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Risk Factors in Surgical Site Infections
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作者 Atilla Duran Hüseyin Gülay Mustafa Cem Terzi 《Surgical Science》 2024年第2期64-80,共17页
Purpose of the Research: Our study aimed to determine and understand the risk factors of surgical site infections in patients operated on in general surgery wards. Method of Research: Between May 2008 and November 200... Purpose of the Research: Our study aimed to determine and understand the risk factors of surgical site infections in patients operated on in general surgery wards. Method of Research: Between May 2008 and November 2008, 422 consecutive patients who underwent emergency and elective surgeries, excluding breast, goitre and laparoscopic surgeries, were included in the study to determine surgical site infections and risk factors. The patients’ risk factors were selected in the preoperative period, and postoperative 3<sup>rd</sup>, 7<sup>th</sup>, and 30<sup>th</sup> days were checked by the physician responsible for conducting the study regarding surgical site infection. Results and Conclusion: Surgical site infections were defined as incisional and organ/space based on NNIS data. Gender, diabetes mellitus, malignancy, degree of contamination, ASA score ≥ 3, preoperative skin cleansing, duration of intensive care unit stay, duration of hospital stay, growth in wound culture, duration of surgery and incision length were determined as risk factors increasing CAI rates. Especially the degree of contamination, duration of intensive care unit stay, hospitalisation, duration of operation, and growth in wound culture were decisive factors in the development of CAI. As a result of our study, in the light of these data, we concluded that to prevent the development of CAI can be modified, interventions to foreseeable factors can be assessed. 展开更多
关键词 INFECTION CAI RISK PATIENT
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Analysis of geriatric patients with minor spinal trauma admitted to the emergency department of a university hospital 被引量:1
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作者 Tufan Akin Giray Afsin Emre Kayipmaz +4 位作者 Erkin Sonmez Kemal Murat Haberal Cem Yilmaz Cemil Kavalci Hakan Oguzturk 《Journal of Acute Disease》 2019年第5期191-194,共4页
Objective:To retrospectively analyze patients aged 65 years and over,who were admitted to a level Ⅱ trauma center in Turkey due to minor spinal trauma in a period of 4 years.Methods:The study included 64 patients age... Objective:To retrospectively analyze patients aged 65 years and over,who were admitted to a level Ⅱ trauma center in Turkey due to minor spinal trauma in a period of 4 years.Methods:The study included 64 patients aged 65 years and over,who were admitted to the Emergency Department of Baskent University Ankara Hospital between January 2011 and January 2015 and diagnosed with vertebral trauma.The information of the patients was obtained from the medical records.The clinical characteristics of patients including localizafions and types of fracture,presence of additional system injuries and treatment options were investigated.Results:The most common cause was fall,accounting for 51 (79.7%),with 7 (10.9%) due to intra-vehicle traffic accident,and 6 (9.4%) due to out-of-vehicle pedestrian injury.The most common site of trauma was the lumbar region.Of the fractures,46.9% (n=30) were in the lumbar region,37.5% (n=24) in the thoracic region and 15.6% (n=10) were in the cervical vertebra region.Fourteen (21.9%) patients had an additional injury.Given the fracture types,47 fractures (74.6%) were compression,14 fractures (22.2%) were spinous process and 2 fractures (3.2%) were burst fractures.Twenty patients (31.2%) had multilevel vertebral fractures.Conclusions:The results of our study demonstrated the importance of vertebral fractures in the geriatric age group.In this age group,falls and motor vehicle accidents are the leading causes of vertebral traumas.Taking the necessary measures to prevent the risk factors which increase with aging is the most important step in preventing the mortality and morbidity that may occur as a result of vertebral fracture. 展开更多
关键词 ELDERLY TRAUMA VERTEBRAL COLUMN
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Peripapillary and macular vascular densities in healthy,ocular hypertensive,and different stages of glaucomatous eyes
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作者 Caner Ozturk Sirel Gur Gungor +2 位作者 Umit Eksioglu Almila Sarıgul Sezenoz Meric Colak 《International Journal of Ophthalmology(English edition)》 SCIE CAS 2023年第12期2018-2026,共9页
AIM:To investigate vascular changes in different stages of glaucoma and to evaluate the role of optical coherence tomography angiography(OCTA)in the early diagnosis of glaucoma.METHODS:Glaucoma patients and healthy co... AIM:To investigate vascular changes in different stages of glaucoma and to evaluate the role of optical coherence tomography angiography(OCTA)in the early diagnosis of glaucoma.METHODS:Glaucoma patients and healthy controls(n=29 eyes)were investigated in this cross-sectional comparative study.Glaucoma patients were grouped as ocular hypertension(n=44 eyes),preperimetric glaucoma(PPG;n=32 eyes),early glaucoma(EG;n=35 eyes),moderate stage glaucoma(MG;n=36 eyes),and advanced glaucoma(AG;n=35 eyes).Peripapillary and macular vascular densities(VDs)of all participants were compared and correlations of VDs and retinal nerve fiber layer thickness(RNFLT),ganglion cell analysis(GCA),and visual field(VF)tests were evaluated.Area under the receiver operation characteristic curves(AUC)of the peripapillary and macular VD parameters were obtained.RESULTS:VD values decreased with the progression of glaucoma.Most peripapillary and macular VD parameters of PPG and EG groups were lower than healthy controls(P<0.001).There was no significant difference in RNFLT between the PPG and EG groups,but most peripapillary and macular VDs were found to be lower in EG group than in PPG group(P<0.05).In most disease group,VDs were significantly correlated with OCT parameters(P<0.001)and VF index(P<0.05).There were no significant correlations between VF and RNFLT indices in the AG group,but significant correlations were found between VF and VD values(P<0.05).AUC for discriminating between healthy and glaucomatous eyes were highest in whole image peripapillary VD(AUC:0.865,0.929,and 0.986,respectively in EG,MG,and AG groups).CONCLUSION:OCTA can be used in the early diagnosis of glaucoma and can be useful in follow-up of the advanced disease.In cases where limitations or suspicions in structural and functional tests are present,OCTA can be used as a supportive diagnostic test,both in EG and AG. 展开更多
关键词 glaucoma optical coherence tomography angiography vascular density early diagnosis
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Efficacy of abatacept treatment in a patient with enteropathy carrying a variant of unsignificance in CTLA4 gene:A case report
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作者 Ugur Musabak Tuba Erdoğan +3 位作者 Serdar Ceylaner EmreÖzbek Nuretdin Suna Binnaz HandanÖzdemir 《World Journal of Clinical Cases》 SCIE 2023年第26期6176-6182,共7页
BACKGROUND Cytotoxic T Lymphocyte Antigen-4(CTLA4)deficiency is a genetic defect that causes a common variable immunodeficiency(CVID)clinical phenotype.Several studies have reported an association between CTLA mutatio... BACKGROUND Cytotoxic T Lymphocyte Antigen-4(CTLA4)deficiency is a genetic defect that causes a common variable immunodeficiency(CVID)clinical phenotype.Several studies have reported an association between CTLA mutations or variants and various autoimmune diseases.Targeted therapy models,which have become increasingly popular in recent years,have been successful in treating CTLA4 deficiency.In this article,we discuss the clinical outcomes of abatacept treatment in a patient with CTLA4 and lipopolysaccharide-responsive beige-like anchor(LRBA)variants that was previously diagnosed with CVID.CASE SUMMARY A 25-year-old female patient,who was visibly cachectic,visited our clinic over the course of five years,complaining of diarrhea.The patient was diagnosed with ulcerative colitis in the centers she had visited previously,and various treatments were administered;however,clinical improvement could not be achieved.Severe hypokalemia was detected during an examination.Her serum immunoglobulin levels,CD19+B-cell percentage,and CD4/CD8 ratio were low.An endoscopic examination revealed erosive gastritis,nodular duodenitis,and pancolitis.Histopathological findings supported the presence of immune mediated enteropathy.When the patient was examined carefully,she was diagnosed with CVID,and intravenous immunoglobulin treatment was initiated.Peroral and rectal therapeutic drugs including steroid therapy episodes were administered to treat the immune mediated enteropathy.Strict follow-ups and treatment were performed due to the hypokalemia.After conducting genetic analyses,the CTLA4 and LRBA variants were identified and abatacept treatment was initiated.With targeted therapy,the patient’s clinical and laboratory findings rapidly regressed,and there was an increase in weight.CONCLUSION The heterozygous CTLA4 variant identified in the patient has been previously shown to be associated with various autoimmune diseases.The successful clinical outcome of abatacept treatment in this patient supports the idea that this variant plays a role in the immunopathogenesis of the disease.In the presence of severe disease,abatacept therapy should be considered until further testing can be conducted. 展开更多
关键词 Common variable immunodeficiency ABATACEPT CTLA4 antigen Case report
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Multi-institutional analysis of cervical esophageal carcinoma patients treated with definitive chemoradiotherapy: TROD 01-005 study
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作者 OZAN CEM GULER EZGI OYMAK +16 位作者 GOZDE YAZICI OZLEM OZKAYA AKAGUNDUZ OGUZ CETINAYAK PETEK ERPOLAT ATIL AKSOY MURSEL DUZOVA BERNA AKKUS YILDIRIM MERAL KURT EMINE CANYILMAZ GULER YAVAS SERAP AKYUREK DIDEM COLPAN OKSUZ ESRA KAYTAN SAGLAM OMUR KARAKOYUN CELIK ENIS OZYAR MUSTAFA CENGIZ CEM ONAL 《Oncology Research》 SCIE 2023年第3期299-306,共8页
The aim of this study was to examine the prognostic factors and treatment outcomes of cervical esophageal carcinoma(CEC)patients who underwent definitive chemoradiotherapy(CRT).The clinical data of 175 biopsyconfirmed... The aim of this study was to examine the prognostic factors and treatment outcomes of cervical esophageal carcinoma(CEC)patients who underwent definitive chemoradiotherapy(CRT).The clinical data of 175 biopsyconfirmed CEC patients treated with definitive CRT between April 2005 and September 2021 were retrospectively analyzed.The prognostic factors predicting overall survival(OS),progression-free survival(PFS),and local recurrence-free survival(LRFS)were assessed in uni-and multivariable analyses.The median age of the entire cohort was 56 years(range:26–87 years).All patients received definitive radiotherapy with a median total dose of 60 Gy,and 52%of the patients received cisplatin-based concurrent chemotherapy.The 2-year OS,PFS,and LRFS rates were 58.8%,46.9%,and 52.4%,respectively,with a median follow-up duration of 41.6 months.Patients’performance status,clinical nodal stage,tumor size,and treatment response were significant prognostic factors for OS,PFS,and LRFS in univariate analysis.Non-complete treatment response was an independent predictor for poor OS(HR=4.41,95%CI,2.78–7.00,p<0.001)and PFS(HR=4.28,95%CI,2.79–6.58,p<0.001),whereas poor performance score was a predictor for worse LRFS(HR=1.83,95%CI,1.12–2.98,p=0.02)in multivariable analysis.Fifty-two patients(29.7%)experienced grade II or higher toxicity.In this multicenter study,we demonstrated that definitive CRT is a safe and effective treatment for patients with CEC.Higher radiation doses were found to have no effect on treatment outcomes,but a better response to treatment and a better patient performance status did. 展开更多
关键词 Esophageal cancer CHEMORADIOTHERAPY RADIOTHERAPY Local control TOXICITY Survival
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Emergency cholecystectomy vs percutaneous cholecystostomy plus delayed cholecystectomy for patients with acute cholecystitis 被引量:23
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作者 Feza Y Karakayali Aydincan Akdur +3 位作者 Mahir Kirnap Ali Harman Yahya Ekici G?han Moray 《Hepatobiliary & Pancreatic Diseases International》 SCIE CAS 2014年第3期316-322,共7页
BACKGROUND: In low-risk patients with acute cholecystitis who did not respond to nonoperative treatment, we prospectively compared treatment with emergency laparoscopic cholecystectomy or percutaneous transhepatic cho... BACKGROUND: In low-risk patients with acute cholecystitis who did not respond to nonoperative treatment, we prospectively compared treatment with emergency laparoscopic cholecystectomy or percutaneous transhepatic cholecystostomy followed by delayed cholecystectomy.METHODS: In 91 patients(American Society of Anesthesiologists class I or II) who had symptoms of acute cholecystitis ≥72 hours at hospital admission and who did not respond to nonoperative treatment(48 hours), 48 patients were treated with emergency laparoscopic cholecystectomy and 43 patients were treated with delayed cholecystectomy at ≥4 weeks after insertion of a percutaneous transhepatic cholecystostomy catheter. After initial treatment, the patients were followed up for 23 months on average(range 7-29).RESULT: Compared with the patients who had emergency laparoscopic cholecystectomy, the patients who were treated with percutaneous transhepatic cholecystostomy and delayed cholecystectomy had a lower frequency of conversion to open surgery [19(40%) vs 8(19%); P=0.029], a frequency of intraoperative bleeding ≥100 mL [16(33%) vs 4(9%); P=0.006],a mean postoperative hospital stay(5.3±3.3 vs 3.0±2.4 days;P=0.001), and a frequency of complications [17(35%) vs 4(9%);P=0.003].CONCLUSION: In patients with acute cholecystitis who presented to the hospital ≥72 hours after symptom onset and did not respond to nonoperative treatment for 48 hours, percutaneous transhepatic cholecystostomy with delayed laparoscopic cholecystectomy produced better outcomes and fewer complications than emergency laparoscopic cholecystectomy. 展开更多
关键词 acute abdomen acute cholecystitis COMPLICATIONS LAPAROSCOPY SURGERY biliary tract
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Surgical and interventional management of complications caused by acute pancreatitis 被引量:19
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作者 Feza Y Karakayali 《World Journal of Gastroenterology》 SCIE CAS 2014年第37期13412-13423,共12页
Acute pancreatitis is one of the most common gastrointestinal disorders worldwide. It requires acute hospitalization, with a reported annual incidence of 13 to 45 cases per 100000 persons. In severe cases there is per... Acute pancreatitis is one of the most common gastrointestinal disorders worldwide. It requires acute hospitalization, with a reported annual incidence of 13 to 45 cases per 100000 persons. In severe cases there is persistent organ failure and a mortality rate of 15% to 30%, whereas mortality of mild pancreatitis is only 0% to 1%. Treatment principles of necrotizing pancreatitis and the role of surgery are still controversial. Despite surgery being effective for infected pancreatic necrosis, it carries the risk of long-term endocrine and exocrine deficiency and a morbidity and mortality rate of between 10% to 40%. Considering high morbidity and mortality rates of operative necrosectomy, minimally invasive strategies are being explored by gastrointestinal surgeons, radiologists, and gastroenterologists. Since 1999, several other minimally invasive surgical, endoscopic, and radiologic approaches to drain and debride pancreatic necrosis have been described. In patients who do not improve after technically adequate drainage, necrosectomy should be performed. When minimal invasive management is unsuccessful or necrosis has spread to locations not accessible by endoscopy, open abdominal surgery is recommended. Additionally, surgery is recognized as a major determinant ofoutcomes for acute pancreatitis, and there is general agreement that patients should undergo surgery in the late phase of the disease. It is important to consider multidisciplinary management, considering the clinical situation and the comorbidity of the patient, as well as the surgeons experience. 展开更多
关键词 Severe acute pancreatitis COMPLICATIONS NECROSECTOMY Percutaneous drainage ENDOSCOPY LAPAROSCOPY
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Toll-like receptors in pathophysiology of liver diseases 被引量:28
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作者 Safak Kiziltas 《World Journal of Hepatology》 CAS 2016年第32期1354-1369,共16页
Toll-like receptors(TLRs) are pattern recognition receptors that participate in host defense by recognizing pathogen-associated molecular patterns alongside inflammatory processes by recognizing damage associated mole... Toll-like receptors(TLRs) are pattern recognition receptors that participate in host defense by recognizing pathogen-associated molecular patterns alongside inflammatory processes by recognizing damage associated molecular patterns. Given constant exposure to pathogens from gut, strict control of TLR-associated signaling pathways is essential in the liver, which otherwise may lead to inappropriate production of pro-inflammatory cytokines and interferons and may generate a predisposition to several autoimmune and chronic inflammatory diseases. The liver is considered to be a site of tolerance induction rather than immunity induction, with specificity in hepatic cell functions and distribution of TLR. Recent data emphasize significant contribution of TLR signaling in chronic liver diseases via complex immune responses mediating hepatocyte(i.e., hepatocellular injury and regeneration) or hepatic stellate cell(i.e., fibrosis and cirrhosis) inflammatory or immune pathologies. Herein, we review the available data on TLR signaling, hepatic expression of TLRs and associated ligands, as well as the contribution of TLRs to the pathophysiology of hepatic diseases. 展开更多
关键词 Toll-like receptors Innate immunity Liver disease PATHOPHYSIOLOGY SIGNALING
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Prevention of Helicobacter pylori infection in childhood 被引量:12
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作者 Oya Yucel 《World Journal of Gastroenterology》 SCIE CAS 2014年第30期10348-10354,共7页
Helicobacter pylori(H.pylori)infection is one of the most common infections worldwide.Although infection rates are falling in the developed and developing countries,H.pylori is still widespread in the world.This artic... Helicobacter pylori(H.pylori)infection is one of the most common infections worldwide.Although infection rates are falling in the developed and developing countries,H.pylori is still widespread in the world.This article has reviewed the important publications on H.pylori in childhood with a focus on its evolving transmission route and the source of infection and preventive strategies in childhood,PubMed was searched up to identify eligible studies.Relevant publications were searched using the following. 展开更多
关键词 CHILDREN Growth retardation Helicobacter pylori Iron deficiency PREVALENCE PREVENTION TRANSMISSION
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Predictability of outcome of caustic ingestion by esophagogastroduodenoscopy in children 被引量:8
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作者 Abdulkerim Temiz Pelin Oguzkurt +2 位作者 Semire Serin Ezer Emine Ince Akgun Hicsonmez 《World Journal of Gastroenterology》 SCIE CAS CSCD 2012年第10期1098-1103,共6页
AIM: To assess the necessity of esophagogastroduodenoscopy (EGD) to predict the outcome of caustic ingestion in children. METHODS: The study included 206 children who underwent EGD because of ingestion of caustic subs... AIM: To assess the necessity of esophagogastroduodenoscopy (EGD) to predict the outcome of caustic ingestion in children. METHODS: The study included 206 children who underwent EGD because of ingestion of caustic substances between January 2005 and August 2010. Retrospective analysis of data of the patients was performed. RESULTS: The male/female ratio was 1.6 and mean age was 38.1 ± 28.8 mo. The caustic substances were acidic in 72 (34.9%) cases, alkaline in 56 (27.2%), liquid household bleach in 62 (30.1%), and unknown in 16 (7.8%). Fifty-seven (27.7%) patients were symptom-free. Significant clinical findings were observed in 149 (72.3%) patients. Upper gastrointestinal endoscopy findings of esophageal injury were grade 0 in 86 (41.7%) patients, grade 1 in 49 (23.8%), grade 2a in 42 (20.4%), grade 2b in 28 (13.6%), and grade 3a in 1 (0.5%) patient. 35 patients with grade 2a, 2b, and 3a injuries underwent esophageal dilation at second week of ingestion. Esophageal stricture, which necessitated a regular dilation program developed in 13 of the aforementioned 35 patients. There is no statistically significant difference in the rate of development of esophageal stricture between the patients who ingested acidic (15.3%) and alkaline (8.9%) substances (P = 0.32). Severe gastric injury was detected in 38 (18.5%) patients. The rate of development of gastric injury was significantly higher in the acidic group (14%) than in the alkaline group (2.9%) (P = 0.001). Out of 149 patients with clinical findings, 49 (32.9%) patients had no esophageal injury and 117 (78.5%) patients had no gastric lesion. Esophageal and severe gastric injuries were detected in 20 (35.1%) and 8 (14%) of patients with no clinical findings respectively. Pyloric stenosis developed in 6 patients. Pyloric obstruction improved with balloon dilation in 2 patients. Mean hospitalization time were 1.2 ± 0.5 d for grade 0 and 2.3 ± 5 d for grade 1 and 6.3 ± 6.2 d for grade 2a and 15.8 ± 18.6 d for grade 2b. It was significantly longer for patients with grade 2a and 2b injuries (P = 0.000). CONCLUSION: Endoscopy is an effective technique for determining the presence of esophageal and gastric damage and to avoid unnecessary treatment in patients with no or mild injury. 展开更多
关键词 ENDOSCOPY CAUSTIC Injury ESOPHAGUS STOMACH
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Choroidal thickness measurements with optical coherence tomography in branch retinal vein occlusion 被引量:6
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作者 Muge Coban-Karatas Rana Altan-Yaycioglu +3 位作者 Burak Ulas Selcuk Sizmaz Handan Canan Cagla Sariturk 《International Journal of Ophthalmology(English edition)》 SCIE CAS 2016年第5期725-729,共5页
AIM: To evaluate central macular thickness(CMT) and mean choroidal thickness(MCT) in eyes with branch retinal vein occlusion(BRVO), before and after ranibizumab treatment using spectral domain-optical coherence... AIM: To evaluate central macular thickness(CMT) and mean choroidal thickness(MCT) in eyes with branch retinal vein occlusion(BRVO), before and after ranibizumab treatment using spectral domain-optical coherence tomography(SD-OCT).·METHODS: Forty-two patients with unilateral BRVO and macular edema were included in this study. There were 25 men and 17 women. Using SD-OCT, choroidal thickness was measured at 500 μm intervals up to 1500μm temporal and nasal to the fovea. MCT was calculated based on the average of the 7 locations. All the eyes with BRVO were treated with intravitreal ranibizumab(0.5 mg/0.05 m L). Comparisons between the BRVO and fellow eyes were analyzed using Mann-Whitney U test. Preinjection and post-injection measurements were analyzed using Wilcoxon test and repeated measure analysis.· RESULTS: At baseline, there was a significant difference between the BRVO and fellow eyes in MCT[BRVO eyes 245(165-330) μm, fellow eyes 229(157-327) μm]and CMT [BRVO eyes 463(266-899) μm, fellow eyes 235(148-378) μm(P =0.041, 0.0001, respectively)]. Following treatment, CMT [295(141-558) μm] and MCT [229(157-329) μm] decreased significantly compared to the baseline measurements(P =0.001, 0.006, respectively).Also BCVA(log MAR) improved significantly(P=0.0001) in the BRVO eyes following treatment. After treatment CMT[BRVO eyes 295(141-558) μm, fellow eyes 234(157-351) μm]and MCT [BRVO eyes 229(157-329) μm, fellow eyes 233(162-286) μm] values did not reveal any significant difference in BRVO eyes and fellow eyes(P=0.051, 0.824,respectively).· CONCLUSION: In eyes with BRVO, CMT and MCT values are greater than the fellow eyes, and decrease significantly following ranibizumab injection. 展开更多
关键词 branch retinal vein occlusion choroidal thickness macular edema optical coherence tomography RANIBIZUMAB
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Expression of COX-2, PCNA, Ki-67 and p53 in gastrointestinal stromal tumors and its relationship with histopathological parameters 被引量:22
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作者 Derya Gumurdulu Seyda Erdogan +4 位作者 Fazilet Kayaselcuk Gulsah Seydaoglu Cem K Parsak Orhan Demircan Ilhan Tuncer 《World Journal of Gastroenterology》 SCIE CAS CSCD 2007年第3期426-431,共6页
AIM: To investigate the expression of Cyclooxygenase-2 (COX-2), proliferating cell nuclear antigen (PCNA), Ki-67 and p53 in gastrointestinal stromal tumors (GISTs) and its relationship with histopathological parameter... AIM: To investigate the expression of Cyclooxygenase-2 (COX-2), proliferating cell nuclear antigen (PCNA), Ki-67 and p53 in gastrointestinal stromal tumors (GISTs) and its relationship with histopathological parameters. METHODS: Twenty-five GISTs were examined by light microscopy and immunohistochemistry. c-kit, CD34, SMA, S-100 protein, COX-2, PCNA, Ki-67 and p53 were detected immunohistochemically and the relationship was evaluated among histopathologic parameters such as mitotic index (MI), tumor grade, tumor size, COX-2, PCNA, Ki-67 and p53. RESULTS: COX-2 protein expression was found in 19 of 25 (76%) of the tumors, and expression was noted in the cytoplasm of the tumor cells. p53 was significantly related to MI and tumor grade but no relationship was found between COX-2, proliferation markers and MI, tumor grade and tumor size. CONCLUSION: COX-2 is expressed in most GISTs and it may play an important role in the proliferation and progression of these tumors or a useful marker to identify GIST. Although immunohistochemical assessment of p53 can be used for distinguishing the risk groups of GISTs, tumor size and mitotic rate should be considered at the same time. 展开更多
关键词 Gastrointestinal stromal tumor CYCLOOXYGENASE-2 Proliferating cell nuclear antigen KI-67 P53 Immunohistochemistw
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Low eradication rate of Helicobacterpyloriwith triple 7-14 days and quadriple therapy in Turkey 被引量:4
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作者 Yuksel Gumurdulu Ender Serin +7 位作者 Birol zer Fazilet Kayaselcuk Kursat Ozsahin Arif Mansur Cosar Murat Gursoy Gurden Gur Ugur Yilmaz Sedat Boyacioglu 《World Journal of Gastroenterology》 SCIE CAS CSCD 2004年第5期668-671,共4页
AIM:The eradication rate of Helicobacter pylori (H pylori) shows variation among countries and regimens of treatment. We aimed to study the eradication rates of different regimens in our region and some factors affect... AIM:The eradication rate of Helicobacter pylori (H pylori) shows variation among countries and regimens of treatment. We aimed to study the eradication rates of different regimens in our region and some factors affecting the rate of eradication. METHODS:One hundred and sixty-four H pylori positive patients (68 males,96 females;mean age:48±12 years) with duodenal or gastric ulcer without a smoking history were included in the study.The patients were divided into three groups according to the treatment regimens.Omeprazole 20mg,clarithromycin 500mg,amoxicillin 1g were given twice daily for 1 week (Group Ⅰ) and 2 weeks (Group Ⅱ). Patients in Group Ⅲ received bismuth subsitrate 300mg, tetracyline 500mg and metronidazole 500mg four times daily in addition to Omeprazole 20mg twice daily.Two biopsies each before and after treatment were obtained from antrum and corpus,and histopathologically evaluated. Eradication was assumed to be successful if no H pylorus was detected from four biopsy specimens taken after treatment.The effects of factors like age,sex,H pylori density on antrum and corpus before treatment,the total H pylori density,and the inflammation scores on the rate of H pylori eradication were evaluated. RESULTS:The overall eradication rate was 42%.The rates in groups Ⅱ and Ⅲ were statistically higher than that in group Ⅰ (P<0.05).The rates of eradication were 24.5%, 40.7% and 61.5% in groups Ⅰ,Ⅱ and Ⅲ,respectively.The eradication rate was negatively related to either corpus H pylori density or total H pylori density (P<0.05).The median age was older in the group in which the eradication failed in comparison to that with successful eradication (55 yr vs 39 yr,P<0.001).No correlation between sex and H pylori eradication was found. CONCLUSION:Our rates of eradication were significantly lower when compared to those reported in literature.We believe that advanced age and high H pylori density are negative predictive factors for the rate of H pylori eradication. 展开更多
关键词 Helicobacter pylori Adolescent Adult Aged AMOXICILLIN dosage Anti-Bacterial Agents Anti-Infective Agents Anti-Ulcer Agents CLARITHROMYCIN Comparative Study Drug Therapy Combination Duodenal Ulcer Female Helicobacter Infections Humans Male METRONIDAZOLE Middle Aged OMEPRAZOLE Organometallic Compounds Stomach Ulcer TETRACYCLINE Treatment Outcome TURKEY
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Comparison of the inhibitory effect of different doses of subconjunctival bevacizumab application in an experimental model of corneal neovascularization 被引量:5
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作者 Burak Ulas Rana Altan-Yaycioglu Nebil Bal 《International Journal of Ophthalmology(English edition)》 SCIE CAS 2018年第7期1090-1095,共6页
AIM: To evaluate the inhibitory effect of subconjunctival bevacizumab as single-and multiple-dose application, and compare their effects on corneal neovascularization in a rat model. METHODS: Thirty adult Sprague-Da... AIM: To evaluate the inhibitory effect of subconjunctival bevacizumab as single-and multiple-dose application, and compare their effects on corneal neovascularization in a rat model. METHODS: Thirty adult Sprague-Dawley rats were used in this experimental study. The central cornea of the rats was cauterized chemically. The rats were randomly enrolled into three groups. All groups received subconjunctival injections. In Group 1(control group, n=10), 0.05 m L 0.9% Na Cl solution was injected on the first day. In Group 2(single-dose group, n=10), 0.05 m L bevacizumab(1.25 mg) was injected on the first day. In Group 3(multiple-dose group, n=10), four doses of 0.05 m L bevacizumab(1.25 mg) were injected on the first, third, fifth and seventh day. Slit-lamp examination of all rats was performed at the third and ninth day. Digital images of the corneas were taken and analyzed using image analysis software to calculate corneal neovascularization area. All rats were sacrificed on the tenth day. In corneal sections, the number of blood vessels, state of inflammation and collagen formation was evaluated histopathologically. RESULTS: In Group 3, corneal edema grades were significantly lower than Group 1 and Group 2(P=0.02, and P=0.035, respectively). The mean percentage of neovascularized corneal area in Group 3 was significantly lower than Group 2(P=0.005). On histopathological examination, Group 2 and Group 3 showed significantly less number of blood vessels than Group 1(P=0.005, and P=0.001, respectively). Additionally, Group 3 showed significantly less number of blood vessels compared to Group 2(P=0.019). Inflammation and edema grades were significantly lower in Group 3 compared to Group 1(P=0.001). CONCLUSION: Subconjunctival bevacizumab injection is effective in inhibition of newly formed corneal neovascularization. The multiple-dose bevacizumab treatment seems to be more effective compared to single-dose treatment. 展开更多
关键词 CORNEA corneal neovascularization BEVACIZUMAB INFLAMMATION RAT
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Role of β2-microglobulin in uremic patients may be greater than originally suspected 被引量:14
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作者 Aysegul Zumrutdal 《World Journal of Nephrology》 2015年第1期98-104,共7页
The role of beta2-microglobulin(β2M) in dialysisrelated amyloidosis as a specific amyloid precursor was defined in the 1980 s. Studies in those years were largely related to β2M amyloidosis. In 2005, for what was pr... The role of beta2-microglobulin(β2M) in dialysisrelated amyloidosis as a specific amyloid precursor was defined in the 1980 s. Studies in those years were largely related to β2M amyloidosis. In 2005, for what was probably the first time in the available literature, we provided data about the association betweenβ2M and early-onset atherosclerosis in hemodialysis patients without co-morbidities. In recent years, the role of uremic toxins in uremic atherosclerosis and the interest in β2M as a marker of cardiovascular(CV) and/or mortality risk have grown. In the current literature,clinical studies suggest that β2M is an independent, significant predictor of mortality, not only in dialysis patients, but also in predialysis patients and in the highrisk portion of the general population, and it seems to be a factor strongly linked to the presence and severity of CV disease. It is still unknown whether β2M is only a uremic toxin marker or if it also has an active role in vascular damage, but data support that it may reflect an increased burden of systemic atherosclerosis in a setting of underlying chronic kidney disease. Thus, although there have been some inconsistencies among the various analyses relating to β2M, it promises to be a novel risk marker of kidney function in the awareness and detection of high-risk patients. However, more research is required to establish the pathophysiological relationships between retained uremic toxins and further biochemical modifications in the uremic milieu to get answers to the questions of why and how. In this review, the recent literature about the changing role of β2M in uremic patients will be examined. 展开更多
关键词 Beta2-microglobulin Carotid atherosclerosis Cardiovascular disease Cardiovascular risk Coronary artery disease Hemodialysis Mortality UREMIA Uremic toxins
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Arterial complication of irreversible electroporation procedure for locally advanced pancreatic cancer 被引量:5
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作者 Yahya Ekici Tugan Tezcaner +2 位作者 Hüseyin Onur Aydin Fatih Boyvat G?khan Moray 《World Journal of Gastrointestinal Oncology》 SCIE CAS 2016年第10期751-756,共6页
Irreversible electroporation(IRE) is a non-thermal ablation technique used especially in locally advanced pancreatic carcinomas that are considered surgically unresectable.We present the first case of acute superior m... Irreversible electroporation(IRE) is a non-thermal ablation technique used especially in locally advanced pancreatic carcinomas that are considered surgically unresectable.We present the first case of acute superior mesenteric artery(SMA) occlusion secondary to pancreatic IRE procedure that has not been reported before in the literature.A 66-year-old man underwent neoadjuvant chemoradiotherapy for locally advanced pancreatic ductal adenocarcinoma.IRE procedure was applied to the patient during laparotomy under general anesthesia.After finishing the procedure,an acute intestinal ischemia was detected.A conventional vascular angiography was performed and a metallic stent was successfully placed to the SMA and blood flow was maintained.It is important to be careful in such cases of tumor involvement of SMA when evaluating for IRE procedure of pancreatic tumor. 展开更多
关键词 Irreversible electroporation Mesenteric artery occlusion Locally advanced pancreatic cancer Superior mesenteric artery
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Pancreatic hyperechogenicity on endoscopic ultrasound examination 被引量:6
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作者 Yucel Ustundag Guray Ceylan Koray Hekimoglu 《World Journal of Gastroenterology》 SCIE CAS CSCD 2011年第15期2061-2062,共2页
There is an ongoing discussion on how to diagnose a hyperechogenic pancreas and what is the clinical significance of diffusely hyperechogenic pancreas. Computerized tomography and magnetic resonance imaging are the mo... There is an ongoing discussion on how to diagnose a hyperechogenic pancreas and what is the clinical significance of diffusely hyperechogenic pancreas. Computerized tomography and magnetic resonance imaging are the more appropriate methods to diagnose pancreatic hyperechogenicity when compared with transcutaneous or endoscopic ultrasound examination. More importantly, pancreatic hyperechogenicity may not be a certain indicator of pancreatic fat infiltration. Even if it is true, we do not know the clinical significances of pancreatic fat accumulation. Some suggested that excess fat in the pancreas is associated with chronic pancreatitis. However, several histological studies on human alcoholic chronic pancreatitis did not prove the presence of fatty pancreas in such cases. Thus, except for aging, it is very rare to have truly steatotic pancreas in the absence of certain human diseases. 展开更多
关键词 Hyperechogenic pancreas Fatty pancreas Endoscopic ultrasound AGING Chronic pancreatitis
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Portopulmonary hypertension in liver transplant candidates 被引量:4
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作者 Serife Savas Bozbas Huseyin Bozbas 《World Journal of Gastroenterology》 SCIE CAS 2016年第6期2024-2029,共6页
Pulmonary vascular disorders including portopulmonary hypertension(PoPHT) are among the common complications of liver disease and are prognostically significant. Survival is very low without medical treatment and live... Pulmonary vascular disorders including portopulmonary hypertension(PoPHT) are among the common complications of liver disease and are prognostically significant. Survival is very low without medical treatment and liver transplantation. With advances in medical therapy for elevated pulmonary artery pressure(PAP) and liver transplant surgery, survival of patients with Po PHT and advanced liver disease is significantly improved. Because of the prognostic significance of Po PHT and the limited donor pool, a comprehensive preoperative cardio-pulmonary assessment is of great importance in cirrhotic patients prior to transplant surgery. Therefore, a detailed transthoracic Doppler echocardiographic examination must be an essential component of this evaluation. Patients with mild Po PHT can safely undergo liver transplant surgery. In cases of moderate to severe Po PHT, right heart catheterization(RHC) should be performed. In patients with moderate to severe Po PHT on RHC(mean PAP 35-45 mm Hg), vasodilator therapy should be attempted. Liver transplantation should be encouraged in cases that demonstrate a positive response. Bridging therapy with specific pulmonary arterial hypertension treatment agents should be considered until the transplant surgery and should be continued during the peri- and post-operative periods as needed. 展开更多
关键词 portopulmonary HYPERTENSION pulmonaryarterial HYPERTENSION LIVER DISEASE LIVER TRANSPLANTATION PORTAL HYPERTENSION
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Comparison of intravitreal bevacizumab and triamcinolone acetonide theraphies for diffuse diabetic macular edema 被引量:6
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作者 Sibel Aksoy Gursel Yilmaz +1 位作者 Imren Akkoyun Ayse Canan Yazici 《International Journal of Ophthalmology(English edition)》 SCIE CAS 2015年第3期550-555,共6页
AIM: To compare therapeutic effects of intravitreal triamcinolone acetonide(IVTA) versus intravitreal bevacizumab(IVB) injections for bilateral diffuse diabetic macular edema(DDME). METHODS: Forty eyes of 20 patients ... AIM: To compare therapeutic effects of intravitreal triamcinolone acetonide(IVTA) versus intravitreal bevacizumab(IVB) injections for bilateral diffuse diabetic macular edema(DDME). METHODS: Forty eyes of 20 patients with bilateral DDME participated in this study. For each patient, 4 mg/0.1 m L IVTA was injected to one eye and 2.5 mg/0.1 m L IVB was injected to the other eye. The effects of injection for diabetic macular edema(DME) were evaluated using best-corrected visual acuity(BCVA), central macular thickness(CMT) by optical coherence tomography(OCT)and intraocular pressure(IOP) by applanation tonometer.Patients underwent eye examinations, including BCVA,CMT, and IOP at pre-injection, 1, 4, 8, 12 and 24 wk after injection. During the follow-up, second injections were performed to eyes which have CMT greater than 400 μm at 12 wk for salvage therapy.RESULTS: BCVA(logarithm of the minimum angle of resolution) at pre-injection, 1, 4, 8, 12 and 24 wk after injection was 0.71 ±0.19, 0.62 ±0.23, 0.63 ±0.12, 0.63 ±0.13,0.63±0.14 and 0.61±0.24 in the IVTA group and 0.68±0.25,0.61 ±0.22, 0.60 ±0.24, 0.62 ±0.25, 0.65 ±0.26 and 0.59 ±0.25 in the IVB group, respectively. CMT(μm) at pre-injection,1, 4, 8, 12 and 24 wk after injection was 544 ±125, 383±96,335 ±87, 323 ±87, 333 ±92, 335 ±61 in the IVTA group and514 ±100, 431 ±86, 428 ±107, 442 ±106, 478 ±112, 430 ±88 in the IVB group respectively. Reduction ratios of mean CMT were 29% at 1wk, 38% at 4wk, 40% at 8wk, 38% at12 wk, and 38% at 24 wk in the IVTA group. Second IVTA injections were performed to the 6 eyes(30%) at 12 wk.Reduction ratios of mean CMT were 16% at 1wk, 17% at4wk, 14% at 8wk, 7% at 12 wk, and 16% at 24 wk in the IVB group. Second IVB injections were performed to the15 eyes(75%) at 12 wk.CONCLUSION: This study showed earlier and more frequent macular edema recurrences in the eyes treated with bevacizumab compared with the ones treated with triamcinolone acetonide. Triamcinolone acetonide was found to provide more efficient and long-standing effect in terms of reducing CMT compared with the bevacizumab. 展开更多
关键词 BEVACIZUMAB diabetic macular edema triamcinolone acetonide
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Helicobacter pylori eradication lowers serum homocysteine level in patients without gastric atrophy 被引量:3
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作者 Birol Ozer Ender Serin +6 位作者 Yuksel Gumurdulu Fazilet Kayaselcuk Ruksan Anarat Gurden Gur Kemal Kul Mustafa Guclu Sedat Boyacioglu 《World Journal of Gastroenterology》 SCIE CAS CSCD 2005年第18期2764-2767,共4页
AIM: To determine whether Helicobacter pylori (H pylori) infection caused hyperhomocysteinemia by altering serum vitamin B_(12), serum folate and erythrocyte folate levels and whether eradication of this organism decr... AIM: To determine whether Helicobacter pylori (H pylori) infection caused hyperhomocysteinemia by altering serum vitamin B_(12), serum folate and erythrocyte folate levels and whether eradication of this organism decreased serum homocysteine level. METHODS: The study involved 73 dyspeptic H pylork positive patients, none of them had gastric mucosal atrophy based on rapid urease test and histology. Out of 73 patients, 41 (56.2%) showed a successful eradication of H pylori 4 wk after the end of treatment. In these 41 patients, fasting serum vitamin B_(12) folate and homocysteine levels, and erythrocyte folate levels before and 4 wk after H pylori eradication therapy were compared. RESULTS: The group with a successful eradication of H pylori had significantly higher serum vitamin B_(12) and erythrocyte folate levels in the post-treatment period compared to those in pre-treatment period (210±97 pg/mL vs 237±94 pg/mL,P<0.001 and 442±212 ng/mL vs 539±304 ng/mL, P=0.024, respectively), but showed no significant change in serum folate levels (5.6±2.6 ng/mL vs 6.0+2.4 ng/mL, P=0.341). Also, the serum homocysteine levels in this group were significantly lower after therapy (13.1±5.2 μmol/L vs 11.9±6.2 μmol/L, P=0.002). Regression analysis showed that serum homocysteine level was positively correlated with age (P=0.01) and negatively with serum folate level before therapy (P=0.003). CONCLUSION: Eradication of H pylori decreases serum homocysteine even in patients who do not exhibit gastric mucosal atrophy. It appears that the level of homocysteine in serum is related to a complex interaction among serum vitamin B_(12), serum folate and erythrocyte folate levels. 展开更多
关键词 H pylorr GASTRITIS Vitamin B_(12) Folate Erythrocyte folate HOMOCYSTEINE
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