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1.
World J Surg ; 42(6): 1748-1753, 2018 06.
Artículo en Inglés | MEDLINE | ID: mdl-29234848

RESUMEN

OBJECTIVES: We aimed to assess possible risk factors related to difficult intubation in patients undergoing thyroid surgery. METHODS: We prospectively collected data of 200 patients scheduled for thyroid surgery. Clinical risk factors were defined as: Mallampati score, interincisor gap, thyromental distance, sternomental distance, range of neck motion, body mass index, neck circumference, goiter, the presence of radiological findings suggesting compression and thyroid weight. All evaluations were performed with Macintosh assessed for Cormack and Lehane (CL) classification and modified intubation difficulty scale (MIDS). RESULTS: It was observed that the proportion of patients with a thyroid weight ≥40 g, goiter, a Macintosh CL score = 3-4 and the mean neck circumference were significantly higher in the group with a MIDS score >5 (p = 0.018, p = 0.011, p < 0.001, respectively). CONCLUSION: The presence of a palpable goiter, thyroid weight ≥40 g and thyromental distance <6.5 cm were risk factors associated with difficult intubation in the multivariate regression model.


Asunto(s)
Bocio/cirugía , Intubación Intratraqueal/métodos , Glándula Tiroides/cirugía , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Factores de Riesgo
2.
Eur Arch Otorhinolaryngol ; 274(5): 2295-2302, 2017 May.
Artículo en Inglés | MEDLINE | ID: mdl-28238161

RESUMEN

Voice alteration is an important complication of thyroid surgery and is closely related to patients' quality of life. There are no studies analyzing effect of energy-based devices (EBD) on voice quality (VQ). Aim of this prospective study is to evaluate impact of sutureless total thyroidectomy performed with EBDs on objective voice parameters of patients without recurrent laryngeal nerve (RLN) and/or external branch of superior laryngeal nerve (EBSLN) injury. Sixty patients underwent total thyroidectomy with meticulous dissection of EBSLN. Patients were assigned to Group L (Ligasure™), Group H (Harmonic), or Group C (Conventional) through random ballot. For analysis of alteration in VQ, digital videolaryngostroboscopy (VLS), voice handicap index (VHI), multidimensional voice program (MDVP), and electroglottography (EGG) were used. VLS was performed by 70°-angled indirect laryngoscopy and evaluation was standardized by VLS scale and laryngeal function scoring. This study is registered on clinicaltrials.gov with number NCT01865006. Forty eight patients were female. There was no difference on demographic data. On post-operative laryngoscopic examination, none of the patients had vocal fold palsy. When mean VHI scores at post-operative 1st week and 2nd month were compared to pre-operative values for each groups, groups L and H demonstrated a significant increase in VHI in the early post-operative evaluation, while there was no significant increase for group C. No significant increase was seen in late post-operative period compared to pre-operative period for any groups. In the early post-operative period, VQ is better with the conventional technique than EBDs; however, in late post-operative period, VQ is detected better in EBDs (especially in Group L) than the conventional technique, but no statistical difference was observed.


Asunto(s)
Complicaciones Posoperatorias , Calidad de Vida , Procedimientos Quirúrgicos sin Sutura , Tiroidectomía , Trastornos de la Voz , Calidad de la Voz , Adulto , Diseño de Equipo , Femenino , Humanos , Laringoscopía/métodos , Masculino , Persona de Mediana Edad , Complicaciones Posoperatorias/diagnóstico , Complicaciones Posoperatorias/etiología , Complicaciones Posoperatorias/psicología , Estudios Prospectivos , Procedimientos Quirúrgicos sin Sutura/efectos adversos , Procedimientos Quirúrgicos sin Sutura/instrumentación , Procedimientos Quirúrgicos sin Sutura/métodos , Tiroidectomía/efectos adversos , Tiroidectomía/instrumentación , Tiroidectomía/métodos , Resultado del Tratamiento , Trastornos de la Voz/diagnóstico , Trastornos de la Voz/etiología
3.
J Craniofac Surg ; 27(1): 166-9, 2016 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-26674915

RESUMEN

OBJECTIVE: The purpose of this study was to evaluate the degree of deviation and the sizes of nasal turbinates and the septal body (SB) on each side separately and to compare the 2 sides, and to evaluate if there is a correlation between SB size and middle and inferior turbinate (IT) sizes on each side. MATERIAL AND METHODS: A retrospective analysis was made of paranasal computerized tomography scans obtained randomly from the database. Computerized tomography was performed at 120 kVp and 100 mA with 2 mm slice thickness. The study comprised 199 paranasal computerized tomography scans on each of which the width of the SB, the degree of deviation, and the width of the inferior and middle turbinates (MTs) were measured on each side separately. RESULTS: In cases of moderate and severe deviation, the sizes of the SB, the MT, and IT contralateral to the deviation were statistically significantly larger than those on the ipsilateral side (P < 0.001). There was a negative correlation between SB size and the MT and IT sizes in each nasal cavity. CONCLUSIONS: The SB is a dynamic structure and may play a role in regulation of nasal airflow.


Asunto(s)
Tomografía Computarizada Multidetector/métodos , Tabique Nasal/anomalías , Cornetes Nasales/anomalías , Adolescente , Adulto , Anciano , Femenino , Humanos , Procesamiento de Imagen Asistido por Computador/métodos , Masculino , Persona de Mediana Edad , Cavidad Nasal/diagnóstico por imagen , Tabique Nasal/diagnóstico por imagen , Senos Paranasales/diagnóstico por imagen , Estudios Retrospectivos , Cornetes Nasales/diagnóstico por imagen , Adulto Joven
4.
J Pak Med Assoc ; 66(5): 568-73, 2016 May.
Artículo en Inglés | MEDLINE | ID: mdl-27183938

RESUMEN

OBJECTIVE: To reveal clinical and polysomnographic features in patients treated for restless leg syndrome, and to examine the compatibility of sleep data and clinical features. METHODS: The study was conducted at the Department of Neurology, Ankara Numune Training and Education Hospital, Ankara, Turkey, and comprised patients who presented to the outpatient clinic between January and July 2014 who were diagnosed with restless leg syndrome based on the International RestIess Leg Syndrome Study Group criteria. Patients underwent polysomnography test in spontaneous sleep in a single room. SPSS 18 was used for statistical analyses. RESULTS: Of the 18 patients, 13(72%)were females and 5(28%)were males. Overall mean age was 51.56±11.57years (range: 23-66 years). Fourteen (77.8%) patients reported insomnia; 10(55.5%) patients had excessive daytime sleepiness; 13(72.2%) reported snoring; and 3(17%) had apnoea. Mean International Restless Legs Syndrome Study Group Rating Scale score was 26.11±7.9 (range: 16-40).Mean Epworth Sleepiness Scale score was 9.17±5.1 (range: 0-20). CONCLUSIONS: Restless leg syndrome was more common in women and the most common complaint was insomnia.


Asunto(s)
Trastornos de Somnolencia Excesiva/complicaciones , Síndrome de las Piernas Inquietas/complicaciones , Adulto , Anciano , Trastornos de Somnolencia Excesiva/diagnóstico , Femenino , Humanos , Masculino , Persona de Mediana Edad , Polisomnografía , Síndrome de las Piernas Inquietas/diagnóstico , Factores Sexuales , Adulto Joven
5.
Surg Technol Int ; 25: 907-101, 2014 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-25433155

RESUMEN

Hospitalizing patients up to 72 hours after thyroidectomy is a classical approach. However, the length of hospitalization has decreased following surgical procedures with new technological devices. Seven hundred one consecutive patients who underwent sutureless total thyroidectomy (STT) between October 2011 and 2013 were included in this study. Six hundred seventy-two (95.9%) were discharged before 24 hours following surgery (short-stay = SS), and 29 were discharged later (delayed-discharge = DD). This study aims to assess short-stay STT with early postoperative complications and readmission to hospital. One hundred forty-three SS patients were male and 529 were female. Mean age was 48 ± 13 years, BMI was 28.7 ± 8.3 kg/m2. Mean hospital stay for SS was 18.13 ± 1.97 (17-23) hours. Histopathology was benign in 443 (65.92%) and malignant in 229 (34.08%) in the SS group. In three (0.4%) of the SS group drainage was required because of hematoma, and in seven (1%) wound infection was observed. One hundred seven (7.9%) [permanent = 7 (0.52%)] of 1344 recurrent laryngeal nerves (RLNs) in SS were seen paralyzed in postoperative vocal cord examination. Hypocalcemia (all transient) was observed in 52 (7.74%) of the SS group. Eight of those 52 readmitted to hospital with symptomatic hypocalcemia and were treated as outpatients. There was no mortality. Of the DD group, two stayed in the intensive care unit, two had dysphonia, two had hematoma with anti-coagulant use, one had fever, four did not tolerate diet, five refused discharge, and 13 had symptomatic hypocalcemia. Sutureless total thyroidectomy can be performed safely and effectively as short-stay surgery.

7.
J Clin Endocrinol Metab ; 107(5): e1924-e1931, 2022 04 19.
Artículo en Inglés | MEDLINE | ID: mdl-35028661

RESUMEN

CONTEXT: There is a significant challenge of attributing specific diagnoses to patients with primary adrenal insufficiency of unknown etiology other than congenital adrenal hyperplasia (non-CAH PAI). Specific diagnoses per se may guide personalized treatment or may illuminate pathophysiology. OBJECTIVE: This work aimed to investigate the efficacy of steroid hormone profiles and high-throughput sequencing methods in establishing the etiology in non-CAH PAI of unknown origin. METHODS: Pediatric patients with non-CAH PAI whose etiology could not be established by clinical and biochemical characteristics were enrolled. Genetic analysis was performed using targeted-gene panel sequencing (TPS) and whole-exome sequencing (WES). Plasma adrenal steroids were quantified by liquid chromatography-mass spectrometry and compared to that of controls. This study comprised 18 pediatric endocrinology clinics with 41 patients (17 girls, median age: 3 mo, range: 0-8 y) with non-CAH PAI of unknown etiology. RESULTS: A genetic diagnosis was obtained in 29 (70.7%) patients by TPS. Further molecular diagnosis could not be achieved by WES. Compared to a healthy control group, patients showed lower steroid concentrations, most statistically significantly in cortisone, cortisol, and corticosterone (P < .0001, area under the receiver operating characteristic curve: .96, .88, and .87, respectively). Plasma cortisol of less than 4 ng/mL, cortisone of less than 11 ng/mL, and corticosterone of less than 0.11 ng/mL had a greater than 95% specificity to ensure the diagnosis of non-CAH PAI of unknown etiology. CONCLUSION: Steroid hormone profiles are highly sensitive for the diagnosis of non-CAH PAI of unknown etiology, but they are unlikely to point to a specific molecular diagnosis. TPS is an optimal approach in the molecular diagnosis of these patients with high efficacy, whereas little additional benefit is expected from WES.


Asunto(s)
Enfermedad de Addison , Hiperplasia Suprarrenal Congénita , Cortisona , Enfermedad de Addison/diagnóstico , Enfermedad de Addison/genética , Hiperplasia Suprarrenal Congénita/complicaciones , Hiperplasia Suprarrenal Congénita/diagnóstico , Hiperplasia Suprarrenal Congénita/genética , Niño , Preescolar , Corticosterona , Femenino , Humanos , Hidrocortisona , Masculino , Patología Molecular , Esteroides
8.
J Anesth ; 25(2): 219-24, 2011 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-21225292

RESUMEN

PURPOSE: The purpose of our study was to compare the equipotent doses of ropivacaine and levobupivacaine for walk-out criteria and the characteristics of spinal anesthesia in inguinal herniorrhaphy surgery. METHODS: Combined spinal-epidural anesthesia was performed. Adult patients were randomly allocated to receive 5 mg 0.5% ropivacaine plus 25 µg fentanyl (group RF, n = 25) or 3.75 mg 0.75% levobupivacaine plus 25 µg fentanyl (group LF, n = 25). Each solution was hypobaric, and the same volume, 3 ml, was administered. Sensory and motor block characteristics, hemodynamic changes, side effects, number of patients having ability to stand and walk at the end of the operation, time to first analgesic requirement, time to urination, time to getting out of bed (ambulation), and time to home discharge were determined. RESULTS: Sensory block onset time and time to reach the T6 dermatome were significantly shorter in group LF, whereas time to the two-segment regression and time to first analgesic requirement were significantly shorter in group RF. All patients in group LF were Bromage 0. Time to home discharge was shorter in group LF, but this difference was not statistically significant. CONCLUSION: We suggest that both local anesthetics can be used in walking spinal technique. Levobupivacaine may be an alternative local anesthetic for walking spinal anesthesia as it provides minimum motor block and a long duration of postoperative analgesia, even if its use is not associated with a shorter home discharge time.


Asunto(s)
Procedimientos Quirúrgicos Ambulatorios , Amidas/farmacología , Anestesia Epidural , Anestesia Raquidea , Anestésicos Locales/farmacología , Hernia Inguinal/cirugía , Adulto , Anciano , Amidas/administración & dosificación , Bupivacaína/administración & dosificación , Bupivacaína/análogos & derivados , Bupivacaína/farmacología , Femenino , Hemodinámica/efectos de los fármacos , Humanos , Levobupivacaína , Masculino , Persona de Mediana Edad , Ropivacaína
9.
J Obstet Gynecol Neonatal Nurs ; 50(3): 307-315, 2021 05.
Artículo en Inglés | MEDLINE | ID: mdl-33684342

RESUMEN

OBJECTIVE: To compare the course of the transcutaneous bilirubin (TcB) values of early-term newborns with those of term newborns in the first month of life and to investigate whether early-term newborns have an increased risk of significant hyperbilirubinemia requiring treatment. DESIGN: A prospective, controlled cohort analysis. SETTING: A tertiary level mother-child birth and health care center. PARTICIPANTS: Four hundred early-term (37 0/7 to 38 6/7 weeks) and 320 term (39 0/7 to 41 6/7 weeks) newborns born during a 27-month period. METHODS: A total of six TcB measurements in a longitudinal manner were made in early-term and term newborns: the first two at 6 and 48 hours after birth and the next four on routine examination days (Days 4, 7, 15, and 30). Demographic characteristics, values of daily TcB measurements, number of newborns with significant hyperbilirubinemia, and risk of jaundice requiring treatment were compared between the two groups. RESULTS: All six TcB values were significantly greater in the early-term group than in the term group (p < .001 for each). Early-term newborns had a statistically significant increased risk of jaundice requiring treatment compared to term newborns (risk ratio = 1.91; 95% confidence interval [1.23-2.96]; p = .0046). Results of the repeated-measures analysis of variance and post hoc adjusted multiple comparison analysis showed that TcB levels increased to and peaked at 96 hours after birth and then gradually decreased to baseline (first measurement) levels at 30 days after birth in each group. CONCLUSIONS: Early-term newborns should not be treated as full-term newborns because they have significantly higher TcB levels. These newborns should be closely monitored for pathologic jaundice because they have increased risk for significant hyperbilirubinemia requiring phototherapy.


Asunto(s)
Bilirrubina , Hiperbilirrubinemia , Estudios de Cohortes , Humanos , Recién Nacido , Tamizaje Neonatal , Fototerapia , Estudios Prospectivos
10.
Turk J Pediatr ; 62(5): 756-762, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33108077

RESUMEN

BACKGROUND: Although the relationship between umbilical cord clamping time and various parameters such as hemoglobin (Hb) levels, iron deficiency, and risk of neonatal jaundice has previously been studied, to the best of our knowleadge there have been no studies investigating the relationship between cord clamping time and the risk of significant hyperbilirubinemia. We aimed to investigate the relationship between the time of umbilical cord clamping and transcutaneous bilirubin (TcB) measurements made on various postnatal hours, Hb and serum total bilirubin (STB) levels measured on postnatal 4th day, and the risk of development of significant hyperbilirubinemia requiring phototherapy treatment. METHODS: Eligible newborns were divided into two groups on the basis of the time of cord clamping: those clamped late (60 seconds or more; Group I) and those clamped early (less than 60 seconds; Group II). Groups were compared with respect to the parameters of cord Hb, postnatal TcB measurements at 6th, 48th, 96th and 168th hours, and 96th hour Hb, STB and direct bilirubin levels. RESULTS: TcB levels at the 96th and 168th hour were significantly higher in Group I when compared to Group II (p < 0.001 and p < 0.001, respectively). The 96th hour STB level was significantly higher in Group I when compared to Group II (p < 0.001). The need of phototherapy requirement was higher in Group I when compared to Group II (p=0.001). Increase in cord blood Hb for each 1 gr/dl caused a 3.94-fold increased risk in the requirement of phototherapy treatment. Cord clamping time showed statistically significant positive correlations with both cord blood and 96th hour venous Hb levels, with both 96th hour and 168th hour TcB levels, and with 96th hour STB levels. CONCLUSIONS: Newborns whose cords are clamped late should be followed up closely with respect to high postnatal bilirubin levels and other risks associated with significant hyperbilirubinemia requiring phototherapy treatment.


Asunto(s)
Hiperbilirrubinemia Neonatal , Ictericia Neonatal , Bilirrubina , Constricción , Humanos , Hiperbilirrubinemia/etiología , Hiperbilirrubinemia Neonatal/diagnóstico , Hiperbilirrubinemia Neonatal/terapia , Recién Nacido , Fototerapia
11.
Turk Pediatri Ars ; 53(1): 45-47, 2018 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-30083074

RESUMEN

Visceral leishmaniasis is an infectious disease that infects and multiplies in macrophages of the liver, spleen, and bone marrow. The most common clinical features are fever, splenomegaly, and anemia. Anemia, leucopenia, and thrombocytopenia are the main hematologic abnormalities commonly seen in visceral leishmaniasis. These findings can be seen in several types of hematologic disorders. The findings are similar to most hematologic disorders and so may make diagnosis problematic. It is difficult to confirm when it is seen except in epidemiologic areas. It can be fatal if it is not treated and appropriate treatment can be lifesaving. In this article a 12 year-old male patient who was followed-up with diagnosis of acute lymphoblastic leukemia and received maintenance therapy while being under remission after BFM-ALL-2000 treatment protocol and diagnosed with hemophagocytic lymphohistiocytosis due to Kala-azar during this period was presented.

12.
Turk J Surg ; 34(2): 146-148, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-30023982

RESUMEN

Adrenal angiosarcoma is an uncommon neoplasm that derives from the vascular endothelium; due to its biological behavior, it should be distinguished from other adrenal tumors. We herein report a case of a 57-year-old woman with diagnosis of an adrenal tumor that was suspected to be malignant. The specimen was histopathologically proved to be an angiosarcoma. The patient was suffering from right upper quadrant pain; after laboratory and radiological workup, a non-functioning right adrenal mass, 14 cm in size, was recognized. A right subcostal incision was made, and adrenalectomy was performed successfully with tumor-free surgical margins. Two months after the operation, a positron emission tomography-computed tomography scan was ordered for follow-up. No tumor tissue or any other metastatic foci remained. The patient had been referred to our medical oncology department and underwent retroperitoneal radiotherapy. However, unfortunately, the patient died due to cardiac insufficiency during the follow-up period.

13.
Turk Pediatri Ars ; 52(3): 162-164, 2017 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-29062250

RESUMEN

In addition to Rh and ABO incompatibilities subgroup incompatibilities may rarely play a role among the causes of hemolytic anemia and indirect hyperbilirubinemia in newborns. The most common minor blood group antigens that cause blood incompatibility between the mother and baby are C, c, E, e, Kell, Duffy, Diego, Kidd and MNSs antigens. In this article, a newborn in whom hyperbilirubinemia due to anti-E minor blood group incompatibility developed and was treated with phototherapy succesfully is presented and minor blood group incompatibilities due to anti-E are reviewed.

14.
Gland Surg ; 6(5): 591-593, 2017 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-29142853

RESUMEN

Silk suture reaction (i.e., a benign granulomatous inflammatory foreign body reaction) is a rare complication of thyroid surgery. Here, two cases of post-thyroidectomy suture reaction are presented. Both of the patients were female, one is 48 and the other is 34 years old. The patients were presented with neck swelling and leakage of serous fluid from the Kocher's incision. Both patients had normal free T4, free T3, and TSH values. The 48-year-old female patient had a right subtotal and left near-total thyroidectomy 6 years ago and the other had bilateral total thyroidectomy 6 years ago. In the physical examination a mobile, painless, red, swelling was palpated in front of neck. In the ultrasound of both patients, a heterogeneous nodule with hypoechoic rim was seen, however, in scintigraphy no radiopharmaceutical involvement was observed in thyroid region. Due to suspicion of thyroid malignancy, a fine needle aspiration biopsy was performed and foreign body reaction was revealed cytologically. A suture reaction can vary from an erythematous swelling to chronic granulomatous reaction. The time interval between the operation and formation of suture reaction was 6 years in both of the cases thus these patients were considered as chronic patients. Foreign body reaction diagnosis was confirmed with fine needle aspiration biopsy. It is important to diagnose these chronic inflammation cases since these cases can mimic recurrence in thyroid malignancies. A post-thyroidectomy suture reaction is diagnosed cytologically with fine needle aspiration biopsy and by surgical removal of suture, this chronic inflammatory reaction can be cured.

15.
Gland Surg ; 6(5): 594-597, 2017 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-29142854

RESUMEN

Skin metastasis of papillary thyroid carcinoma (PTC) is rare. Here, two cases of skin metastases of PTC are presented. Both of the patients were females, one is 83 and the other is 65 years old. The patients were admitted to the hospital with a movable skin lesion on anterior neck region. Free T3 and T4 levels were in normal levels and TSH levels were low in both patients. The 83-year-old patient underwent total thyroidectomy due to papillary thyroid cancer and received 131I ablation therapy and then thyroid suppression therapy. After the surgery, the patient lived without evidence of disease for 3 years and then skin metastasis occurred. The 65-year-old patient had a total thyroidectomy 5 years ago due to PTC then neck dissection due to metastasis 3 years later and then received 131I ablation therapy. Thyroid ultrasonography of both patients showed hypoechoic nodules with central vascularization. In the histological examination of both patients, cystic lesions filled with papillary structures were seen. Fine needle aspiration biopsy (FNAB) taken from both patients were papillary carcinoma with solid trabecular pattern. PTC tends to metastasize to regional lymph nodes but distant metastasis is rare. When distant metastasis develops, prognosis of the disease is poor. Therefore, skin metastasis of papillary thyroid cancer is a poor prognostic factor. If the patient does not have a thyroid malignancy history, diagnosis of PTC metastatic to the skin may be difficult since primary skin tumors such as apocrine tumors have similar histopathological features. However, in the presented cases since there was a PTC history, the diagnosis was easier with the help of histopathological examination. Skin metastasis of PTC should be kept in mind when differential diagnosis of atypical skin lesions are made especially in the patients with thyroid malignancy history.

16.
Clin Med Insights Pediatr ; 11: 1179556517701118, 2017.
Artículo en Inglés | MEDLINE | ID: mdl-28469520

RESUMEN

BACKGROUND AND PURPOSE: Etiologic role, incidence, demographic, and response-to-treatment characteristics of urinary tract infection (UTI) among neonates, its relationship with significant neonatal hyperbilirubinemia, and abnormalities of the urinary system were studied in a prospective investigation in early (⩽10 days) idiopathic neonatal jaundice in which all other etiologic factors of neonatal hyperbilirubinemia were ruled out. PATIENTS AND METHODS: Urine samples for microscopic and bacteriologic examination were obtained with bladder catheterization from 155 newborns with early neonatal jaundice. Newborns with a negative urine culture and with a positive urine culture were defined as group I and group II, respectively, and the 2 groups were compared with each other. RESULTS: The incidence of UTI in whole of the study group was 16.7%. Serum total and direct bilirubin levels were statistically significantly higher in group II when compared with group I (P = .005 and P = .001, respectively). Decrease in serum total bilirubin level at the 24th hour of phototherapy was statistically significantly higher in group I compared with group II (P = .022). CONCLUSIONS: Urinary tract infection should be investigated in the etiologic evaluation of newborns with significant hyperbilirubinemia. The possibility of UTI should be considered in jaundiced newborns who do not respond to phototherapy well or have a prolonged duration of phototherapy treatment.

17.
Turk Psikiyatri Derg ; 17(4): 276-85, 2006.
Artículo en Turco | MEDLINE | ID: mdl-17183444

RESUMEN

OBJECTIVE: In this study, we aimed to investigate the prevalence, association with sociodemographic characteristics, and comorbidity with other anxiety and depressive disorders of generalized anxiety disorder (GAD) among psychiatric outpatients. METHOD: In the first phase of the study, outpatient psychiatry clinic physician interviewed with consecutive 950 patients who applied to psychiatry outpatient clinic of an university hospital by using GAD module of CIDI (Composite International Diagnostic Interview, version 2.1) during 4-month. Ninety-nine patients with diagnosis of GAD in the first phase were referred to the researcher physician for further evaluation. In the second phase, patients were interviewed by using CIDI anxiety and mood (major depression, dysthymic disorder) disorder modules. By this way, 12-month additional diagnoses were examined, and diagnosis of GAD was confirmed. One patient was excluded, because did not meet the GAD criteria during reexamination by the researcher physician. RESULTS: Ninety-eight patients (10.3%) met DSM-IV criteria for GAD. Eighty-nine (90.8%) of the cases had comorbid any anxiety or depressive disorder. The rates of comorbidity with any of depressive disorders and anxiety disorders were found 84.7% and 56.1%, respectively. The most common comorbid diagnosis was major depression (83.7%). The most common anxiety disorders were social phobia (30.6%), OCD (19.4%) and specific phobia (17.4%). The prevalence of GAD was observed significantly higher in women, married ones, housewives, unworking girls, subjects with history of medical illness and lower educational status. CONCLUSION: Our results show that among psychiatric outpatients, GAD has high comorbidity rates with depressive and other anxiety disorders, and it is associate with some sociodemographic characteristics such as gender, and marital, working and educational status.


Asunto(s)
Trastornos de Ansiedad/epidemiología , Adulto , Atención Ambulatoria , Trastornos de Ansiedad/etiología , Trastornos de Ansiedad/psicología , Comorbilidad , Trastorno Depresivo , Femenino , Humanos , Masculino , Trastornos Fóbicos , Prevalencia , Escalas de Valoración Psiquiátrica , Factores Sexuales , Factores Socioeconómicos , Turquía/epidemiología
18.
J Pediatr Orthop B ; 25(6): 504-8, 2016 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-27379670

RESUMEN

In this study, we aimed to evaluate the long-term clinical and radiological results of single-stage open reduction through a medial approach and Pemberton acetabuloplasty in developmental dysplasia of the hip. We treated 32 hips (22 patients) with developmental dysplasia by a single-stage open reduction through Ferguson's medial approach and Pemberton acetabuloplasty. The procedure was performed bilaterally in 10 patients. The mean age of the patients at the time of the operation was 19.8 months (16-24 months). The mean follow-up period was 10.9 years (7-19 years). Group I avascular necrosis according to the Kalamchi and MacEwen classification was observed in two hips and group II in one hip. Radiologically, 90.6% of the hips were classified as Severin class I and 9.4% of the hips were classified as Severin class II. At the latest follow-up, 30 hips were assessed clinically as excellent and two hips as good. No patient required subsequent surgery. We conclude that single-stage medial open reduction and Pemberton acetabuloplasty represent an effective method for developmental dysplasia of the hip in children older than 15 months of age.


Asunto(s)
Acetabuloplastia , Acetábulo/cirugía , Necrosis de la Cabeza Femoral/cirugía , Luxación Congénita de la Cadera/cirugía , Osteotomía , Preescolar , Femenino , Estudios de Seguimiento , Humanos , Lactante , Masculino , Radiografía , Estudios Retrospectivos
19.
Gland Surg ; 5(6): 565-570, 2016 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-28149801

RESUMEN

BACKGROUND: We aimed to evaluate the impact of bupivacaine administration into the surgical field after total thyroidectomy on post-operative pain and analgesic requirement with a double-blind, prospective, clinical and randomized study. METHODS: The study was performed between 2010 and 2011. Pain assessment was performed with the visual analog score (VAS). Patients were pre-operatively, randomly divided into two groups to receive either bupivacaine or saline. One group received a 10-mL of bupivacaine solution while the other group was treated with the same volume of 0.9% NaCl through the drain after completion of total thyroidectomy procedure. All patients were anesthetized and operated with the same anesthesia and surgical team. RESULTS: Ninety-one patients (20 males) were included in the study. No patient dropped out of the study during the procedures. No mortality was seen. The VAS scores were significantly lower in the bupivacaine administered group at post-operative minute 30 (3.7±3.2 vs. 5±2.9; P=0.03), hour one (3.04±2.4 vs. 4.2±2.8; P=0.04), and hour eight (1.8±2.04 vs. 3.2±2.1; P=0.005). Thirteen patients required analgesia during their hospital stay in the bupivacaine group while this number was twenty-two in the saline group (P=0.005). CONCLUSIONS: Local bupivacaine administration into the surgical field after total thyroidectomy reduces pain and analgesic requirement during the hospital stay.

20.
Phys Med Biol ; 61(13): 5089-5102, 2016 07 07.
Artículo en Inglés | MEDLINE | ID: mdl-27321132

RESUMEN

In the past decade, extensive research on dielectric properties of biological tissues led to characterization of dielectric property discrepancy between the malignant and healthy tissues. Such discrepancy enabled the development of microwave therapeutic and diagnostic technologies. Traditionally, dielectric property measurements of biological tissues is performed with the well-known contact probe (open-ended coaxial probe) technique. However, the technique suffers from limited accuracy and low loss resolution for permittivity and conductivity measurements, respectively. Therefore, despite the inherent dielectric property discrepancy, a rigorous measurement routine with open-ended coaxial probes is required for accurate differentiation of malignant and healthy tissues. In this paper, we propose to eliminate the need for multiple measurements with open-ended coaxial probe for malignant and healthy tissue differentiation by applying support vector machine (SVM) classification algorithm to the dielectric measurement data. To do so, first, in vivo malignant and healthy rat liver tissue dielectric property measurements are collected with open-ended coaxial probe technique between 500 MHz to 6 GHz. Cole-Cole functions are fitted to the measured dielectric properties and measurement data is verified with the literature. Malign tissue classification is realized by applying SVM to the open-ended coaxial probe measurements where as high as 99.2% accuracy (F1 Score) is obtained.

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