Adana il merkezinde 1999'dan 2009'a Hepatit A seroprevalansında epidemiyolojik shift (kayma)

TEZ7838Tez (Uzmanlık) -- Çukurova Üniversitesi, Adana, 2010.Kaynakça (s. 66-76) var.vii, 80 s. : res. ; 29 cm.Aim: The aim of the study was to carry out the anti-Hepatitis A virus (HAV) seroprevalence among children of different socioeconomic status and age groups in Adana city center and to determine the epidemiological shift that may have occurred in the last 10 years. Material and Method: In 1999, Yapıcıoğlu and et al. reported the anti-HAV seroprevalence in 711 children aged between 2 and 16 years children with various socioeconomic levels in Adana city center. Ten years later we repeated the same study at the same locations in a similar population with the same method. Blood samples were taken from a total of 711 children between the ages of 2-16 years. Socioeconomic statuses (SES) of the families were determined according to the World Health Organization criteria and the general socioeconomic structure of Turkey. After the data collection and scoring of the questionnaires, groups were formed based on the scores. Participants with scores of 3-9 formed SES Group 1 (low), scores of 10-14 formed SES Group 2 (medium) and scores of 15-20 formed SES Group 3 (high). The total anti-HAV was studied with Architect equipment and CMIA (Chemiluminescent Immunoassay) method. Results: From 1999 to 2009 anti-HAV seroprevalence declined from 33,9 % to 22,2 %, 29,5 % to 25,3 % (p>0,05), 52,2 % to 30,8 %, 69,7 % to 35,2 %, 66,9 % to 37,7 % and 71,4 % to 47,3 % (p0.05). In 2009 anti-HAV seroprevalence among schoolage children 85 to198 months decreased from 85,7 % to 53,8 % in SES Group 1, 64,4 % to 36 % in SES Group 2 and 43,7 % to 29,3 % in SES Group 3, respectively compared to 1999 (p0,05), % 52,2'den % 30,8'e, % 69,7'den % 35,2'e, % 66,9'dan % 37,7'e ve % 71,4'den % 47,3'e (p0,05). 1999 yılı ile karsılastırıldığında okul dönemindeki çocuklarda (85-198 ay) ise anti-HAV seropozitifliğinin 2009 yılında SED Grup 1, SED Grup 2 ve SED Grup 3'de sırasıyla % 85,7'den % 53,8'e, % 64,4'den % 36'a ve % 43,7'den % 29,3'e düstüğü görüldü (p<0,0001, p<0,0001, p<0,05). Sonuç: Sonuç olarak çalısmamız okul dönemindeki çocuklarda anti-HAV seropozitifliğinin sosyoekonomik düzey farkı gözetmeksizin 10 yıl boyunca istatistiksel olarak anlamlı sekilde azaldığını göstermistir. Sonuçlarımız sosyoekonomik düzey ne olursa olsun, anti-HAV seropozitifliğinin ileri yaslara kaydığını göstermistir. Bu nedenle adolesan ve genç eriskinler semptomatik HAV enfeksiyonu için risk altında olacağından dolayı bölgemizde çocuklara rutin Hepatit A ası uygulamasına baslanmasının doğru olacağı kanaatindeyiz.Bu çalışma Ç.Ü. Bilimsel Araştırma Projeleri Birimi tarafından desteklenmiştir. Proje No: TF2008LTP7

Indication and efficacy of splenectomy in children with hematological disease

WOS: 000437950000007Purpose:. We aimed to research benefits and indications of splenectomy operation due to hematological disease in children. Materials and Methods: The children who underwent to splenectomy due to hematological diseases between 2009-2015 were included in this study. Age of patients, sex, diagnosis, post splenectomy infection, portal vein thrombosis (PVT), operation types, pre and post operative thrombocyte, leucocyte and hematocrit counts, simultaneous cholecystectomy, spleen size, the efficacy of operation were noted retrospectively. Results: Median age of the patients (n=58) was 8. 41% of them were girl and 51% were boy. PVT occurred in 4 patients after splenectomy. 8 of them underwent splenectomy laparoscopically. 2 had conversion due to uncontrolled bleeding. 14 patients underwent cholecystectomy simultaneously. Diagnosis were sickle cell anemia (SCA) (n=20, 34.5%), thalassemia major (n=17, 29.3%) and immune thrombocytopenic purpura (ITP) (n=6, 10.3%). 9 (15%) patients were hospitalized because of post splenectomy infections. Efficacy of splenectomy was not evaluated in 17 patients due to data lack. Efficacy of splenectomy was 85% in evaluated patients. 4 patients were death. One each of thalassemia major and ITP patients had no benefit and all of SCA patients had benefited from splenectomy. Conclusion: Splenectomy is still efficient operation procedure for many hematologic diseases. Age of patients is also important in respect of increasing thrombocyte count

Two Different Cell Populations Is an Important Clue for Diagnosis of Primary Cutaneous Adenoid Cystic Carcinoma: Immunohistochemical Study

Primary cutaneous adenoid cystic carcinoma (PCACC) is a very rare malignancy. The differential diagnosis of PCACCs in pathology practice can be difficult and a group of primary and metastatic lesions, including adenoid basal cell carcinoma of the skin, should be considered in the differential diagnosis. Besides histomorphological clues, immunohistochemistry studies are very helpful in the differential diagnosis of PCACC. We report herein a case of PCACC with extensive immunohistochemical studies and review the literature from an immunohistochemistry perspective

Indication and efficacy of splenectomy in children with hematological

Amaç: Bu çalışmada çocuklarda hematolojik hastalıklar nedeniyle yapılan splenektominin faydasını ve endikasyonlarının araştırılması amaçlanmıştır. Gereç ve Yöntem: Hastanemizde 2009-2015 yılları arasında, 0-17 yaş aralığında, herhangi bir sebepten dolayı splenektomi yapılmış hastalar araştırıldı. Hastalarının yaşı, cinsiyeti, tanıları, postsplenektomi enfeksiyon olup olmadığı, portal venoz tromboz (PVT) olup olmadığı, ameliyat tipi, preoperatif ve postoperatif beyaz küre sayısı, hemotokrit ve trombosit sayısı, eşzamanlı kolesistektomi, dalak boyutu ve ameliyattan fayda görüp görmediği retrospektif olarak incelendi. Bulgular: Hastaların (n=58) yaş ortancası 8’di. %41’i kız, %59 ‘u erkekti. Dört hastada splenektomi sonrası PVT gelişti. Hastaların 8’ine laparoskopik splenektomi yapıldı. 2 hasta ise ameliyata laparoskopik başlanmış ancak kanama sebebiyle açığa dönülmüştür. On dört hastaya eş zamanlı kolesistektomi yapıldı. En çok orak hücreli anemi (n=20 %34.5) ,daha sonra talasemi major ( n=17 %29,3) ve immün trombositopenik purpura (n=6 %10,3) tanılarıyla splenektomi yapıldı. Dokuz (%15) hasta splenektomi sonrası enfeksiyon nedeniyle hastanemize yatışı yapıldı. Hastaların 17 ‘sinde splenektomiden fayda görüp görmediği veri yetersizliğinden dolayı değerlendirilemedi. Değerlendirilen hastaların %85’i (n=35) splenektomiden fayda gördü. 4 hasta eksitus olmuştur. Talasemi major ve immün trombositopenik purpura olan birer hasta splenektomiden fayda görmedi. Orak hücreli anemi olan hastaların hepsi splenektomiden fayda gördü. Sonuç: Splenektomi, hala birçok hematolojik hastalığın tedavisi için kullanılan etkili cerrahi bir işlemdir. Trombosit sayısını yükseltmek için yapılan ameliyatlarda hastanın yaşı, azda olsa önemlidir.Purpose:. We aimed to research benefits and indications of splenectomy operation due to hematological disease in children. Materials and Methods: The children who underwent to splenectomy due to hematological diseases between 2009-2015 were included in this study. Age of patients, sex, diagnosis, post splenectomy infection, portal vein thrombosis (PVT), operation types, pre and post operative thrombocyte, leucocyte and hematocrit counts, simultaneous cholecystectomy, spleen size, the efficacy of operation were noted retrospectively. Results: Median age of the patients (n=58) was 8. 41% of them were girl and 51% were boy. PVT occurred in 4 patients after splenectomy. 8 of them underwent splenectomy laparoscopically. 2 had conversion due to uncontrolled bleeding. 14 patients underwent cholecystectomy simultaneously. Diagnosis were sickle cell anemia (SCA) (n=20, 34.5%), thalassemia major (n=17, 29.3%) and immune thrombocytopenic purpura (ITP) (n=6, 10.3%). 9 (15%) patients were hospitalized because of post splenectomy infections. Efficacy of splenectomy was not evaluated in 17 patients due to data lack. Efficacy of splenectomy was 85% in evaluated patients. 4 patients were death. One each of thalassemia major and ITP patients had no benefit and all of SCA patients had benefited from splenectomy. Conclusion: Splenectomy is still efficient operation procedure for many hematologic diseases. Age of patients is also important in respect of increasing thrombocyte count

Effects of sevoflurane and desflurane on microcirculation during non-cardiac surgery

Objectives: Assessment of microcirculation is thought to be a surrogate of tissue perfusion and anesthetic drugs are known to alter the microcirculation in cardiac surgery patients, but their effects in less complicated non-cardiac surgery remain unknown. Our aim is to investigate the effects of sevoflurane and desflurane on the microcirculation parameters during non-cardiac surgery. Design: Prospective cohort study Setting: Hacettepe University Medical Faculty and Hospital Subjects: Patients with American Society of Anesthesiologists (ASA) score of I-II who underwent ≥2 hours of non-cardiac surgery were randomly divided into two groups: sevoflurane (n=20) and desflurane (n=19). Intervention: Sevoflurane or desflurane Main outcome measures: Demographic, hemodynamic (heart rate, mean arterial pressure) and laboratory parameters (hematocrit, hemoglobin, urea and creatinine) were measured. Microcirculation imaging was performed by using side stream dark field imaging. Results: There were no statistical differences in demographic, hemodynamic and laboratory parameters between groups. In the sevoflurane group, the proportion of perfused vessel (PPV) was slightly increased at the second hour intraoperatively compared to the post-induction period in small vessels (94.7% vs 93%, P=.036), but other parameters (microvascular flow index, total vascular density and perfused vascular density) were comparable in both measurement periods. In the desflurane group, all microcirculation parameters were comparable between post-induction period and second hour intraoperatively. Conclusions: Sevoflurane anesthesia slightly increases the PPV in small vessels, whereas desflurane has no effect on microcirculation parameters in ASA I-II non-cardiac surgery patients. Neither sevoflurane nor desflurane have major effects on microcirculation in this patient population

The effects of non-leukoreduced red blood cell transfusions on microcirculation in mixed surgical patients

Background: The impact of the storage process on oxygen-carrying properties of red blood cells and the efficacy of red blood cell (RBC) transfusions concerning tissue oxygenation remain an issue of debate in transfusion medicine. Storage time and leukocyte content probably interact since longer storage duration is thought to cause greater accumulation of leukocyte-derived cytokines and red blood cell injury. Objectives: The aim of this study was to investigate the effects of storage and the efficacy of fresh (stored for less than 1 week) versus aged (stored for more than 3 weeks) non-leukoreduced RBC transfusions on sublingual microvascular density and flow in mixed surgical patients. Methods: Eighteen surgical patients were included in this study. Patients were randomly assigned into two groups receiving fresh (Group A) and aged (Group B) RBC transfusions. Sublingual microcirculatory functional capillary density (FCD) and microvascular flow index (MFI) were assessed using orthogonal polarization spectral COPS) imaging. Measurements and collection of blood samples were performed after induction of general anesthesia, before RBC transfusion and 30 min after the RBC transfusion Results: In both groups RBC transfusions caused an increase in hemoglobin concentration (p < 0.001). RBC transfusions increased FCD in Group A (p < 0.001), while FCD remained unaffected in Group B. Changes in MFI following RBC transfusion in both groups remained unaltered. Conclusions: Fresh non-leukoreduced RBC transfusions but not RBCs stored for more than 3 weeks, were effective in improving microciruculatory perfusion by elevating the number of perfused microvessels in mixed surgical patien

Clinical and cognitive profiles of patients with both Parkinson's disease and essential tremor

Ankarali, Handan Camdeviren/0000-0002-3613-0523WOS: 000319357200002PubMed: 22926528Although Parkinson's disease (PD) and essential tremor (ET) are distinct clinical disorders, their coexistence can sometimes cause diagnostic problems. In this study, we conducted detailed investigations of patients with both ET and PD (ET-PD) and compared their clinical and cognitive profiles with those of patients with only ET or only PD. This study examined three groups of patients: the first group had ET-PD concomitantly (n = 9); the second group had only ET (n = 9); the third group had only PD (n = 10). The groups were compared in terms of demographic characteristics, clinical features, and cognitive functions. With the exception of positive family histories, which were more common in ET-PD than in PD patients, we found no differences among the groups with respect to demographic characteristics (p = 0.044). PD-only patients had more akinetic-rigid type Parkinsonism (p = 0.016), and their levodopa response was better than that of ET-PD patients (p = 0.017). Patients with ET-PD obtained significantly lower scores than those with pure ET on several cognitive tests, suggesting a prominent frontal-type cognitive dysfunction. In conclusion ET-PD patients differed from PD patients, showing more frequent familial tremor histories and lower levodopa responsiveness. This patient population also demonstrated more severe cognitive impairments than pure-ET patients. This result suggests that ET-PD patients are a subset of ET patients with more widespread neurodegeneration, which may indicate the presence of a syndrome that includes overlap between ET and PD

A retrospective- multicenter study: Evaluation of the same brand (Confort) negative pressure wound therapy (NPWT) with silver coated and standard foam in diabetic foot ulcers

Diabetic foot ulcers are hard to treat ulcers that are common in population. This situation causes amputations and extremity loss. Among therapeutic options negative pressure wound therapy (NPWT) seems a good option to treat specially non osteomyelitic and non ischemic wounds. This method can be widely used in deep, large and infected wounds. The antibacterial effect of silver on wounds has been used for centuries. Silver wound closure sets, which are also used in NPWT systems, have gained importance in recent years. In this study, the effect of Confort brand NPWT with and without silver on wound healing evaluated retrospectively. This is a multi center study involving five different institution. As a success criterion, a reduction of &gt;50% in the initial dimensions of the wound (width/length/depth) after 7 applications is accepted. When the silver coated and standard foam Confort NPWT groups were compared, the reduction of 50% or more in the wound volume was relatively shorter in the silver group; while it was 3.2 +/- 1.2 weeks in the silver group, it was 5.14 +/- 2.3 weeks in the silver-free group (p=0.08). [Med-Science 2023; 12(4.000): 1320-1323