Ganglion cysts in the lateral portal region of the knee after arthroscopy: report of two cases

A ganglion cyst (GC) is a mucinous or gelatinous-filled benign tumor overlying a joint or tendon sheath, which commonly arises in the dorsal and volar wrist side but may occur anywhere in the body. Although cystic lesions around the knee are common, the occurrence of GCs are rare. Ganglia may arise from intra or extra-articular, soft tissue, intraosseous, or periosteal location. Symptoms may vary according to the size and location. After the more frequent performance of magnetic resonance imaging for the assessment of a knee joint, the number of incidental, asymptomatic lesions have been increasingly diagnosed. The etiology of GC remains unclear; however, trauma and a flaw in the joint tissues may explain its appearance. The authors report two cases of women aged 47 years and 37 years who presented pain and swelling in their left knees following arthroscopic partial medial meniscectomy. The former was surgically treated and had a favorable outcome, while the latter had conservative treatment and a gloomy outcom

Ganglion cysts in the lateral portal region of the knee after arthroscopy: report of two cases

A ganglion cyst (GC) is a mucinous or gelatinous-filled benign tumor overlying a joint or tendon sheath, which commonly arises in the dorsal and volar wrist side but may occur anywhere in the body. Although cystic lesions around the knee are common, the occurrence of GCs are rare. Ganglia may arise from intra or extra-articular, soft tissue, intraosseous, or periosteal location. Symptoms may vary according to the size and location. After the more frequent performance of magnetic resonance imaging for the assessment of a knee joint, the number of incidental, asymptomatic lesions have been increasingly diagnosed. The etiology of GC remains unclear; however, trauma and a flaw in the joint tissues may explain its appearance. The authors report two cases of women aged 47 years and 37 years who presented pain and swelling in their left knees following arthroscopic partial medial meniscectomy. The former was surgically treated and had a favorable outcome, while the latter had conservative treatment and a gloomy outcom

Ultrasonography-Guided Injection for Quadriceps Fat Pad Edema: Preliminary Report of a Six-Month Clinical and Radiological Follow-Up

Purpose: To investigate efficacy and safety of ultrasonography-guided local corticosteroid and anesthetic injection followed by physical therapy for the management of quadriceps fat pad (QFP) edema. Materials and Methods: We prospectively evaluated 1671 knee MRI examinations in 1542 patients for QFP edema with mass effect, which was present in 109 (6.5%) knees. Participants were assigned into injection and therapy groups (both received the same physical therapy program). Injection group was first treated with ultrasonography-guided QFP injection of 1 mL corticosteroid and 1 mL local anesthetic agent. Patients were evaluated at baseline and 1-, 2-, 6-month follow-up for pain using static and dynamic visual analogue scale (VAS), suprapatellar tenderness, and QFP edema on MRI. Results: Final sample size consisted of 19 knees (injection group, 10; therapy group, 9) in 17 patients. An overall improvement was detected in both groups between baseline and final assessments. The injection group fared better than the therapy group in static VAS scores (3.33 ± 1.70 versus 0.56 ± 1.33), while there was no such difference for dynamic VAS. Incidence of suprapatellar tenderness decreased in both groups, statistically significantly in the injection group (from 100% to 0%). Pain reduction was greater in the injection group at the first month (88.9% – 90% good response versus 50% – 66.7% good response, static-dynamic VAS scoring, respectively), whereas there was no such superiority at the sixth month. No severe adverse events were identified. Conclusion: Ultrasonography-guided local injection followed by physical therapy is safe in the management of QFP edema; however, it is not superior to stand-alone physical therapy program in the long term

Epidemiology of surgery associated acute kidney injury (EPIS-AKI): a prospective international observational multi-center clinical study

Purpose: The incidence, patient features, risk factors and outcomes of surgery-associated postoperative acute kidney injury (PO-AKI) across different countries and health care systems is unclear. Methods: We conducted an international prospective, observational, multi-center study in 30 countries in patients undergoing major surgery (> 2-h duration and postoperative intensive care unit (ICU) or high dependency unit admission). The primary endpoint was the occurrence of PO-AKI within 72 h of surgery defined by the Kidney Disease: Improving Global Outcomes (KDIGO) criteria. Secondary endpoints included PO-AKI severity and duration, use of renal replacement therapy (RRT), mortality, and ICU and hospital length of stay. Results: We studied 10,568 patients and 1945 (18.4%) developed PO-AKI (1236 (63.5%) KDIGO stage 1500 (25.7%) KDIGO stage 2209 (10.7%) KDIGO stage 3). In 33.8% PO-AKI was persistent, and 170/1945 (8.7%) of patients with PO-AKI received RRT in the ICU. Patients with PO-AKI had greater ICU (6.3% vs. 0.7%) and hospital (8.6% vs. 1.4%) mortality, and longer ICU (median 2 (Q1-Q3, 1-3) days vs. 3 (Q1-Q3, 1-6) days) and hospital length of stay (median 14 (Q1-Q3, 9-24) days vs. 10 (Q1-Q3, 7-17) days). Risk factors for PO-AKI included older age, comorbidities (hypertension, diabetes, chronic kidney disease), type, duration and urgency of surgery as well as intraoperative vasopressors, and aminoglycosides administration. Conclusion: In a comprehensive multinational study, approximately one in five patients develop PO-AKI after major surgery. Increasing severity of PO-AKI is associated with a progressive increase in adverse outcomes. Our findings indicate that PO-AKI represents a significant burden for health care worldwide

Intraperitoneal drain placement and outcomes after elective colorectal surgery: international matched, prospective, cohort study

Despite current guidelines, intraperitoneal drain placement after elective colorectal surgery remains widespread. Drains were not associated with earlier detection of intraperitoneal collections, but were associated with prolonged hospital stay and increased risk of surgical-site infections.Background Many surgeons routinely place intraperitoneal drains after elective colorectal surgery. However, enhanced recovery after surgery guidelines recommend against their routine use owing to a lack of clear clinical benefit. This study aimed to describe international variation in intraperitoneal drain placement and the safety of this practice. Methods COMPASS (COMPlicAted intra-abdominal collectionS after colorectal Surgery) was a prospective, international, cohort study which enrolled consecutive adults undergoing elective colorectal surgery (February to March 2020). The primary outcome was the rate of intraperitoneal drain placement. Secondary outcomes included: rate and time to diagnosis of postoperative intraperitoneal collections; rate of surgical site infections (SSIs); time to discharge; and 30-day major postoperative complications (Clavien-Dindo grade at least III). After propensity score matching, multivariable logistic regression and Cox proportional hazards regression were used to estimate the independent association of the secondary outcomes with drain placement. Results Overall, 1805 patients from 22 countries were included (798 women, 44.2 per cent; median age 67.0 years). The drain insertion rate was 51.9 per cent (937 patients). After matching, drains were not associated with reduced rates (odds ratio (OR) 1.33, 95 per cent c.i. 0.79 to 2.23; P = 0.287) or earlier detection (hazard ratio (HR) 0.87, 0.33 to 2.31; P = 0.780) of collections. Although not associated with worse major postoperative complications (OR 1.09, 0.68 to 1.75; P = 0.709), drains were associated with delayed hospital discharge (HR 0.58, 0.52 to 0.66; P < 0.001) and an increased risk of SSIs (OR 2.47, 1.50 to 4.05; P < 0.001). Conclusion Intraperitoneal drain placement after elective colorectal surgery is not associated with earlier detection of postoperative collections, but prolongs hospital stay and increases SSI risk

Measurement of Service Quality in Public and Private/Foundation University Dormitories: Comparison of Turkish and Foreign Students

The main aim of this study is to determine the service quality of dormitories based on service quality perceptions and expectations of students. In this article, it is also aimed to reveal the shortcomings of student dormitories in terms of service quality levels, and to present Turkish and foreign students' suggestions to address these shortcomings. There are many studies on the service quality of student dormitories in Turkey. However, none of these studies have addressed the service quality of student dormitories from the perspective of Turkish and foreign students. Therefore, this study is original and valuable. The study was carried out through quantitative data analysis. It was carried out with 394 students selected through the convenience sampling method. The SERVQUAL scale, which is frequently used in the measurement of service quality, was used. According to the research results, both the state and private/foundation university dormitories fail to meet the quality of service expected by the students. In particular, it seems that state dormitories perform worse in this regard. In addition, it was determined that the foreign students' service quality expectation about the dormitories was lower than that of the Turkish students, but their satisfaction levels were low and similar to theirs

Measurement of Service Quality in Public and Private/Foundation University Dormitories: Comparison of Turkish and Foreign Students

The main aim of this study is to determine the service quality of dormitories based on service quality perceptions and expectations of students. In this article, it is also aimed to reveal the shortcomings of student dormitories in terms of service quality levels, and to present Turkish and foreign students' suggestions to address these shortcomings. There are many studies on the service quality of student dormitories in Turkey. However, none of these studies have addressed the service quality of student dormitories from the perspective of Turkish and foreign students. Therefore, this study is original and valuable. The study was carried out through quantitative data analysis. It was carried out with 394 students selected through the convenience sampling method. The SERVQUAL scale, which is frequently used in the measurement of service quality, was used. According to the research results, both the state and private/foundation university dormitories fail to meet the quality of service expected by the students. In particular, it seems that state dormitories perform worse in this regard. In addition, it was determined that the foreign students' service quality expectation about the dormitories was lower than that of the Turkish students, but their satisfaction levels were low and similar to theirs

Effect of anterior cruciate ligament reconstruction with hamstring tendons on Insall-Salvati index and anterior knee pain

WOS: 000436254500009Introduction/Objective The relationship between anterior knee pain and the Insall-Salvati ratio after anterior cruciate ligament (ACL) reconstruction with hamstring tendon were evaluated in this study. Methods We evaluated 39 patients that had an ACL reconstruction surgery with hamstring tendon. All the patients were evaluated for the Insall-Salvati ratio preoperatively and postoperatively. Fourteen patients had anterior knee pain at the end of the first year after the surgery. The patients were evaluated at the end of the first year after the surgery with the Lysholm score and the Tegner activity scale. The patients' preoperative and postoperative measurements were analyzed by using the Wilcoxon test, and the differences between the patients with anterior knee pain and those without it were analyzed by the Mann-Whitney U test. Results Preoperatively, mean Insall-Salvati ratio was found to be 0.91 +/- 0.1, whereas postoperative ratio was 0.85 +/- 0.09 (p <= 0.05). In the group without anterior knee pain, the mean Tegner activity score was 8.56 +/- 1.04, and the mean Lysholm score was 87.36 +/- 9.42. The mean Tegner activity score was 7.21 +/- 0.97 and the mean Lysholm score was 74.43 +/- 9.94 in the group with anterior pain. There was a decrease in the Insall-Salvati ratio as a result of the surgery, but patients with anterior knee pain had lower values of the Insall-Salvati ratio preoperatively. Conclusion Low preoperative Insall-Salvati ratio can be an indicator of anterior knee pain in the early period after ACL reconstruction with hamstring tendons. The mean Tegner activity score and the mean Lysholm score have higher values in the group without anterior pain postoperatively

An Unusual Case of Tracheobronchial Foreign Body Aspiration in a Laryngectomized Patient: Rolled Tissue

Tracheobronchial foreign body aspirations are the most common cause of acute respiratory obstruction and vital health problem that have to be diagnosed and managed immediately. Aspiration can lead to serious consequences up to respiratory arrest, if complete or near complete airway obstruction occurs or intervention is delayed. The existence of tracheal stoma after previous surgeries is an important factor that facilitates foreign body aspiration. In this article we present a case with total laryngectomy who aspirated roll of tissue when he tried to clean tracheal stoma. It is very important to keep in mind the possibility of foreign body aspiration through stoma in tracheotomized patients presented with respiratory comprimise. Immediate diagnosis and proper intervention of this situation is lifesaving. [Med-Science 2015; 4(2.000): 2263-70