Sürdürülebilir Kalkınma Amaçları
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- ArticleYalnız künye2017Metalloproteinases and Their Inhibitors in Patients with Inguinal Hernia
Isik, Arda; Gursul, Cebrail; Peker, Kemal; Aydın, Merve; Fırat, Deniz; Yılmaz, İsmayil
Aim: The aim of this prospective study is to investigate if there is a relationship between inguinal hernia, matrix metalloproteinases (MMPs), and tissue inhibitors of metalloproteinases (TIMPs). Materials and methods: This case control study was performed on patients admitted to the general surgery department of Erzincan University Hospital. Four groups were created: control, indirect hernia, direct hernia, and bilateral hernia. All groups were comprised of 11 patients. Serum and tissue levels of MMP-1, MMP-2, MMP-9, MMP-13, TIMP-1, TIMP-2, TIMP-3, and hydroxyproline were evaluated. Results: MMPs values were significantly high at hernia groups, especially at bilateral hernia group (p < 0.05), whereas TIMPs values were significantly low at bilateral hernia group (p < 0.05). MMPs values were increasing at hernia groups in an order as control, indirect, direct, and bilateral. TIMPs values were decreasing at hernia groups in an order as control, indirect, direct, and bilateral. Conclusion: Increased levels of MMP-1-2-9-13 and decreased levels of TIMP-1-2-3 may have played role in the formation of inguinal hernia. Hernia is not only a local defect, but a reflection of systemic disease. This is even more significant for bilateral hernias.
RDL Kalıcı Kaydıİncele - ArticleAçık Erişim2017A Global Declaration on Appropriate Use of Antimicrobial Agents across the Surgical Pathway
Sartelli, Massimo; Kluger, Yoram; Ansaloni, Luca; Carlet, Jean; Brink, Adrian; Hardcastle, Timothy C.; Khanna, Ashish; Chicom-Mefire, Alain; Rodríguez-Baño, Jesús; Nathwani, Dilip
This declaration, signed by an interdisciplinary task force of 234 experts from 83 different countries with different backgrounds, highlights the threat posed by antimicrobial resistance and the need for appropriate use of antibiotic agents and antifungal agents in hospitals worldwide especially focusing on surgical infections. As such, it is our intent to raise awareness among healthcare workers and improve antimicrobial prescribing. To facilitate its dissemination, the declaration was translated in different languages.
RDL Kalıcı Kaydıİncele - Review ArticleAçık Erişim2017The management of intra-abdominal infections from a global perspective: 2017 WSES guidelines for management of intra-abdominal infections
Sartelli, Massimo; Chichom-Mefire, Alain; Labricciosa, Francesco M.; Hardcastle, Timothy; Abu-Zidan, Fikri M.; Adesunkanmi, Abdulrashid K.; Ansaloni, Luca; Bala, Miklosh; Balogh, Zsolt J.; Beltrán, Marcelo A.
Intra-abdominal infections (IAIs) are common surgical emergencies and have been reported as major contributors to non-trauma deaths in the emergency departments worldwide. The cornerstones of effective treatment of IAIs are early recognition, adequate source control, and appropriate antimicrobial therapy. Prompt resuscitation of patients with ongoing sepsis is of utmost important. In hospitals worldwide, non-acceptance of, or lack of access to, accessible evidence-based practices and guidelines result in overall poorer outcome of patients suffering IAIs. The aim of this paper is to promote global standards of care in IAIs and update the 2013 WSES guidelines for management of intra-abdominal infections.
RDL Kalıcı Kaydıİncele - CorrectionAçık Erişim2017Erratum to: IROA: International Register of Open Abdomen, preliminary results. [World J Emerg Surg. 12, (2017), (10)] DOI: 10.1186/s13017-017-0123-8
Coccolini, Federico; Montori, Giulia; Ceresoli, Marco; Catena, Fausto; Ivatury, Rao; Sugrue, Michael; Sartelli, Massimo; Fugazzola, Paola; Corbella, Davide; Salvetti, Francesco
The original article [1] mistakenly incorporated a sentence within the Abstract that stated: "Mean BMI: 36 +/- 5.6" This statement was incorrect and has now been removed from the original article.
RDL Kalıcı Kaydıİncele - ArticleYalnız künye2016Laparoskopik Apendektomide Manuel Düğümün Etkinliği
Eken, Hüseyin; Isik, Arda; Firat, Deniz; Yılmaz, İsmayil; Çimen, Orhan; Demiryılmaz, İsmail
Amaç: güdüğünün manuel düğüm veya diğer yöntemlerle kapatılması arasında ki etkinlik farkı araştırıldı. Gereç ve Yöntem: Çalışma için, 2012 mart-2015 mart tarihleri arasında Erzincan Üniversitesi Tıp Fakültesi Genel Cerrahi Kliniğinde laparoskopik apendektomi ameliyatı yapılan 30 hastanın dosyaları retrospektif olarak tarandı. Bulgular: Çalışmamızda 14 kadın, 16 erkek mevcuttu. Hastaların median yaşı 25 idi. Ortalama operasyon süresi manuel düğümde 45 dakika, diğer gereçlerde 40 dakika olarak tespit saptandı. Postoperatif hastanede ortalama yatış süresi manuel düğümde 1,3 gün, diğer gereçlerde 1,5 gün olarak tespit edildi. Postoperatif morbidite sadece manuel düğüm grubunda(%8) ve postoperatif apse olarak gözlendi. Sonuç: güdüğü manuel düğüm ile intra veya güvenli şekilde kapatılabilir. Bu şekilde uygulamanın diğer yöntemler uygulanarak yapılan kapama tekniğinden dezavantajı olmamakla beraber, operasyonel maliyet açısından avantajı bulunmaktadır.
RDL Kalıcı Kaydıİncele - ArticleYalnız künye2016Fascioliasis: A Rare Case Mimicking Cholelithiasis
Isik, Arda; Sayar, Ilyas; Firat, Deniz; Gülhan, Barış
Fascioliasis is a zoonotic disease that is very rarely seen in human beings. Histopathological examination of surgical specimen of a 43-year-old male patient who underwent surgery for cholelithiasis revealed the presence of Fasciola hepatica. Fascioliasis has liver (acute) and biliary (chronic) phases. Peripheral eosinophilia is dominant during liver phase; signs of cholelithiasis are dominant in biliary phase
RDL Kalıcı Kaydıİncele - ArticleYalnız künye2016Mixt Signet-ring Cell Mucinous Carcinoma in the Large Bowel
Balci, Mecdi Gurhan; Eken, Huseyin; Tayfur, Mahir; Isik, Arda; Ayerden, Dila
Carcinomas of the large bowel are the third most commonly seen cancer in both males and females and are the second reason of deaths resulting from cancer. The most frequently seen microscopic type of large bowel cancer is adenocarcinoma. Signet-ring cell carcinoma is a rarely seen microscopic subtype of large bowel carcinomas and may be accompanied by other microscopic types. The diagnosis of signet-ring cell carcinomas is made while the count of signet ring cells is over 50% of the tumor cells. The presence and ratio of signet-ring cells should be noted because the prognosis of signet-ring cell carcinoma is very bad. In our case, it is viewed mixt mucinous signet-ring cell carcinoma including mucinous components in the large bowel. This report is presented because it is rarely seen and because the prognosis is very bad and is necessary be specified in the report.
RDL Kalıcı Kaydıİncele - ArticleAçık Erişim2016Gallbladder Duplication
Isik, Arda; Firat, Deniz; Soytürk, Mehmet; Eken, Huseyin; Çimen, Orhan; Demiryilmaz, Ismail; Yilmaz, Ismayil
Gallbladder duplication which occurs during embryogenesis is a rare congenital anomaly. Two hundred ten cases were defined in the world. Forty years old patient who had abdominal pain was evaulated. He had gallbladder duplication diagnosed by hepatobiliary ultrasonography. After laparoscopic cholecystectomy, his complaints diminished. There can be variations such as duplication, triplication and septate gallbladder. Preoperative evaulation is important for perioperative complications.
RDL Kalıcı Kaydıİncele - ArticleAçık Erişim2016Idiopathic Periportal Lymphadenopathy
Isik, Arda; Firat, Deniz; Soyturk, Mehmet; Demiryilmaz, Ismail; Yilmaz, Ismayil
Objective: Periportal lymphadenopathy is observed frequently at imaging of liver, biliary tract, pancreas cancers, and lymphoma. It has importance for staging-treatment. But there are less number of studies about the importance of periportal lymph node except these cancers. We designed this study to determine the clinical significance of periportal lymphadenopathy. Material and methods: Between 2012-2015 January, patients who have idiopathic periportal lymphadenopathy followed in our clinic were retrospectively evaulated. Lymphadenopathy was considered as lymph nodes greater than 1 cm. Patients with a known history of cancer were excluded from the study. Results: Three patients (2 female, 1 male) were evaluated. Mean age was 40 (20-65). The mean size of lymphadenopathy was 1.83 (1.5-2.5) cm. In follow-up of patients one had non-Hodgkin's lymphoma whereas one had biliary cholangitis a week after the application. Other patient had no evidence of any pathology in the follow-up. Conclusion: Periportal lymphadenopathy, is a radiological finding which should be investigated further as a pioneer of various diseases. In terms of the progression or regression of the lymphadenopathy patients should be kept under close surveillance.
RDL Kalıcı Kaydıİncele - ArticleAçık Erişim2016Effectiveness of Manual Knotting at Laparoscopic Appendectomy
Isik, Arda; Demiryilmaz, Ismail; Yilmaz, Ismayil; Firat, Deniz; Çimen, Orhan; Eken, Huseyin
Objective: In this study, effectiveness of manual knotting at appendix stump closing versus other methods at laparoscopic appendectomy were compared. Material and Method: In this retrospective study, 30 patients who were performed laparoscopic appendectomy at Department of Surgery in School of Medicine at Erzincan University, between 2012 March-2015 March, were evaluated. Results: There were 14 female and 16 male patients. Median age was 25(18-52). Mean operation time at manual knotting and other methods was 45 minutes and 40 minutes, respectively. Mean length of postoperative stay at manual knotting and other methods was 1.3 days and 1.5 days, respectively. Postoperative morbidity was only seen at manual knotting group(8%) as abscess. Conclusion: Apendix stump can be safely closed by intra or extracorporeal manual knotting at laparoscopic appendectomy. This type of closing has no disadvantage compared with other methods, but it is more cost effective than the other methods.
RDL Kalıcı Kaydıİncele - ArticleAçık Erişim2016A rare case of isolated cystic hydatid of thyroid gland
Eken, Huseyin; Isik, Arda; Balci, Gulhan; Firat, Deniz; Cimen, Orhan; Soyturk, Mehmet
Hydatid cysts are most frequently localized within the liver and lungs, although they can also be found in highly vascularized tissues such as the brain, muscle, heart, pancreas, adrenal, and thyroid glands. A 65-year-old female patient was admitted to our clinic with complaints of a progressively growing mass that was compressing the surrounding tissues and causing respiratory distress. The pathological result was obtained as cytic hydatid. In patients with diagnosed hydatid cysts in the liver, systemic evaluation is necessary to rule out involvement of other organs. Among patients presenting with growths located in the neck, primary hydatid cyst of the thyroid gland must be considered in endemic regions.
RDL Kalıcı Kaydıİncele - ArticleAçık Erişim2016Male Mondor's Disease is a Rare Entity
Isik, Arda; Karavas, Erdal; Peker, Kemal; Soyturk, Mehmet; Yilmaz, Ismayil
RDL Kalıcı Kaydıİncele - ArticleYalnız künye2015Percutaneous Endoscopic Gastrostomy Our Experience: Evaluation of 66 Cases
Eken, Hüseyin; Isik, Arda; Özçiçek, Adalet; Yılmaz, İsmayil; Sekban, Nurdan; Çimen, Orhan; Peker, Kemal; Biçer, Şenol; Demiryılmaz, İsmail
Objective: While the patients who will not to be fed orally for less than a month are fed enterally with nasoenteral feeding tube, for the patients who are not able to take food orally more than a month gastrostomy application is recommended. Different gastrostomy techniques are used for this purpose. We aimed to discuss indications of percutaneous endoscopic gastrostomy (PEG) in the patients who underwent PEG operation, their early or late complications and the management of these complications. Material and Methods: This study was performed simultaneously in two different hospitals between 01.06.2010- 05.01.2014. The files of 66 patients whose oral feeding is not possible and PEG administered for enteral nutrition were reviewed retrospectively. Results: The most common indications for PEG placement in 47 patients (71.2 %) was malnutrition due to cerebrovascular diseases. A major complication related to procedure was not observed. The most common minor complications were feeding intolerance in 5 (7.6 %) patients and occlusion of tube in 5 (7.6 %) patients. Serious wound infection accompanied by necrosis that requires surgical debridement developed in 3 (4.6 %) patients. Conclusion: PEG offers great advantages because of ease of application especially in the critical patients who are not able to be fed orally due to a problem at proximal part while their gastrointestinal system are intact, and with its capability of being applied even at bedside, not requiring serious anesthesia and team. It is gaining widespread use with the improvement of intensive care units in terms of number of beds and facilities. Major and minor complications encountered require a surgical overview because application is an ostomy procedure. Therefore, we consider that in the PEG applications performed by the physicians other than surgeons, it would be appropriate to follow up these patients together with surgery clinics.
RDL Kalıcı Kaydıİncele - EditorialAçık Erişim2015Spontaneous Milk Fistula from an Accessory Breast: An Extremely Rare Case
Firat, Deniz; Idiz, Oguz; Isik, Arda; Peker, Kemal; Atar, Nilgun; Gul, Eylem
RDL Kalıcı Kaydıİncele - ArticleYalnız künye2015Diagnostic evaluation and treatment of patients with rectus abdominis hematoma
Isik, Arda; Peker, Kemal; Soyturk, Mehmet; Firat, Deniz; Yoruker, Uygar; Yilmaz, Ismayil
Purpose: To identify clinical characteristics, treatment modalities, and course of spontaneous rectus sheath hematoma (SRSH). In the literature, there is no prospective clinical trial that is intended for treatment in clinical research. Methods: Seventeen SRSH patients diagnosed and treated between March 2012 and March 2014 at the general Surgery Department of Erzincan University Training and Research Hospital were included. Age, sex, weight, height, predisposing factors, comorbid diseases, Charlson index, current medical treatment, physical examination signs, imaging methods, lowest hemoglobin value, blood type, SRSH type, INR/Factor V Leiden mutation/Factor VII/Factor VIII/Factor X/Protein S/Protein C values, treatment method, transfusions hospitalization duration, and outcome were studied. Results: Thirteen patients were female. The mean age was 63.3 +/- 18.7 years (range, 22-87 years), and the mean BMI was 27.8 +/- 3.5 (range, 20.9-33.7). Six patients had Grade I SRSH, 5 had Grade II SRSH, and 6 had Grade III SRSH. Thirteen were hospitalized for a mean duration of 9.3 +/- 8.1 days (range, 1-30 days). The death rate attributable to SRSH was 5.8%. Conclusion: Early diagnosis of SRSH by ultrasonography and/or computerized tomography is important for a low mortality rate. Even though medical treatments are important, arterial embolization by interventional radiology, or more radical interventions such as surgery, may be required. (C) 2014 AEC. Published by Elsevier Espana, S.L.U. All rights reserved.
RDL Kalıcı Kaydıİncele - ArticleAçık Erişim2015WSES guidelines for management of Clostridium difficile infection in surgical patients
Sartelli, Massimo; Malangoni, Mark A.; Abu-Zidan, Fikri M.; Griffiths, Ewen A.; Di Bella, Stefano; McFarland, Lynne V.; Eltringham, Ian; Shelat, Vishal G.; Velmahos, George C.; Kelly, Ciarán P.
In the last two decades there have been dramatic changes in the epidemiology of Clostridium difficile infection (CDI), with increases in incidence and severity of disease in many countries worldwide. The incidence of CDI has also increased in surgical patients. Optimization of management of C difficile, has therefore become increasingly urgent. An international multidisciplinary panel of experts prepared evidenced-based World Society of Emergency Surgery (WSES) guidelines for management of CDI in surgical patients.
RDL Kalıcı Kaydıİncele - ArticleAçık Erişim2015The effect of ozone and naringin on intestinal ischemia/reperfusion injury in an experimental model
Isik, Arda; Peker, Kemal; Gursul, Cebrail; Sayar, Ilyas; Firat, Deniz; Yilmaz, Ismayil; Demiryilmaz, Ismail
Background: The aim of the study was to evaulate the effect of ozone and naringin on the intestine after intestinal ischemia-reperfusion(II/R) injury. Methods: Thirty five rats divided into 5 groups of 7 animals: control, II/R, ozone, naringin and naringin + ozone. Only laparotomy and exploration of the superior mesenteric artery (SMA) were done in control group. In the experimental groups, SAM was occluded for 1 h and reperfused for 1 h. 15 min after ischemia, ozone (25 μg/ml, 0.5 mg/kg), naringin (80 mg/kg) and naringin + ozone(80 mg/kg + 25 μg/ml, 0.5 mg/kg) were infused intraperitoneally to each groups. Ileum tissues were harvested to determine intestinal mucosal injury and oxidative stress markers. For SMA occlusion, different than literature, silk suture binding was used. Results: Oxidative stress markers were significantly low in experimental groups compared with II/R group (p < 0.05). Histopathologically, the injury score was significantly low at experimental groups compared with II/R group (p < 0.05). The lowest injury score was encountered at naringine + ozone group. Conclusions: Ozone alone or combined with naringin has a protective effect for mesenteric ischemia. Instead of using instruments such as clamps in the II/R rat model, silk binding may be used safely.
RDL Kalıcı Kaydıİncele - ArticleAçık Erişim2015Relationship among mismatch repair deficiency, CDX2 loss, p53 and E-cadherin in colon carcinoma and suitability of using a double panel of mismatch repair proteins by immunohistochemistry
Sayar, Ilyas; Akbas, Emin Murat; Isik, Arda; Gokce, Aysun; Peker, Kemal; Demirtas, Levent; Gürbüzel, Mehmet
Biomarkers such as mismatch repair proteins, CDX2, p53, and E-cadherin are blamed for colon cancers, but the relationships of these biomarkers with each other and with pathological risk factors in colon carcinoma are still not clear. The aim of this study was to evaluate the association of these biomarkers with each other by using immunohistochemical staining and to compare their expression with pathological risk factors for colonic adenocarcinoma. We also aimed to study the usability of a double panel of mismatch repair proteins. One hundred and eleven cases with colonic adenocarcinoma were examined. There was a statistically significant relationship between tumor histological differentiation and perineural invasion, vascular invasion, mismatch repair deficiency, p53, CDX2, and E-cadherin (p < 0.05). PMS2 and MSH6 loss covered 100% of cases with mismatch repair deficiency. Mismatch repair deficiency was correlated with CDX2 loss and E-cadherin expression (p < 0.05). It was also observed that cases with PMS2 loss covered all the cases with CDX2 loss. In conclusion, this double panel may be used instead of a quadruple panel for detecting mismatch repair deficiency. Association of CDX2 and PMS2 in the present study is necessary to conduct further genetic and pathological studies focusing on these two markers together.
RDL Kalıcı Kaydıİncele - LetterYalnız künye2015A rare complication of colorectal surgery and its management: Chylous leakage; [Una complicación muy poco frecuente de la cirugía colorrectal y su tratamiento: Fuga quilosa]
Isik, Arda; Okan, Ismail; Firat, Deniz; Idiz, Oguz
RDL Kalıcı Kaydıİncele - ArticleAçık Erişim2015Rare tumors of the gallbladder: Clear cell carcinoma
Eken, Huseyin; Balci, Mecdi Gurhan; Buyukakincak, Sercan; Isik, Arda; Firat, Deniz; Cimen, Orhan
Introduction Gallbladder cancer is a rare tumor in the gastrointestinal tract has poor prognosis, low survival and is difficult to diagnose. The most common type of gallbladder cancer is adenocarcinoma, and the incidence of clear cell carcinoma is low. Mostly, it is difficult to determine whether the isolated tumor is a primary tumor in the gallbladder or a metastatic tumor from another region. Before accepting a clear cell carcinoma as a primary gallbladder tumor, the kidneys and other possible secondary focuses are clinically considered in terms of metastases. Presentation of case Here, we present a rarely seen case of gallbladder clear cell carcinoma, which was diagnosed by pathological examination after the surgery. Discussion Prior to establishing that clear cell carcinoma is a primary gallbladder cancer, it is appropriate to clinically investigate possible secondary focuses, in particular the kidneys in terms of metastasis. Conclusion Our goal in presenting this case was to emphasize the importance of taking an accurate medical history in patients with clear cell carcinoma, a rarely seen gallbladder cancer.
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