Fetal Heart Evaluation

Congenital heart diseases are considered the most common fetal anomalies. While some of these anomalies may have a minimal impact on the life of a newborn, some may result in neonatal deaths in the early period. With early diagnosis, detection of anomalies that are incompatible with life and termination of pregnancy with the consent of the patient can be offered as options. In addition, since many cardiac anomalies are treated during the postpartum period, it is important to detect those having this type of anomaly and offer them an early and appropriate treatment option during the postpartum period. It is highly appropriate to have delivery in hospitals that are technically equipped to handle cardiac anomalies. For these reasons, fetal cardiac evaluations are now being performed recently. Technical difficulties, inability to spare enough time for the patient or lack of experience in the cardiac evaluation may facilitate the lack of detection of fetal heart anomalies. Cardiac anomalies are among the most undetected anomalies. Although it may seem like a very difficult evaluation at first, fetal cardiac evaluation is actually a very simple and easy to perform examination. By creating a certain algorithm, the most common cardiac anomalies can be detected easily. Each clinician should establish a certain order according to their own physical conditions and the basic structures to be considered should be evaluated in this order. In this article, we present suggestions on how to perform a fetal cardiac evaluation using current approaches

Comparison of intramedullary nailing and minimal invasive plate osteosynthesis in the treatment of simple intra-articular fractures of the distal tibia (AO-OTA type 43 C1-C2)

The aim of this study was to compare midterm functional and radiographic results of minimal invasive plate osteosynthesis (MIPO) with intramedullary nailing (IMN) of simple intra-articular distal tibial fractures (AO-OTA type 43 C1-C2). Seventy-three simple intra-articular distal tibial fracture patients were evaluated retrospectively. All were treated between 2009 and 2014. The average age of the patients was 40.3 years. Thirty-seven patients were treated with IMN and 36 patients were treated with MIPO. Fibular plate osteosynthesis was applied in 5 cases (13.5%) in the IMN group and in 23 patients (63.9%) in the MIPO group. Functional results and complications of IMN and MIPO methods were assessed in 73 patients. The average union time was 16.4 ± 2.7 weeks in the IMN group and 15.2 ± 1.8 weeks in the MIPO group (p = 0.079). The average Olerud-Molander Ankle Score was 87.8 ± 8.1 in the IMN group and 81.5 ± 11.8 in the MIPO group (p = 0.013). Four patients in the IMN group experienced valgus malunion, while it was not observed in any patients in the MIPO group (p = 0.042). Recurvatum malunion was detected in 10 patients in the MIPO group and not seen in the IMN group (p = 0.001). Ankle dorsiflexion angle was 25.8 ± 4.5° in the IMN group and 33.3 ± 8.9° in the MIPO group (p = 0.000). Simple intra-articular distal tibial fractures are successfully treated with IMN and MIPO. Prevalence of valgus malunion was higher in the IMN group and recurvatum was more prevalent in the MIPO group. MIPO is the first preference according to the literature, however, successful results have been obtained with IMN in this fracture pattern. Level III, Therapeutic Study

Gebelikte İlaç Maruziyetinin Prenatal ve Postnatal Sonuçları

Amaç: Hastanemize başvuran ve perinatoloji konseyimizde değerlendirdiğimiz gebelerden ilaç kullanım öyküsü olanların demografik özelliklerini ve maruz kalınan ilaçların Yapısal Tedavi Edici Kimyasallar Sınıflaması (ATC) sistemine göre dağılımlarını belirlemektir. Yöntem: Bu araştırma retrospektif kohort bir çalışma olarak tasarlanmıştır. Hastane veri tabanından elde edilen veriler, literatür ışığında değerlendirilmiştir. Gebeliğinde ilaç kullanımı tespit edilen gebelerin sıklıkla hangi ilaçları kullandıkları ATC sistemine göre kategorize edildi. Aynı zamanda gebelerin demografik verileri, eğitim durumları, gelir seviyeleri, alkol sigara kullanımları, obstetrik sonuçları incelendi. Bulgular: Çalışmamıza İzmir Tepecik Eğitim ve Araştırma Hastanesi, Perinatoloji Bölümü Konseyi’nde değerlendirilen 99 gebe dahil edildi. Gebelerde ortalama yaş 31,70 [18-47, standart sapma (SS)=5,880], ortalama gravida 2,81 (1-8, SS=1,452), ortalama parite 1,4 (0-5, SS=0,988) ve başvuru sırasındaki ortalama gebelik haftası 11,27 (5-30, SS=4,692) olarak hesaplandı. Ortalama ilaç kullanım süresinin ortalama 66,56 gün olduğu tespit edildi. Çalışmamızda %29,33 oranıyla en sık sinir sistemini ilgilendirilen ilaçların kullanıldığı bunu %15,03 oranıyla sindirim sistemini ilgilendiren ilaçların takip ettiği gözlendi. İlaca maruz kalan 100 gebenin sadece 5’inde doğumsal anomali gözlemlenmiştir. Sonuç: Gebelerin demografik verileri, maruz kaldıkları ilaçların dağılımları literatür ile benzer şekildedir. Ancak daha önceki çalışmalardan farklı olarak isteğe bağlı küretaj tercihi daha düşük orandadır. Bununla birlikte doğumsal anomali görülme durumu da beklenenden yüksek değildir

THE COMPARISON OF THE EFFECTIVENESS OF RENAL REPLACEMENT THERAPIES (DIALYSIS AND TRANSPLANTATION) ON UREMIC POLYNEUROPATHY IN CHRONIC RENAL FAILURE

Objective: The aim of this study was to compare the effectiveness of dialysis (dx) and transplantation on polyneuropathy

Haemoperfusion in Amanita phalloides poisoning

Amanita phalloides is responsible for about 90 per cent of all fatal cases of mushroom intoxication, The amatoxins, the main toxic component of these fungi, are responsible for gastro-intestinal symptoms, as well as hepatic and renal failure

The prognostic value of P53 index in predicting the recurrence of early low-risk endometrial cancer

Aim: We aimed to clarify the clinical value of P53 index in patients with early low-risk endometrial cancer (EC) and find an optimal cut-off value of P53 index for predicting the recurrence of these patients. Methods: The clinicopathological data of 157 patients with early low-risk EC (stage 1A with grade 1 or 2 endometrioid EC) were analyzed. The optimal cut-off value of the P53 index was calculated by the receiver operating characteristic curve analysis and Youden index. Cox regression model was used to evaluate the independent prognostic predictors of recurrence of EC. Then all patients were divided into two groups according to the optimal cut-off value of the P53 index. Differences of the clinicopathological parameters between the two groups were compared. Results: Multivariate analysis showed age PR (p = 0.020) and P53 (p = 0.001) were independent prognostic factors for the recurrence of EC. The value of P53 index was found to be the optimal cut-off point of 17.5% in estimating the recurrence of EC. The 5-year recurrence-free survival rates of patients in the low P53 index group (<17.5%) and the high P53 index group (≥17.5%) were 94.6% and 65.4% (p < 0.001). Conclusion: It has been revealed that the P53 index is a prognostic factor for recurrence in early low-risk EC. The optimal cut-off value of P53 index may contribute to the postoperative individualized treatment options for early low-risk EC patients