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1.
Transpl Immunol ; 72: 101568, 2022 06.
Artigo em Inglês | MEDLINE | ID: mdl-35257892

RESUMO

INTRODUCTION: In Turkey, even if a person wishes to be an organ donor while alive, approval from the family is required after brain death. Therefore, many potential organ donations are lost as approval cannot be obtained from the family of the deceased. The aim of this study was to determine the factors affecting organ donation. METHOD: A total of 219 organ donation documents of Voluntary Organ Donors (VOD) were examined in a public hospital. The information examined included the age, gender, occupation, marital status, and place of birth of the donor, the number of organs donated, and the person from whom permission should be requested after brain death. RESULTS: Of the total organ donors, 62.6% were aged 19-25 years, 67.6% had a high level of education, 35.6% stated that permission should be sought from their father, and 69% were born in the Mediterranean region. A significant relationship was determined between age and the number of organs donated (p < 0.05). CONCLUSION: It can be recommended that education about organ transplantation and donation is given in regions where donor rates are low and there are groups with a high mean age, and a low education level of nurses. It could also be effective for nurses to lead organ donation campaigns to be able to increase the number of donations.


Assuntos
Transplante de Órgãos , Obtenção de Tecidos e Órgãos , Morte Encefálica , Humanos , Doadores de Tecidos
2.
World J Surg ; 45(2): 507-514, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33067685

RESUMO

BACKGROUND: It was aimed to evaluate the relationship between delta neutrophil index (DNI) and neutrophil-to-lymphocyte ratio (NLR) in the preoperative differentiation of nodular goiter and thyroid malignancy. METHODS: Patients over the age of 18 who underwent thyroid surgery between November 2014 and November 2019 were evaluated in this retrospective cohort study. Patients were divided into two groups according to their pathology results: malignant (Group M) and benign (Group B) thyroid disorders. White blood cell (WBC) count, neutrophil count, lymphocyte count, IG count and DNI were measured using an automated hematological analyzer from blood samples obtained at the preoperative period and postoperative 6th month of the follow-up. Neutrophil-to-lymphocyte ratio (NLR) values were manually calculated. Numerical data are expressed as means ± standard deviations (minimum-maximum values) or medians (minimum-maximum values) according to the normal distribution. Categorical values are expressed as percentages (%). RESULTS: A total of 243 patients (190 patients in Group B and 53 patients in Group M) who met the inclusion criteria were evaluated. The male/female ratio was 49/194. A statistically significant difference between Group M and Group B in terms of preoperative NLR, DNI and IG count was observed (p = 0.001, < 0.001 and < 0.001, respectively). No statistically significant difference was observed between the groups in terms of the control values performed in the postoperative period in terms of the NLR, DNI and IG count (p = 0.711, 0.333 and 0.714, respectively). A significant decrease was observed in the preoperative and postoperative DNIs, IG counts and NLRs in Group M (p = 0.009, < 0.001 and < 0.001, respectively). For the diagnosis of malignant thyroid diseases, the cut-off value of DNIs was ≥0.35%, and DNI sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were 79.2%, 78.9%, 79.2% and 77.9%, respectively (area under the curve [AUC]: 0.847; confidence interval [CI]: 0.784-0.911). The cut-off value of the IG count was ≥25/mm3, and its sensitivity, specificity, PPV and NPV were 83%, 72.1%, 83%, and 72.1%, respectively (AUC: 0.847; CI: 0.784-0.911). CONCLUSION: DNI and IG counts are cheap and easily accessible tests that can be automatically calculated from automated systems without additional cost in differentiation of thyroid malignancies from benign disorders in the preoperative period.


Assuntos
Diferenciação Celular , Bócio Nodular/sangue , Linfócitos/patologia , Neutrófilos/patologia , Neoplasias da Glândula Tireoide/sangue , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Bócio Nodular/patologia , Bócio Nodular/cirurgia , Humanos , Contagem de Leucócitos , Contagem de Linfócitos , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Prognóstico , Estudos Retrospectivos , Neoplasias da Glândula Tireoide/patologia , Neoplasias da Glândula Tireoide/cirurgia , Tireoidectomia , Carga Tumoral
3.
Transplant Proc ; 51(7): 2198-2201, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31371214

RESUMO

OBJECTIVE: This study, which we believe will contribute to more successful transplant processes, was carried out to evaluate the level of job satisfaction among organ transplant coordinators and the difficulties experienced by them. MATERIALS AND METHODS: As a cross-sectional study, this research was conducted between July 15, 2018, and August 8, 2018, through the support of the organ transplant coordinators working in the Turkish National Coordination Centre. Sociodemographic characteristics, insititutional difficulties and Minnesota Satisfaction Questonnaire were used for data collection. For the evaluation of the collected data, mean, standard deviation, t test, the Kruskal-Wallis test, and the Pearson and Spearman correlation analyses were used. FINDINGS: Forty-eight percent of the organ transplant coordinators in this study experienced difficulties in getting overtime pay, whereas 38.2% experienced difficulties in getting the wages they deserved. A significant difference (P < .05) was found between having professional certification and job satisfaction level and between coordination system working unit and job satisfaction level. There was a negative correlation between job and job satisfaction level (P < .05). CONCLUSION: It will be useful to provide the necessary support to overcome the difficulties experienced by transplant coordinators and to increase job satisfaction levels.


Assuntos
Pessoal de Saúde/psicologia , Satisfação no Emprego , Obtenção de Tecidos e Órgãos , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Transplante de Órgãos/psicologia , Salários e Benefícios , Inquéritos e Questionários , Turquia
4.
Bratisl Lek Listy ; 111(5): 253-7, 2010.
Artigo em Inglês | MEDLINE | ID: mdl-20568413

RESUMO

AIM: We assumed that one of the most widely used anesthetic agents, propofol, which is the most widely used anesthetic for sedation, may reduce inflammatory processes and organ injury induced by cecal ligation and puncture. STUDY DESIGN: Bacterial peritonitis was induced in 18 rats by cecal ligation and puncture. The rats were randomly assigned to three groups. Group 1 (n=6) received propofol, group 2 (n=6) received intralipid, group 3 (n=6) was a control group, which did not receive any injection. All animals were killed 14 days later so we could assess the adhesion score. Tissue antioxidant levels were measured in 1-g tissue samples taken from the abdominal wall. RESULTS: The adhesion score was significantly lower in the propofol group than in the control group (p<0.05). The catalase levels were higher in the intralipid and control groups than the propofol groups. CONCLUSIONS: Intraperitoneal propofol reduced the formation of postoperative intra-abdominal adhesions without compromising wound healing in this bacterial peritonitis rat model. Propofol also decreased the oxidative stress during peritonitis (Tab. 1, Fig. 5, Ref. 28). Full Text (Free, PDF) www.bmj.sk.


Assuntos
Anestésicos Intravenosos/farmacologia , Perfuração Intestinal/complicações , Doenças Peritoneais/prevenção & controle , Propofol/farmacologia , Animais , Doenças Peritoneais/patologia , Peritonite/patologia , Peritonite/fisiopatologia , Ratos , Ratos Wistar , Aderências Teciduais/patologia , Aderências Teciduais/prevenção & controle
5.
Ren Fail ; 32(5): 578-83, 2010 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-20486841

RESUMO

AIM: The purpose of this study was to investigate and compare the efficiency of propofol in the reduction of injury induced by free radicals in a rat model of renal ischemia/reperfusion (I/R). METHOD: Twenty-four Wistar rats were divided into four groups in our study. Rats in the sham group underwent laparotomy and were made to wait for 120 min without ischemia. Rats in the control group were given nothing with ischemia-reperfusion. Rats in the I/R groups were given propofol (25 mg/kg) and 10% intralipid (250 mg/kg) ip, respectively, 15 min before the ischemia for 60 min followed by reperfusion for 60 min. The kidney tissues of the rats were taken under anesthesia at the end of the reperfusion period. Evaluation of biochemical malondialdehyde (MDA), superoxide dismutase, and catalase activities and histopathological analysis were performed with these samples. RESULTS: I/R significantly increased MDA levels (p < 0.05). Histopathological findings of the control group confirmed that there was renal impairment by tubular cell swelling, interstitial edema, medullary congestion, and tubular dilatation. MDA levels were lower in the propofol group compared to control group (p < 0.05). In the propofol group, the level of histopathological scores is significantly decreased than control and intralipid groups in ischemia-reperfusion. CONCLUSION: Our results demonstrate that I/R injury was significantly reduced in the presence of propofol. The protective effects of propofol may be due to their antioxidant properties. These results may indicate that propofol anesthesia protects against functional, biochemical, and morphological damage better than control in renal I/R injury.


Assuntos
Anestésicos Intravenosos/uso terapêutico , Rim/irrigação sanguínea , Propofol/uso terapêutico , Traumatismo por Reperfusão/prevenção & controle , Anestésicos Intravenosos/farmacologia , Animais , Catalase/metabolismo , Rim/efeitos dos fármacos , Rim/enzimologia , Malondialdeído/metabolismo , Propofol/farmacologia , Ratos , Ratos Wistar , Superóxido Dismutase/metabolismo
6.
Ren Fail ; 32(3): 391-5, 2010 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-20370458

RESUMO

UNLABELLED: Ischemia/reperfusion (I/R) occurs in a number of pathological conditions, including myocardial infarction, stroke, aortic surgery, cardiopulmonary bypass surgery, organ transplantation, resuscitation, and critical care. Massive and abrupt release of oxygen-free radicals after reperfusion triggers oxidative damage. Before critical operations or after resuscitation, it would be wise to find a suitable prophylactic treatment to avoid I/R damage. We aimed to determine whether several commonly used intravenous anesthetics protect against renal I/R injury. METHODS: Animals were randomly divided into seven groups, each consisting of six animals: sham group, control group, thiopental group, propofol group, intralipid group, etomidate group, and ketamine group. At the end of the 60-min ischemic period, 60 min reperfusion was established and the materials administered 15 min before the reperfusion. At the end of the reperfusion period, the samples of blood and tissue were reaped for biochemical and serological evaluation. RESULTS: I/R procedure significantly increased malondialdehyde (MDA) levels, decreased catalase (CAT) activities, and superoxide dismutase (SOD) levels. The lowest MDA mean level was in the thiopental group and the highest MDA mean level was in control group. The lowest CAT mean level was in the intralipid group and the highest CAT mean level was in the etomidate group. The lowest SOD mean level was in the control group and the highest SOD mean level was in the propofol group. CONCLUSION: Thiopental and propofol, especially thiopental, are more effective to protect renal I/R injury.


Assuntos
Anestésicos Intravenosos/farmacologia , Antioxidantes/farmacologia , Rim/irrigação sanguínea , Rim/metabolismo , Traumatismo por Reperfusão/metabolismo , Tiopental/farmacologia , Anestésicos Dissociativos/farmacologia , Animais , Antioxidantes/metabolismo , Catalase/metabolismo , Etomidato/farmacologia , Emulsões Gordurosas Intravenosas/farmacologia , Ketamina/farmacologia , Peroxidação de Lipídeos/efeitos dos fármacos , Malondialdeído/metabolismo , Propofol/farmacologia , Ratos , Ratos Wistar , Traumatismo por Reperfusão/prevenção & controle , Superóxido Dismutase/metabolismo
7.
J Invest Surg ; 22(4): 263-7, 2009.
Artigo em Inglês | MEDLINE | ID: mdl-19842901

RESUMO

AIM: Postoperative abdominal adhesions represent one of the most common causes of intestinal obstruction in surgical patients. In this study, the effects of intraperitoneal administration of estrogen on the development of postoperative intraabdominal adhesions and peritoneal leucocytes in a rat adhesion model were investigated. METHODS: Sixty Wistar albino rats were divided into three groups. Group 1 (control group) had their abdomen closed after surgery without administration of any material or drug. Group 2 (saline group) received 2 ml of 0.9% NaCl, and group 3 (estrogen group) animals received a single intraperitoneal dose of 2 cc (1 mg) estrogen (Estradiol propionate, 50.000U, Akrofilline, Biofarma, Turkey). All the groups were exposed to the same adhesion-creating procedure (Swolin K. Experimental studies on the prevention of intra-abdominal adhesions. Studies on rats with an emulsion of lipid and prednisolone. Acta Obstet Gynecol Scand. 1966;45:473-498.). After 7-42 days, all animals were sacrificed. Adhesions were scored and peritoneal leucocytes were counted. RESULTS: The adhesion formation and peritoneal leucocyte count of the estrogen group were significantly less than the control and saline groups and a statistically significant difference was determined in comparison of those groups (p <. 05). CONCLUSION: We concluded that intraperitoneal estrogen decreases the incidence of postoperative intraabdominal adhesion formation in rat adhesion model.


Assuntos
Estradiol/administração & dosagem , Doenças Peritoneais/prevenção & controle , Complicações Pós-Operatórias/prevenção & controle , Telas Cirúrgicas/efeitos adversos , Animais , Modelos Animais de Doenças , Injeções Intraperitoneais , Contagem de Leucócitos , Cavidade Peritoneal/citologia , Ratos , Ratos Wistar , Aderências Teciduais/prevenção & controle
9.
Diagn Interv Radiol ; 15(3): 188-92, 2009 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-19728265

RESUMO

Situs inversus totalis is a rare anomaly that is characterized by mirror image anatomy of the abdominal and thoracic organs. This anomaly is often discovered incidentally in adults during an emergent surgical procedure or by radiologic investigations performed for other medical reasons. Cecal volvulus is a surgical emergency requiring urgent laparotomy. Coexistence of these two abnormalities poses a challenge in establishing a definitive diagnosis because of the alteration of normal anatomy; this may cause a delay in emergent surgical intervention. We present a case of situs inversus totalis complicated by cecal volvulus. In our case, a different type of pancreatic malrotation, which we called "folded", also accompanied these abnormalities. To our knowledge, this is the first case in the literature involving situs inversus totalis, cecal volvulus, and a "folded" type of pancreatic malrotation.


Assuntos
Ceco/anormalidades , Pâncreas/anormalidades , Situs Inversus/diagnóstico por imagem , Abdome/anormalidades , Adulto , Ceco/diagnóstico por imagem , Ceco/cirurgia , Feminino , Cardiopatias Congênitas/diagnóstico por imagem , Humanos , Fígado/anormalidades , Fígado/diagnóstico por imagem , Pâncreas/diagnóstico por imagem , Radiografia/métodos , Tomografia Computadorizada por Raios X
10.
Tohoku J Exp Med ; 218(3): 251-8, 2009 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-19561396

RESUMO

The intestine is highly susceptible to ischemia/reperfusion (I/R) injury. Splanchnic ischemia is the initial event that releases injurious factors, leading to systemic disorders with high morbidity and mortality. Oxidative stress mediators are believed to contribute to the intestinal I/R injury. Resveratrol, a polyphenol found in grapes, is shown to be a strong antioxidant in various tissues, with a property of an estrogen-receptor agonist. Therefore, we investigated the effects of resveratrol on oxidative injury in the intestine. Female Wistar rats were randomly allocated into four groups (n = 8, each). The sham group was only subjected to surgical procedures, while other animals were subjected to intestinal ischemia (60 min) and subsequent reperfusion (60 min). One group received resveratrol (15 mg/kg, 0.3 ml/day intraperitoneally) for both 5 days before surgery and 15 min before ischemia, while the other was treated intraperitoneally with 0.5% ethyl alcohol as vehicle (0.3 ml/day). In the I/R rat intestines, we detected severe tissue injuries (p < 0.001), the significant increases in the tissue levels of malondialdehyde (MDA), nitric oxide (NO), and myeloperoxidase (MPO) (p < 0.001), and the decrease in superoxide dismutase (SOD) activity (p < 0.001), compared to the sham control. Resveratrol significantly ameliorated the intestinal injury, decreased MDA, NO and MPO levels to the sham control levels, and decreased bacterial translocation in mesentery lymph nodes, liver and spleen (p < 0.001). Resveratrol also restored the SOD activity. These results suggest that resveratrol could protect intestinal tissue against I/R injury with its potent antioxidant properties.


Assuntos
Antioxidantes/metabolismo , Translocação Bacteriana , Traumatismo por Reperfusão/metabolismo , Estilbenos/metabolismo , Animais , Antioxidantes/farmacologia , Translocação Bacteriana/efeitos dos fármacos , Feminino , Sequestradores de Radicais Livres/metabolismo , Mucosa Intestinal/metabolismo , Mucosa Intestinal/patologia , Intestinos/efeitos dos fármacos , Intestinos/patologia , Malondialdeído/metabolismo , Nitratos/análise , Óxido Nítrico/metabolismo , Nitritos/análise , Peroxidase/metabolismo , Proteínas/análise , Ratos , Ratos Wistar , Traumatismo por Reperfusão/patologia , Resveratrol , Estilbenos/farmacologia , Superóxido Dismutase/metabolismo
11.
Ren Fail ; 31(4): 290-6, 2009.
Artigo em Inglês | MEDLINE | ID: mdl-19462278

RESUMO

BACKGROUND: Renal ischemia/reperfusion (I/R)-induced tubular epithelial cell injury, called ischemic acute renal failure, is associated with high mortality in humans. Protecting the kidney against I/R injury is very important during complicated renal operations, transplantation surgery, and anesthesia. Aim. The purpose of this study was to investigate and compare the efficiency of ketamine, thiopental, propofol, etomidate, and intralipid in reducing the injury induced by free radicals in a rat model of renal I/R. METHOD: Forty-two Wistar rats were divided into seven groups in our study. Rats in the sham group underwent laparotomy and waited for 120 minutes (min) without ischemia. Rats in the control group were given nothing with ischemia-reperfusion. Rats in the I/R groups were given ketamine (20 mg/kg), thiopental (20 mg/kg) propofol (25 mg/kg), etomidate (10 mg/kg) and 10% intralipid (250 mg/kg) intraperitoneally 15 min prior to the ischemia for 60 min, followed by reperfusion for 60 min. The blood samples and kidney tissues of the rats were obtained under anesthesia at the end of the reperfusion period. Biochemical malondialdehyde (MDA), superoxide dismutase (SOD), catalase (CAT), blood urea nitrogen (BUN), creatine (Cr), aspartate aminotransferase (AST) were determined, and histopathological analysis was performed with these samples. RESULTS: MDA level was increased significantly in the control group (p < 0.05). Histopathological findings of the control group confirmed that there was renal impairment by tubular cell swelling, interstitial edema, medullary congestion, and tubular dilatation. MDA levels were lower in the ketamine, thiopental, and propofol groups compared to the control group (p < 0.05). In the thiopental and propofol groups, the levels of histopathological scores were significantly lower than control and etomidate groups in ischemia-reperfusion. CONCLUSION: Our results demonstrated that I/R injury was significantly reduced in the presence of propofol and thiopental. The protective effects of these drugs may belong to their antioxidant properties. These results may indicate that propofol and thiopental anesthesia protects against functional, biochemical, and morphological damage better than control in renal I/R injury.


Assuntos
Anestésicos Intravenosos/uso terapêutico , Rim/irrigação sanguínea , Traumatismo por Reperfusão/prevenção & controle , Animais , Ratos , Ratos Wistar
12.
Int J Surg ; 7(1): 54-7, 2009 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-19042166

RESUMO

AIM: We investigated the effects of intraperitoneal honey on the development of postoperative intra-abdominal adhesions and oxidative stress in a model of bacterial peritonitis. METHODS: Bacterial peritonitis was induced in 18 rats by cecal ligation and puncture. The rats were randomly assigned to three groups. Group 1 (n=6) received honey intraperitoneally, group 2 (n=6) received 5% dextrose intraperitoneally, and the third group received no fluid or medicine intraperitoneally one day after cecal ligation and puncture procedure. All animals were killed 14 days later so we could assess the adhesion score. Tissue antioxidant levels were measured in 1-g tissue samples taken from the abdominal wall. RESULTS: Adhesion scores of honey treated group were significantly lower according to the control group (P<0.05) and statistically significant. Adhesion scores of honey were lower from 5% dextrose but not statistically significant (P>0.05). Malondialdehyde values of honey group were significantly lower from the control group (P<0.05) and levels in 5% dextrose group was higher than the honey group. Catalase levels were high in control and 5% dextrose groups. Superoxide dismutase levels were higher in the control group than the honey group (statistically significant). CONCLUSIONS: Intraperitoneal honey decreased the formation of postoperative intra-abdominal adhesions without compromising wound healing in this bacterial peritonitis rat model. Honey also decreased the oxidative stress during peritonitis.


Assuntos
Infecções por Bactérias Gram-Negativas/complicações , Infecções por Bactérias Gram-Positivas/complicações , Mel , Peritonite/complicações , Complicações Pós-Operatórias , Aderências Teciduais/prevenção & controle , Animais , Modelos Animais de Doenças , Feminino , Injeções Intraperitoneais , Estresse Oxidativo/fisiologia , Peritonite/cirurgia , Ratos , Ratos Wistar , Aderências Teciduais/etiologia , Aderências Teciduais/patologia
13.
Cases J ; 1(1): 362, 2008 Nov 29.
Artigo em Inglês | MEDLINE | ID: mdl-19040758

RESUMO

BACKGROUND: Insulinoma is the most common endocrine tumor of the pancreas. Accurate preoperative detection and localization of insulinomas is essential for the appropriate selection of candidates for surgery. We present two cases with benign pancreatic insulinoma. CASE PRESENTATION: Preoperative evaluation for patients with suspected insulinomas has been controversial. Endoscopic ultrasonography (EUS) has a sensitivity of 95% in well skilled operators and well tolerated preoperative imaging method. CONCLUSION: We have detected the insulinomas with EUS before surgery in our patients but other imaging modalities did not help us for localization of them. Patients have been asymptomatic postoperatively with no hypoglycemia on repeat fasting. We reviewed here the different modalities for preoperative localization of insulinoma.

14.
Cases J ; 1(1): 134, 2008 Aug 29.
Artigo em Inglês | MEDLINE | ID: mdl-18759991

RESUMO

BACKGROUND: The non-malignant, acquired tracheoesophageal fistulas (TEF), resulting from tracheal intubation are usually iatrogenic lesions. Tracheal lesions resulting from intubation may occur and pneumomediastinum, pneumothorax or subcutaneous emphysema may develop due to the stream of air. CASE PRESENTATION: We present a-39-year old, Caucasian patient, developing severe hypoxia fallowing cesarean section under general anesthesia. The findings of the patient were diffuse subcutaneous emphysema; together with pneumothorax and pneumomediastinum TEF was diagnosed in the patient by bronchoscopy and eusophagoscopy performed due to cough and difficulty in swallowing developing after extubation. CONCLUSION: It is important to the clinicians to be aware of the TEF can be accompanied to the traumatic intubation and urgent endoscopy or water-soluble contrast radiography may be prudent.

15.
Med Sci Monit ; 14(7): CS60-3, 2008 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-18591923

RESUMO

BACKGROUND: Rectal prolapse is an intussusception of the rectum through the anal canal. The extent of the prolapse varies from the rectal mucosa to the full thickness of the rectum and sigmoid colon. It usually appears after 50 years of age, with a female predominance of over 80-90% of cases. CASE REPORT: A rare case of incarcerated rectal prolapse with sigmoid colon perforation is reported. A different approach for large incarcerated rectal prolapse was used that can easily be performed in the emergency department in comorbid elderly patients. In emergent conditions, comorbid diseases of the patient increase the risk of mortality. Perineal resection allowed using loco-regional anesthesia. Perineal resection was safely applied and uncomplicated. Spinal anesthesia decreases the risk of operation and at same time allows correction of the main defect. After this operation there is no need for a second attempt. The patient was discharged seven days after the operation. CONCLUSIONS: The perineal resection technique used in this case has two distinctive features: it reconstructs the pathology as closely as possible to its original anatomical condition and allows the use of spinal anesthesia.


Assuntos
Prolapso Retal/cirurgia , Anastomose Cirúrgica , Humanos , Masculino , Pessoa de Meia-Idade , Omento/patologia , Prolapso Retal/patologia
16.
Cases J ; 1(1): 10, 2008 May 25.
Artigo em Inglês | MEDLINE | ID: mdl-18577248

RESUMO

INTRODUCTION: Adrenal incidentaloma can be described as adrenal lesions that are incidentally diagnosed during abdominal laparotomy or any abdominal screening without prior suspicion of adrenal disease. It is important to diagnose adrenal lesions to learn if they are hormonally active or malignant. The most common clinical sign of pheochromocytoma is sustained or paroxysmal hypertension, and the most common symptoms are headache, excessive truncal sweating, and palpitation. In some cases, the clinical symptoms are not clear. Roughly 70% of adrenal incidentalomas are non-functional. A small group of 5-7% of the functional ones (30%) may exist as pheochromocytoma. Ten percent of pheochromocytoma cases are diagnosed incidentally during computed tomography (CT) or magnetic resonance imaging (MRI) screenings for other reasons. The most frequent symptom of the pheochromocytoma is hypertension, and 90-100% of cases exhibit it. The literature indicates that incidental pheochromocytoma cases that are smaller than 1 cm have no clinical symptoms. Rarely, some large pheochromocytoma cases do not show any clinical symptoms, and it is difficult to diagnose very small ones. CASE PRESENTATION: A 45-year-old male patient experienced an epigastric ache and distended stomach for 7 years. The serum cortisol level was 19.2 ng/dL (normal range: 5-20 ng/dL), and urinary free cortisol excretion was 25.00 mug/24 h (normal range:10.00-100.00 mug/24 h). The serum basal level of adrenocorticotropic hormone (ACTH) was 21 pg/mL (normal range: 9 to 52 pg/mL). Plasma cortisol was under 1.00 mug/dL after low dose (1 mg) overnight dexamethasone suppression test. 24 hours urinary catecholamines level were vanil mandilic acid (VMA) 8.90 mg/day (normal range, 3 to 90 mg/day), metanefrin 330 mug/day (normal range, 52 to 341 mug/day), epinefrin 13 mug/day (normal range, 2 to 24 mug/day), norepinefrin 41 mug/day (normal range; 15 to 100 mug/day). During abdominal ultrasonography (USG), a tumor was diagnosed in the right perirenal space. A regular-shaped mass (dimension 36 x 35 x 35 mm) with a homogeneous and solid structure was diagnosed in CT. The density of the mass was 80 Hounsfield units (HU) in postcontrast CT. The patient was given a diagnosis of a non-functional adrenal incidental lesion, underwent a right adrenalectomy. Histopathological data correlated with pheochromocytoma as well CONCLUSION: Pheochromocytoma can be diagnosed by establishing an increase in catecholamines and metabolites in the plasma and urine. The level of catecholamines and metabolites in the plasma and urine provide 95% of the evidence of the disease. Because the dimensions of the lesion were large and the HU was very clear, the patient was underwent surrenalectomy. During laboratory investigation, there was no evidence of abnormality; we, therefore, think that these cases can be named sublaboratory pheochromocytoma.

17.
Cases J ; 1(1): 11, 2008 May 25.
Artigo em Inglês | MEDLINE | ID: mdl-18577251

RESUMO

We report a rare event of old hemorrhage into a thyroid causing respiratory distress. A 67-year-old man with chronic cough and recent dysphagia was found to have a retrosternal mass extending into the visceral mediastinum on chest roentgenogram. A computed tomographic (CT) scan confirmed eggshell callcification, which was 53 x 53 x 80 mm in size a retrosternal thyroid mass and revealed significant tracheal deviation to the right due to an extensive mass surrounded by a calcificated capsule in the left lobe of the thyroid gland with extension to the upper mediastinum. He successfully underwent left lobectomy of the thyroid gland with sternotomy. The pathological examination revealed intrathyroidal hemorrhage of the thyroid gland with massive intracystic old bleeding.

18.
JOP ; 9(3): 357-61, 2008 May 08.
Artigo em Inglês | MEDLINE | ID: mdl-18469455

RESUMO

The role of homocysteine role in inflammation and malignancy has been studied experimentally. Some researchers suggest that a relationship exists between pancreatitis and homocystinuria, possibly being secondary to occlusive vascular disease of the pancreas. To date, plasma homocysteine levels in pancreatic disease have not been studied. We aimed to analyze the homocysteine status in patients with acute pancreatitis, and the changes of the plasma homocysteine level at the acute phase of the disease and six months after hospital discharge. Fourteen acute pancreatitis patients and 14 healthy subjects were studied. Plasma homocysteine, vitamin B12, folate, amylase, lipase, C-reactive protein, total, HDL and LDL cholesterol, triglycerides, blood urea nitrogen, white blood cells, and creatinine were measured in the two groups of subjects. Plasma levels of homocysteine were significantly higher in patients with acute pancreatitis as were serum creatinine, blood urea nitrogen, WBC counts, amylase, lipase, and C-reactive protein. An impaired creatinine clearance was also found in these patients but this did not reach statistical significance. Serum total, HDL, and LDL cholesterol concentrations were not significantly different between the two groups of subjects. Our data suggest that homocysteine may play a role in inflammatory diseases of the pancreas. Increased plasma homocysteine levels in acute pancreatitis may be a reason, or a marker, for the diagnosis of acute pancreatitis. In conclusion, this is the first report showing that patients with acute pancreatitis have higher plasma homocysteine levels than healthy subjects.


Assuntos
Homocisteína/sangue , Pancreatite/sangue , Doença Aguda , Idoso , Idoso de 80 Anos ou mais , Nitrogênio da Ureia Sanguínea , Proteína C-Reativa/análise , Estudos de Casos e Controles , Creatinina/metabolismo , Progressão da Doença , Feminino , Seguimentos , Humanos , Contagem de Leucócitos , Lipídeos/sangue , Masculino , Pessoa de Meia-Idade , Fatores de Tempo
19.
J Invest Surg ; 21(2): 71-5, 2008.
Artigo em Inglês | MEDLINE | ID: mdl-18340623

RESUMO

In the surgical history of hepatic hydatid disease, multiple scolicidal agents have been used for sterilization of the cyst contents. However, none of these agents can be safely used, because most have unacceptable side effects, such as toxicity, caustic sclerosing cholangitis, bile duct stricture, and hypernatremia. Protoscolices were aseptically removed from liver hydatid cysts obtained from sheep slaughtered at the municipal abattoir in Kahramanmaras, Turkey. In this study, the effects of 0.9% NaCl (control group), 20% NaCl (hypertonic saline), 20% silver nitrate, albendazole 20 mg/cm3, 50% dextrose (hypertonic glucose), and 20% mannitol and aminomix-1 solutions on echinococe cysts were investigated under in vitro conditions. After 5, 10, 15, 20, 25, 30, 45, and 60 min for each concentration, the first 100 protoscolices were counted on the 10x microscopical field. Protoscolices, which showed positive staining by eosine were considered as dead ones. The averages of dead and total protoscolices were calculated. Our results showed that all observed protoscolices were dead after the treatments by 20% silver nitrate in 20 min, by 50% dextrose and by aminomix-1 solution in 30 min, and by 20% NaCl and by 20% mannitol in 45 min. Albendazole at 20 mg/cm3 was observed to lead to death of 65% of protoscolices in the first 5 min and 70% of protoscolices at the end of 60 min. Compared with 0.9% NaCl (saline), all of these scolicidal agents were significantly effective (p < .05). Aminomix-1, 20% mannitol, and 50% dextrose solutions may be used in percutaneous and surgical treatment of hydatid cyst. They may be preferred because they are readily available, can be administered intravenously, and have an equal or greater effectiveness than 20% hypertonic saline.


Assuntos
Anticestoides/administração & dosagem , Equinococose/tratamento farmacológico , Echinococcus/efeitos dos fármacos , Animais , Ovinos
20.
J Invest Surg ; 21(2): 65-9, 2008.
Artigo em Inglês | MEDLINE | ID: mdl-18340622

RESUMO

The objective of our study was to investigate the efficacy of catalase in preventing the formation of peritoneal adhesions induced by cecal serosal laceration in rats. A research study was set up using a randomized complete block design. This study was performed in the Experimental Surgical Research Center, Kahramanmaras Sutcuimam University, Kahramanmaras, Turkey. Thirty Wistar albino rats were assigned to 3 groups of 10 animals each. The animals were anesthetized, a median laparotomy was performed, and the cecum was traumatized. In the final stages of surgery, the first group received 30,000 U of catalase intraperitoneally (ip) (catalase group), the second group received 2 mL of saline solution ip (isotonic group), and the last group received no treatment (control group). All rats were sacrificed on day 14. Adhesions were counted and blood samples were taken for measuring the catalase level. There were significant differences between the adhesion scores among all groups (p < .05, Kruskal-Wallis test). The catalase group had significantly lower adhesion scores than the other groups (post hoc Mann-Whitney test). At day 14, blood catalase levels in the catalase group were significantly lower than in the other groups (p < .05). We conclude that introduction of catalase into the peritoneal cavity during surgery inhibited adhesion formation.


Assuntos
Antioxidantes/uso terapêutico , Catalase/uso terapêutico , Peritonite/prevenção & controle , Aderências Teciduais/prevenção & controle , Animais , Antioxidantes/administração & dosagem , Catalase/administração & dosagem , Procedimentos Cirúrgicos do Sistema Digestório , Modelos Animais de Doenças , Feminino , Infusões Intralesionais , Complicações Pós-Operatórias , Distribuição Aleatória , Ratos , Ratos Wistar
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