and non-combined forms were established. At stage II, the classification of the benign tumor, MT and control groups was made. At stage III, patients with a tumor in the parotid gland and those with a healthy parotid gland were classified. Results: A stage I, the accuracy value for classification in the non-combined and combined approaches was 86.43% and 92.86%, respectively. This value at stage II and stage III was found respectively as 92.14% and 99.29%. Conclusions: The approach presented in this study classifies parotid tumors automatically and with high accuracy using DL models.
Peripheral facial paralysis during the COVID-19 pandemic
(İnönü Üniversitesi, 2022) Aydın, Şükrü; Fırat Koca, Çiğdem; Çelik, Turgut; Kelleş, Mehmet; Yaşar, Şeyma
The mechanism surrounding idiopathic peripheral facial nerve paralysis remains unclear, though viral infections and even immunizations have been suspected of its origin. Thus, the relationship between COVID-19 and facial paralysis should be studied. With this research, we aimed to investigate the characteristics of facial paralysis during the COVID-19 illness as well as the relationship between facial paralysis and COVID-19, the length of time needed for recovery, concurrence with COVID-19 infection, and whether facial paralysis is a late complication or initial symptom of the disease. Forty-five patients thought to have had idiopathic peripheral facial paralysis were included in the study. Pure tone audiometry, COVID-19 PCR tests, and contrast-enhanced ear MRIs were performed on all participants. A standard prednisolone treatment protocol was followed. Participants were monitored for one month; we recorded whether they had COVID-19 previously, initially, or contracted it within the one-month testing period. At the same time, facial paralysis recovery rates were recorded and used in statistical analyses. PCR test at initial admission was reported as positive for COVID-19 in only one participant (2.2%). We discovered an improvement delay regarding facial paralysis in participants who had had COVID-19 previously (p<0.001). Prednisolone therapy used for peripheral facial paralysis did not pose an additional risk for COVID-19. Having had COVID-19 previously may cause delayed recovery of peripheral facial paralysis. Peripheral facial paralysis may be both a late manifestation as well as an early symptom of COVID-19.
Have malignancy rates increased in thyroidectomy cases
(27 mart 2021) KANAT, Burhan Hakan; Çay, Ferhat; Kutluer, Nizamettin; Aksoy, Nurullah; BOZAN, Mehmet Buğra; Arslan Solmaz, Özgen; KARACA KARAGÖZ, Zühal; İrtegün, Sinan; Aydın, Yusuf
ntroduction: This study aims to review thyroidectomy cases performed by a single surgeon in a single centre during the course of 1 year, to determine if the malignancy rate increased, and to compare the results with the liter ature. Material and methods: We retrospectively evaluated data of patients who underwent thyroidectomy between August 2018 and August 2019 in the General Surgery Clinic of our hospital. The malignancy rate was calculated and analysed according to the demographic data of the patients (gender and age), preoperative thyroid nodule sizes, and postoperative pathological mass sizes. Also, age, preoperative nodule size, and tumour size were all evaluated according to gender. Results: There were a total of 60 patients (14 (23%) male and 46 (77%) fe male). The pathology result revealed 16 (26.7%) malignant and 44 (73.3%) benign biopsies. The mean age was 46.72 ±12.08 years (20–74). We found that age, preoperative nodule size (cm), pathological tumour size (cm), and thyroid function tests were not significantly associated with malignancy. However, when age, preoperative nodule size, and tumour sizes were evalu ated according to gender, it was found that tumour sizes were significantly larger in men than in women (p < 0.001). In addition, the mean age of male patients was higher than that of women (p = 0.025). Conclusions: The malignancy rate has increased in the thyroidectomies per formed in our centre. This finding is consistent with relevant studies from the last 30 years. Therefore, it is likely that clinicians will continue to handle an increased number of thyroid malignancies
Complications during laparoscopic cholecystectomy performed due to acute cholecystitis
(28.05.2020) KANAT, Burhan Hakan
Introduction: Today, laparoscopic cholecystectomy is essential in the treatment of acute cholecystitis, particularly in all patients who have applied in the early period and can tolerate surgery. Although the rates of complication and conversion to open surgery tend to decrease over time with the increasing experience, they are still among the important problems today. The most important complications of laparoscopic cholecystectomy in acute cholecystitis are biliary tract injuries and bleeding. In this article, we aimed to retrospectively present the complications that we encountered in laparoscopic cholecystectomy due to acute cholecystitis. Materials and Methods: The patients, who underwent laparoscopic cholecystectomy with the diagnosis of acute cholecystitis between March 2016 and December 2019, were retrospectively examined. The patients’ age, gender, symptoms–examination findings, laboratory findings, ultrasonography findings and pathology findings were analyzed. Complications and the rate of conversion to open in surgical treatment were evaluated. Results: Of 70 the patients included in this study, 22 (31%) were male and 48 (69%) were female. The ages of the patients were between 25–70 and the mean age was 46.08±11.8. Open surgery was performed in six patients (9%). Perop–postop complications developed in three (4%) patients in total. Conversion to open was required in one of these patients. Biliary tract injury occurred in one patient, cystic duct stump leak occurred in one patient, and choledochal stenosis occurred in one patient. Conclusion: As a result, early laparoscopic cholecystectomy in acute cholecystitis is an acceptable treatment option with these complications and rates of conversion to open. It should be considered that complications may occur in the interim period and patients will be at a second risk due to the postponed operation. Minimal invasive methods should be preferred as much as possible with developing complications, and if necessary, support should be obtained from more experienced teams
An evaluation of cost analysis of palliative care centers
(Oterkus, Mesut, 2022) Dişli, Zeliha Korkmaz; Acun Delen, Leman; Erce, Çiğdem; Ötekuş, Mesut
Palliative care services were established in order to reduce the work and patient burden of intensive care units (ICU) and to reduce the treatment and care costs of patients. We objectives to make a reference study for the determination and planning of expenditure items by making expense analyzes of these centers. The files of 149 patients hospitalized in the palliative care center of Malatya Training and Research Hospital were reviewed retrospectively. The hospital automation system and files were analyzed and recorded for the data of the patients. Demographic data of patients, diagnoses of hospitalization, length of stay, treatment and care costs, including, antibiotics and other drugs, nutrition, wound care, laboratory and imaging studies, consultations, and daily bed costs were recorded and evaluated. 72 (48%) of the patients were male and the mean age was 75.4±13.0 years. The most common indications for hospitalization were malignancy 35.6% (n:53) and cerebrovascular disease (CVD) 33.6% (n:50). The average cost per patient was 7700 Turkish Liras (TL). It was found that the most important expenditure items in the palliative care center were daily cost of bed (6835 TL) per day), non-antibiotic drugs (2395 TL), and nutrition (1087 TL), respectively. Palliative care services are very effective units in reducing the care and treatment expenses of hospitals, which reduces the work and patient burden of intensive care units. In this respect determining and analyzing the costs of expenditure items will play an important role in health planning.
The effect of stump ligation techniques on operative time in laparoscopic appendectomy
(20 haziran 2021) Kutluer, Nizamettin; Aksu, Ali; Kanat, Burhan Hakan; Aday, Ulaş; Böyük, Abdullah; Doğan, Serhat
Introduction: We aimed to evaluate the effect of stump ligation techniques on operative time in laparoscopic appendectomy. Material and methods: The patients who underwent laparoscopic appen dectomy in our General Surgery Clinic between January 2016 and August 2018 were retrospectively reviewed. The effects of stump ligation tech niques used in the operations on operative times were evaluated. Results: Sixty consecutive patients were screened and 3 groups, 20 patients in each group, were formed based on stump ligation techniques. Extracor poreal knotting – loop ligation was used in Group 1; intracorporeal knotting was used in the Group 2; hem-o-lok clip was used in Group 3.There was no statistically significant difference between the groups in terms of gender distribution and mean age. However, there was a significant difference be tween the hem-o-lok clip group (Group III) and the intracorporeal knot group (Group II) in terms of operative time. Group III had a shorter operative time. The Group III patients had the shortest operative time, while the Group II patients had the longest operative time (p < 0.05). Conclusions: We can speculate that hem-o-lok clip among the stump liga tion techniques reduces the cost, is a safe method and shortens the opera tive time. However, prospective randomized studies with a large sample size comparing different techniques are needed to determine the ideal treat ment procedure. At the same time, stapler use may be considered in cases where the base of the appendix is too inflamed or necrosed. It is known that the use of a stapler and endoloop is more expensive than all other tech niques. However, the most important issue for the surgeon is patient safety; therefore the most appropriate technique should be preferred.
A FORGOTTEN STATUS: GOSSYPIBOMA
(2021) KANAT, Burhan Hakan; ÖZTÜRK, Tülin; AKSOY, Nurullah; BOZAN, Mehmet Buğra; KUTLUER, Nizamettin
Gossypiboma is used to describe the forgotten cotton/gauze piece in the body after the surgical procedure. It is formed by the combination of the words “gossypium”, a Latin word for cotton, and the word “boma” in Swahili, which means the place of hiding1 . Although many different materials have been reported in the literature, cotton materials are among the most forgotten objects. Though there is no consensus, the incidence is given as 0.01-0.001%. Gossypiboma, which is more common after abdominal and pelvic surgery, has also been reported after thoracic surgery, spinal, orthopedic, and breast surgery2,3. This article aimed to present five gossypiboma cases
Hipertiroidili Hastalarda Tedavinin Beyin Natriüretik Peptid Düzeyine Etkisi
(11.09.2020) KANAT, Burhan Hakan; KARACA KARAGÖZ, Zühal; KURT, Feyzi
Amaç: Kardiyak problemi ve herhangi bir sistemik hastalığı olmayan hipertiroidili hastalarda beyin natriüretrik peptid (BNP) düzeyini ve tedavinin BNP düzeyine etkisini değerlendirmeyi planladık. Gereç ve Yöntemler: Çalışmaya 29 hipertiroidili ve 30 sağlıklı olgu dahil edildi. Hastalarda total T3, total T4, serbest T3, serbest T4, TSH, anti TPOAb, Anti TgAb ve BNP düzeylerine tedavi öncesinde ve ötiroid olduktan sonra bakıldı. Bulgular: Hipertiroidili hastalarının tedavi öncesi BNP düzeyleri kontrol grubuna göre anlamlı olarak daha yüksek bulunmuştur (P<0,05). Hastaların tedavi öncesi ve ötiroid olduktan sonraki BNP düzeyleri arasında anlamlı ilişki saptanmıştır (P<0,05). TT3 ve Anti TPOAb ile BNP arasında pozitif bir korelasyon gözlenmiştir (P<0,05). BNP ile TSH arasında ise tedavi öncesi ve sonrası anlamlı bir korelasyon saptanmamıştır (P>0,05). Ayrıca hastalarda Anti TgAb, ST3, ST4 ve TT4’de tedavi öncesi pozitif bir korelasyon gözlenmiş (P<0,05) olup tedavi sonrası ise korelasyon tespit edilmemiştir (P>0,05). Sonuç: Hipertiroidili hastalarda BNP düzeyi artmıştır. Antitiroid tedavi BNP düzeyini anlamlı olarak düşürmektedir.
The effects of sponges soaked with chlorhexidine gluconate and metronidazole on safety of colonic anastomosis in an experimental model of peritonitis
(2021) Kanat, Burhan Hakan
BACKGROUND: The present study aims to evaluate the use of the chlorhexidine gluconate and metronidazole impregnated compresses concerning anastomosis safety in the left colonic anastomosis in the presence of peritonitis. METHODS: This study was conducted on 21 Wistar-Albino-rats divided into three equal groups. After median laparotomy, the whole layer of the left colon was cut 2 cm over the pelvic peritoneum. The faeces were spread around the injury for fecal contamination. Then, fasia and skin were closed with 3/0 silk. After one day period, relaparatomy was performed. The abdomen was cleared isotonic sodium chloride with impregnated material before starting colonic anastomosis in the first group and then double layer colonic anastomosis was performed. In the second Group-II, abdomen was cleared with the metronidazole impregnated compresses then double layer colonic anastomosis was performed. In the group-III, abdomen was cleared with the chlorhexidine gluconate impregnated compresses then double layer colonic anastomosis was performed. Tissue hydroksiproline levels and anastomosis bursting pressures were measured and histopathologic findings on the anastomosis line were evaluated on the postoperative tenth day by performing relaparatomy. RESULTS: The highest anastomosis bursting pressure was found in Group-III (p<0.05). The highest tissue hydroksiproline level was found in Group-III (p<0.005 Group I-III, Group II-III). When histopathologic findings were evaluated by comparing the three groups in this study, the healing of the intestine tissue score was statistically insignificant between group-II and III, for both group-II and III, healing score was statistically significant higher than Group-I (p<0.05 Group I–III and Group I-II). CONCLUSION: Cleaning the abdomen before the anastomosis using antibacterial soaked material increased resection safety in the presence of peritonitis and anastomosis safety in primary anastomosis.
Investigation of the Level of Serum Irisin in Patients With Gestational Diabetes Mellitus
(2021-03-10) Kahraman, Gülcan; Kahraman, Mustafa; Öterkuş, Mesut
Aim: In pregnancy, the most common metabolic disorder is Diabetes Mellitus (DM). Gestational diabetes mellitus (GDM) is glucose intolerance that first appears during pregnancy or is diagnosed. Especially in late pregnancy, the fetüs, rapidly growing glucose metabolism, directs glucose and amino acids to the fetus. The mother’s energy needs are arranged in the provision (free fatty acids, ketones, and glycerol) from alternative sources. It is the irisin the main function is turning from white adipose tissue to brown adipose tissue, uncover energy as heat and induced by exercises, such as weight loss, reduction in insulin resistance, associated with obesity, glucose regulation and effects on lipid metabolism are known to have many physiological properties. This study, it is aimed to investigate the level of irisin, which is GDM involved in energy metabolism, a new hormone. Material and Method: In Firat University Faculty of Medicine, Obstetrics and Gynecology Clinic, the 40 pregnant women diagnosed with GDM (Group 1) and 40 healthy pregnant women without any problems in pregnancy (Group 2) so that the total 80 patients were included in this study. These groups were divided into four subgroups, GDM in the second trimester, 20 patients (Group 1A), GDM in the third trimester, 20 patients (Group 1B), In the second trimester, 20 healthy patients (Group 2A), In the third trimester, 20 healthy patients (Group 2B). Results: In this study compared with control groups, serum irisin levels were increased significantly, including the 2. trimester higher (263.70±127.69 ng/ml) in the GDM group. There was no correlation between serum irisin level and BMI. Conclusion: In future studies, the necessity of questioned physical activity and exercise, the need for more extensive experimental and clinical studies, and if the pathophysiological mechanisms between the iris and GDM are illuminated, the clinical conclusion was reached irisin related options can be treated.
The Effectiveness Of The Ambu® Auragain™ Laryngeal Mask On Hemodynamic And Respiratory Parameters İn Patients Undergoing Septoplasty: A Randomized Prospective Clinical Study
(2021-08-28) Öterkuş, Mesut; Selçuk Kuşderci, Hatice
Background/Aim: The use of laryngeal masks is increasing with the introduction of 3rd generation airway vehicles. However, endotracheal intubation is preferred by most anesthesiologists in septoplasty operations due to airway safety concerns. In this study, we aimed to compare the 3rd generation airway device, Ambu® Auragain ™ LMA, with tracheal intubation in terms of hemodynamic and respiratory parameters. Methods: This study included 69 patients aged 18–60 years with an ASA score of 1–2 who were scheduled for septoplasty in Adıyaman University Research and Educational Hospital between 2016.01.01 and 2017.06.31. Study groups were randomly defined as Group 1 - Ambu® AuraGain™ laryngeal mask (LMA, n = 37) and Group 2 - endotracheal intubation (ETT, n = 32), and the hemodynamic and respiratory parameters were measured and recorded. Results: The demographic data and partial oxygen saturation of the patients were similar (P>0.05 for all values). The patients in the ETT group had a higher heart rate at induction, intubation and at the first minute compared to the LMA group (P<0.05 for all values). The mean arterial pressure was significantly lower at induction, intubation, at minutes 1, 2, 3, and 4 of intubation, and at extubation in the LMA group (P<0.05 for all values). Conclusion: The Ambu® AuraGain™ laryngeal mask was similar to or better than tracheal intubation in terms of hemodynamic and respiratory parameters. The Ambu® AuraGain™ LMA can be used as an equivalent to tracheal intubation in terms of hemodynamic and respiratory parameters.
Evaluating The Knowledge Level, Perception and Attitude Towards COVID-19 Among Otolaryngologists
(2021-12-25) Fırat Koca, Çiğdem
Aim: Otolaryngologists cope with the COVID-19 pandemic at first lines. Inadequate knowledge level among healthcare workers may cause inadequate controlling efforts to maintain required treatments, facilitate the rapid spread of infections and an impenetrable process start.The aim of the study was to determine the attitude, knowledge level and perception of the risk of infection with COVID-19 among otolaryngologists. Material and Method: A questionnaire consist of a total of 36 questions was prepared in order to evaluate the knowledge and attitude about COVID-19 among Otolaryngologists. Results: The average true answer rate of knowledge questions was% 86 (range 63-100 %) showing that a great of participants had good knowledge level about the COVID-19 in our study. The majority of the otolaryngologists showed a positive behaviour towards COVID-19. Conclusion: According to our knowledge this present study was the first study that focused on the knowledge level and attitude towards COVID-19 among otolaryngologists.
Stress And Fluid Restriction Before Anesthesia İnduction, İnvestigation Of The Effects Of The Patient’s Clinic, Endocrine Responses, And The Level Of The Nesfatin-1
(2021-05-15) Kahraman, Mustafa; Öterkuş, Mesut; Kahraman, Gülcan
Background/Aim: Preoperative fasting, fluid restriction and stress trigger many hormonal responses, one of which is the newly described Nefsatin-1. It has important effects on energy metabolism and stress. In this study, we aimed to examine the relationship between stress, fasting, fluid restriction, and Nesfatin-1. Methods: A total of 100 ASA I-II adult patients between 18 and 60 years of age with no psychiatric, cardiovascular, or metabolic disorders, who were operated under general anesthesia for various reasons at Fırat University Hospital between June and November 2013 were included in this randomized prospective case-control study. Patients were categorized into fluid restriction (Group 1) and no-fluid restriction (Group 2) groups. These groups were further sub-categorized as those receiving (Groups 1A and 2A) and not receiving pre-medication (Group 1B and Group 2B). State Trait Anxiety Inventory was applied to all patients by an independent member of the research team before the surgical procedure. Also, blood samples were obtained 6-8 hours, 1 hour, and just before the induction to measure insulin, glucose, epinephrine, norepinephrine, cortisol, and Nesfatin-1 levels. Results: In both groups, the test score for pre-operative anxiety was 44. While there were no differences in serum insulin levels between the study groups (P>0.05), serum glucose and epinephrine levels were higher in Group 1A than in other groups (P<0.05 for both). Except for the 2nd period, serum norepinephrine levels were elevated in all stages (P<0.05). Serum cortisol levels were higher in Group 2B (P<0.05), while serum Nesfatin-1 levels were higher in Group 2A (P<0.05). Conclusion: According to our findings, the highest reflection of stress in patients, together with clinical and endocrine responses, coincided just before the induction period. Further studies are warranted before firmer conclusions can be drawn regarding the association between Nesfatin-1 and anxiety. We believe that if the pathophysiological mechanisms between anxiety and Nesfatin-1 are clarified, Nesfatin-1 targeting treatment approaches can be tried in the clinic.
Reply to the Letter to the Editor regarding 'The long-term effectiveness of coblation cryptolysis treatment for tonsillar-induced halitosis'
(Elsevier, 3 ocak 2022) Çelik,T., Koca,Ç.F., Gül,O., Erdur,Ö.
First we thank to Xiangming Meng due to his valuable comments on our paper regarding coblation cryptolysis method in treatment of tonsil caseum-induced halitosis [1]. Since human is a social creature, halitosis puts the person in a difficult situation in this social life, in communi cation with his friends and close environment. The oral cavity, which contains the palatine tonsils, which can cause bad odor due to the caseous formation of the cryptic structures they contain, can be one of the main sources of halitosis in the person [2]. Definitely tonsillectomy is a quite effectual procedure carried out for tonsil stones, as is the case all over the World, serious complications such as possible intraoperative and postoperative bleeding may push the surgeon to seek alternative treatment options. The results of the coblation cryptolysis method we used for tonsil caseums in our study showed that this method was quite successful [1]. The technology used in coblation basis on the transition of a radiofrequency bipolar electrical current via an environment of normal saline that concludes in the generation of a plasma field of so dium ions [3]. In our study investigating coblation cryptolysis in halitosis caused by tonsillolithiasis, we found that halitosis control was achieved in 83.1% of patients in 6-month follow-up. We have been applying this procedure to our patients for about 4 years. The longest follow-up of these patients was 36 months and we did not detect any recurrence in most of our patients. We have been performing the procedure under local anes thesia, in a short time and the most advantageous feature is that the procedure can be carried out in office conditions and has satisfactory results. We recommend tonsillectomy as an alternative and gold stan dard treatment method in addition to coblation cryptolysis to our pa tients who are suffering from halitosis caused by tonsillolithiasis.
Alarin: A new predictive marker in infertile women with polycystic ovary syndrome: A case-control study
(wiley, 21 ocak 2022) Görkem,Ü., Yıldırım,E.
Aim: There is scant evidence concerning the relationship of alarin concentrations for polycystic ovary syndrome (PCOS) status in the existing literature. Therefore, we aimed to reveal the relationship about predictive value of serum alarin concentrations for PCOS risk in infertile women. Methods: This prospective case–control study included a total of 151 infertile women who met eligibility criteria of the study. Infertile women diagnosed with PCOS formed the study group (n = 80). Women with diagnoses of unexplained infertility constituted the control group (n = 71). The biochemical analyses of serum concentrations of lipid profiles, estradiol (E2), follicle-stimulating hormone (FSH), luteinizing hormone (LH), anti-Mullerian hormone (AMH) and alarin were performed. Results: There were no differences for the study parameters, including age, body mass index, fasting glucose, total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, total triglyceride, E2, and FSH levels in either group. Serum LH, AMH, alarin concentrations, and antral follicle counts had higher values in the PCOS group compared with the controls. Correlation analysis revealed that serum alarin levels were significantly positively correlated with LH and AMH levels, only in the PCOS group. Multivariate binary logistic regression analysis demonstrated that infertile women with high alarin concentrations were significantly more likely to develop PCOS (OR = 1.77, 95% CI = 0.095–0.332, p < 0.001). Conclusion: Higher serum concentrations of alarin and a positive correlation with serum LH levels were found in infertile women with PCOS. This evidence supported that high alarin concentrations might play a role in the development of PCOS
The relationship between oxidative stress markers and endometrial hyperplasia: A case-control study
(Yildirim, Engin, 2021) Yıldırım, Engin; Türkler, Can; Görkem, Ümit; Şimşek, Ömer Yavuz; Yılmaz, Ercan; Aladağ, Hulya
Objective: Endometrial hyperplasia (EH) is considered an endometrial cancer precursor. This study aimed to determine the role of oxidative stress and thiol groups with antioxidant properties in EH pathogenesis. Materials and methods: In our prospective case-control study, participants were washed with 5 mL of saline before the endometrial biopsy. Endometrial washing fluid was taken into microtubules, and thiol and disulfide levels were analyzed using the Ellman reagent. Results: A total of 108 patients were in the EH group and 84 patients in the control group. The total and native thiol levels were higher values in the control group (p<0.001, for both). Disulfide levels were higher in the EH group (p<0.001). Native/total thiol ratio and disulfide/total thiol ratio were higher in the EH group (p<0.001, for both). The analysis performed in the control group revealed a significant positive correlation between estradiol and disulfide levels (r=0.322, p=0.033). No significant correlation was found between estradiol and disulfide in the EH group. Conclusion: Oxidative stress level was higher in the washing fluids of patients with EH and this stress plays a role in the EH etiology.

Güncel Gönderiler