24 research outputs found
Son Bir Yıl İçindeki Nekrotizan Fasiitis Tanısı Alan Hastaların Değerlendirilmesi
Objective: To share experiences about diagnosis, follow-up and treatment of necrotizing fasciitis patients who applied to our clinic.
Methods: The records of patients who had a diagnosis of necrotizing fasciitis that referred to our clinic between 01.01.2016 and 01.01.2017 were retrospectively examined. Patients' age, sex, additional disease, total number of operations, duration of hospitality and treatment responses was examined.
Results: A total of 13 patients with necrotizing fasciitis were followed up and treated at our clinic. We found 62% of the patients were male (n:8) and 38% were female (n:5). The mean age of the patients was 61 years (38-80 years). While 69% (n:9) of patients had diabetes mellitus, two female patients had under gone chemo-radio therapy last year due to over-carcinoma. The history of the perianal abscess and fistula was seen in the anamnesis of the other two patients. In all patients, necrotizing fasciitis was in the perianal region. After the diagnosis of the patients, an average of three times debridement were performed (min: 2, max: 6). Negative pressure wound closure was applied to 69% (n: 9) of the patients after debridement and 31% of the patients (n: 4) were treated with surgical flap methods. Tissue culture was obtained from all patients during debridement and the necrotizing fasciitis was confirmed with culture result. In 77% of patients (n: 10), ceftriaxone + metranidazole combination was sufficient as antibiotherapy whereas imipenem group antibiotic support was needed in there maining patients. The average hospital stay was 24 days (min: 4max: 71). Ninety percent of the patients (n: 12) were discharged successfully with healing and a case with necrotizing fasciitis developed due to over carcinoma was lost because of developing severe sepsis at postoperative 34th day.
Conclusion: Necrotizing fasciitis is a disease that is frequently associated with mortality when it is not treated with early diagnosis. Many of the patients are immuno suppressed and for this reason diagnosis can be delayed. Patients with early diagnosis, rapid and aggressive debridement for treatment can obtain satisfactory results
Interventions to treat premature ejaculation: a systematic review short report
Background: Premature ejaculation (PE) is commonly defined as ejaculation with minimal sexual
stimulation before, on or shortly after penetration and before the person wishes it. PE can be either
lifelong and present since first sexual experiences (primary), or acquired (secondary), beginning
later (Godpodinoff ML. Premature ejaculation: clinical subgroups and etiology. J Sex Marital Ther
1989;15:130–4). Treatments include behavioural and pharmacological interventions.
Objective: To systematically review evidence for clinical effectiveness of behavioural, topical and systemic
treatments for PE.
Data sources: The following databases were searched from inception to 6 August 2013 for published
and unpublished research evidence: MEDLINE; EMBASE; Cumulative Index to Nursing and Allied Health
Literature; The Cochrane Library including the Cochrane Systematic Reviews Database, Cochrane
Controlled Trials Register, Database of Abstracts of Reviews of Effects and the Health Technology
Assessment database; ISI Web of Science, including Science Citation Index, and the Conference
Proceedings Citation Index-Science. The US Food and Drug Administration website and the European
Medicines Agency (EMA) website were also searched.
Methods: Randomised controlled trials (RCTs) in adult men with PE were eligible (or non-RCTs in the
absence of RCTs). RCT data were extrapolated from review articles when available. The primary outcome
was intravaginal ejaculatory latency time (IELT). Data were meta-analysed when possible. Other outcomes
included sexual satisfaction, control over ejaculation, relationship satisfaction, self-esteem, quality of life,
treatment acceptability and adverse events (AEs).
Results: A total of 103 studies (102 RCTs, 65 from reviews) were included. RCTs were available for all
interventions except yoga. The following interventions demonstrated significant improvements (p < 0.05)
in arithmetic mean difference in IELT compared with placebo: topical anaesthetics – eutectic mixture of
local anaesthetics (EMLA®, AstraZeneca), topical eutectic mixture for PE (Plethora Solutions Ltd) spray;
selective serotonin reuptake inhibitors (SSRIs) – citalopram (Cipramil®, Lundbeck), escitalopram
(Cipralex®, Lundbeck), fluoxetine, paroxetine, sertraline, dapoxetine (Priligy®, Menarini), 30 mg or
60 mg; serotonin–noradrenaline reuptake inhibitors – duloxetine (Cymbalta®, Eli Lilly & Co Ltd); tricyclic
antidepressants – inhaled clomipramine 4 mg; phosphodiesterase-5 (PDE5) inhibitors – vardenafil (Levitra®,
Bayer), tadalafil (Cialis®, Eli Lilly & Co Ltd); opioid analgesics – tramadol (Zydol SR®, Grünenthal).
Improvements in sexual satisfaction and other outcomes compared with placebo were evident for SSRIs,
PDE5 inhibitors and tramadol. Outcomes for interventions not compared with placebo were as follows:
behavioural therapies – improvements over wait list control in IELT and other outcomes, behavioural
therapy plus pharmacotherapy better than either therapy alone; alpha blockers – terazosin (Hytrin®, AMCO) not significantly different to antidepressants in ejaculation control; acupuncture – improvements over
sham acupuncture in IELT, conflicting results for comparisons with SSRIs; Chinese medicine – improvements
over treatment as usual; delay device – improvements in IELT when added to stop–start technique;
yoga – improved IELT over baseline, fluoxetine better than yoga. Treatment-related AEs were evident
with most pharmacological interventions.
Limitations: Although data extraction from reviews was optimised when more than one review reported
data for the same RCT, the reliability of the data extraction within these reviews cannot be guaranteed
by this assessment report.
Conclusions: Several interventions significantly improved IELT. Many interventions also improved
sexual satisfaction and other outcomes. However, assessment of longer-term safety and effectiveness is
required to evaluate whether or not initial treatment effects are maintained long term, whether or not dose
escalation is required, how soon treatment effects end following treatment cessation and whether or not
treatments can be stopped and resumed at a later time. In addition, assessment of the AEs associated with
long-term treatment and whether or not different doses have differing AE profiles is required
Trace metal concentrations in hair and nails from Alzheimer's disease patients: Relations with clinical severity
Background and objectives: Metals, especially transition metals, seem to be important in the pathogenesis of Alzheimer disease. This study aims to determine the relationship of trace metal elements to the pathogenesis and/or course of Alzheimer Disease in terms of clinical severity
Arsenic and selenium measurements in nail and hair show important relationships to Alzheimer's disease in the elderly
Background and research question: The relationships of Arsenic (As) and selenium (Se) to Alzheimer's Disease (AD) are not clearly known. This case-control observational study aims to investigate the possible relationship of these elements to the diagnosis and pathophysiology of the disease
Primitive robotic procedures: Automotions for medical liquids in 12th century Asia minor
In recent years, day by day, robotic surgery applications have increase their role in our medical life. In this article, we reported the discovery of the first primitive robotic applications as automatic machines for the sensitive calculation of liquids such as blood in the literature. Al-Jazari who wrote the book “Elcâmi ‘Beyne’l - ‘ilm ve’l - ‘amel en-nâfi ‘fi es-sınaâ ‘ti’l - hiyel”, lived in Anatolian territory between 1136 and 1206. In this book that was written in the twelfth century, Al-Jazari described nearly fifty graphics of robotic machines and six of them that were designed for medical purposes. We found that some of the robots mentioned in this book are related to medical applications. This book reviews approximately 50 devices, including water clocks, candle clocks, ewers, various automata used for amusement in drink assemblies, automata used for ablution, blood collection tanks, fountains, music devices, devices for water lifting, locks, a protractor, a boat-shaped water clock, and the gate of Diyarbakir City in south-east of Turkey, actually in northern Mesopotamia. We found that automata used for ablution and blood collection tanks were related with medical applications; therefore, we will describe these robots