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1.
Pediatr Int ; 64(1): e14931, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34297425

RESUMO

BACKGROUND: Video endoscopy, which remains the diagnostic gold standard after ingestion of a corrosive substance, is performed under general anesthesia in children, requires advanced technology, and is costly. Simple and accessible methods are therefore needed to determine the need for endoscopy. The aim of this study was to evaluate the role of the pH and specific gravity of ingested substance in determining endoscopy indications after corrosive ingestion. METHODS: This prospective study included pediatric patients who presented after ingesting a corrosive substance from June 2018 to June 2019. Relationships between the extent of damage detected by endoscopy and the patient's age, physical examination findings, and the pH and specific gravity of the causative substance were evaluated. RESULTS: The degree of damage detected on endoscopy was significantly milder for corrosive substances with a pH between 2 and 12 (P = 0.003). In addition, pH values between 2 and 12 were significantly more common among patients without physical examination findings (P = 0.029). Specific gravity less than 1,005 was associated with mild injury detected by video-endoscopy (P = 0.011). Patients in whom severe injury was detected by endoscopy had marked findings on physical examination (P < 0.001). There was no significant relationship between physical examination findings and the specific gravity of the substance involved (P = 0.087). CONCLUSIONS: The results of this study suggest that conservative treatment options can be used without performing endoscopy in patients who have no physical examination finding after corrosive ingestion and where the pH of the substances is between 2 and 12 and the specific gravity of the substances is less than 1,005.


Assuntos
Cáusticos , Cáusticos/toxicidade , Criança , Endoscopia Gastrointestinal , Humanos , Concentração de Íons de Hidrogênio , Estudos Prospectivos , Gravidade Específica
2.
Turk J Med Sci ; 49(2): 639-643, 2019 Apr 18.
Artigo em Inglês | MEDLINE | ID: mdl-30997979

RESUMO

Background/aim: Intraabdominal pressure (IAP) is one of the main reasons for gastroesophageal reflux (GER). This study investigates whether IAP during laparoscopic surgery leads to GER in a time-dependent manner. Materials and methods: In a laparoscopy model, 15 mmHg IAP was created in 8 Wistar albino rats in the Trendelenburg position (TP). A 5 mm laparotomy was performed in the left lower abdominal region, and a 6 Fr catheter was placed intraabdominally. Air was insufflated into the abdominal cavity, and the pressure was kept constant at 15 mmHg. Esophageal pH alterations were measured by pH sticks for 4 h every 30 min. Results: The basal median esophageal pH value was 9 (8­10), the value after placing the catheter was 9 (7­10) (P = 0.47), and the median pH value after placing the subjects in TP was 9 (8­10) (P = 0.70). In our experimental model, esophageal pH values were found to decrease significantly at the 150th minute in TP and at 15 mmHg IAP (P < 0.05). Two rats died: one at the 120th minute and the other at the 240th minute (P > 0.05) Conclusion: Esophageal pH values decreased and continued to remain low following IAP increase and TP in this experimental rat model. Prolonged laparoscopic procedures can particularly lead to GER that requires instant recognition and rapid and appropriate intervention.


Assuntos
Refluxo Gastroesofágico/etiologia , Refluxo Gastroesofágico/cirurgia , Hipertensão Intra-Abdominal/complicações , Laparoscopia/efeitos adversos , Laparoscopia/métodos , Animais , Modelos Animais de Doenças , Pneumoperitônio Artificial , Ratos , Ratos Wistar , Fatores de Tempo
3.
Minim Invasive Ther Allied Technol ; 26(5): 300-306, 2017 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-28281403

RESUMO

PURPOSE: To evaluate the predictability of the initial endoscopic evaluation of the effectiveness of endoscopic balloon dilatation (EBD) in childhood esophageal strictures caused by corrosive ingestion. MATERIAL AND METHODS: Medical records of 635 endoscopies caused by corrosive ingestion between January 2000 and December 2015 in children between the ages of 0 and 18 years were retrospectively analyzed. Among them, five children with grade 2a and 15 with grade 2 b who developed esophageal strictures were evaluated for the effectiveness of endoscopic balloon dilatation. RESULTS: The stricture rate was 5/136 (3.6%) in grade 2a and 17/25 (68%) in grade 2 b esophageal burns. Strictures with grade 2a burn had seven (1-10) EBD sessions, and grade 2 b had 8.8 (1-30) EBD sessions. For grade 2a burns, the treatment period was 15 months and 18.8 months for grade 2 b burns. Three patients with grade 2 b and two patients with grade 2a are still on the EBD program. CONCLUSION: Initial endoscopy for caustic ingestion and esophageal injury grading may help to provide healthcare givers with information about future stricture formation and management.


Assuntos
Queimaduras Químicas/complicações , Cáusticos/efeitos adversos , Dilatação/instrumentação , Estenose Esofágica/cirurgia , Adolescente , Criança , Pré-Escolar , Dilatação/métodos , Estenose Esofágica/etiologia , Esofagoscopia , Feminino , Humanos , Lactente , Masculino , Estudos Retrospectivos , Resultado do Tratamento
4.
Pediatr Int ; 58(3): 202-205, 2016 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-26273790

RESUMO

BACKGROUND: The aim of this study was to evaluate the diagnostic value of red blood cell distribution width (RDW) in children with acute appendicitis. METHODS: In this retrospective study, a total of 344 children aged ≤18 years with clinically suspected acute appendicitis who underwent appendectomy between January 2007 and January 2014 were reviewed, and 200 healthy controls of the same age group were included. Based on histopathology, the patients were classified as having normal appendix, simple or perforated appendicitis, and preoperative white blood cell count (WBC), C-reactive protein (CRP) and RDW were compared. RESULTS: Compared with the controls, mean WBC, CRP and RDW were significantly higher in the appendectomy group (P <0.001). The children with simple or perforated appendicitis had significantly higher WBC, CRP and RDW than did those with normal appendix (P <0.001). Mean WBC and CRP were significantly higher in the children with perforated appendicitis (P <0.001), but no statistically significant difference was found in RDW between the simple and perforated appendicitis groups (P = 0.081). CONCLUSIONS: Children with histologically proven acute appendicitis have higher RDW than children without appendicitis, but the diagnostic value of RDW was not superior to WBC or CRP in children with acute appendicitis. Although higher RDW may be valuable for aiding the diagnosis of acute appendicitis in children, it is not a useful marker for predicting perforated appendicitis.


Assuntos
Apendicectomia , Apendicite/diagnóstico , Proteína C-Reativa/metabolismo , Eritrócitos/patologia , Doença Aguda , Adolescente , Apendicite/sangue , Apendicite/cirurgia , Biomarcadores/sangue , Criança , Pré-Escolar , Diagnóstico Diferencial , Contagem de Eritrócitos , Feminino , Humanos , Masculino , Estudos Retrospectivos
5.
Int Braz J Urol ; 42(3): 514-20, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27286115

RESUMO

PURPOSE: Subureteral injection of bulking agents in the endoscopic treatment of vesicoureteral reflux is widely accepted therapy with high success rates. Although the grade of vesicoureteric reflux and experience of surgeon is the mainstay of this success, the characteristics of augmenting substances may have an effect particularly in the long term. In this retrospective study, we aimed to evaluate the clinical outcomes of the endoscopic treatment of vesicoureteric reflux (VUR) with two different bulking agents: Dextranomer/hyaluronic acid copolymer (Dx/HA) and Polyacrylate polyalcohol copolymer (PPC). MATERIALS AND METHODS: A total 80 patients (49 girls and 31 boys) aged 1-12 years (mean age 5.3 years) underwent endoscopic subureteral injection for correction of VUR last six years. The patients were assigned to two groups: subureteral injections of Dx/HA (45 patients and 57 ureters) and PPC (35 patients and 45 ureters). VUR was grade II in 27 ureters, grade III in 35, grade IV in 22 and grade V in 18 ureters. RESULTS: VUR was resolved in 38 (66.6%) of 57 ureters and this equates to VUR correction in 33 (73.3%) of the 45 patients in Dx/HA group. In PPC group, overall success rate was 88.8% (of 40 in 45 ureters). Thus, Thus, this equates to VUR correction in 31 (88.5%) of the 35 patients. CONCLUSIONS: Our short term data show that two different bulking agent injections provide a high level of reflux resolution and this study revealed that success rate of PPC was significantly higher than Dx/HA with less material.


Assuntos
Acrilatos/uso terapêutico , Resinas Acrílicas/uso terapêutico , Materiais Biocompatíveis/uso terapêutico , Dextranos/uso terapêutico , Ácido Hialurônico/uso terapêutico , Polímeros/uso terapêutico , Refluxo Vesicoureteral/terapia , Criança , Pré-Escolar , Feminino , Seguimentos , Humanos , Lactente , Injeções/métodos , Masculino , Próteses e Implantes , Reprodutibilidade dos Testes , Estudos Retrospectivos , Resultado do Tratamento , Ureter , Ureteroscopia/métodos
6.
J Craniofac Surg ; 26(3): e238-40, 2015 May.
Artigo em Inglês | MEDLINE | ID: mdl-25974821

RESUMO

Congenital laryngoceles are defined as cystic dilatation of laryngeal saccules and are an extremely rare cause of newborn respiratory distress. A laryngomucocele occurs when the neck of the laryngocele gets obstructed and fills with the mucoid secretions of the saccule. It may cause stridor, respiratory distress, and severe airway obstruction in the narrow airway of a newborn and necessitates urgent surgical intervention. There is only 1 case of congenital laryngomucocele reported in an autopsy examination in the English literature, and here we report the first living congenital laryngomucocele case and discuss the clinical approach.


Assuntos
Obstrução das Vias Respiratórias/etiologia , Laringocele/complicações , Mucocele/complicações , Procedimentos Cirúrgicos Otorrinolaringológicos/métodos , Obstrução das Vias Respiratórias/diagnóstico , Obstrução das Vias Respiratórias/cirurgia , Feminino , Humanos , Recém-Nascido , Laringocele/diagnóstico , Laringoscopia , Mucocele/congênito , Mucocele/cirurgia
7.
Urol Int ; 92(1): 119-21, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-23886912

RESUMO

Hydrocalycosis is defined as cystic dilatation of a major calyx with a demonstrable connection to the renal pelvis and an epithelial lining of the cyst wall. Although this condition has long been known, there are no sufficient data concerning this pathology in the literature. In this study, we present two complicated hydrocalycosis--'pyocalycosis'--and discussed the therapeutic approaches.


Assuntos
Doenças Renais Císticas , Pelve Renal , Adolescente , Antibacterianos/uso terapêutico , Criança , Dilatação Patológica , Feminino , Humanos , Cálices Renais/diagnóstico por imagem , Cálices Renais/cirurgia , Doenças Renais Císticas/diagnóstico por imagem , Doenças Renais Císticas/terapia , Pelve Renal/diagnóstico por imagem , Pelve Renal/cirurgia , Masculino , Nefrectomia , Tomografia Computadorizada por Raios X , Resultado do Tratamento
8.
Pediatr Int ; 56(3): e1-3, 2014 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-24894937

RESUMO

Although necrotizing enterocolitis (NEC) is a frequently encountered entity in premature infants in the neonatal intensive care unit, intussusception is extremely rare. Abdominal distension, bilious/non-bilious gastric residuals and bloody stool are the common clinical findings of both entities. Here we present three cases of intussusception misdiagnosed as NEC, two of which were complicated with intestinal perforation. Similar clinical findings of NEC and intussusception leads to misdiagnosis and delay in treatment, particularly in premature infants with intussusception.


Assuntos
Doenças do Prematuro/diagnóstico , Intussuscepção/diagnóstico , Síndrome de Stevens-Johnson/diagnóstico , Erros de Diagnóstico , Feminino , Humanos , Recém-Nascido , Masculino
9.
Jpn J Radiol ; 2024 May 09.
Artigo em Inglês | MEDLINE | ID: mdl-38720059

RESUMO

This study provides a comprehensive evaluation of the occupational radiation exposure faced by healthcare professionals during Endoscopic Retrograde Cholangiopancreatography (ERCP) procedures. Utilizing an anthropomorphic RANDO phantom equipped with Thermoluminescent Dosimeters (TLDs), we replicated ERCP scenarios to measure radiation doses received by medical staff. The study meticulously assessed radiation exposure in various corresponding body regions typically occupied by medical staff during ERCP, with a focus on eyes, thyroid, hands, and reproductive corresponding organ regions. The findings revealed significant variations in radiation doses across different body parts, highlighting areas of higher exposure and underscoring the need for improved protective measures and procedural adjustments. The effective radiation doses were calculated using standard protocols, considering the varying levels of protection offered by lead aprons and thyroid shields. The results demonstrate the substantial radiation exposure experienced by healthcare staff, particularly in regions not adequately shielded. This study emphasizes the necessity for enhanced radiation safety protocols in clinical settings, advocating for advanced protective equipment, training in radiation safety, and the exploration of alternative imaging modalities. The findings have crucial implications for both patient and staff safety, ensuring the continued efficacy and safety of ERCP and similar interventional procedures. This research contributes significantly to the field of occupational health and safety in interventional radiology, providing vital data for the development of safer medical practices.

10.
Curr Ther Res Clin Exp ; 75: 5-7, 2013 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-24465035

RESUMO

BACKGROUND: Although bevacizumab has deleterious effects on the healing of colonic anastomoses, trapidil improves wound healing of colonic and tracheal anastomoses. OBJECTIVE: We aimed to assess the effects of bevacizumab and trapidil on wound healing after tracheal transection. MATERIALS AND METHODS: We evaluated 35 rats divided in 5 groups: bevacizumab (Group I, n = 7), trapidil (Group II, n = 7), trapidil + bevacizumab (Group III, n = 7), controls (Group IV, n = 7), and sham (Group V, n = 7). Anastomotic healing was assessed by measurement of bursting pressure and inflammation score at the anastomotic region on the seventh day. RESULTS: The bursting pressures of Group II, Group III, and Group V were significantly higher than controls (P = 0.001, P = 0.033, and P = 0.035, respectively). Fibrosis was significantly high in the sham group when compared with the other four groups (P = 0.047). CONCLUSIONS: Although bevacizumab seems to impair anastomotic healing, trapidil can be suggested to improve tracheal anastomoses.

11.
Anat Sci Int ; 98(2): 155-163, 2023 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-36018443

RESUMO

The aim of this study is to contribute to the determination of the normal values of human anogenital distance (AGD) and anal position index (API) in the antenatal period. 59 formalin-fixed human fetuses were examined. AGD was measured by the distance between the center of the anus and the posterior fourchette in females, and the distance between the center of the anus and the posterior scrotal raphe in males. API in female fetuses was determined with the formula API = fourchette-center of anus/fourchette-coccyx formula, and API = posterior scrotal raphe-center of anus/posterior scrotal raphe-coccyx in males. The mean AGDs of the female and male fetuses in the second trimester were 5.60 ± 1.60 mm and 9.64 ± 2.75 mm and 12.88 ± 4.14 mm and 17.26 ± 5.55 mm in the third trimester, respectively. The AGD values were found to be significantly higher in the males (p = 0.002). While the API values detected in the female and male fetuses were 0.43 ± 0.085 and 0.55 ± 0.072 in the second trimester, they were 0.46 ± 0.079 and 0.55 ± 0.058 in the third trimester. The API values were found to be significantly higher in the male fetuses (p < 0.001). When the distribution of API values of the fetuses in the second and third trimesters was examined, no significant difference was found (p = 0.499). In addition, no significant correlation was found between API and AGD values and percentile groups of fetuses (p Ëƒ 0.05). The AGD and API differed significantly between female and male fetuses starting from the antenatal second trimester, and the difference was preserved independently of the fetal percentile in the later stages of pregnancy.


Assuntos
Canal Anal , Feto , Humanos , Masculino , Feminino , Gravidez , Escroto , Pelve , Cadáver
12.
Adv Clin Exp Med ; 32(5): 545-549, 2023 May.
Artigo em Inglês | MEDLINE | ID: mdl-36424912

RESUMO

BACKGROUND: Acute pancreatitis (AP) is a disease that can still be fatal despite rapid advances in medicine. The relationship between serum nesfatin-1 levels and AP is still to be fully resolved. OBJECTIVES: To investigate the utility of serum nesfatin-1 levels in the diagnosis of AP. MATERIAL AND METHODS: Twenty-four male Sprague Dawley rats were divided into control, mild pancreatitis and severe pancreatitis groups (n = 8/group). Acute pancreatitis was induced by cerulein injection and the control group received saline injections. Then, the serum nesfatin-1, amylase, lipase, aspartate aminotransferase (AST), and alanine aminotransferase (ALT) levels were determined. A pathologist blinded to the study scored the severity of pancreatitis. RESULTS: There was a considerable decrease in serum nesfatin-1 levels in parallel to the severity of pancreatitis, though there was no statistically significant relationship observed between pancreatitis and nesfatin-1. In addition, there was no significant difference in AST or ALT levels among the groups. However, a strong positive correlation between amylase and lipase levels was observed (p < 0.05). The severe pancreatitis group (group 3) had a higher lipase level and pathology score than mild pancreatitis group (group 2), and this difference was statistically significant. CONCLUSIONS: Serum nesfatin-1 may be used as a diagnostic and severity marker in pancreatitis in the future.


Assuntos
Pancreatite , Ratos , Masculino , Animais , Pancreatite/induzido quimicamente , Pancreatite/patologia , Ratos Sprague-Dawley , Doença Aguda , Amilases , Lipase
13.
Ulus Travma Acil Cerrahi Derg ; 29(1): 17-21, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36588519

RESUMO

BACKGROUND: Acute mesenteric ischemia (AMI) has very high mortality and morbidity rates, and the most important factor in the prognosis of AMI is the duration of ischemia. This study aims to evaluate the changes of these markers according to the ischemia duration and possible use of cytokines and chemokines in the early diagnosis of AMI. METHODS: Twenty-one male Sprague-Dawley rats were divided into three equal groups. The Superior Mesenteric Artery and Superior Mesenteric Vein were tied tightly and exposed to ischemia for 2 h for Group 1 and 6 h for Group 2. There was no intervention for Group 3, and it was selected as a control group. Intracardiac blood samples were collected after 2 h in Group 1 and 6 h in Groups 2 and 3. The IL-1α, 1ß, 6, 10, 12p70, 17A, 18, 33, CXCL1/KC, CCL2/MCP-1, GM-CSF, IFN-γ, and TNF-α were measured using flow cytometry. RESULTS: Significant differences were observed between the groups in IFN-γ, CXCL1, MCP1, TNF-α, and IL-6 parameters. In the correlation analyses performed according to the mesenteric ischemia time, a very strong correlation was observed in CXCL1, as well as a strong level for MCP-1, TNF-α, and IL-6. Furthermore, a moderate level of correlation was found in IFN-γ, IL-10, and IL-18. CONCLUSION: The increased levels of CXCL1, MCP-1, TNF-α, and IL-6, which had a high correlation with the duration of ischemia in patients with intestinal ischemia, may help clinicians with diagnoses and treatment decision-making.


Assuntos
Citocinas , Isquemia Mesentérica , Ratos , Animais , Masculino , Fator de Necrose Tumoral alfa , Interleucina-6 , Isquemia Mesentérica/diagnóstico , Ratos Sprague-Dawley , Quimiocinas , Diagnóstico Precoce
14.
J Coll Physicians Surg Pak ; 32(7): 869-873, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-35795934

RESUMO

OBJECTIVE: To investigate the roles of cytokines in the etiopathogenesis of idiopathic granulomatous mastitis (IGM). DESIGN: Case-control study. PLACE AND DURATION OF STUDY: Istanbul Training and Research Hospital, Istanbul, Turkey, from September 2020 to January 2021. METHODOLOGY: Idiopathic Granulomatous Mastitis patients in active or remission who were admitted to the breast diseases outpatient clinic and healthy volunteers were included prospectively in the present study. The IL-1ß, IFN-α2, IFN-γ, TNF-α, MCP-1, IL-6, IL-8, IL-10, IL-12p (p70), IL-17A, IL-18, IL-23 and IL-33 values were measured with Flow Cytometry. The blood samples were taken before the treatment in the active IGM group. The ages, physical examination findings, menopausal and smoking conditions, and treatment methods were also evaluated. RESULTS: A total of 32 patients including 19 patients with active and 13 in remission, and 18 controls, were inducted making up a total of 50 subjects. The mean age was 37.18±7.15. The IL-1ß, TNF-α, IL-10, and IL-18 values were lower in patients with IGM than in the control group. Granulomatous Mastitis patients smoked more than the healthy participants. When the active patients, remission patients, and control group were evaluated together, no significant differences were detected in cytokine levels. CONCLUSION: The autoimmune and granulomatous reactions may not play a role in the etiopathogenesis of IGM because of the low levels of Th1 and Th17-related cytokines. However, some to baseline reference ranges were established. KEY WORDS: Idiopathic granulomatous mastitis, Cytokine, Autoimmunity, Smoking.


Assuntos
Citocinas , Mastite Granulomatosa , Adulto , Estudos de Casos e Controles , Feminino , Mastite Granulomatosa/etiologia , Humanos , Imunoglobulina M , Interleucina-10 , Interleucina-18 , Fator de Necrose Tumoral alfa
15.
Ulus Travma Acil Cerrahi Derg ; 28(10): 1449-1454, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-36169454

RESUMO

BACKGROUND: The increased intra-abdominal pressure during laparoscopic surgical procedures was reported to be a factor in the development of gastroesophageal reflux. This study evaluated the presence of gastroesophageal reflux and associated factors using 24-h pH monitoring in children undergoing laparoscopic appendectomy. METHODS: Children who underwent laparoscopic surgery for presumed acute appendicitis between June 2017 and June 2018 were included in the study. After pre-operative endotracheal intubation, pH catheters were placed for 24-h esophageal pH monitoring. Relationships between gastroesophageal reflux and procedure time, pre-operative fasting time, age, weight, and body mass index (BMI) were evaluated. RESULTS: A total of 60 pediatric patients were included in the study. Their mean (SD) age was 11.82 (3.71) years (range, 4-17 years). The mean (SD) body weight was 41.27 (16.72) kg (range, 15-90 kg) and the mean (SD) BMI were 17.96 (4.37). The mean pre-operative fasting time was 15.52 (12.1) h, while the mean operative time was 38.42 (17.96) min. Lower age and weight were significantly associated with the presence of post-operative gastroesophageal reflux (p<0.05). Mean procedure time, mean pre-operative fasting time, and BMI were not significantly associated with intra- or post-operative gastroesophageal reflux (p>0.05). CONCLUSION: The lack of a significant relationship between mean procedure time and gastroesophageal reflux suggests that the mean duration of the laparoscopic procedures performed in this study is safe in terms of gastroesophageal reflux. The results also indicate that young age and low weight should be considered risk factors for gastroesophageal reflux in pediatric patients undergoing laparoscopic appendectomy.


Assuntos
Apendicite , Refluxo Gastroesofágico , Laparoscopia , Adolescente , Apendicectomia/efeitos adversos , Apendicite/complicações , Apendicite/cirurgia , Criança , Pré-Escolar , Refluxo Gastroesofágico/etiologia , Refluxo Gastroesofágico/cirurgia , Humanos , Laparoscopia/efeitos adversos , Laparoscopia/métodos , Duração da Cirurgia
16.
Cureus ; 14(12): e33198, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36742275

RESUMO

Background and aim Acute pancreatitis is a common inflammation of the pancreas which can be severe and even potentially mortal. High rates of mortality showed the importance of immediate identification of patients at high risk and led the clinicians to refer to various scoring systems. Our aim was to investigate a clinical predictive model using the Model for End-Stage Liver Disease-Sodium (MELD-sodium) scoring system, adapting it to acute pancreatitis patients referring to the systemic inflammatory nature of the disease and potential multi-organ failures in severe form. Methods Our multicenter study was designed retrospectively. The medical records were reviewed for the period of two years. Demographics, biochemical results, MELD-sodium scores and mortality rates were analysed. Results MELD-sodium score was found to be statistically correlated with both mortality and the severity of pancreatitis (p<0.001) and significant difference between both mild and severe (p<0.001), moderate and severe groups (p<0.001). Mortality was found to be significantly higher in patients with MELD-Na score when the cut-off value was accepted as '≥11'. Conclusion We found that MELD-sodium score was significantly associated with both severity of disease and mortality rates and also significantly effective between both mild/severe and moderate/severe groups which may be a guide for future multi-center reviews with larger patient and control groups, which can define the potential role of this non-invasive and easy-to-use predictive model in acute pancreatitis patients.

17.
Scand J Urol Nephrol ; 45(5): 300-5, 2011 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-21612323

RESUMO

OBJECTIVE: In a cystometry procedure in a child with myelomeningocele (MMC), a pressure increase in the abdominal pressure (P (abd)) tracing was detected during filling. This pressure alteration was not related to other known events (straining, talking, rectal contractions). This study was conducted to investigate this phenomenon. MATERIAL AND METHODS: Forty-three children with MMC were enrolled in the study. A slow and gradual pressure increase associated with the bladder filling was sought in the P (abd) tracings. End filling and initial P (abd) gradient more than 3 cm H(2)O were considered as increased P (abd). If the defined pressure event occurs, the bladder was evacuated for verifying the filling-pressure relation. Age, gender, study position, pelvic floor tonicity and cystometric capacity were correlated with the pressure alteration. RESULTS: P (abd) increase was noted in 18 (41.8%) children. The mean P (abd) gradient between end and initial filling was 4.78 ± 1.63 cm H(2)O in these children. No statistically significant difference was noted for age, gender and study position. Statistically significant differences were noted with decreased pelvic floor tonicity and high values of cystometric capacity (p = 0.003 and p < 0.001, respectively). CONCLUSIONS: The pressure increase is thought to be a consequence of a posterior positional change in the bladder during filling die to decreased pelvic floor support in MMC. This pressure alteration was more obvious with increased bladder capacity. Urodynamic studies of children with MMC should be carefully evaluated for the presence of this phenomenon to prevent low measurement of the detrusor pressure, compliance and detrusor leak point pressure values.


Assuntos
Meningomielocele/fisiopatologia , Tono Muscular , Diafragma da Pelve/fisiopatologia , Urodinâmica/fisiologia , Adolescente , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Estudos Prospectivos
18.
Turk J Anaesthesiol Reanim ; 49(5): 389-393, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-35110040

RESUMO

1Background: Anaesthesia is known to reduce gastric emptying and motility, which can cause gastroesophageal reflux (GER) in some patients. Monitoring pH is a reliable method for detecting reflux. In this study, we aimed to show whether GER is a risk factor for post-operative nausea and vomiting (PONV) with oesophageal reflux measures in paediatric patients undergoing laparoscopic appendectomy. METHODS: After obtaining approval from ethics committee, 55 paediatric patients were included. An oesophageal pH metre catheter was inserted through the nasal passage to 3 cm above the lower oesophageal sphincter. pH measurements were evaluated with DeMeester score. It was accepted as acid reflux if the score was >14.7. The patients' demographic data, history of GER and verbal descriptive scale (VDS) to assess PONV and pH values were analysed with Statistical Package for the Social Sciences (SPSS) version 21 (IBM SPSS Corp.; Armonk, NY, USA). RESULTS: Of the 55 patients, 41.8% were girls, 58.2% were boys, the mean age was 13.2 years, the mean fasting period was 7.47 hours and the mean operation time was 1.1 hours. Mean fasting and operation times did not differ statistically according to VDS. There was no significant association between VDS group and gender or pH. None of the patients had a history of GER. Thirteen patients had DeMeester score >14.7. CONCLUSION: This is the first study about the relationship between gastric pH and PONV in paediatric patients. Although some studies have shown an association between anaesthesia and reflux, we detected reflux in nine of our patients and reflux was not statistically associated with PONV in our study. Further studies with larger patient groups are needed to provide a clearer opinion.

19.
North Clin Istanb ; 8(6): 629-633, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-35284800

RESUMO

A 54-year-old male was admitted to our department with neurofibromatosis and hypertension. During his examination, a mass was detected in the abdomen, and he was transferred to a surgical clinic. At the first examination of the patient, extensive café-au-lait spots and granulomas were detected on the body and the mass occupying right abdomen quadrant was palpable. The patient's medical history indicated that he had hypertension for almost a decade. The patient also stated that nodules on the body existed from his earliest recollection and he had relatives with neurofibromatosis. The patient was taken to a surgical operation. A mass with 30×23 cm in size was removed. The area of the nodular structure, with 0.5 cm in diameter, in the stomach serosa was also removed. The tumor was composed of phaeochromocytoma in the larger spaces and ganglioneuromas in the relatively narrow spaces. The nodular area removed in gastric serosa was reported as a very low-risk gastrointestinal stromal tumor. Apart from this rare combination, adrenal mass removed from the patient was considerably larger than the masses in the literature until now. Therefore, we aimed to present this rare case with a literature background.

20.
J Coll Physicians Surg Pak ; 29(10): 928-931, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31564263

RESUMO

OBJECTIVE: To investigate the diagnostic value of nesfatin-1 in cases of intestinal ischemia and ischemia/reperfusion. STUDY DESIGN: An experimental study. PLACE AND DURATION OF STUDY: The Experimental Animals Laboratory of Bezmialem University, in June 2018. METHODOLOGY: Twenty-one healthy male Sprague Dawley rats were randomly divided into three groups of 7 rats each. In group 1: 1-hour intestinal ischemia followed by 5-hour reperfusion was performed. In group 2: rats were subjected to 6-hour intestinal ischemia. In group 3: rats underwent laparotomy and closure without performing any further procedure. Changes in leukocyte count, amylase, blood sugar, LDH, SGOT, CRP, and nesfatin-1 levels were determined. For histopathological examination, a small intestinal sample was taken and preserved in 10% formaldehyde. RESULTS: Nesfatin-1 value in group 2 was significantly higher than that in group 1 and group 3 (p=0.005, and p <0.001 respectively). Nesfatin-1 value in group 1 was significantly higher than that in group 3. A significant (r = 0.864/p <0.001) positive correlation was observed between nesfatin-1 value and pathology score. The pathology score of group 2 was significantly higher than that of group 1 and group 3 (p <0.001). CONCLUSION: Serum nesfatin-1 can be a biomarker in acute mesenteric ischemia.


Assuntos
Biomarcadores/sangue , Isquemia Mesentérica/sangue , Nucleobindinas/sangue , Doença Aguda , Animais , Modelos Animais de Doenças , Masculino , Ratos , Ratos Sprague-Dawley
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