Anthropometric measurements of the ventrogluteal injectıon area: A cross-sectional study

Research Problem / Aim: The ventrogluteal injection area is one of the areas most frequently used by nurses in intramuscular injection applications. The thicknesses of the subcutaneous tissue and the muscle tissue in this area are important for a safe injection. The aim of this study is the determination of the subcutaneous and muscle tissue thicknesses on the ventrogluteal injection area and the anthropometric data about it. Method: The study has designed a cross-sectional study. 150 individuals who applied to the ultrasound unit of the hospital and accepted to participate in the study were included in the study. The ventrogluteal injection area was determined with the ‘’V’’ method by the researcher. The subcutaneous and muscle tissue thicknesses from the areas on the injection area and the areas 2 and 4 cm around the injection area were determined using the ultrasound device. Moreover, the relation between the anthropometric measurements of the individuals (height, weight, waist, hip and crista iliaca circumferences, distance between the large trochanter and crista iliaca and crista iliaca anterior) and the tissue thicknesses on the injection area were evaluated. The data of the research were evaluated with definitive statistics, ANOVA test and posthoc Tukey test, t test and correlation analysis. The p<0.05 value was accepted as statistically significant for all results. Findings: The average subcutaneous tissue thickness in the injection area was determined as 15.44±8.01 mm and the average tissue thickness there was determined as 31.75±11.86 mm. The subcutaneous tissue thickness in women was found more than the subcutaneous tissue thickness in men. When the tissue thicknesses 2 and 4 cm around the injection area were analyzed, it was found that the area where the total tissue thickness was the least was over 2 cm (41.67±14.83) and over 4 cm (35.79±15.55) of the injection area. It was determined that the average total thickness 4 cm around the injection area was less than 38 mm in underwight individuals. Conclusions: According to the results obtained from the study, the weight and body mass index of the individual should be considered in the choice of the injection area and the length of the needle to be used when the ventrogluteal injection area was used in intramuscular injections. Especially in obese individuals, longer needles can be preferred. Besides, it must be thought that there may be the risk of bone injury 4 cm around the injection area in asthenic individuals and individuals with normal weight. Moreover, since the individuals’ having a large waist and hip circumference is related to their subcutaneous tissue thickness, it is recommended that long needles should be chosen in these individuals

Hepatosteatoz olgularında elastografi bulguları

OBJECTIVE: This study evaluates whether dynamic elastography could better characterize and differentiate the non-alcoholic fatty liver disease (NAFLD) and patient pool for biopsy. MATERIALS AND METHODS: 18 patients with NAFLD were examined by ultrasound (US) and elastography at the Department of Radiology. The patients, none of whom had any chronic liver disease, were 54±9.5 (35-71) years old (8 men; 10 women). Biochemical markers were evaluated. Patients with high liver echogenicity were classified as Stage III NAFLD. B-mode US equipment includes a Hitachi HI VISION Preirus system with an embedded elastography (EL) module (Hitachi Medical Systems Europe) and 6.5 MHz linear probe. RESULTS: Of the cases, 55.6% were female and 44.4% were male. All cases with Stage I NAFLD were female (n:5). Only 33.3% of the cases with Stage III NAFLD were female (n:2). According to the results of elastography, no intergroup difference was differentiated when the stages of NAFLD were compared. When biochemical and hepatomegaly values were considered, differences were only detected in GGT and hepatomegaly values among the NAFLD groups (p:0.015). CONCLUSION: In the study, the stages of hepatosteatosis could not be differentiated with the EL examination. Therefore, it was thought to be of no benefit to the selection.AMAÇ: Bu çalışma alkolik olmayan yağlı karaciğer (NAFLD) olgularının biopsi öncesi değerlendiriminde elastografinin etkinliğini araştırmak için planlandı. GEREÇ VE YÖNTEMLER: Radyoloji bölümünde 18 NAFLD hastası B mod ultrason ile incelendikten sonra elastografi ile değerlendirildi . Olguların hiçbirinde kronik karaciğer hastalığı yoktu. Yaşları 35 ila 71 arasında değişen 8 erkek hasta ile 10 kadın hasta çalışmaya dahil edildi ( ortalama 54±9.5). Son 6 ay içerisindeki biyokimyasal değerlendirmeleri de kayıt altına alındı. Karaciğer dalak ile karşılaştırılarak ekojenite artışına göre I., II. ve III. derecelerde ile sınıflandıırldı. B mod ve elastografi değerlendirilmesi Hitachi HI VISION Preirus sistemi ile 6.5 MHz lineer prob ile yapıldı. BULGULAR: Olguların %55,6’sı kadın, %44’ ü erkek idi. Evre I NAFLD olgularının tümü kadın idi (n:5). Evre III olgularının sadece %33,3’ü kadın idi (n:2). Gruplar arası hepatosteatoz evresi göz önüne alındığında elastografi sonuçları arasında fark saptanmadı. Biyokimyasal değerler ve hepatomegali ölçüm değerleri göz önüne alındığında GGT ve hepatomegali ölçümleri gruplar arası farklılık göstermekte idi (p:0.015). SONUÇ: Bu çalışmada, B mod ultrasonda sıklıkla kullanılan hepatosteatoz evreleme sistemi elastografi tekniği ile doğrulanamadı. Böylelikle NAFLD tanısı ile biyopsi gereken ile gerekmeyen takipteki olgular arasında ayrım yapılamadı. Bu veri transient elastografi bulgularından oldukça farklı idi

Current practice of emergency radiology in Turkey and future expectations: a survey study

PURPOSEThe development of emergency radiology (ER) in Turkey has accelerated with the increase in the number of patients admitted to emergency departments. We aimed to present and discuss the responses to a survey distributed to radiologists in Turkey, which included questions about the current practice of ER and future expectations.METHODSA survey with 29 questions enquiring about the infrastructure of respondents’ hospitals and radiology units, information about emergency services and ER (including patient volume), the number of staff and equipment, the ER working plan and reporting method, and training in the field of ER were distributed to members of the Turkish Radiological Society by email.RESULTSThe response rate was 21.97% (328/1.493). The presence of distinct ER units in radiology departments was confirmed by 40.55% of respondents, while for 34.25%, ER was located inside the emergency room. Of the respondents, 26.96% stated they believed that emergency cases should be reported by emergency radiologists, and the necessity for an ER subunit in the emergency room was agreed upon by 58.64% of contributors. The majority of respondents (69.54%) agreed with the opinion that residents should receive their ER training in an ER unit.CONCLUSIONKeeping abreast of current ER practices and radiologists’ expectations may be helpful for improving national ER practices and academic studies

Yüksek pozitif ekspiryum sonu basıncı nedeniyle oluşan pnömomediyastinum olgusu

A 26-year-old female patient, who presented to the emergency department with chronic renal failure, general condition disturbance and dyspnea, was intubated due to low oxygen saturation. The results of the blood biochemical test were normal except for low saturation. Our case did not have any coronary artery disease or obstructive pulmonary disease. While she was undergoing the positive end-expiratory pressure (PEEP) treatment in the intensive care unit, the patient was detected to have right heart failure on her echocardiogram examination and pneumomediastinum was found on her direct radiography examination and on chest x-ray and computed tomography (CT) on the 2nd day of her hospitalization. The development of pneumomediastinum associated with PEEP for low saturation appears to be a rare phenomenon. In accompany with the findings of the case, the examination data and the literature information were prepared as a case report.Kronik böbrek yetmezliği, genel durum bozukluğu ve solunum sıkıntısı ile acil servise başvuran 26 yaşındaki kadın hasta satürasyon problemi nedeniyle entübe edildi. Satürasyon düşüklüğü dışında genel kan biyokimyasında belirgin patoloji ayırt edilmedi. Olguda koroner arter hastalığı ya da kronik obstruktif akciğer hastalığı yoktu. Yoğun bakımda, pozitif ekspiryum sonu basınç (PEEP) tedavisi altındayken, ekokardiyografi (EKO) tetkikinde olgunun sağ kalp yetmezliği olduğu ve direkt grafi tetkikinde, yatışının 2. gününde akciğer grafisinde ve bilgisayarlı tomografi (BT) tetkikinde pnömomediyastinum tespit edildi. Düşük saturasyon için yapılan pozitif expirium sonu basınç (PEEP) tedavisi altında iken pnömomediastinum gelişmesi nadir bir durumdur. Olgunun bulguları eşliğinde tetkik verileri ve literatür bilgisi olgu sunumu olarak hazırlandı

Yüksek pozitif ekspiryum sonu basıncı nedeniyle oluşan pnömomediyastinum olgusu

A 26-year-old female patient, who presented to the emergency department with chronic renal failure, general condition disturbance and dyspnea, was intubated due to low oxygen saturation. The results of the blood biochemical test were normal except for low saturation. Our case did not have any coronary artery disease or obstructive pulmonary disease. While she was undergoing the positive end-expiratory pressure (PEEP) treatment in the intensive care unit, the patient was detected to have right heart failure on her echocardiogram examination and pneumomediastinum was found on her direct radiography examination and on chest x-ray and computed tomography (CT) on the 2nd day of her hospitalization. The development of pneumomediastinum associated with PEEP for low saturation appears to be a rare phenomenon. In accompany with the findings of the case, the examination data and the literature information were prepared as a case report.Kronik böbrek yetmezliği, genel durum bozukluğu ve solunum sıkıntısı ile acil servise başvuran 26 yaşındaki kadın hasta satürasyon problemi nedeniyle entübe edildi. Satürasyon düşüklüğü dışında genel kan biyokimyasında belirgin patoloji ayırt edilmedi. Olguda koroner arter hastalığı ya da kronik obstruktif akciğer hastalığı yoktu. Yoğun bakımda, pozitif ekspiryum sonu basınç (PEEP) tedavisi altındayken, ekokardiyografi (EKO) tetkikinde olgunun sağ kalp yetmezliği olduğu ve direkt grafi tetkikinde, yatışının 2. gününde akciğer grafisinde ve bilgisayarlı tomografi (BT) tetkikinde pnömomediyastinum tespit edildi. Düşük saturasyon için yapılan pozitif expirium sonu basınç (PEEP) tedavisi altında iken pnömomediastinum gelişmesi nadir bir durumdur. Olgunun bulguları eşliğinde tetkik verileri ve literatür bilgisi olgu sunumu olarak hazırlandı

Melatonin Kontrast Madde İle İlişkili Renal Yetmezlikten Korur mu?

Amaç: Çalışmanın amacı, erkek sıçanlarda myoglobinüri ve radyokontrast maddeye bağlı oluşan böbrekyetmezliğinde melatoninin etkisini araştırmaktır. Gereç ve Yöntem: Anestezi eşliğinde,tüm sıçanların her iki arka bacağına eşit miktarda %50 lik gliserol uygulanarak myoglobinürik böbrekyetmezliği geliştirildi. 3 saatsonra :Grup I (n:7): Iopromide (Ultravist-300®) 2 ml/kg (intrakardiak); Grup II (n:7): Iopromide(Ultravist -300®)ve intraperitoneal olarak Melatonin (10 mg/kg) ; Grup III (n:7): 2 ml/kg fizyolojik salin (Kontrolgrubu). Kan örnekleri toplanarak üre, kreatinin ve cystatin c değerleri çalışıldı. Protokolü bilmeyen iki patolog tarafından böbrekler incelendi. Bulgular: Grup 2 ile 3 arasında kreatinin ve cystatin c değerleriiçinfarkyoktu (p=0.9; 0.2). Tartışma: Çalışmada, kontrasta bağımlı böbrekte oluşan oksidatif stresin melatonin ile önlenebildiğini gösterdik. Ancak, insanlar damelatoninin koruyucu etkilerinin ekklinik çalışmalarla değerlendirilmesine ihtiyaç vardır.Aim: The aim of the study was to investigate the effect of melatonin on the renal injury resulting from radiocontrast media and myoglobinuria in male Wistar albino rats. Material and Method: 50% glycerol at equal amounts was intramuscularly administered to both hind legs of all animals under ether anesthesia at the dose of 10 mg/kg. Three hours later, the groups were ad- ministered the following: Group I (number:7): Iopromide(Ultravist -300®) at the dose of 2 ml/kg (intracardiac); Group II (number:7): Iopromide(Ultravist -300®) and intraperitoneally administered Melatonin at the dose of 10 mg/ kg (Melatonin was dissolved in 7.5% absolute ethanol and further dilutions were made in saline.); and Group III (number:7): 2 ml/kg of sterile physiologic saline (Control group). The levels of Uurea, Ccreatinine and Ccystatin C were studied on the blood samples collected. The renal samples were evaluated by 2two distinct pathologists who did not know the protocol. Results: There was no difference in the values of Creatinine and cystatin c between Groups 2 and 3 (p=0.9; 0.2). Discussion: In conclusion, we evaluated the possible prevention of contrast-induced oxidative stress in the kidney with using melatonin. How- ever, additional clinical studies are needed to evaluate the role of preventive melatonin treatment in humans

Pathological rupture of the normal spleen: Review with the literature

Introduction: Atraumatic spontaneous rupture of the spleen is an uncommon but fatal condition that may coexist with other disease. Our case was presented with obvious CT findings of a spontaneous rupture of the spleen. Presentation of the case: A 75-year-old woman admitted to the emergency service with abdominal pain. Although there was no evident splenomegaly in the abdominal CT examination, the patient was diagnosed with diffuse large B-cell lymphoma, and densities in harmony with the free air were detected in the spleen and the abdomen. Discussion: It is clear that a healthy spleen does not rupture without marked trauma; hence, a doctor must carefully investigate the underlying pathology. Splenomegaly, the infiltration of the spleen and the capsule and consequently a splenic infarct and hemorrhage were set forth as the causes of the rupture of the spleen in lymphomas. However, our case had no splenomegaly or splenic involvement of lymphoma in the pathological examination. Even in the absence of splenomegaly, rupture may develop for such reasons as inflammation and embolism. Splenic infarcts are also in the developmental mechanism. Conclusion: Although atraumatic rupture of the spleen is not prevalent, it is a case which must be considered in an acute abdominal pain as it has highly fatal outcomes without CT exam