Yanık sonrası akut dönemde gelişen kemik kaybı

Bu çalışmanın amacı yanık sonrası akut dönemde kemik kaybının olup olmadığı ve çeşitli parametrelerin kemik kaybı üzerine etkisini araştırmaktır. Hastalar ve Yöntem: Bu çalışma, yanık yüzey alanı %20 ve üzerinde olan 20-50 yaşındaki 19 hasta üzerinde gerçekleştirildi. Hastalar yanık nedeni, yeri, yüzdesi, derecesi, ambulasyon durumu ve fonksiyonel açıdan değerlendirildi. Birinci ayın sonunda total L1-L4 vertebra, distal sol önkol ve total sol femur kemik mineral yoğunluğu ölçüldü. Z skorunun -1'in altında olması kemik kaybı olarak değerlendirildi. Bulgular: Ondördü erkek beşi kadın olan 19 hastanın yaş ortalaması 33.09±11.61 idi. Hastalarımızın %68.4 ünde distal sol ön kol, %21.1 inde total sol femur, %36.8 inde total L1-L4 vertebra z skoru <-1 olarak bulundu. Yanık total vücut yüzey alanı yüzdesi, Fonksiyonel Ambulasyon Skalası ve Fonksiyonel Bağımsızlık Ölçütü ile distal sol ön kol, total sol femur ve total L1-4 vertebra Z skorları arasında istatistiksel açıdan anlamlı bir ilişki yoktu. Sonuç: Yanık hastalarında ilk bir ayda görülen kemik mineral yoğunluğundaki azalma kemik kaybının erken dönemde başladığını göstermekte olup akut dönemdeki kaybın yanık yüzdesi ve fonksiyonel durum ile ilişkili olmadığı bulunmuştur. The purpose of this study was to determine whether a bone loss occurs during acute period following burn injury or not, and to investigate the effects of various parameters on it. Materials and Methods: This study was conducted on 19 patients, ages between 20 and 50, who had a burn injury with more than %20 of Total Body Surface Area (TBSA). We recorded the patients' burn cause, localization, percantage, ambulation and functional status. At the end of the first month, we measured bone mıneral densıty of total L1-L4 vertebrae, left distal forearm, left total femur, in all patients. A Z score less than -1 was accepted to be the indicator of bone loss. Results: The mean age of the patients (14 male and 5 female) was 33.09±11.61. We found a Z score less then -1 in 68.4% of left distal forearm, 21.1% of left total femur and 36.8% of total L1-L4 vertabrae measurements. There were no significant correlations between TBSA, Functional Ambulatıon Scale and Functional Independence Measure, and Z scores. Conclusion: There is a reduction in Bone Mineral Density in patıents wıth moderate/severe burn ınjuries in the acute period which is not correlated wıth neither TBSA nor functional status

Bone Loss in the Acute Stage Following Burn Injury - Original Investigation

Aim: The purpose of this study was to determine whether a bone loss occurs during acute period following burn injury or not, and to investigate the effects of various parameters on it. Materials and Methods: This study was conducted on 19 patients, ages between 20 and 50, who had a burn injury with more than %20 of Total Body Surface Area (TBSA). We recorded the patients’ burn cause, localization, percantage, ambulation and functional status. At the end of the first month, we measured bone mıneral densıty of total L1-L4 vertebrae, left distal forearm, left total femur, in all patients. A Z score less than –1 was accepted to be the indicator of bone loss. Results: The mean age of the patients (14 male and 5 female) was 33.09±11.61. We found a Z score less then -1 in 68.4% of left distal forearm, 21.1% of left total femur and 36.8% of total L1-L4 vertabrae measurements. There were no significant correlations between TBSA, Functional Ambulatıon Scale and Functional Independence Measure, and Z scores. Conclusion: There is a reduction in Bone Mineral Density in patıents wıth moderate/severe burn ınjuries in the acute period which is not correlated wıth neither TBSA nor functional status. (From the World of Osteoporosis 2007;13:33-6

Tumour cell frequency in pleural lavage in cases with stage I epidermoid lung cancer with no visceral pleural involvement

Background: The presence of tumour cells in the pleural lavage of lung cancer patients with no malignant pleural effusion is a negative prognosticator. In the present study we aimed to determine the lowest frequency of positive pleural lavage in lung cancer.BACKGROUND:The presence of tumour cells in the pleural lavage of lung cancer patients with no malignant pleural effusion is a negative prognosticator. In the present study we aimed to determine the lowest frequency of positive pleural lavage in lung cancer.METHODS:The study included 26 consecutive patients who underwent thoracotomy for curative resection for Stage I epidermoid lung cancer. The cases had neither visceral pleural involvement nor obstructive pneumopathy. The patients were applied pleural lavage cytology immediately after thoracotomy.RESULTS:The frequency of malignant cells in pleural lavage was 7.7% (Stage IA, n = 1, and IB, n = 1).CONCLUSION:Our series, in which we predicted the lowest probability of the presence of tumour cells in pleural lavage, had such a frequency of positive tumour cells that should'nt be neglected. The present study concluded that pleural lavage cytology before pulmonary resection should routinely be performed in 'all' lung cancers and that pleural lavage cytology may also be included in the current staging system

Fluid management in major burn injuries

It is a widely accepted fact that severe fluid loss is the greatest problem faced following major burn injuries. Therefore, effective fluid resuscitation is one of the cornerstones of modern burn treatment. The aim of this article is to review the current approaches available for modern trends in fluid management for major burn patients. As these current approaches are based on various experiences all over the world, the knowledge is essential to improve the status of this patient group

Is malignancy associated with pericardial effusion fluid volume or fluid character?

© 2020 Wiley Periodicals LLCIntroduction: Pericardial effusion develops due to different etiologies. The main goals of our study are to understand the etiology and determine whether the amount of pericardial effusion is significant in terms of malignancy. Material and Methods: 142 patients with pericardial effusion, who met the criteria between 1 January 2014 and 1 January 2019, were retrospectively analyzed. All of these patients underwent operation with the subxiphoidal approach. The fluid samples were sent to the microbiology and pathology laboratories for evaluation. Patients underwent follow-up after 1 month. Results: Of the patients included in this study, 72 (61%) of 118 patients were operated on under general anesthesia with a laryngeal mask, and 46 (39%) underwent sedation and local anesthesia. The etiologies found in patients were as follows: effusions resulting from malignancy in 27 (22.9%), idiopathic in 24 (20.3%), cardiac causes (depending on the use of anticoagulants or postoperation) in 22 (18.6%), uremia in 20 (16.9%), infection in 18 (15.3%), and heart failure in 7 patients. The amount of fluid drained from the patients was 661.61 ± 458.34 mL. Out of 27 patients with malignancy, 21 (77.8%) had drainage over 500 mL of effusion fluid, and 6 (22.2%) had drainage under 500 mL. Patients who had positive results tended to have drainage over 500 mL compared with patients who had negative results in terms of malignancy (P =.033). Conclusion: The subxiphoidal approach to pericardial effusion is an easily applicable operation, whether therapeutic or diagnostic. The advantages of the subxiphoidal approach include drainage of all of the fluid and ease of sampling the pericardial fluid. We believe that the amount of fluid drained can lead us to consider malignancy as an etiology