Organ Donation Course in Medical Education Program

The number of patients waiting for organ transplantation is increasing. Today, living donors and cadaveric donors comprise the donor pool. Although it varies from country to country, organ transplants are mostly based on living donors because the cadaveric donor pool is not enough. There are different alternatives to increase the cadaveric donor pool. One of them is to raise awareness of organ donation in undergraduate medical education. Unfortunately, its effectiveness is controversial. In this section, to increase the effectiveness of the organ donation course given in medical education programs, a method proposal is presented. Medical professionals’ knowledge of and attitudes toward donation have an impact on donation rates. It is possible that these attitudes and knowledge are molded during pre-graduation. As such, educating medical students may be an important factor in increasing organ donation. Learners’ participation in an educational program is one of the most important factors contributing to learning. Flipped classroom is a student-oriented education method based on the combination of in- and out-of-class activities. With the use of the flipped classroom method in organ donation courses offered in medical education programs, students’ knowledge and skills that enable them to discuss the topic of donation with patients can be improved

Apandisit ile komplike gebeliklerin cerrahi tedavisi ve gebelik sonuçları: obstetrisyen görüşü

Objective: To evaluate the pregnancy outcomes of patients who underwent appendectomy during pregnancy. Materials and Methods: Patients who underwent appendectomy between years 2010 and 2014 were retrospectively evaluated. All patients’ pregnancy outcomes were followed-up by using university registry system and telephone interview. Patients were evaluated regarding age, gestational age, clinical and laboratory examinations, imaging studies, mean time interval between emergency department and operation, mean operative time, pregnancy outcome and pathologic results of the appendix. Results: Thirty-nine patients were included in the study. Sixteen of 39 patients were in the first, 15 of them in the second and 8 of them were in the third trimester of the pregnancy. Three patients underwent laparoscopic appendectomy and the rest underwent laparotomy. In pathologic evaluation of the appendix, seven patients (17%) had normal appendix, 4 patients had perforated appendix, one patient had neuro-endocrine tumor and rest of the patients had appendicitis. Two missed abortion occurred after operation, rest of the patients had live birth. Six of them were preterm and 31 had term birth. Twelve patients delivered through vaginal birth and the rest via caesarean section. Twenty patients were in the first half of the pregnancy (group 1) and 19 patients were in the second half of the pregnancy (group 2). There were no significant differences between the groups in operation time and mean time interval between emergency administration and operation. Conclusion: Delayed operation and negative appendectomy can cause adverse pregnancy outcomes. Expectant management in suspected cases may decrease negative appendectomy rates but can also lead to perforation. Computed tomography and MRI ought to be considered if ultrasonography is inconclusive. Tocolytic regimens can be administered to prevent threatened preterm labor. Obstetric indications were valid for delivery mode.Amaç: Gebeliğinde apendektomi yapılan hastaların gebelik sonuçlarının değerlendirilmesi. Gereç ve Yöntemler: 2010-2014 yılları arasında apendektomi yapılan hastalar retrospektif olarak incelendi. Tüm hastaların gebelik sonuçları üniversite kayıt sistemi ve telefon görüşmeleri ile takip edildi. Hastalar yaş, gebelik yaşı, klinik ve laboratuvar muayeneleri, görüntüleme çalışmaları, acil servis ve operasyon arasındaki ortalama zaman, ortalama operasyon süresi, gebelik sonucu ve apandiksin patoloji sonucuna göre değerlendirildi. Bulgular: Otuz dokuz hasta çalışmaya dahil edildi. Otuz dokuz hastanın 16’sı ilk, 15’i ikinci ve 8’i gebeliğin üçüncü trimesterindeydi. Üç hastaya laparoskopik apendektomi kalanlarına laparatomi yapıldı. Apendiksin patolojik değerlendirilmesinde, yedi hasta (17%) normal apendiks, dört hasta perfore apendiks, bir hasta nöro-endokrin tümor ve kalanları apandisit saptandı. Operasyon sonrası iki missed abortus meydana gelirken kalanları canlı doğum yaptı. Bunlardan altısı preterm ve otuz biri term doğum yaptı. On iki hasta vajinal yolla ve kalanları sezaryen yoluyla doğurtuldu. Yirmi hasta gebeliğin birinci yarısında (grup 1) ve 19 hasta gebeliğin ikinci yarısındaydı (grup 2). Gruplar arasında operasyon zamanı ve acile kabul ile operasyon arasındaki ortalama zaman aralığı açısıdan anlamlı farklılık yoktu. Sonuç: Gecikmiş operasyon ve negatif apendektomi olumsuz gebelik sonuçlarına neden olabilir. Şüpheli olgulardaki izlem tedavisi negatif apendektomi oranlarını düşürebilir; ancak aynı zamanda perforasyona neden olabilir. Bilgisayarlı tomografi ve manyetik rezonans görüntüleme, ultrasonografinin net olmadığı zaman düşünülmelidir. Erken doğum tehditini önlemek için tokolitik rejimler uygulanabilir. Doğum şekli için obstetrik endikasyonlar geçerlidir

Duodenal Duplication Cyst with Recurrent Acute Pancreatitis: Report of a Case

Introduction:Duplication cyst can be occurred in any level of GI tract but the duodenal cysts are extremely rare. Most of the duplication cysts are detected in children. Duodenum duplication cysts are difficult to diagnose, as the presenting symptoms are nonspecific and are closely related to the type, size and location of the lesion. Both CT imaging and MRI can adequately identify a duodenal duplication cyst.Presentation of the case: We report an adult with recurrent episodes of acute pancreatitis who was diagnosed with ERCP. With the diagnosis of duodenal duplication cyst, we planned to perform surgical resection of the cyst.Conclusions: The surgical intervention for duodenal duplication cyst includes complete or partial surgical resection of the cyst. The location of the cysts in relation to the duodenum, especially to the ampulla, is important to determine the treatment strategy. Alternatively, duodenum duplication can be safely and effectively treated by different endoscopic interventions

Pregnancy Outcomes and Surgical Management of Pregnancy Complicated By Appendicitis: Obstetrician View

Objective: To evaluate the pregnancy outcomes of patients who underwent appendectomy during pregnancy. Materials and Methods: Patients who underwent appendectomy between years 2010 and 2014 were retrospectively evaluated. All patients’ pregnancy outcomes were followed-up by using university registry system and telephone interview. Patients were evaluated regarding age, gestational age, clinical and laboratory examinations, imaging studies, mean time interval between emergency department and operation, mean operative time, pregnancy outcome and pathologic results of the appendix. Results: Thirty-nine patients were included in the study. Sixteen of 39 patients were in the first, 15 of them in the second and 8 of them were in the third trimester of the pregnancy. Three patients underwent laparoscopic appendectomy and the rest underwent laparotomy. In pathologic evaluation of the appendix, seven patients (17%) had normal appendix, 4 patients had perforated appendix, one patient had neuro-endocrine tumor and rest of the patients had appendicitis. Two missed abortion occurred after operation, rest of the patients had live birth. Six of them were preterm and 31 had term birth. Twelve patients delivered through vaginal birth and the rest via caesarean section. Twenty patients were in the first half of the pregnancy (group 1) and 19 patients were in the second half of the pregnancy (group 2). There were no significant differences between the groups in operation time and mean time interval between emergency administration and operation. Conclusion: Delayed operation and negative appendectomy can cause adverse pregnancy outcomes. Expectant management in suspected cases may decrease negative appendectomy rates but can also lead to perforation. Computed tomography and MRI ought to be considered if ultrasonography is inconclusive. Tocolytic regimens can be administered to prevent threatened preterm labor. Obstetric indications were valid for delivery mode