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Unicameral bone cysts of the proximal femur in skeletally immature patients: Do radiological parameters, pathological fracture, treatment method and recurrence affect the outcomes?

Original Article

Unicameral bone cysts of the proximal femur in skeletally immature patients: Do radiological parameters, pathological fracture, treatment method and recurrence affect the outcomes?

Osman Emre Aycan, Ozan Kaya, Muhammet Coskun Arslan, Alper Koksal, Muhammed Mert

   

Abstract
Unicameral bone cysts (UBC) are reported to be the underlying lesion in 40% of pathological femoral neck fractures in skeletally immature patients. They are typically asymptomatic and incidentally found on imaging. However, when symptomatic, it commonly may present with pathologic fracture that causes pain, swelling, or deformity. The purpose of this study was to assess the natural history of the pediatric proximal femoral unicameral bone cyst, risk factors for pathological fracture and recurrence. Medical records were retrospectively reviewed of patients with pediatric proximal femoral UBC’s who underwent surgery between 2004 and 2018. We included 51 consecutive patients with pediatric proximal femoral UBC (36 impending fractures/15 pathological fractures). The patients were evaluated regarding the localization of the UBC and the activity of the cyst. The cyst parameters were measured, and the patients were further assessed regarding the presence of pathological fracture and applied treatment. The pathological fracture group was compared to the impending fracture group using radiological cyst parameters, management options, healing, recurrences, and other related complications. The most commonly affected localizations were combined involvement of femoral neck and intertrochanteric (n=21) The number of latent lesions was 27 and active lesions were 24. The mean cyst index in our series was 3.8±1.2 (1.2-7.2). The cyst index in our series was correlated with pathological fractures. (p=0.048) There were significantly higher cyst index values in recurrent cases. (p=0.016) The cyst extension below the trochanter minor level was found as a risk factor for pathological fractures. (p=0.021) The most common treatment in our series was curettage, graft packing, and plate fixation with 27 patients. The treatment method showed no correlation with consolidation or recurrence rate. According to the healing criteria for UBC’s at final follow-up, 36 cysts were completely consolidated, 13 were evaluated as incomplete healing and two were persistent. The recurrence rate was significantly high in UBC’s who were operated on at

Key words: Unicameral bone cyst, pathological fracture, immature proximal femur, cyst index, recurrence

Med-Science. 2021; 10(3): 670-8

 
 
Medicine Science Vol:10 Issue:3 Year:2021 PP:670–1086

Vitreoretinal surgery outcomes in patients with lens or lens fragments luxated into the vitreous cavity

Original Article

Vitreoretinal surgery outcomes in patients with lens or lens fragments luxated into the vitreous cavity

Seyhan Dikci, Turgut Yilmaz

   

Abstract
To evaluate the clinical characteristics of patients with lens or lens fragments luxated into the vitreous cavity and the visual and anatomical outcomes of pars plana vitrectomy (PPV) in these patients. This retrospective study reviewed the files of patients who had undergone PPV for lens or lens fragments luxation into the vitreous cavity at the Ophthalmology Department at Inonu University, Faculty of Medicine between January 2014-December 2018. Patient age, gender, preoperative and postoperative best corrected visual acuity (BCVA), intraocular pressure (IOP), anterior segment examination and posterior segment examination findings, preoperative and postoperative complications, and postoperative follow-up times were recorded. This study included 43 eyes of 43 total patients, of which 29 (67.4%) were male and 14 (32.6%) were female. Median patient age was 70 (36-89) years. Median preoperative BCVA was 1.7 (0.5-2) logMAR and median final BCVA was 0.8 (0-2) logMAR (p

Key words: Pars plana vitrectomy, lens, lens fragment, retinal detachment

Med-Science. 2021; 10(3): 679-83

 
 

The Effect of Co-Morbid Diseases on The Need for Mechanical Ventilation and Mortality of Patients with Covid-19 in Intensive Care Unit

Original Article

The Effect of Co-Morbid Diseases on The Need for Mechanical Ventilation and Mortality of Patients with Covid-19 in Intensive Care Unit

Ulku Ince, Harun Tolga Duran, Yusuf Yildirim, Sule Gokce

   

Abstract
It is aimed to contribute to the literature on Covid 19, a new disease, by examining the mechanical ventilation support, mortality and factors affecting them during the follow-up of patients infected with Covid 19 in the intensive care unit. The clinical course of covid 19 infected patients who were hospitalized in the intensive care unit between March 30 and October 30, 2020, such as length of stay, additional diseases, mechanical ventilation support and mortality rates, were analyzed retrospectively and compared. 66 of 100 patients included in the study required invasive mechanical ventilation, 34 of them did not. The probability of having two or more comorbidities was significantly higher in patients requiring invasive mechanical ventilation (P:0,007). The motrality rate was 64% among all patients. Advanced age and additional systemic diseases increase mortality in patients infected with Covid19 treated in intensive care. We believe that patients of advanced age and 2 and above with additional systemic diseases need more invasive mechanical ventilation support and that adequate clinical improvement cannot always be achieved with high flow nasal oxigenation (HFNO) and invasive mechanical ventilation (IMV) support applications in these patients.

Key words: Covid-19, mechanical ventilation, mortality

Med-Science. 2021; 10(3): 684-7

 
 

Prevalence and predictors of 25-OH Vitamin D deficiency in peritoneal dialysis patients: A single center study

Original Article

Prevalence and predictors of 25-OH Vitamin D deficiency in peritoneal dialysis patients: A single center study

Dilek Barutcu Atas, Arzu Velioglu, Murat Tugcu, Hakki Arikan, Ebru Asicioglu

   

Abstract
Vitamin D has a critical role in bone-mineral disorders in chronic kidney disease (CKD) and its deficiency is further associated with increased cardiovascular morbidity and mortality among CKD patients. We aimed to evaluate prevalence of vitamin D deficiency and investigate the laboratory and clinical parameters associated with 25- OH vitamin D deficiency in peritoneal dialysis (PD) patients. Sixty-four (33M/31F) peritoneal dialysis patients were enrolled in this retrospective single center study. Clinical and laboratory data were obtained from patient charts. Prevalence of 25-OH vitamin D deficiency and its associations were analyzed. The patients’ mean age was 49.7±13.3 years and the mean duration of PD was 61.0±55.0 months. The mean 25-OH vitamin D level was 8.9±2.4 ng/ml and none of the patients were on 25-OH vitamin D therapy. All of the patients had lower than normal 25-OH vitamin D levels according to KDOQI guidelines. Levels of 25-OH vitamin D were deficient and insufficient in 84.4% (57.8% mild; 26.6% severe) and 15.6% of the patients, respectively. There was no association between 25-OH vitamin D levels and sex, age, BMI, duration of PD and cause of ESRD. There was a negative correlation between 25-OH vitamin D levels and uric acid and parathyroid hormone. Uric acid was an independent predictor of 25-OH vitamin D deficiency in the logistic regression analysis [OR (95%CI): 0.139 (0.029-0.667), p: 0.014]. We conclude that 25-OH vitamin D deficiency is very common in PD patients. Serum uric acid is an independent predictor of 25-OH vitamin D deficiency which should further be investigated in larger studies.

Key words: 25-hydroxyvitamin D, parathyroid hormone, peritoneal dialysis, uric acid, vitamin D deficiency

Med-Science. 2021; 10(3): 694-7

 
 

Evaluation of patients admitted to the intensive care unit from the emergency department

Original Article

Evaluation of patients admitted to the intensive care unit from the emergency department

Erdal Yavuz

   

Abstract
To determine the factors affecting mortality and transfer time in patients admitted from the emergency department to the intensive care unit (ICU). This study was designed as a retrospective cohort study in a tertiary hospital. For patients who were transferred to ICU from the emergency department, the hospital records regarding waiting times in the emergency department, type of ICU admitted, diagnoses/symptoms, demographic characteristics, presence of cardiac arrest at presentation and clinical outcomes were recorded. During the study period, a total of 1.621 patients were admitted to the intensive care unit from the emergency department. The majority of these patients (61%) were male. After admission to the intensive care unit, 12.9% of the patients died. Gender, age, type of ICU admitted, diagnoses/symptoms, and presence of cardiac arrest at presentation were associated with mortality (p

Key words: Intensive care, emergency department, mortality, waiting time

Med-Science. 2021; 10(3): 688-93

 
 

The effect of transurethral prostate resection due to benign prostate hyperplasia on sexual functions

Original Article

The effect of transurethral prostate resection due to benign prostate hyperplasia on sexual function

Sedat Tastemur, Mehmet Yilmaz, Yusuf Kasap, Erkan Olcucuoglu, Arslan Ardicoglu

   

Abstract
Benign prostatic hyperplasia is an important health problem that is common in the society and negatively affects the quality of life of patients. In our study, we aimed to reveal the effects of transurethral prostate resection performed for benign prostatic hyperplasia on erectile functions and quality of sexual life. We include 56 patients to whom performed transurethral resection of prostate between January 2011, and January 2012 in Türkiye Yüksek İhtisas Training and Research Hospital, Clinic of Urology. The patients were administered the International Prostate Symptom Score (IPSS), International Erectile Function Index (IIEF-5), Sexual Quality of Life (SQoL-M) questionnaires before the operation and the ejaculation method was asked. These questionnaires were repeated in the 6th month after the operation and compared with the pre-operative questionnaires. The mean age of 56 patients included in the study was 66.2±7.09 years. The mean of the IIEF-5 questionnaire was 15.2±7.4, 14.19±8.42 before the operation and 6 months after the operation, respectively. The mean SQoL-M questionnaire of the patients was 64.1±31.9, 59.08±31.9 before the operation and 6 months after the operation, respectively. There was no statistically significant difference between the IIEF-5 and SQoL-M questionnaires performed before and at the 6th month after the operation. Surgery has an important role in the treatment of benign prostatic hyperplasia. While patients are being treated, they suffer from different complaints after surgery. For this reason, it is important to evaluate the treatment method and patients before and after the operation.

Key words: Erectile function, benign prostatic hyperplasia, transurethral prostate resection

Med-Science. 2021; 10(3): 698-701

 
 

PFAPA (periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis) syndrome in children; surgical versus medical treatment?

Original Article

PFAPA (periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis) syndrome in children; surgical versus medical treatment?

Yuksel Toplu, Tuba Bayindir, Mehmet Tekin, Mahmut Tayyar Kalcioglu

   

Abstract
PFAPA (periodic fever, aphthous stomatitis, pharyngitis, and cervical lymphadenopathy) syndrome usually presents in childhood and one of the most common periodic fever syndromes. The syndrome is self-limitted, characterized by periodic fevers at regular intervals and standard clinical features of pharyngitis, aphtous ulcers and cervical lympadenitis. The diagnosis is based upon clinical criteria with the exclusion of other recurrent fever causes. The treatment of PFAPA syndrome is divided two parts; to control of the acute attacks and to decrease the frequency of the attacks. In this retrospective study we aimed to compare the indications and efficiency of medical versus surgical treatment in children with PFAPA syndrome. Forty-five children with PFAPA syndrome whom treated with surgical or medical options were included and divided into two groups. The recovery rates before and after treatments were statistically analyzed. In both groups symptomatic improvement were seen. In surgical and medical treatment groups, complete clinical recovery was found 80% and 74%, respectively. Besides, statistically significant reduction in frequency (p

Key words: Periodic fever, aphthous stomatitis, pharyngitis, cervical adenitis, treatment

Med-Science. 2021; 10(3): 702-5

 
 

Comparison of results of revision total knee arthroplasty surgery due to septic and aseptic loosening

Original Article

Comparison of results of revision total knee arthroplasty surgery due to septic and aseptic loosening

Fatih Dogar, Okkes Bilal, Duran Topak, Mustafa Abdullah Ozdemir, Burak Kuscu

   

Abstract
The purpose of this study was to share the clinical, functional and radiological results of patients who underwent revision total knee arthroplasty (RTKA) for septic or aseptic loosening after total knee arthroplasty. 34 patients who were diagnosed with septic (n=19) or aseptic (n = 15) loosening after total knee arthroplasty and underwent single stage (aseptic group) or two-stage (septic group) RTKA surgery between May 2015 and June 2020 were analyzed retrospectively. Patients with septic loosening were checked again with clinical and laboratory evaluations for the second stage of revision surgery at the postoperative 3rd and 6th weeks. The changes in the joint line before and after the surgery were measured radiographically. The classification of the defects was performed by using the Anderson Orthopedic Research Institute criteria. Preoperative and postoperative Knee Society Score (KSS) was completed by all patients. KSS scores were a statistically significant increase observed in the postoperative values compared to the preoperative ones in both groups (p = 0.001). Moreover, there was a statistically higher increase observed among the aseptic loosening patients compared to the septic patients and the preoperative period in the KSS scores (p = 0.001). In terms of the preoperative distance between the fibular styloid and distal part of the femoral component used in the evaluation of the joint line, it was observed that postoperatively, there was a higher increase in among the patients with septic loosening TKA compared to the aseptic loosening TKA (p = 0.002). As a result, restoration of the joint line is a very important parameter in RTKA, and the increase in joint distance negatively affects the results clinically and functionally. Two-stage surgical treatment in septic loosening TKA is an effective and successful surgical method for the prevention reinfection.

Key words: Total knee arthroplasty, septic, aseptic, loosening, revision

Med-Science. 2021; 10(3): 706-13

 
 

Macro-CK in carbon monoxide poisoning: A guide for in-hospital mortality?

Original Article

Macro-CK in carbon monoxide poisoning: A guide for in-hospital mortality?

Erdal Tekin, Oktay Gulcu, Ugur Aksu, Mustafa Bayraktar

 

   

Abstract
Carbon monoxide (CO) poisoning is common in developing countries and can be mortal. CO poisoning can present with various signs and symptoms. In addition, it has been observed that some people have increased cardiovascular diseases and are associated with high mortality. In this study, the usability of Macro creatine-kinase (Macro-CK) for in-hospital mortality detection in CO poisoning was investigated. This study is a retrospective and single-center study. Data of patients diagnosed with CO poisoning were accessed from the hospital automation system. Macro-CK was accepted for patients with CK-MB higher than total CK. The patients were divided into two groups according to the Macro-CK determination. Macro-CK detected patients were arranged as group-1, and the others as group-2. In-hospital mortality rates were determined in the groups and compared between groups and analyzed. 1100 patients were eligible for the study. Of these patients, Macro-CK was detected in 33 patients (0.03%). The mean age of the patients was 37.6 ± 16.9 and 43.2% were male. In-hospital mortality was 20 (60.6%) in group 1, and 50 (4.7%) in group 2 and was statistically significant (p

Key words: Poisoning, cardiotoxic, mortality, creatine kinase, toxicity

Med-Science. 2021; 10(3): 714-9

 
 

Effect of the COVID-19 pandemic on medication adherence in psychiatric disorders

Original Article

Effect of the COVID-19 pandemic on medication adherence in psychiatric disorders

Bahadir Demir, Esra Guneysu, Muhammet Sancaktar, Sengul Kocamer Sahin, Gulcin Elboga, Abdurrahman Altindag

 
   

Abstract
The aim of this study is to investigate the effect of COVID-19 pandemic and the restrictions taken on the medication, thus treatment adherence of patients with psychiatric disorders. A semi-structured form prepared by the authors and the Morisky treatment adherence scale were applied to the patients who were regularly followed up in Gaziantep University Medical Faculty Psychiatry outpatient clinic for 6 months before March 11, 2020, which was the first date of the COVID-19 case in Turkey and who visited the outpatient clinic for follow-up after the pandemic. 206 patients who met the study criteria were evaluated. Of these patients, it was found that 29 (14.1%) had their medication adherence impaired due to non-pandemic reasons. Analysis was performed with the remaining 177 patients. The average age of patients was 41.73 ± 13.48. According to the general characteristics of the participants, 117 were women and 60 men. With regard to the treatment adherence rates, 69 patients (39%) were not affected by the pandemic in which treatment adherence was high, 46 (26%) had moderate treatment adherence, and 62 (35%) showed poor treatment adherence. The comparison of patients in terms of treatment adherence according to their diagnosis revealed no statistically significant difference (p = 0.100). To the best of our knowledge, this is the first study investigating the medication (treatment) adherence of patients with psychiatric disorders who were on treatment before the pandemic. Studies with large samples are warranted to better understand the effect of the pandemic on treatment adherence.

Key words: COVID-19, pandemic, outbreaks, adherence, treatment, psychiatric disorders

Med-Science. 2021; 10(3): 720-4