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The investigation of clinical and radiological findings of igG4-related autoimmune pancreatitis

Original Article

The investigation of clinical and radiological findings of igG4-related autoimmune pancreatitis

Mustafa Koc

   

Abstract
This study aims to investigate the clinical and radiological findings of IgG4-related autoimmune pancreatitis diagnosed in our clinic. The data of patient files diagnosed as IgG4-related autoimmune pancreatitis in our hospital between March 2015 and February 2020 were reviewed retrospectively. 17 cases were included in the study. 10 of the cases were male (59 %) and 7 were female (41 %). Their ages ranged between 47 and 72, and the mean age was 61 ± 4.5. Clinical and laboratory findings with radiological imaging findings of the cases were investigated. The most common symptoms seen during admission to the clinic were obstructive jaundice (65 %), weight loss (53 %) and diabetes mellitus (29 %) that occurred recently. In laboratory examination, there was an increase in CEA and CA 19-9 in 9 patients (53 %). Increased IgG4 was measured in 11 patients (65 %). Some of the patients were accompanied by retroperitoneal fibrosis (3 cases), thyroiditis (2 cases), cholangitis (2 cases) and cholecystitis (1 case). In computed tomography (CT) and Magnetic Resonance Imaging (MRI) examination, diffuse increase in the size of the pancreas was observed in 14 cases (82 %). The focal increased size was most frequently observed in the pancreatic head. Recurrence developed in 5 of the patients (29 %) who received steroid treatment. As a Conclusion, autoimmune pancreatitis is a rare form of chronic pancreatitis that occurs with autoimmune mechanisms. It can be confused clinically with pancreatic cancer. Other extrapancreatic pathologies associated with IgG4 may accompany. Although IgG4 is helpful in diagnosis, the positive predictive value is low. The diagnosis of the disease is very important in terms of treatment. Clinical and radiological findings have an important role in the diagnosis of the disease.

Key words: Autoimmune pancreatitis, computed tomography, magnetic resonance imaging

Med-Science. 2020; 9(3): 526-9

 
 
 
Medicine Science Vol:9 Issue:3 Year:2020 PP:526–801

Immunohistochemical expression of E-Cadherin and β-catenin in prostate adenocarcinoma and benign prostate hyperplasia

Original Article

Immunohistochemical expression of E-Cadherin and β-catenin in prostate adenocarcinoma and benign prostate hyperplasia

Aysegul Isal Arslan, Sevil Karabag, Murat Akgul, Ilker Yildirim

   

Abstract
Disruption of the E cadherin mediated complex due to loss or depletion of E cadherin results in epithelial abnormalities and serious developmental impairment in various tissues and organs. The present study aims to determine E cadherin and β catenin expression in patients diagnosed with benign prostatic hyperplasia (BPH) and prostate carcinoma (PCa) based on Gleason scores and investigate the association of these proteins with PSA levels and Gleason scoring. Immunohistochemical staining for E cadherin and β catenin was performed in 59 patients diagnosed with PCa and 30 patients with BPH. Mean E cadherin expression was 3.00 in patients diagnosed with BPH and 2.38±0.5 in patients with PCa, with a statistically significant difference between these values (p

Key words: Prostate carcinoma, benign prostatic hyperplasia, E cadherin, β catenin

Med-Science. 2020; 9(3): 530-4

 
 
 

Is the number of dislocations after bipolar hemiarthroplasty affected by anatomical parameters?

Original Article

Is the number of dislocations after bipolar hemiarthroplasty affected by anatomical parameters?

Erdal Uzun, Abdulhamit Misir

   

Abstract
The aim of this study was to evaluate the relationship between the number of dislocations and anatomical parameters after bipolar hemiarthroplasty (BHA) in femoral neck fracture (FNF) treatment. ‘A total of 240 consecutive patients (157 females, 83 males) with FNFs who were treated with BHA were evaluated retrospectively. Of these 24 patients with dislocations divided into two main groups according to the number of dislocations: Single-dislocation (Group 1, n=15) and multiple-dislocation groups (Group 2, n=9). Surgery-related and anatomical morphologic features as well as patient factors and clinical outcomes were comparatively analyzed between the groups. Pre and postoperative standard anteroposterior (AP) and lateral radiographs were used to evaluate for surgical and anatomical parameters. Harris and Modified Harris Scores were used to evaluate postoperative clinical outcomes. The mean follow-up period was 30.2±11.7 months (range, 12-56 months). Mean age was 80.1±6.4 years (range, 71-98 years). Dislocation incidence was 10.0% (24/240). Mean time to first dislocation was 2.3±1.4 months (range, 1-6 months). Mean number of dislocations was 2.1±1.0 (range, 1-4). There was significant difference in surgical factors and anatomical parameters between groups including nonoperated side offset (ON), nonoperated side femoral offset (FO), residual femoral neck length (RFNL), major trochanter upper end and femoral head center distance (TEFHCD) of nonoperated side, height of hip center (HHC) of operated and nonoperated side, femoral neck-shaft angle (FNSA) of operated side and pelvic obliqity (PO) between the groups (p0.05). Surgery-related and anatomical morphologic features were found to be effective in the number of dislocations (re-dislocation) after BHA. Patients who experienced the first-time dislocation after BHA with anatomical and surgical risk factors should be carefully monitored and more controlled physiotherapy may be recommended in terms of re-dislocation risk.

Key words: Hemiarthroplasty, dislocation, risk factor, pelvic morphology, anatomical features

Med-Science. 2020; 9(3): 535-40

 
 
 
 
 

Phase value assessment reveals iron accumulation in parkinson disease

Original Article

Phase value assessment reveals iron accumulation in parkinson disease

Ayse Nur Sirin Ozcan, Ebru Bilge Dirik

   

Abstract
PD is characterized by iron accumulation in the substantia nigra (SN) different from healthy controls. We aim to quantify iron accumulation via susceptibility weighted imaging (SWI) in Parkinson disease (PD). Twenty patients with PD and 21 healthy controls were included in this study. The SWI phase value was evaluated from SN in two areas (middle midbrain and lateral side of middle midbrain) at the axial plane for both sides (right and left). The PD group was divided into two subgroups after clinical examination: the affected side (AS), which was the contralateral of the clinically prominent side and the non-affected side (NAS). The subgroups were analyzed individually. The results of both sides compared between the PD and control groups, as well as between the PD subgroups. The phase values were statistically different in the PD-AS and control group in both areas (< 0.001). Furthermore, at the middle midbrain, the PD-NAS showed a statistical difference compared with the control group (p=0.002). Within the PD groups, only the lateral side of the middle midbrain area (LMMA) demonstrated a statistical difference between the AS and NAS subgroups (p = 0.005). Phase value assessment is useful to demonstrate the effect of iron accumulation on substantia nigra in PD.

Key words: Parkinson disease, susceptibility weighted imaging, iron accumulation, substantia nigra, phase value

Med-Science. 2020; 9(3): 541-4

 
 
 
 
 

Evaluation of single low-dose caudal epidural block effectiveness in children undergoing circumcision surgery: Single center experience

Original Article

Evaluation of single low-dose caudal epidural block effectiveness in children undergoing circumcision surgery: Single center experience

Volkan Ozen

   

Abstract
The aim of this study was to evaluate the effectiveness of a single-dose caudal epidural block administered during circumcision surgery on postoperative analgesia. The study was conducted with the permission of the local ethics committee by screening the files of the patients with ASA I status between the ages of 4-9 years who had undergone circumcision surgery under general anesthesia at the Anesthesiology and Resuscitation Department of a training and research hospital between July 2018 and January 2019. Data were collected by using the anesthesia follow-up form of the participants and the Children’s Hospital of Eastern Ontario Pain Scale when post-operative pain was evaluated. Descriptive statistics of the constant numerical variables were presented with median, IQR [interquartile range] while number (n) and percentage (%) were used for the categorical variables. A total of 149 patient files were screened within the scope of the study. The median [IQR] age was 7 [6-9] years. No side effect developed and no analgesic was required during hospitalization in any patient. The median [IQR] of CHEOPS score was 4 [4-4] with a range of 4 to 6. When asked, 98.0% of the parents said that they were perfectly satisfied with the surgery. Effective postoperative analgesia was provided without any side effects or complications with the use of 0.25% bupivacaine at a low single dose of 0.2 ml/kg for caudal epidural block in the pediatric population undergoing circumcision surgery.

Key words: Caudal epidural block, postoperative pain, CHEOPS, parent satisfaction, analgesia

Med-Science. 2020; 9(3): 545-8

 
 
 
 
 

Evaluation of factors influencing quality of life in the third trimester of pregnancy: A cross-sectional study

Original Article

Evaluation of factors influencing quality of life in the third trimester of pregnancy: A cross-sectional study

Selda Yoruk, Hulya Turkmen

   

Abstract
Quality of life in pregnancy plays a key role in maternal healthcare. This study sought to determine the effects of sociodemographic characteristics, maternal risk factors and pregnancy complaints on pregnant women’s quality of life. This descriptive study assessed the quality of life of 327 pregnant women using the short form of the World Health Organization’s Quality of Life Assessment in conjunction with a questionnaire about sociodemographic and obstetric characteristics. Results were statistically analyzed using Independent Samples t-tests, Kruskal Wallis Variance Analysis, the Mann-Whitney U test and multiple regression analysis. Physical symptoms of pregnancy, such as fatigue, constipation, dizziness and frequent urination, decreased women’s physical quality of life. Caesarean deliveries, higher spousal education levels and fewer children were significantly correlated with a higher environmental quality of life. Poor social quality of life was correlated with a history of mental illness and lower education levels (p

Key words: Pregnancy, obstetric features, pregnancy complaints, quality of life

Med-Science. 2020; 9(3): 549-55

 
 
 
 
 

The frequency and causes of pes equinavarus in the neonatal intensive care unit in a tertiary care center from eastern in anatolia

Original Article

The frequency and causes of pes equinavarus in the neonatal intensive care unit in a tertiary care center from eastern in anatolia

Sezai Ozkan, Cihan Adanas, Murat Basaranoglu

   

Abstract
PEV is one of the most common deformities in the foot. The incidence of PEV varies between communities and many theories about its etiology have been proposed. In this study, we aimed to share our experience with the incidence and etiology of PEV in the neonatal intensive care unit of a tertiary hospital. 3658 patients who were followed up in a tertiary neonatal intensive care unit from 2014 to 2017 were included in the study. Data on the number and etiology of newborns with PEV deformity were obtained from the automation records of our hospital. PEV deformity was diagnosed in 32 (0.87%) of 3658 babies treated in the neonatal intensive care unit over a period of 3 years. Of these 32 patients, 18 (56.25%) were bilateral, and 14 (43.75%) unilateral PEV. Two (6.25%) of our patients had a positive family history. While 23(71.87%)) of our patients were delivered by cesarean, 9 (28,1%) of our patients were born normally. Considering birth weights, the number of babies born under 2500 grams was 7 (21.8%), and the number of babies born above 2500 grams was 25 (78.1%). Considering the data we obtained at the end of the study, the incidence of PEV was lower than in the literature. In fact, our hypothesis before starting the study was that the incidence of PEV was higher in the neonatal intensive care unit. Although the frequency of PEV is known to vary between populations, the etiology of PEV is not fully known. We believe that future studies (such as genetic studies) will be more beneficial to science than classical knowledge about PEV etiology.

Key words: Pes equinavarus, deformity, newborn, anatolia

Med-Science. 2020; 9(3): 556-9

 
 
 

Seasonal distribution of sudden sensori̇neural hearing loss

Original Article

Seasonal distribution of sudden sensori̇neural hearing loss

Nevreste Didem Sonbay Yılmaz, Nuray Ensari, Ozer Erdem Gur

   

Abstract
Sudden Sensorineural Hearing Loss (SSHL) is sensorineural hearing loss that occurs in 3 days or less, characterized by 30 dBHL or more, over at least 3 contiguous audiometric frequencies. In this study, we aimed to evaluate the SSHL incidence and its relationship with the seasons retrospectively by examining the patients diagnosed with SSHL in our clinic in the last 10 years. In our study, the files of 1920 patients diagnosed with SSHL in our hospital between January 2000 and December 2019 were analyzed retrospectively. The patients were evaluated separately according to age groups, gender, sudden hearing loss, months and seasons. SSHL was most common in January and October, but this difference was not statistically significant compared to other months (p>0.05). When the distribution according to the seasons was examined, it was observed that 28% of patients were in winter, 24% in spring, 26% in autumn and 22% in summer. The difference between seasons was not statistically significant (p>0.05). In October, the first month of the autumn season, and January, the first month of the winter season, we can attribute the high rate of SSHL to seasonal transitions. However, a more detailed study is required in this regard. A more precise result could be achieved with data on annual temperature transitions, humidity status and frequency of viral infections, which can only give us a preliminary information.

Key words: Sudden Sensorineural Hearing Loss, Seasonal, Sensorineural Hearing Loss

Med-Science. 2020; 9(3): 560-2

 
 
 
 
 

Comparison of palm print test with other difficult intubation prediction tests in patients with diabetes mellitus

Original Article

Comparison of palm print test with other difficult intubation prediction tests in patients with diabetes mellitus

Ali Ihsan Uysal, Basak Altiparmak, Melike Korkmaz Toker, Semra Gumus Demirbilek

   

Abstract
Prediction of difficult intubation has critical importance in anesthesia practice. Diabetic patients usually have limited joint mobility which limits the head and neck extension during laryngoscopy. On the day prior to surgery, the patients who had diagnosis of diabetes mellitus at least for one year, were examined by an investigator by using palm print test (PPT) and other standard assessment indices. The investigator assigned a score to each evaluation indices. PPT was found to have better sensitivity (0.944), spesivity (0.692), positive predictive value (0.895) and negative predictive value (0.818) than standard assessment tests (p < 0.01). PPT should be kept in mind as a viable and easy-to-perform test for predicting difficult intubation of patients with Diabetes Mellitus.

Key words: Difficult intubation, diabetes mellitus, palm print test

Med-Science. 2020; 9(3): 563-8

 
 
 
 
 

An examination of forensic autopsy cases with pulmonary embolism

Original Article

An examination of forensic autopsy cases with pulmonary embolism

Ahmet Sedat Dundar, Mucahit Oruc, Ismail Altin, Bedirhan Sezer Oner, Semih Petekkaya, Emine Turkmen Samdanci, Osman Celbis

   

Abstract
The aim of this study was to examine the frequency, origin, histopathology, and risk factors of PE, the vascular characteristics causing obstruction and the direct or indirect effect on mortality. A retrospective examination was made of autopsies conducted between 2013 and 2016 in the Malatya Forensic Medicine Group Directorate. Cases determined with PE were evaluated in respect of age, gender, event origin, risk factors, history of hospitalization, size of the vessels obstructed by the thromboembolism and histopathological examination. Pulmonary embolism is a frequently seen complication during hospitalization and is one of the leading causes of preventable hospital deaths. When advanced diagnostic methods are used, deep vein thrombosis is determined in 79% of PE patients. The annual incidence in Turkey is approximately 15/10,000 cases, which is comparable to rates in western populations. Although PE is seen more at advanced ages, attention must be paid to young cases with trauma-related injuries. Histopathological examination is of the greatest importance as the mortality rate associated with large vessel obstruction is high and obstructions in small vessels alone also contribute to mortality.

Key words: Autopsy, death, pulmonary thromboembolism, risk factors

Med-Science. 2020; 9(3): 569-72