Does Mesh Application by Using Inside-Out and Outside-In Techniques during Transobturator Tape Surgery Change the Success?

Aim: This study aimed to evaluate the effect of transobturator tape (TOT) surgery, which is performed in the treatment of stress urinary incontinence (SUI) in women, using the inside-out or outside-in technique on the success of the surgery. Material and Methods: Sixty-five women diagnosed with SUI and for whom it was decided to perform TOT surgery were included in this prospective randomized study. Participants were divided into two groups, 32 women underwent TOT surgery using the inside-out technique and 33 women underwent TOT surgery using the outside-in technique. The surgical data of patients, the 3-month incidence of complications, pre-, and postoperative scores of the incontinence impact questionnaire (IIQ-7), and the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) were recorded. Objective, subjective, and inadequate treatment rates were determined for the evaluation of the success of the treatment. Results: When the two groups were compared, there was no statistically significant difference in terms of age, body mass index, parity, menopause status, duration of incontinence, and preoperative IIQ-7 and ICIQ-SF scores. There were no statistically significant differences between surgical durations, length of hospital stay, early surgical complications, and postoperative 3rd month IIQ-7 and ICIQ-SF scores. There were no statistically significant differences between the two groups in terms of objective, subjective, and inadequate treatment rates. Conclusion: TOT surgery is successful with both techniques in patients with SUI. Choosing the technique with which the surgeon is experienced and feels most confident will increase the success of TOT surgery regardless of the technique

Kalıcı yapıtlar bırakan bir müzik adamıydı

Taha Toros Arşivi, Dosya No: 259-Melih Kiba

Yttrium-90 radioembolization for the treatment of unresectable liver cancer: Results of a single center

Objective: To determine the effects of yttrium-90 (Y-90) resin microsphere radioembolization therapy on patients with unresectable liver cancer who do not benefit from chemotherapy. Methods: Fifty-five patients underwent radioembolization therapy included in the study whose had unresectable primary or metastatic liver cancer originating from the gastrointestinal tract. Three were excluded from the study after pre-evaluation angiography. Thirteen (23.6%) of the remaining 52 patients had hepatocellular carcinoma and 39 (76.4%) had metastatic liver cancer. Fifty-two patients underwent Y-90 radioembolization treatment. Each patient's response to the administered treatment was evaluated using the Response Evaluation Criteria in Solid Tumors (RECIST) and the overall probability of survival was displayed graphically by the Kaplan-Meier method. Results: After Y-90 therapy, 47 patients were follow-up. While 57% of the patients responded to treatment as clinical benefit, the disease progressed in 43%. The median hepatic progression-free survival time of the patients was 3.4 months (95% confidence interval (ci):1.4-5.3) and the overall survival time was 11.3 months (95%, CI:8.7-14.03). Conclusion: This study emphasizes that Y-90 resin microsphere radioembolization treatment is effective in patients with unresectable liver cancer

Elli beş yaşındaki bir kadında ki-67 ekspresyonu olmamasının düşük malign potansiyeli yansıttığı muhtemel olarak wolffian kaynaklı dişi adneksial tümör

Female adnexial tumors of probable Wolffian origin (FATWO) are rare tumors derived from the remnants of the mesonephric duct. These tumors generally exhibit a low malignant potential, but recurrence and or metastasis is possible during the course of the disease according to the tumors’ possible malignant potential. We report a case of FATWO without estrogen and progesterone receptors and with negative immunostaining for Ki-67 (a proliferation marker) as a probable low-malignant-potential tumor. A 55-year-old woman presented with a complaint of heavy menstrual bleeding and pelvic pain. Preoperative ultrasonographic evaluation revealed an intramural uterine leiomyoma of 4 cm in diameter and a right adnexial solid mass measuring 5 cm in diameter. Following total abdominal hysterectomy and bilateral salpingo-oophorectomy, immunostaining based on the labeled streptavidin-biotin method was performed on sections from representative blocks of paraffin-embedded tissues sampled from the mass, revealing a low mitotic index with negative Ki-67 immunostaining. Immunohistochemical staining with promising new markers and pathological investigation of the entire tumor are needed to determine the malignant behavior of an individual FATWO. Ki-67 is a helpful marker for determining Wolffian duct tumors’ potential malignant behavior

The outcomes of surgical treatment modalities to decrease "near miss" maternal morbidity caused by peripartum hemorrhage

BACKGROUND: The treatment of patients with peripartum hemorrhage is unfortunately characterized by inadequate treatment that does not adhere to standard therapeutic measures. AIM: Assessment of different management strategies among patients with severe hemorrhage, particularly the ones with "near-miss" maternal morbidity and mortality to establish clinically useful guidelines for the prevention and management of peripartum hemorrhage. PATIENTS AND METHODS: In this study, the medical records of 458 patients who have experienced peripartum hemorrhage between March 2009 and March 2012 in a tertiary perinatal center were retrospectively reviewed. Specific surgical treatment modalities utilized to 61 patients with severe peripartum hemorrhage with respect to the procedure timing and effectivity were compared according to the outcomes and efficiency. RESULTS: Sixty-one patients who have been diagnosed as severe peripartum hemorrhage have been included to the study. Six (75%) of the 8 patients who were treated with B-Lynch brace suture for uterine atony and 9 (60%) of the 15 patients who were treated with the Bakri balloon tamponade system for uterine atony or placenta accreta required hysterectomy following the initial therapeutic measures. The patients who have been treated with bilateral hypogas-tric artery ligation and B-Lynch brace suture or Bakri balloon uterine tamponade system were less likely to need a complementary hysterectomy for definitive treatment of peripartum hemorrhage when compared with patients treated with either B-Lynch brace suture or Bakri uterine tamponade balloon system alone. CONCLUSIONS: The efficiency of B-Lynch compression brace sutures and the Bakri balloon uterine tamponade system is unpredictable in terms of the need for hysterectomy for peripartum hemorrhage patients diagnosed as either uterine atony or placenta previa. Regardless of the initial diagnosis, these modalities seem to be more effective in alleviating peripartum hemorrhage when accompanied by hypogastric artery ligation

Prevention of adhesion formation in wistar-albino rats by increased bowel movements achieved with oral ricinus oil use for 8 days postoperatively: an experimental study

Objective: Adhesion formation frequently occurs after abdominopelvic surgery and can cause significant morbidity for patients. Meticulous hemostasis, minimal access surgery and utilization of surgical adjuvants intraoperatively are clinically useful measures to minimize adhesion formation. We investigated the clinical efficiency of oral Ricinus oil treatment for 8 days postoperatively to decrease adhesion formation in this case-control study in a rat model. Study design: Following computer-generated randomization, 24 female Wistar-albino rats were operated on, with 10 standard cautery lesions on the right uterine horn and two simple suture lesions on left uterine horn generated with absorbable material. Half (n = 12) the rats received 0.13 g (0.2 ml) Ricinus oil emulsion (40 g/60 ml) via the oral route during the first 8 days postoperatively, and the remaining rats (n = 11) were considered as controls. The extent, severity, degree, total adhesion scores and histopathological features of the adhesions were the main outcome measures. Results: The degree and total adhesion formation scores in the Ricinus oil group and control group revealed significant differences in adhesion extent and severity. The total adhesion scores of the Ricinus oil and control groups were 3.00 +/- 2.21 and 5.18 +/- 2.78 respectively (P 0.05). Conclusions: Ricinus oil treatment following abdominopelvic surgery for the 8-day period that covers the completion of tissue healing process may be a promising, cheap and cost-effective treatment strategy for patients. (C) 2012 Elsevier Ireland Ltd. All rights reserved

Squatting Facet: A Case Study Dilkaya and Van-Kalesi Populations in Eastern Turkey

Anomalies of the skeleton provide information on living conditions, cultural structure and health problems in ancient societies. Squatting facet is a kind of anomaly that forms on the surfaces where the tibia and talus articulate is the squatting facet states the daily activities and living style of the society. The aim of this study is to learn the daily activities of the medieval societies in the Van region through studying of squatting facets. In this study, adult skeletons from Dilkaya and Van Kalesi-Eski Van Şehri societies dating to the Medieval Age were investigated (65 tibia and 82 tali from Dilkaya, 61 tibia and 52 tali from Van Kalesi-Eski Van Şehri). The lateral squatting facet had high ratios in both societies. The tibia lateral squatting facet found on females and males of Dilkaya was 97.2% and 96.9%, respectively, and on females and males of Van kalesi Eski Van Şehri was 87.5% and 89.2 %, respectively. The talus lateral squatting facet found on females and males of Dilkaya was 72.1% and 51.3%, respectively, and on females and males of Van kalesi Eski Van Şehri was 91.2% and 83.7%, respectively. The results provide an opportunity to study the relationship between past and modern population, and also describe the daily activity of life and cultural structure

COVİD-19 PANDEMİSİ İŞE YENİ BAŞLAYAN HEMŞİRELERİN MESLEĞE ADAPTASYONLARINI VE İŞ MOTİVASYONLARINI NASIL ETKİLEDİ? HEMŞİRE DENEYİMLERİ: FENOMENOLOJİK BİR ÇALIŞMA

Amaç: Bu çalışma COVİD-19 pandemisi sürecinin işe yeni başlayan hemşirelerin mesleğe adaptasyonlarını ve iş motivasyonlarını nasıl etkilediğini derinden incelemek amacıyla yapılmıştır. Yöntem: Bu çalışma nitel araştırma modelinin durum çalışma deseni kapsamında görüşme yöntemi kullanılarak yapılmıştır. Veriler yarı yapılandırılmış görüşme formu aracılığıyla toplanmıştır. Bulgular: Pandemi sürecinde işe başlayan hemşirelerin yoğun çalışma saatleri, koruyucu ekipman sıkıntısı, günlük streslerinde artış, kişisel sağlıkları ve sevdiklerinin risk ile karşı karşıya kalması gibi sorunlar yaşadıkları ve bu yaşanan sorunların hemşirelerin mesleğe adaptasyonlarını ve motivasyonlarını olumsuz yönde etkilediği belirlenmiştir. Sonuç: COVID pandemisinin işe yeni başlayan hemşirelerin adaptasyon ve motivasyon süreçlerinin olumsuz etkilediği görülmüştür

Diagnostic value of CA 19-9 in pregnancies complicated by spinal neural tube defects: a preliminary study

Objectives: Various physiological and pathological conditions can induce significant variations in plasma concentrations of tumor markers, such as CA 19-9, which is present in the serum and amniotic fluid of pregnant women. Herein, we aimed to determine the clinical importance of maternal serum CA 19-9 levels in the diagnosis of neural tube defects (NTDs). Material and methods: A total of 100 women were included in this controlled cross-sectional study. Thirty-three patients whose pregnancies were complicated by isolated meningocele or meningomyelocele constituted the study group, whereas 33 normal, healthy pregnant women constituted the control group, and 34 age- and body mass index (BMI)-matched non-pregnant women were chosen for the validation group. Results: The mean maternal serum CA 19-9 levels were 17.2 ± 17.0 IU/mL, 7.1 ± 5.9 IU/mL, and 4.7 ± 3.6 IU/mL in the study, control, and validation groups, respectively (p < 0.001). ROC analyses showed that elevated CA 19-9 values may predict NTDs (p < 0.001). The cut-off value for CA 19-9 was found to be 9.6 IU/mL at 70% (51%–84%, 95% CI) sensitivity and 84% (74%–92%, 95% CI) specificity. Conclusions: CA 19-9 may be a promising noninvasive marker for NTDs. Further studies are needed to reveal the clinical applicability and diagnostic potential of maternal serum CA 19-9 levels in the identification of NTDs