The risks and benefits of non-predictive splenectomy: The necessity of splenectomy and early postoperative outcomes

Although, most splenectomy is predictive due to preoperative tests, sometimes the decision to perform the splenectomy is made intraoperatively for non-primary splenic diseases. The aim of this study to investigate the risks, benefits and necessity of non-predictive of splenectomy and early outcomes. Splenectomy was performed as predictive splenectomy (PS) for primary splenic diseases and non-predictive splenectomy (Non-PS) for non-primary splenic diseases. Preoperative, operative, and 1-month postoperative data included to study. Between June 2012 and July 2018, 108 patients underwent splenectomy. Of these patients, 67 (62%) had PS for primary splenic disease, and 41 (38%) had non-PS due to non-primary splenic diseases. Patients with PS were statistically younger compared to Non-PS patients (52.82 ± 15.07 vs. 44.32 ± 19.23 years, p = 0.022). The most common cause of splenectomy in the PS group was immune thrombocytopenic purpura (ITP) in 16 (23.9%) and splenic trauma in 16 (23.9%), whereas in the non-PS group the major causes were gastric cancer in 16 (39%) and pancreas cancer in 10 (24.4%). Patients in the PS group had significantly lower postoperative hospital stay day (11.2 ± 7.3 vs. 6.4 ± 4.2, p = 0.001). The total complication rate was statistically higher in the non-PS patients (31.7% vs. 10.4%, p = 0.012). However, no significant differences were found in the postoperative infection rates (17% in non-PS versus 7.5% in PS, p = 0.22). Even if the preoperative investigation does not show any indication for splenectomy, but the surgeon has intraoperative concerns about sub-optimal oncological surgery without splenectomy, we recommend that the surgeon should perform the splenectomy. [Med-Science 2019; 8(1.000): 203-7

Complete transection of epicardial pacing lead during pregnancy

Herein, we presented a case of pregnancy associated complete transection of epicardial pacing lead

Successful repair of a large aortic abscess causing apical displacement of the anterior mitral valve

Anatomic continuity between the anterior mitral leaflet and the aortic root may predispose those patients with aortic root pathology to functional changes of the mitral valve without any involvement of this valve. A 34-year-old man presented with aortic valve endocarditis. Transthoracic echocardiograpy showed severe aortic regurgitation with a large aortic root abscess. The anterior leaflet of the mitral valve was displaced towards the apex of the heart causing moderate mitral regurgitation. The patient underwent aortic valve replacement with reconstruction of the aortic annulus and ventriculoaortic continuity. This procedure alone restored the mitral valve structure and function without any need for intervention on the mitral valve. Aortic abscess is a serious complication of aortic valve endocarditis and may alter the function of other structures of the heart, especially the mitral valve. Restoration of aortic wall integrity and left ventricular - aortic continuity usually restores the mitral valve structure and function if the valve is unaffected by the infection. A decision on the mitral valve should be made following correction of the aortic pathology

Self-harm, suicidal ideation and suicide attempts among college students

WOS: 000290183700024PubMed ID: 21040980Self-harm, suicidal ideation, and suicide attempts are well represented behaviours in the general population of both developed and developing countries. These behaviours are indicative of underlying risk factors that show a strong interdependent correlation. In this study we attempted to define correlates for and prevalence of self-harm, suicidal ideation, and suicide attempts among Turkish college students. This 2006 study included 636 students from two Turkish state universities. Our results showed that the lifetime prevalence of self-harm was 15.4%, the prevalence of suicidal ideation was 11.4%, and the prevalence of suicide attempts was 7.1%. We uncovered correlates for self-harm, including low income, unsatisfying familial relationships, smoking, and alcohol, inhalant, and tranquilizer abuse. Tranquilizer abuse shared a dual role as a correlate for suicide ideation and as a means to attempt suicide. Additionally, we found that drug abusers and adolescents who practise self-harm presented the highest suicide risk. (C) 2010 Elsevier Ireland Ltd. All rights reserved

Interventricular hydatid cyst imitating pulmonary stenosis

Cardiac hydatid cyst is known to be a rarely occurring disease. The appearance of large cysts in the interventricular septum in childhood is even more rare. Although such cysts are usually asymptomatic, they can behave like valvular disorders, depending on their location. In addition, cardiac hydatid cysts originating from the interventricular septum carry the risk of rupturing into both ventricular cavities, which may lead to fatal complications. Thus, early surgical treatment is of extreme importance. We describe the case of a 7-year-old girl with a cardiac hydatid cyst that originated in the interventricular septum

A penetrating dorsal thoracic injury that is lucky from every aspect: A case report

INTRODUCTION: Penetrating thoracic trauma management represents a major problem for emergency department staff. In these cases, we reported a patient, who can be deemed very lucky, because of both the trauma mechanism and the provided first aid at scene

Posterior Pericardial Annuloplasty in Ischemic Mitral Regurgitation

Background: Ischemic mitral regurgitation (IMR) is an important risk factor in coronary artery bypass grafting (CABG) operations. The decision to perform concomitant mitral annuloplasty along with the CABG depends on the surgeon's choice. The aim of this study was to evaluate the results of posterior annuloplasty procedures with autologous pericardium performed in patients with midadvanced and advanced functional ischemic mitral regurgitation

Can ionized calcium levels and platelet counts used for estimating the prognosis of pediatric trauma patients admitted to the emergency surgery intensive care?

BACKGROUND: Injury is the leading cause of death for pediatric population older than 1 year of age and 95% of those deaths are from the low-and middle-income countries. Most of those injured pediatric patients are treated in general hospitals. In designated trauma centers, the outcomes of severely injured patients are better. Scoring systems used frequently in intensive care units (ICUs) to make triage easier and to estimate prognosis. However, some of the scores may require additional expensive and sometimes time consuming tests. The purpose of the present study was to compare the usefulness of several scoring systems with initial ionized calcium levels and platelet counts to predict prognosis of pediatric trauma patients admitted to the emergency surgery department