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Bulunan: 14 Adet 0.001 sn
Koleksiyon [15]
Tam Metin [2]
Yayın Türü [3]
Yazar [20]
Yayın Yılı [9]
Konu Başlıkları [20]
Yayıncı [6]
Yayın Dili [2]
Dergi Adı [13]
Role of radial endosonography in the diagnosis of acute cholangitis

Alper E. | Unsal B. | Buyrac Z. | Baydar B. | Akca S. | Arslan F. | Ustundag Y.

Article | 2011 | Digestive Diseases and Sciences56 ( 7 ) , pp.2191 - 2196

Background and Study Aim: We aimed to assess radial endoscopic ultrasound (EUS) features of the bile duct wall as well as biliary luminal liquid characteristics in cases with acute cholangitis. Patients and Methods: This prospective study was performed during the period from January 2009 to February 2010 in a tertiary referral center. Twenty-eight patients with acute cholangitis and 60 patients without acute cholangitis but with cholestasis due to gallstone disease were enrolled in the study. During radial EUS examination, sonographic features of the common bile duct wall, the intraductal luminal content, and nearby periductal struc . . .tures were investigated. Mild hyperechogenic-heterogenic appearances with waving-type movements without acoustic shadowing enclosing one-third of the common bile duct were noted as purulent materials. Results: EUS indicated an increased focal and/or diffuse concentric bile duct wall thickness (>1.5 mm) in 68 and 27% of the cases with and without acute cholangitis, respectively. The mean bile duct wall thickness was 1.9 mm (0.9-2.9 mm) and 1.1 mm (0.6-2.1 mm) in the study and control groups, respectively (P < 0.05). On EUS, a pericholedochal hypoechoic strand more than 1.5 cm in length was present in 13 of 28 patients with acute cholangitis (46%). It was less than 1 cm long in 11 cases without acute cholangitis (18%). Bile duct content with heterogenous dense echogenicity without acoustic shadowing was present in 18 patients (64%) with acute cholangitis and in two patients (3%) without cholangitis. Those 20 patients were successfully drained with a same-day endoscopic retrograde cholangiography (ERCP) procedure which confirmed purulent biliary content after sphincterotomy. Same-day ERCP revealed no purulent material drainage from the bile duct in the other eight patients without cholangitis. The accuracy and positive and negative predictivity of diffuse concentric wall thickening and a peribiliary hypoechoic strand of greater than 1.5 cm in length for a diagnosis of acute cholangitis were 91, 86.3, and 67.1%, and 76, 72, and 54%, respectively. For purulent material, the accuracy and positive and negative predictive values of EUS for acute cholangitis were noted to be 87, 93.3, and 82%, respectively. Conclusion: Through this study, it was concluded that EUS findings such as diffuse and/or concentric wall thickening of more than 1.5 mm and intraductal heterogenous echogenicity without acoustic shadowing are highly accurate and predictive for diagnosing acute cholangitis. © 2011 Springer Science+Business Media, LLC Daha fazlası Daha az

Turkish dermatologists' approach for chronic spontaneous urticaria: A questionnaire based study

Kocatürk E. | Piril E. | Oktay T. | Nilgun A. | Teoman E. | Serap U. | Ekin S.

Article | 2018 | Dermatologica Sinica36 ( 2 ) , pp.70 - 74

Background/Objectives: Chronic spontaneous urticaria (CSU) is a common skin disorder which represents a challenge both for the patients and physicians. Guidelines and treatment algorithms have been created to help physicians to ease management. Our aim was to determine Turkish dermatologists' approach to CSU with regard to treatment, search for causative factors and use of instruments to assess the quality of life and severity of the disease. Methods: This was a cross-sectional methodological study which was performed by delivery of a questionnaire including ten questions about the management of CSU. Results: Analyses of 314 questio . . .nnaires revealed that the most common first-line treatments were non-sedating antihistamines in standard doses (65.6%), while second-line treatment was updosing antihistamines (59.9%) followed by addition of sedative-antihistamines (26.4%) and systemic steroids (19.1%). Third-line treatment option was omalizumab in 35% followed by systemic steroids. Twenty-two percent of the dermatologists referred the patients to a center experienced in urticaria. Most of them were performing laboratory testing for underlying causes including thyroid function tests, C-reactive protein, thyroid auto-antibodies, stool analyses, infection markers. Urticaria activity score and chronic urticaria quality of life questionnaire were used by 30 and 13%, respectively, while 56% were using none of the instruments. Conclusion: Our study showed that the therapeutic management of Turkish dermatologists was parallel to the European Urticaria Guidelines. The high utility of omalizumab as a third line regimen improved patient care. Nevertheless there is a need for centers experienced in urticaria to refer antihistamine-resistant patients where third-line treatment options can not be implemented. © 201 Daha fazlası Daha az

Colon perforation related to percutaneous nephrolithotomy: from diagnosis to treatment

Akbulut F. | Tok A. | Penbegul N. | Daggulli M. | Eryildirim B. | Adanur S. | Gurbuz G.

Article | 2015 | Urolithiasis43 ( 6 ) , pp.521 - 526

We present our experience with the largest series of colon perforation (CP) as complication of percutaneous nephrolithotomy (PNL). From January 1998 to August 2014, 22 cases that presented with PNL-related CP from seven referral centers were retrospectively reviewed. The patients with CP were evaluated in terms of probable risk factors. Peri-operative and postoperative findings, timing of diagnosis, and treatment modalities of the CP were reviewed. Of the 22 patients, previous ipsilateral renal surgery (n:2) and retrorenal colon (n:5) were the risk factors for CP. The CP was directly visualized via nephroscopy during the surgery in . . .3 (13.6 %) and with nephrostography at the end of the procedure in 4 patients (18.2 %). In two patients, perforation was realized via the passage of contrast into the colon with nephrostography on the postoperative second day. Postoperative passage of feces through the nephrostomy tube was seen in six patients. The clinical signs in 13 cases directed CP diagnosis. The confirmation of the CP was achieved with a CT scan in all the patients. The patients with extraperitoneal perforation were primarily managed conservatively. Open surgical treatment was performed in cases with intraperitoneal perforation (n:5) and those with extraperitoneal perforation resistant to conservative treatment (n:5). Meticulous evaluation of the risk factors preoperatively is the initial step in the prevention of CP. Timely diagnosis plays essential role in the management of this PNL complication. Although extraperitoneal CP may be managed conservatively, surgery is required for intraperitoneal CPs. © 2015, Springer-Verlag Berlin Heidelberg Daha fazlası Daha az

Appendiceal mucocele: Case reports and review of current literature

Karakaya K. | Barut F. | Emre A.U. | Ucan H.B. | Cakmak G.K. | Irkorucu O. | Tascilar O.

Article | 2008 | World Journal of Gastroenterology14 ( 14 ) , pp.2280 - 2283

The mucocele of the appendix is an uncommon disorder which is often asymptomatic but sometimes causes acute appendicitis-like symptoms. Sometimes, patients with mucocele can present with confusing symptoms. Preoperative suspicion and diagnosis of appendiceal mucocele are important. Ultrasonography and camputed tomography are useful tools for the diagnosis of appendiceal mucocele. It may be also recognised by colonoscopy as a smooth submucosal lesion of the cecum. Optimal management of the mucocele could be achieved through accurate preoperative diagnosis. Preoperative diagnosis is a major component for minimizing intra-operative and . . . post-operative complications. We herein report five cases and discuss the diagnostic methods and surgical treatment. © 2008 WJG. All rights reserved Daha fazlası Daha az

No suspicion, no disease! renal infarction: Case series

Karacabey S. | Hocagil . | Sanri E. | Hocagil A.C. | Ardic S. | Suman E.

Note | 2014 | Urology Journal11 ( 6 ) , pp.1984 - 1986

[No abstract available]

An adult case of visceral leishmaniasis in a province of black-sea region, Turkey [Zonguldak'ta erişkin viseral ley¸maniyaz olgusu]

Öztoprak N. | Aydemir H. | Pişkin N. | Keskin A.S. | Arasli M. | Gökmen A. | Çelebi G.

Article | 2010 | Mikrobiyoloji Bulteni44 ( 4 ) , pp.671 - 677

Visceral leishmaniasis (VL) which is a chronic disease caused by the protozoon, Leishmania, occurs widely worldwide and it is widespread in most of the countries in the Mediterranean basin. The infection which is transmitted by a sandfly (Phlebotomus) vector, has a prolonged incubation period and insidious onset. VL generally affects children and may be fatal if not treated. In this report, a 31 years old male patient, who was the first adult VL case from Zonguldak (a province located at western Black-Sea region of Turkey) was presented. He was admitted to the hospital with two-months history of fever, chills, sweating and weight lo . . .ss. There was no history of travel outside the city nor insect bites, however, he indicated that there would be unnoticed sandfly bites since sandflies were very common in the coal mines he worked. His physical examination revealed body temperatue of 39.2°C and hepatosplenomegaly, while laboratory findings yielded anemia, leucopenia, hypoalbuminemia and hypergamaglobulinemia. Erythrocyte sedimentation rate was 62 mm/h, C-reactive protein was 113 mg/L and liver transaminases were 2 to 5 folds higher than the reference values. The only pathological finding was hepatosplenomegaly in the abdominal ultrasound and computerized tomography. He was further examined to rule out infections with similar signs and symptoms, connective tissue diseases and malignancies and all were found negative. Hypercellular bone marrow were detected in the aspiration material. Bone marrow smears, bone marrow samples inoculated in NNN medium and serum samples of the patient were sent to the reference parasitology laboratory of Refik Saydam National Public Health Agency for evaluation in terms of VL. The diagnosis was confirmed by the detection of Leishmania IgG titer as 1/512 with in-house indirect immunofluorescence antibody test, by positivite rK39 Dipstick (InBios, USA) test and by the observation of Leishmania amastigote forms in the bone marrow smears. Bone marrow culture in NNN medium also revealed positive result by the determination of Leishmania promastigote forms on the 7 th day. The treatment was initiated by pentavalent antimony [glucantime 1 × 10 mg/kg/day intramuscular (IM)] however, due to severe adverse effects it has switched to liposomal amphotericin B (3 mg/kg/day). The patient completely recovered without complication. In conclusion VL should be considered in the differential diagnosis of patients, even adults, with persistent fever, hepatosplenomegaly and pancytopenia, in endemic countries such as Turkey Daha fazlası Daha az

Diagnostic utility of the neutrophil-lymphocyte ratio in patients with acute mesenteric ischemia: A retrospective cohort study [Akut mezenterik iskemili hastalarda nötrofil-lenfosit oranının tanısal yararı: Geriye dönük kohort çalışma]

Tanrıkulu Y. | Tanrıkulu C.Ş. | Sabuncuoğlu M.Z. | Temiz A. | Köktürk F. | Yalçın B.

Article | 2016 | Ulusal Travma ve Acil Cerrahi Dergisi22 ( 4 ) , pp.344 - 349

BACKGROUND: Acute mesenteric ischemia (AMI) remains fatal in 50-70% of cases. AMI is recognized as a vascular emergency, requiring rapid and efficient clinical evaluation and treatment. In the present retrospective study, the possible utility of the neutrophillymphocyte ratio (NLR) in the early diagnosis of AMI was explored. The potential use of this ratio to distinguish AMI from non-vascular bowel necrosis (NVBN) was investigated. METHODS: A total of 58 AMI, 62 NVBN, and 62 control patients were enrolled between May 1, 2010 and April 30, 2015. Patients who underwent laparotomies and/or bowel resections to treat AMI were included, a . . .s were NVBN patients who underwent segmental bowel resection to treat incarcerated and strangulated hernias. Controls were patients who presented to the emergency room with non-specific abdominal pain. RESULTS: Mortality rate was 51.7% in the AMI and 4.8% in the NVBN groups. White blood cell (WBC) count, C-reactive protein (CRP) level, and red cell distribution width (RDW) were highest in the AMI group. NLR was higher in the AMI and NVBN groups than in the control group ( Daha fazlası Daha az

Diagnostic value of serum ghrelin levels in prostate cancer

Mungan N.A. | Eminferzane S. | Mungan A.G. | Yesilli C. | Seckiner I. | Can M. | Ayoglu F.

Article | 2008 | Urologia Internationalis80 ( 3 ) , pp.245 - 248

Purpose: Expression of recently identified growth hormone-releasing peptide, ghrelin, and its receptor has been demonstrated in prostate cancer (PCA) cell lines. It was also shown that ghrelin has increased cell proliferation in vitro when added to PCA cell lines. The aim of this study was to evaluate the diagnostic value of serum ghrelin levels in detection of PCA. Material and Method: 30 patients with PCA and 50 patients with benign prostate hyperplasia (BPH) were enrolled in the study. The serum ghrelin levels of PCA and BPH patients were compared. The correlations between ghrelin and age groups, body mass index, total prostate-s . . .pecific antigen (PSA) levels, free/total PSA ratio, Gleason score, and prostate volume were also studied. Results: There were no statistically significant differences between the two groups and parameters mentioned above in terms of serum ghrelin levels (p > 0.05). Conclusion: Although ghrelin has been shown to induce PCA cell proliferation by in vitro studies, its role in the diagnosis of PCA was not demonstrated in our clinical study. Insufficient secretion of ghrelin into serum or the effect of other sources of ghrelin to serum ghrelin levels could be responsible for this discrepancy. Copyright © 2008 S. Karger AG Daha fazlası Daha az

Idiopathic ileoileal invagination two days after cesarean section

Harma M. | Harma M.I. | Karadeniz G. | Arikan I. | Barut A. | Bayar U.

Article | 2011 | Journal of Obstetrics and Gynaecology Research37 ( 2 ) , pp.160 - 162

Postoperative enteroenteric invagination is rare. The only previously reported case post-cesarean was secondary to colonic adenocarcinoma. A 27-year-old woman with preeclampsia delivered a baby by cesarean section. On the second postoperative day, she had abdominal pain, nausea, vomiting, constipation, and distention. An abdominal x-ray showed air-fluid levels, while free fluid (ascites) was detected by ultrasonography. A computed tomography scan did not show the typical invagination picture. Her condition did not improve after 72 h of conservative treatment, and diagnostic laparotomy was performed. A 10 x 3-cm ileoileal invaginatio . . .n 80 cm proximal to the ileocecal valve was found and manually reduced. The patient was discharged on the fifth postoperative day, and her six-month follow-up was normal. © 2011 Japan Society of Obstetrics and Gynecology Daha fazlası Daha az

Glomerular filtration rate: Which method should we measure in daily clinical practice?

Yildiz G. | Magden K. | Abdulkerim Y. | Ozcicek F. | Hür E. | Candan F.

Article | 2013 | Minerva Medica104 ( 6 ) , pp.613 - 623

Aim. In this study, we compared estimated glomerular filtration rate (eGFR) calculated with the formulas of Cockcroft-Gault (C&G), Modification of Diet in Renal Disease (MDRD), Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) and Mayo Clinic Quadratic (Mayo Q) and, GFR (mGFR) that was scintigraphically measured with creatinine clearance (CrC1) and technetium-99m di-ethylene triamine penta-acetic acid (99mTc-DTPA). Objective of this study was to define the correlations between the formulas, provide a reliable method for measurement and estimation of GFR in daily clinical practice and demonstrate the potential errors. M . . .ethods. C&G, CKD-EPI, Mayo Q and MDRD eGFR of 84(37 males, 47 females) patients diagnosed with chronic kidney disease were calculated. Values of 99mTc-DTPA based on mGFR were compared with eGFR values of the formulas. Results. Significant correlations were found with the values of 99mTc-DTPA mGFR, CrCl, MDRD, CKD-EPI, Mayo Q and C&G eGFR. The highest correlation was found between LBM (lean body mass) corrected C&G, MDRD-6, Mayo Q and CKD-EPI eGFR. The best estimate was made with MDRD-6 in the cases with 99mTc-DTPA mGFR<30 mL/min/1.73 m2 and with MDRD-4 in the cases with 99mTc-DTPA mGFR?30 mL/min/1.73 m2, while the worst estimate was made with uncorrected C&G formula in both groups. Conclusion. All eGFR formulas can be used in daily clinical practice. However, using MDRD-6 in the cases with GFR<30 mL/min/1.73 nil and MDRD-4 in the cases with GFR?30 mL/min/1.73m2 as well as using LBM for C&G eGFR or correction according to LBM when AW (actual weight) is used, might provide a more accurate estimation Daha fazlası Daha az

Frozen section experience with emphasis on reasons for discordance

Özdamar, Şükrü Oğuz | Bahadır, Burak | Ekem, Tulu Emre | Kertiş, Gürkan | Gün-Doğan, Banu | Numanoğlu, Gamze | Yünten, Zafer | Kuzey-Mocan, Gamze

Article | 2006 | Turkish Journal of Cancer36 ( 4 ) , pp.157 - 161

Intraoperative consultation is a high-risk procedure of pathology departments with important consequences. Therefore, it is critical to determine institutional efficiency of frozen section performance periodically. Frozen section diagnoses of 552 specimens from 401 cases between June 2001 and January 2005 were rewieved and correlated with subsequent histopathological examination, to assess concordant, discordant and deferred diagnoses as well as false negative and false positive rates and to determine reasons for discordance. Each individual specimen from the same case was considered and evaluated as one case. Excluding deferred dia . . .gnosis constituting 4.53% of the cases, accuracy, false negative and false positive rates were consecutively found 97.47%, 2.08%, and 0.57%. Interestingly, a great proportion of false negative cases were found to be associated with papillary carcinoma of thyroid. Gross sampling error and misinterpretation appeared as the leading reasons for frozen section discordance. Considering discordant frozen section diagnoses have a great impact on patient's care, intra and interinstitutional monitoring of frozen section performance may serve as a quality control programme Daha fazlası Daha az

Aggressive vaginal angiomyxoma mimicking a bladder mass

Erol B. | Pelit E.S. | Bektaş S. | Şimşek A.

Article | 2014 | Urology Journal11 ( 3 ) , pp.1710 - 1713

[No abstract available]

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