Yazarlar
- Suleyman, Halis(167)
- Mammadov, Renad(95)
- Türkeş, Cüneyt(84)
- Aydin, Sonay(83)
- Altuner, Durdu(74)
- Suleyman, Bahadir(68)
- Isik, Arda(67)
- Beydemir, Şükrü(66)
- Kantarci, Mecit(64)
- Kurt, Nezahat(57)
- Demir, Yeliz(54)
- Bulut, Seval(51)
- Arslan, Yusuf Kemal(50)
- Sofu, Hakan(50)
- Coban, Taha Abdulkadir(49)
- Karakeçili, Faruk(47)
- Altay, Ahmet(46)
- Huyut, Mehmet Tahir(46)
- Aydin, Suleyman(45)
- Türkmenoğlu, Burçin(45)
- Kuzucu, Mehmet(40)
- Yazici, Gulce Naz(40)
- Peker, Kemal(39)
- Algul, Oztekin(38)
- Cicek, Betul(37)
- Mertoglu, Cuma(36)
- Camurcu, Yalkin(35)
- Suleyman, Zeynep(34)
- Bozkurt, Aliseydi(32)
- Mendil, Ali Sefa(32)
- Gunay, Murat(31)
- Gözcü, Sefa(31)
- Köksal, Ekrem(31)
- Yuca, Hafize(31)
- Dilek, Esra(30)
- Karakurt, Papatya(30)
- Ozcicek, Fatih(30)
- Süleyman, Halis(30)
- Onk, Didem(29)
- Ucpunar, Hanifi(29)
Yayınlar
- MakaleYalnız künye2020Synthesis, characterization and biological activity evaluation of novel naphthalenylmethylen hydrazine derivatives as carbonic anhydrase inhibitors
Shirinzadeh, Hanif; Dilek, Esra
In the current study some derivatives of naphthalenylmethylen hydrazine were synthesized and possible in vitro hCA I and II enzymes inhibition effects were investigated. The designed compounds were synthesized by condensation of phenylhydrazine with 1-naphthaldehyde or 6-methoxy-2-naphthaldehyde and eight compounds (1a-h) were obtained. The novel Schiff bases derivatives (compounds 1a-1h) were effective inhibitors of the cytosolic carbonic anhydrase I and II isoforms (hCA I and II) with Ki values in the range of 80.60 ± 17.90 to 492.53 ± 95.23 nM for hCA I, 102.88 ± 18.44 to 461.09 ± 102.50 nM for hCA II. 1f compound shows a remarkable inhibitory effect of hCA I and hCA II isoenzymes among the new synthesized compounds. The new derivatives of naphthalenylmethylen hydrazine can be a potent inhibitor of both cytosolic CA isoenzymes which are commonly used in the pharmaceutical industries and medical areas.
- MakaleAçık Erişim2020The attitudes, behaviors, and opinions about non-pharmacological agents in patients with tinea pedis
Kara Polat, Asude; Akın Belli, Aslı; Göre Karaali, Müge; Koku Aksu, Ayşe Esra
Tinea pedis affects the life quality distinctly and patients those with a prolonged disease often resort to non-medical methods. We sought to evaluate patients' knowledge about tinea pedis and approaches to the non-pharmacological agents. A cross-sectional study was conducted on 152 patients with tinea pedis who answered the survey between July and November 2019. Demographic and clinical features, patients' attitudes, behaviors, and opinions about non-pharmacological treatments related to tinea pedis were evaluated. Of 152 patients, 65 (42.8%) were female and 87 (57.2%) were male. The frequency of at least one non-pharmacological agent use for tinea pedis was 55.9%. The most common non-pharmacological agent was cologne (27.0%), followed by saltwater, vinegar, and henna. The rate of non-pharmacological agent use was not significantly different between genders and patients with different education levels. Information sources for tinea pedis were dermatologists in only 42 patients (27.8%). The opinion that the disease will improve spontaneously was not significantly different between the groups according to the education level (P =.154). Tinea pedis needs awareness as a health problem particularly in Muslim populations. Patients should be prevented from applying wrong practices and informed about the risk factors, contagiousness, and treatment options by physicians.
- MakaleYalnız künye2020Renal Parenchymal Volumetric Expansion Assessed by CT Imaging After Laparoscopic Cyst Decortication
Gultekin, Mehmet Hamza; Yalcin, Ahmet; Erbay, Guven
Purpose: To delineate the expansion of the renal parenchyma using volumetric CT imaging before and after the laparoscopic cyst decortication procedure and to determine the possible associations between parenchymal expansion and laboratory parameters and cyst volume. Materials and Methods: Thirty-five patients who underwent laparoscopic cyst decortication were included in this prospective study. Abdominal contrast-enhanced CT was performed in all patients in the preoperative and postoperative period. Semi-automatic volume quantification was undertaken offline, and renal parenchymal volumes before and after cyst decortication, as well as serum creatinine and estimated glomerular filtration rate (eGFR) were compared. Results: The changes in serum creatinine and eGFR in the postoperative period were non-significant. The mean postoperative renal parenchymal volumes were higher compared to the preoperative measurements for both observations (P = .014 and .034 for the first and second measurements, respectively). There was no correlation between the volumetric change and the cyst volume (r = -0.18, P = .560). Conclusion: In patients undergoing laparoscopic cyst decortication, post-operative parenchymal expansion can be detected using volumetric CT imaging to confirm the immediate benefits of the procedure.
- MakaleYalnız künye2020Magnetic Resonance Imaging and Outcomes of Osteochondral Lesions of the Talus Associated With Ankle Fractures
Özcan, Seçkin; Koçkara, Nizamettin; Camurcu, Yalkın; Yurten, Hakan
Background: Osteochondral lesions of the talus (OCLTs) secondary to ankle fractures have previously been reported in the literature. However, no study has evaluated OCLTs using magnetic resonance imaging (MRI) following ankle fracture treatment. The purpose of our study was to investigate accompanying OCLTs in patients with an ankle fracture and evaluate its relationship with the clinical outcomes. Methods: Fifty-six patients with ankle fractures who were treated with either a nonoperative or operative method at our center between June 2016 and February 2017 were included in this prospective comparative study (37 men and 19 women; mean age, 44.6 ± 13 years; range, 20-65 years). The mean American Orthopaedic Foot & Ankle Society (AOFAS) scores were used to evaluate the clinical results in all patients in the second month and second year. The second-month ankle MR images were evaluated for OCLTs in all patients. Thirty patients were treated operatively and 26 nonoperatively. Results: Accompanying OCLTs were detected in 19 of 56 patients (34%). Our results showed no statistically significant association between OCLT and fracture type, as well as the treatment type. In the second postoperative month, the mean AOFAS scores were 87.2 ± 10.8 and 77.6 ± 12.0 in patients with and without OCLTs, respectively (P =.005). In the second postoperative year, the mean AOFAS scores were 81.3 ± 6.8 and 86.2 ± 8.4 in patients with and without OCLTs, respectively (P =.031). The mean AOFAS score significantly decreased in the OCLT group in the second-year control, whereas a significant increase was observed in patients without OCLTs (P =.026 and P <.001, respectively). Conclusion: According to our results, the accompanying OCLTs were found in one-third of patients treated for ankle fractures. We observed a significant correlation between OCLT presence and the AOFAS score. According to the AOFAS score, OCLTs statistically significantly affected clinical results at 2 years. Level of Evidence: Level II, prospective comparative study.
- MakaleAçık Erişim2020Altered blood and aqueous humor levels of asprosin, 4-hydroxynonenal, and 8-hydroxy-deoxyguanosine in patients with diabetes mellitus and cataract with and without diabetic retinopathy
Oruc, Yavuz; Celik, Fatih; Ozgur, Gokhan; Beyazyildiz, Emrullah; Ugur, Kader; Yardim, Meltem; Sahin, Ibrahim; Akkoc, Ramazan Fazil; Aydin, Suleyman
Purpose:Diabetic retinopathy (DRP) is the formation of edema and small vessels in the retina due to high blood glucose levels. Asprosin is a hormone that stimulates the release of glucose from the liver into the circulation. Considering the relationship between oxidative stress and DRP, our study aimed to determine the levels of the oxidative stress markers 4-hydroxynonenal (4-HNE) and 8-hydroxy-2′-deoxyguanosine (8-OHdG), as well as asprosin, in the blood and aqueous humor (Aq) of patients with and without DRP.Methods:Thirty patients with single-eye DRP and cataract (DRP + C), 30 patients with diabetes mellitus and cataract without DRP (DM + C), and 30 healthy control (CON) participants were enrolled into this retrospective study. Except for healthy controls, Aq and blood samples were taken from these patients during their cataract operation. Asprosin, 4-HNE, and 8-OHdG concentrations were analyzed using enzyme-linked immunosorbent assays.Results:In patients with DRP, the levels of asprosin, 4-HNE, and 8-OHdG were significantly higher in both Aq and blood samples compared with the group of patients without DRP.Conclusion:These findings suggest that the measurement of asprosin, 4-HNE, and 8-OHdG levels may support clinicians in determining the risk of DRP development.
- MakaleAçık Erişim2020Assessment of the frequency and biochemical parameters of conjunctivitis in COVID-19 and other viral and bacterial conditions; [COVID-19 ile diğer viral ve bakteriyal durumlarda konjonktivit sıklığı ve biyokimyasal parametrelerin değerlendirilmesi]
Oruc, Yavuz; Aydin, Suleyman; Akkoc, Ramazan Fazil; Aydin, Suna; Gul, Fatih Cem; Ugur, Kader; Sahin, İbrahim; Hanbeyoglu, Onur; Sirri Kilic, Suleyman; Aksoy, Aziz
Objectives: We compared the laboratory and clinical symptoms of coronavirus disease 2019 (COVID-19), other viral (beside COVID-19), and bacterial conjunctivitis patients with the values of controls. Methods: Twenty COVID-19, 15 other viral, 15 bacterial patients, and 15 control group were included in the study. COVID-19 was diagnosed with the real time reverse transcription–polymerase chain reaction while the indirect immunofluorescent antibody test was used in the detection of other viral agents. Bacterial agents were determined with the detection of the agent. The ophthalmologic examination of all cases was carried out by direct penlight, and the anterior segment evaluation was performed. The laboratory findings of all cases included in the study were obtained from the hospital records. Results: It was determined that 5% conjunctivitis and 5% diplopia developed in patients diagnosed with COVID-19, 20% conjunctivitis developed in patients due to other viral agents, and 66.6% conjunctivitis developed in patients due to bacterial agents. Conclusion: The incidence of conjunctivitis in COVID-19 patients was lower than in other viral and bacterial groups. Neutrophil/lymphocyte ratio and C-reactive protein come to the forefront as precious parameters with high specificity and sensitivity that might be useful to distinguish these diseases.
- MakaleAçık Erişim2020Serum Clara cell secretory protein (CC-16) in non-smoking patients with obstructive sleep apnea
Gulec Balbay, Ege; Ataoglu, Ozlem; Ercelik, Merve; Sahin, Ibrahim Ethem; Admis, Ozlem; Arbak, Peri Meram
Objective: This study aimed to determine the association between the severity of obstructive sleep apnea (OSA) and serum Clara cell protein (CC16) levels in non-smoking patients with OSA. Methods: This prospective study included non-smoking patients who presented with sleep-related disturbances and underwent polysomnography (PSG). The serum CC16 level was measured and its relationship to PSG parameters was investigated. Results: The study included 128 patients (83 men) with a mean age of 48.4 ± 11.9. OSA was detected in 66 men (70%) and 29 women (30%) (p = 0.051). The severity of OSA was mild in 32 (25%), moderate in 28 (22%), and severe in 35 (27%) of the patients. There was no significant difference in CC16 levels between the OSA group (1746 ± 1006) and the OSA negative group (1721 ± 1201, p = 0.91) levels. There was no significant difference between the CC16 levels of the each four groups. Mean serum CC16 levels were significantly lower in OSA negative men than OSA positive men (777 vs 1462, p = 0.005). No significant difference was observed in CC16 values according to OSA severity in women. Conclusion: The serum CC16 level does not differ between non-smoking OSA patients and OSA negative patients.
- MakaleAçık Erişim2020Thiazolyl-pyrazoline derivatives: In vitro and in silico evaluation as potential acetylcholinesterase and carbonic anhydrase inhibitors
Sever, Belgin; Türkeş, Cüneyt; Altıntop, Mehlika Dilek; Demir, Yeliz; Beydemir, Şükrü
Alzheimer's disease (AD) is a complex, predominant, and progressive form of dementia. The treatment of AD alters depending on the cognitive and behavioral symptoms. The utility of cholinergic replacement by acetylcholinesterase (AChE) inhibitors in AD treatment has been well-documented so far. Recent studies have also demonstrated that human carbonic anhydrases (hCAs) serve as important targets for AD treatment. In an attempt to identify potent AChE and hCA inhibitors, new thiazolyl-pyrazolines (3a-k) were designed based on the molecular hybridization of thiazole and pyrazoline scaffolds. A facile and versatile synthetic route consisting of three steps, namely Claisen-Schmidt reaction, the formation of the 2-pyrazoline ring system, and Hantzsch thiazole synthesis was used to prepare compounds 3a-k. The synthesized derivatives were experimentally validated for efficacy by in vitro and direct enzymatic assays. Furthermore, the compounds were subjected to in silico screening using Schrödinger Suite software to identify the binding affinities of potential compounds based on Glide XP scoring, MM-GBSA calculating, and validation. The results of in vitro and in silico studies revealed that compounds 3a, 3f, and 3d were the most promising derivatives in this series due to their significant effects on AChE, hCA I, and hCA II, respectively.
- MakaleYalnız künye2020The effect of Internet addiction on sleep quality in adolescents
Çelebioğlu, Ayda; Aytekin Özdemir, Aynur; Küçükoğlu, Sibel; Ayran, Gülsün
Problem: This cross-sectional type study was conducted to investigate the effect of Internet addiction on sleep quality in adolescents. Methods: The study was conducted between September and December 2017 in three high schools located in the city center of Erzincan determined according to three socioeconomic levels. The population of the study was composed of 9th, 10th, 11th, and 12th grade students in the high schools determined. In the study, sample group selection was not made and all students, for whom parental permission and student permissions were obtained, were included in the study. A total of 1487 students were included in the study. Findings: The average age of adolescents who participated in the study was 16.16 ± 1.19, 60.6% were male, and 27.6% were 9th grader. Adolescents' Young Internet Addiction Test-Short Form (YIAT-SF) total score average was 25.12 ± 9.14 and Pittsburgh Sleep Quality Index (PSQI) total score average was 5.11 ± 3.02. Poor sleep quality was found in 61.6% of adolescents. A positive and statistically significant relationship was found between the YIAT total score and the PSQI total score of adolescents (p <.01). Conclusions: It was determined that adolescents have a moderate Internet addiction, poor sleep quality, and Internet addiction negatively affects sleep quality.
- MakaleYalnız künye2020A significant differential diagnosis in foot injury: Os calcaneus secundarius
Pirimoglu, Berhan; Sade, Recep; Yalcin, Ahmet; Polat, Gokhan
- MakaleYalnız künye2020Antibacterial azole derivatives: Antibacterial activity, cytotoxicity, and in silico mechanistic studies
Sari, Suat; Avci, Ahmet; Koçak, Ebru; Kart, Didem; Sabuncuoğlu, Suna; Doğan, İnci Selin; Özdemir, Zeynep; Bozbey, İrem; Karakurt, Arzu; Saraç, Selma
Azole antifungal drugs are commonly used in antifungal chemotherapy. Antibacterial effects of some topical antifungals, such as miconazole and econazole, have lately been revealed, which suggests a promising venue in antimicrobial chemotherapy. In this study, we tested an in-house azole collection with antifungal properties for their antibacterial activity to identify dual-acting hits using the broth microdilution method. The in vitro screen yielded a number of potent derivatives against gram-positive bacteria, Enterococcus faecalis and Staphylococcus aureus. Compound 73's minimum inhibitory concentration (MIC) value less than 1 μg/ml against S. aureus; however, none of the compounds showed noteworthy activity against methicillin-resistant S. aureus (MRSA). All the active compounds were found safe at their MIC values against the healthy fibroblast cells in the in vitro cytotoxicity test. Molecular docking studies of the most active compounds using a set of docking programs with flavohemoglobin (flavoHb) structure, the proposed target of the azole antifungals with antibacterial activity, presented striking similarities regarding the binding modes and interactions between the tested compounds and the antifungal drugs with crystallographic data. In addition to being noncytotoxic, the library was predicted to be drug-like and free of pan-assay interference compounds (PAINS). As a result, the current study revealed several potential azole derivatives with both antifungal and antibacterial activities. Inhibition of bacterial flavoHb was suggested as a possible mechanism of action for the title compounds.
- MakaleYalnız künye2020Unexpected lesion of the prepontine cistern: A colloid cyst
Kiziloglu, Alper; Sakci, Zakir; Ogul, Hayri; Kantarci, Mecit
- MakaleYalnız künye2020The effect of loneliness and perceived social support on medication adherence self-efficacy in hypertensive patients: An example of Turkey
Hacihasanoglu Asilar, Rabia; Yildirim, Arzu; Saglam, Rabia; Demirturk Selcuk, Ezgi; Erduran, Yeliz; Sarihan, Ozlem
This study was conducted to investigate the effect of loneliness and perceived social support on medication adherence self-efficacy in hypertensive patients. This descriptive cross-sectional study was conducted between March and June 2015 at 5 Family Health Centers in central Erzincan in eastern Turkey. The data were collected through face-to-face interviews using a descriptive questionnaire, the UCLA Loneliness Scale, the Multidimensional Scale of Perceived Social Support, and the Medication Adherence Self-Efficacy Scale Short Form. The mean score obtained from the UCLA Loneliness Scale was 38.35 ± 9.85, from the Multidimensional Scale of Perceived Social Support 64.10 ± 18.31, and from the Medication Adherence Self-Efficacy Scale 40.27 ± 11.97. The mean UCLA Loneliness Scale score was found to have a low negative correlation with the mean Medication Adherence Self-Efficacy Scale score and a highly significant negative correlation with the mean Multidimensional Scale of Perceived Social Support score (P <.001). There was also a very low positive significant correlation between the mean scores of the Multidimensional Scale of Perceived Social Support and the Medication Adherence Self-Efficacy Scale (P <.001). This study revealed that individuals with hypertension perceived a moderate level of loneliness, and their perceived social support and medication adherence self-efficacy were higher than the moderate level. Perceived loneliness and perceived social support were significant indicators of perceived medication adherence self-efficacy. Therefore, effective consultancy services should be provided to hypertensive patients to increase their social support and to make positive changes in their perceived loneliness so that their perceived medication adherence self-efficacy can be improved.
- MakaleYalnız künye2020Thiols and ceruloplasmin levels in serum of children with attention deficit hyperactivity disorder: A cross-sectional study
Öğütlü, Hakan; Mertoğlu, Cuma; Gök, Gamze; Neşelioğlu, Salim
Attention deficit hyperactivity disorder (ADHD) is a childhood onset disorder with well-known findings that include impulsivity, hyperactivity, and inattention. This study aims to explore the relationship between the levels of ceruloplasmin, native thiol, total thiol, and disulfide and ADHD by comparing case and control groups. The study case group comprised 50 children aged 6–16 years who had been diagnosed with ADHD. The control group included 47 healthy children. Clinical interviews were conducted and the Schedule for Affective Disorders and Schizophrenia for School-Age Children—Present and Lifetime Version Turkish Adaptation and the Conners Parent Rating Scale were administered. Additionally, blood samples were taken and native thiol, total thiol, disulfide, and ceruloplasmin levels measured. In the ADHD group, the mean native thiol, total thiol, and disulfide levels were significantly lower than the control group. There was no significant difference between the ADHD and control groups in ceruloplasmin levels. Total thiol and native thiol levels were inversely correlated with scores on the Conners Inattention and Hyperactivity subscales; total thiol was negatively correlated with the ADHD index. Thiol–disulfide homeostasis was impaired in ADHD children and was related to symptom severity. Oxidative stress balance may play a role in ADHD.
- MakaleYalnız künye2020Clinical and Magnetic Resonance Imaging Outcomes of Microfracture Plus Chitosan/Blood Implant vs Microfracture for Osteochondral Lesions of the Talus
Camurcu, Yalkin; Ucpunar, Hanifi; Yapici, Furkan; Karakose, Resit; Ozcan, Seckin; Cobden, Adem; Duman, Serda; Sofu, Hakan
Background: The aim of this study was to compare the clinical and magnetic resonance imaging (MRI) outcomes of arthroscopic microfracture (MF) plus chitosan-glycerol phosphate/blood implant and MF alone for the treatment of the osteochondral lesions of the talus (OCLTs). Methods: Patients who underwent either MF plus chitosan (group 1, n = 32) or MF alone (group 2, n = 31) between 2015 and 2019 in 2 separate time periods were retrospectively analyzed. Visual analog scale (VAS) score and American Orthopaedic Foot & Ankle Society (AOFAS) score were used for clinical evaluation. The magnetic resonance observation of cartilage repair tissue (MOCART) system was used for MRI evaluation. The mean follow-up time was 32 ± 13 months (range, 12-61 months). Results: Postoperatively, we detected significant improvements in both groups in terms of VAS and AOFAS scores. However, we observed no statistically significant difference between groups in terms of clinical scores, except the mean VAS function score, which was significantly higher in group 1 (P =.022). According to MOCART scale, complete repair with the filling of the chondral defect and intactness of the surface of the repair tissue were more common in group 1. However, these parameters did not significantly differ between groups (P =.257 and.242, respectively). Conclusion: Arthroscopic MF plus chitosan glycerol phosphate/blood implant did not result in better clinical and MRI outcomes compared with MF alone in the treatment of OCLTs. Level of Evidence: Level III, retrospective comparative study.
- MakaleAçık Erişim2020Open abdomen management for severe peritonitis in elderly. Results from the prospective International Register of Open Abdomen (IROA): Cohort study
Rausei, Stefano; Pappalardo, Vincenzo; Ceresoli, Marco; Catena, Fausto; Sartelli, Massimo; Chiarugi, Massimo; Kluger, Yoram; Kirkpatrick, Andrew; Ansaloni, Luca; Coccolini, Federico
Background: Analyzing the data of the International Register of Open Abdomen (IROA), the feasibility of open abdomen treatment has been demonstrated at every age. This new analysis on the IROA database investigates the risk factors for mortality in elderly patients treated with open abdomen for intra-abdominal infection. Methods: Data were derived from the IROA, a prospective observational international cohort study that enrolled patients treated with open abdomen worldwide. A univariate analysis of potential risk factors was performed. Inclusion criteria were patients older than 65 years and treated with open abdomen for intra-abdominal infection. End point was overall mortality, calculated within 30 days after open abdomen management, after 1-month and 1-year follow-up. Results: A total of 116 patients was analyzed with mean age of 76 ± 7 years. Definitive closure was achieved in 93 patients (93/116, 80.2%) for a mean open abdomen duration of 5.0 ± 5.0 days. Complicated patients were 101 (101/116, 87.1%) for a total of 201 complications. Overall, 62 out of 116 patients (53.4%) died: 23 patients (23/62, 37.1%) during open abdomen management, 29 patients (46.8%) within 30 days after abdominal closure, 9 patients (14.5%) after 1-month follow-up, and 1 patient (1.6%) after 1-year follow-up. Age did not affect mortality (75 ± 6 years in alive patients versus 77 ± 7 years in dead patients, p = 0.773). Definitive abdominal closure was the most important factor to prevent mortality. Conclusions: This study confirmed that age alone cannot be considered a determinant for death, even in elderly patients managed with open abdomen for severe intra-abdominal infection.
- MakaleAçık Erişim2020Impact of the SARS-CoV-2 pandemic on emergency surgery services—a multi-national survey among WSES members
Reichert, Martin; Sartelli, Massimo; Weigand, Markus A.; Doppstadt, Christoph; Hecker, Matthias; Reinisch-Liese, Alexander; Bender, Fabienne; Askevold, Ingolf; Padberg, Winfried; Coccolini, Federico
Background: The SARS-CoV-2 pandemic is a major challenge for health care services worldwide. It’s impact on oncologic therapies and elective surgery has been described recently, and the literature provides guidelines regarding appropriate elective patient treatment during the pandemic. However, the impact of SARS-CoV-2 pandemic on emergency surgery services has been poorly investigated up to now. Methods: A 17-item web survey had been distributed to emergency surgeons in June 2020 around the world, investigating the impact of SARS-CoV-2 pandemic on patients and septic diseases both requiring emergency surgery and the time-to-intervention in emergency surgery routine, as well as experiences with surgery in COVID-19 patients. Results: Ninety-eight collaborators from 31 countries responded to the survey. The majority (65.3%) estimated the impact of the SARS-CoV-2 pandemic on emergency surgical patient care as being strong or very strong. Due to the pandemic, 87.8% reported a decrease in the total number of patients undergoing emergency surgery and approximately 25% estimated a delay of more than 2 h in the time-to-diagnosis and another 2 h in the time-to-intervention. Fifty percent make structural problems with in-hospital logistics (e.g. transport of patients, closed normal wards etc.) mainly responsible for delayed emergency surgery and the frequent need (56.1%) for a triage of emergency surgical patients. 56.1% of the collaborators observed more severe septic abdominal diseases during the pandemic, especially for perforated appendicitis and severe septic cholecystitis (41.8% and 40.2%, respectively). 62.2% had experiences with surgery in COVID-19-infected patients. Conclusions: The results of The WSES COVID-19 emergency surgery survey are alarming. The combination of an estimated decrease in numbers of emergency surgical patients and an observed increase in more severe septic diseases may be a result of the fear of patients from infection with COVID-19 and a consecutive delayed hospital admission and diagnosis. A critical delay in time-to-diagnosis and time-to-intervention may be a result of changes in in-hospital logistics and operating room as well as intensive care capacities. Both reflect the potentially harmful impact of SARS-CoV-2 pandemic on emergency surgery services.
- MakaleAçık Erişim2020Subtype distribution and molecular characterization of Blastocystis from hemodialysis patients in Turkey
Gulhan, Baris; Aydin, Merve; Demirkazik, Mehtap; Koltas, Ismail Soner; Cikman, Aytekin; Turkmen, Kultigin; Duran, Tugce
Introduction: The aim of this study was to determine the Blastocystis prevalence and subtypes in hemodialysis patients in Turkey. Methodology: Eighty-four patients diagnosed with end-stage renal failure who were undergoing hemodialysis and 20 healthy volunteers were enrolled. Blastocystis presence was investigated by native-Lugol, trichrome staining, PCR using STS primers, and DNA sequencing analysis. Results: Among the stool samples from the hemodialysis patients, 9.52% (8/84) were found to be Blastocystis-positive with the native-Lugol and trichrome staining. Seven of the eight Blastocystis isolates were subtyped using STS primers. Blastocystis subtype distribution was as follows: one had ST1, two had ST2, two had ST3, two had ST3+ST6, and one was not subtyped. Blastocystis positivity was detected in two healthy control (2/20, %10), one subject had ST1, and the other was not subtyped. All subtypes identified by PCR were confirmed by the sequencing analysis. In the two samples that had mixed subtypes (ST3+ST6) when using the STS primers, only ST3 was detected in the sequencing analysis. Although some patients have multiple symptoms, the most common symptoms in Blastocystis positive patients were bloating (5/8), diarrhea (4/8), nausea and vomiting (2/8), and gas and weight loss (1/8). Also, only one patient had Giardia intestinalis. Conclusions: This was the first study to determine the Blastocystis subtypes in hemodialysis patients. A rare subtype, ST6, was identified in two of the patients. Thus, the ST6 infections were attributable to transmission from poultry infections. The presence of this unusual subtype suggests the need for further extensive studies of hemodialysis patients.
- MakaleYalnız künye2020Can aprepitant used for nausea and vomiting be good gastrointestinal complaints?
Ugan, Rustem Anil; Un, Harun; Kose, Duygu; Cadirci, Elif; Bal Tastan, Tugba; Yayla, Muhammed; Halici, Zekai
Aprepitant is a selective SP/NK-1 receptor antagonist and used in postoperative and chemotherapeutics induced emesis and vomiting. The aim of our study is to show aprepitant may have beneficial effects on gastrointestinal complaints in cancer patients undergoing chemotherapeutics by indomethacin-induced gastric ulcer model. A total of 48 rats were fasted 24 h for ulcer experiment. Aprepitant doses of 5, 10, 20, and 40 mg/kg were evaluated for their antiulcer activity. Omeprazole (20 mg/kg) was used as a positive control group. Six hours after 25 mg/kg indomethacin administration, all stomachs were dissected out. After macroscopic analyses, tumor necrosis factor-alpha (TNF-α), interleukin-1β (IL-1β), COX-1, and COX-2 mRNA levels and SOD activity, and GSH and MDA levels of stomachs were determined. Histopathological examinations were evaluated. Aprepitant administration exerted 48.14%, 49.62%, 65.92%, and 76.77% ulcer inhibition effects at 5, 10, 20, and 40 mg/kg, respectively. Aprepitant administration decreased oxidative stress and inflammatory parameters in stomach tissues dose dependently. Aprepitant administration increased stomach COX-2 mRNA levels at 20 and 40 mg/kg doses. Although aprepitant appears to be disadvantageous in terms of treating gastric ulcer due to COX enzyme inhibition according to the previous studies, aprepitant has been shown to have ulcer healing effect in our study. When aprepitant is given as an anti-nausea and vomiting drug to cancer patients undergoing chemotherapy, we can argue that it will not be necessary to add a new gastric protective agent as it also shows beneficial effects in gastrointestinal complaints.
- MakaleAçık Erişim2020Open Abdomen and Fluid Instillation in the Septic Abdomen: Results from the IROA Study
Coccolini, Federico; Gubbiotti, Francesca; Ceresoli, Marco; Tartaglia, Dario; Fugazzola, Paola; Ansaloni, Luca; Sartelli, Massimo; Kluger, Yoram; Kirkpatrick, Andrew; Amico, Francesco
Background: Open abdomen (OA) is a surgical option that can be used in patients with severe peritonitis. Few evidences exist to recommend the use of intraperitoneal fluid instillation associated with OA in managing septic abdomen. Materials and methods: A prospective analysis of adult patients enrolled in the International Register of Open Abdomen (trial registration: NCT02382770) was performed. Results: A total of 387 patients were enrolled in two groups: 84 with peritoneal fluid instillation (FI) and 303 without (NFI). The groups were homogeneous for baseline characteristics. Overall complications were 92.9% in FI and 86.3% in NFI (p = 0.106). Complications during OA were 72.6% in FI and 59.9% in NFI (p = 0.034). Complications after definitive closure were 70.8% in FI and 61.1% in NFI (p = 0.133). Entero-atmospheric fistula was 13.1% in FI and 12% in NFI (p = 0.828). Fascial closure was 78.6% in FI and 63.7% in NFI (p = 0.02). Analysis of FI in negative pressure wound therapy (NPWT) showed: Overall morbidity in NPWT was 94% and in non-NPWT 91.2% (p = 0.622) and morbidity during OA was 68% and 79.4% (p = 0.25), respectively. Definitive fascial closure in NPWT was 87.8% and 96.8% in non-NPWT (p = 0.173). Overall mortality was 40% in NPWT and 29.4% in non-NPWT (p = 0.32) and morality during OA period was 18% and 8.8% (p = 0.238), respectively. Conclusion: We found intraperitoneal fluid instillation during open abdomen in peritonitic patients to increase the complication rate during the open abdomen period, with no impact on mortality, entero-atmospheric fistula rate and opening time. Fascial closure rate is increased by instillation. Fluid instillation is feasible even when associated with nonnegative pressure temporary abdominal closure techniques.
