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Objective: Spontaneous subarachnoid hemorrhage (sSAH) is a significant disease requiring urgent intervention. It may develop because of the rupturing of intracranial aneurysms and has high mortality and morbidity rates. This study was conducted at a hospital that serves as a reference center in the region in which it is located with the aim of evaluating patient characteristics, patient preferences, and complication management among patients with aneurysmal subarachnoid hemorrhage (aSAH) and presenting the results of these intracranial aneurysm clipping surgeries. Methods: Cases of 261 patients who were admitted with a diagnosis of sSAH were retrospectively examined. Subsequently, 107 patients with aSAH who were treated with 117 microsurgical aneurysm clippings were included in the study. The effects of patient demographics, Glasgow coma scale (GCS) scores, clinical World Federation of Neurological Surgeons scale and Hunt/Hess scale scores, and radiological modified Fisher scale gradings on modified Rankin scale (mRS) scores were examined. The management of complications such as rebleeding, cerebral vasospasm (CV), and delayed cerebral ischemia and surgical results were compared according to clinical and radiological data. Results: Of the patients, 52 were female (48%) and 55 were male (52%). Their average age was 50.4 years (range: 29-78 years), and the mean follow-up period was 13.8 months or 414 days (range: 30-892 days). The most common complaint of the patients at admission was headache (75.8%). Approximately 72.9% of patients had GCS scores of 14 or 15 at first admission. Twenty-eight (26.1%) patients had multiple aneurysms. Thirteen (12%) patients required a permanent cerebrospinal fluid drainage system. Rebleeding occurred in 7 (6.5%) patients before treatment. Thirty-six (33.6%) patients had a clinical CV. Delayed cerebral ischemia occurred in 25 (23.3%) patients. At the end of the mean follow-up period of 13.8 months, 82.3% of the patients had slight or no disabilities (mRS: 0-2), whereas 11.2% had severe disabilities (mRS: 3-5). Seven (6.5%) patients died, thus having an mRS score of 6 (exitus). Five (4.6%) patients had residual aneurysms. Six (5.6%) patients had parent or perforating artery occlusion. Conclusion: Poor prognosis at admission, rebleeding, and CV complications remain the most important causes of mortality and morbidity related to aSAH. Evaluations of the diagnoses, treatments, and complication management of patients with sSAH and the multidisciplinary approaches of experienced endovascular and neurosurgical teams are important for better understanding and management of this disease. [ABSTRACT FROM AUTHOR]

Copyright of Bagcilar Medical Bulletin / Bağcılar Tıp Bülteni is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Ankara University Faculty of Medicine / Ankara Üniversitesi Tip Fakültesi Mecmuasi is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objectives: The purpose of this study was to compare maternal and fetal outcomes between planned and emergent placenta previa operations. Methods: Patients who underwent cesarean section for placenta previa were included in the study between January 2018 and January 2019 at tertiary center, retrospectively. Patients were divided into two groups as planned cesarean delivery and emergent cesarean delivery. Maternal characteristics, maternal and neonatal outcomes were compared. Results: Of the 84 patients with placenta previa, 36 (43%) were in the planned group, and 48 (57%) were in the emergent cesarean delivery group. There were no significant differences in the transfusion rates, operation time, length of hospital stay, hemostasis procedures, intraoperative complications between planned and emergency deliveries. Lower birth weight and higher neonatal intensive care unit acceptance were detected in the emergent cesarean delivery group due to earlier gestational week of delivery (34±2.4 vs. 36±2.3 p < 0.001). There was no statistically significant difference in hysterectomy rates performed due to the placental accreata spectrum between the two groups. Conclusions: In conclusion, emergency cesarean delivery for women with placenta previa by an experienced multidisciplinary team in a tertiary center with adequate resources is not associated with increased maternal morbidity in terms of transfusion rate, hospital stay, and intraoperative complications. Planned cesarean delivery at 37 0/7 -37 6/7 gestational weeks may be considered in the absence of significant antenatal bleeding or other risk factors. [ABSTRACT FROM AUTHOR]

Objective: Cholangiocarcinomas (CC) are rare tumors that develop from the biliary tract and surgery is the gold standard for them. All efforts have been made by surgeons from past to present to obtain R0 resection. The aim of the study was to examine the surgical therapy of CCs, which we have applied various surgical treatments in our clinic in the last three years. Methods: Patients whose pathological examination yielded Hiler CC and underwent surgical operation at our clinic between February 2019 and February 2022 were retrospectively evaluated. Results: Twenty five patients were found suitable for the study. Nine were male and 16 were female, with a mean age of 61.72±11.12 (minimummaximum: 29-76) years. The overall morbidity rate in the postoperative period was 52%, and liver failure in the postoperative period was seen in 4 patients. Bile leakage developed in 2 patients. Portal vein thrombosis was detected in 2 patients and surgical site infection was detected in 5 patients. No mortality was seen in the intraoperative and postoperative periods. In the follow-up period, recurrence was observed in 3 patients and mortality was observed in 3 patients. Conclusion: Advanced surgical techniques have induced extended indications in surgery and reduced mortality and morbidity ratios, and oncologic outcomes were more acceptable than before. The most significant purpose is to perform R0 resection to maintain adequate remnant liver volume. Such complex surgeries require multidisciplinary treatment in specialized hepatopancreaticobiliary and liver transplant services to optimize surgical and oncological outcomes. [ABSTRACT FROM AUTHOR]

Copyright of Turkish Journal of Obstetrics & Gynecology is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: Late preterm infants are immature regarding respiratory, metabolic, neurological, and immunological features and have a high risk for morbidity and mortality. Therefore, it is aimed to draw attention to the problems that may develop in newborn care by scanning all hospitalization and mortality rates of late preterm infants. Method: In this retrospective study, late preterm infants hospitalized in a tertiary university hospital between January 1, 2007, and December 31, 2014, having the study admission criteria, were enrolled. Results: A total of 1,088 late preterm infants were included in the eight-year study period. According to their gestational weeks, the infants were divided into three main groups; 31.4% (n=342) were in group 1 (340/7-346/7), 30.6% (n=333) were in group 2 (350/7-356/7), 38% (n=413) were in group 3 (360/7-366/7). The most common causes for admission to the neonatal intensive care unit were hyperbilirubinemia, suspected sepsis and infections, respiratory morbidities, poor feeding, and hypoglycemia; reasons for rehospitalization included jaundice, infections, suspicion of sepsis, and poor feeding. In addition, neonatal transient tachypnea, apnea, hypoglycemia, early-onset sepsis, healthcare-associated infection were most common in those born at 34-346/7 gestational weeks; respiratory distress syndrome, pneumonia, late-onset sepsis were most frequently in those born at 35- 356/7 gestational weeks. Conclusion: As a result, late preterm infants are at risk for respiratory disorders, sepsis, jaundice, and metabolic problems; the need for intervention increases as gestational age decreases. The delivery timing should be planned with these problems in mind, and the follow-up and treatment of late preterm infants should be carried out accordingly. [ABSTRACT FROM AUTHOR]

Objective: Laboratory parameters may predict the severity and mortality of coronavirus disease-2019 (COVID-19). We investigated the relationship of laboratory findings obtained at admission and 72nd hour and mortality and morbidity of patients with pneumonia who were treated in two intensive care units. Materials and Methods: Chart data of 75 patients (March-May 2020) were retrospectively analysed. Patient characteristics and laboratory parameters were compared according to the presence of COVID-19 and mortality. Patients with COVID-19 were compared according to mortality and gender. Results: The mean patient age was 74.7±11.3 years. COVID-19 positivity was not associated with marked differences in laboratory values. Lung disease, bedridden status, worse renal function scores, and high C-reactive protein level was more often observed in non-survivors (p<0.05). A decline in D-dimer level was more apparent in survivors; the increase in ferritin and neutrophil-lymphocyte ratio was more apparent in non-survivors (not significant). Among patients with COVID19, women had higher mean platelet volume than men (p=0.033). The rise in ferritin level was more pronounced in men, whereas the rise in neutrophil-lymphocyte ratio and platelet-lymphocyte ratio was higher in women. Conclusion: In this geriatric cohort, chronic lung disease and bedridden status were the main determinants of mortality. Moreover, different patterns of inflammatory markers may help predict the severity of COVID-19. [ABSTRACT FROM AUTHOR]

Introduction: Newborns having a gestational age between 37 to 416/7 weeks are defined as term newborn. The aim of the study was to investigate the rates and causes of hospitalization, and the differences in neonatal morbidities between early-term and full-term infants as a single-center experience in our hospital. Materials and Methods: This retrospective study was carried out in a tertiary neonatal intensive care unit between January 2013 and December 2014. Maternal characteristics and comorbidities; neonatal characteristics, length of hospital stay, and neonatal morbidities were recorded. Primary outcome measure was need for neonatal intensive care unit (NICU) admission. Results: Maternal comorbidities, ceserean delivery, low birth weight, SGA and multiple gestations were found to be higher in early-term infants and earlyterm infants were at higher risk for respiratory morbidities, respiratory support requirement, hypoglycemia and intravenous antibiotic therapy. After multivariate logistic regression analyses, only higher risk for respiratory morbidity persisted (OR:1.28 [1.02-1.59]; p=0.02). In contrast to that, full-term infants was found to be at higher risk for hypernatremia compared to early-term infants. Conclusions: Early term birth is associated with a higher neonatal morbidity and NICU admissions, and gestational age is known to be the most important determinant of this situation. With advanced maternal care and better understanding of the factors causing early term birth will lead to prevention and successfull management of this risk group. [ABSTRACT FROM AUTHOR]

Copyright of Turkish Journal of Obstetrics & Gynecology is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: Postoperative morbidity may occur more in laparoscopic treatment of perforated appendicitis than simple appendicitis. In this study, we aimed to investigate the risk factors affecting the development of morbidity in laparoscopic treatment of perforated appendicitis. Method: The files of patients who underwent laparoscopic appendectomy due to perforated appendicitis were analysed retrospectively. Finding of perforation has been documented by surgeons who performed surgery. Information on the patients such as age, gender, Charlson Comorbidity Index (CCI), body mass index (BMI), ASA scores, symptom onset time, time between hospital admission and surgery, surgical findings, perforation sites, type of surgery, stump closure materials, white blood cell counts, pathology results and postoperative morbidities were recorded. Data were compared between patients with and without morbidity, and multivariate regression analysis of variables with significant p value was performed. Results: The rate of morbidity development in laparoscopic treatment of perforated appendicitis was 22.14% (66/298). In multivariate regression analysis, the onset of symptoms longer than 72 hours, proximal perforation, grade 5 diffuse peritonitis in surgical finding according to Disease Severity Score (DSS), conversion from laparoscopic to open surgery and gangrene or necrosis in histopathological finding were found to be effective risk factors in the development of morbidity. (p=0.013, odds ratio=1,455, p=0.010, odds ratio=2.009, p=0.002, odds ratio=2.648, p=0.014, odds ratio=6.537, p=0.003, odds ratio=1.843; respectively). Conclusion: The development of postoperative morbidity in laparoscopic treatment of perforated appendicitis is associated with late admission development of diffuse peritonitis, conversion to open surgery, proximal perforation and presence of necrosis. According to odds ratio, the risk factor with the highest probability of developing morbidity was found to be conversion to open surgery. We think that patients diagnosed with perforated appendicitis should be operated on as early as possible, routinely placing a drain should be avoided, and laparoscopic approach should be preferred as much as possible to reduce the morbidity rates. [ABSTRACT FROM AUTHOR]

Copyright of Turkish Journal of Obstetrics & Gynecology is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: Macrosomy is defined as birth weight being over 4000 grams. Neonatal complications are common in macrosomic infants. In this study, we aimed to compare macrosomic infants with normal weighed infants in terms of neonatal morbidities. Methods: Macrosomic infants born between 01.01.2015 and 31.08.2015 were included in the study. The study group consisted of 100 infants (group 1) with a birth weight above 4000 grams and the control group consisted of 100 infants (group 2) weighing between 2500-4000 grams. Antenatal, natal and postnatal data of macrosomic and normal weighed infants were recorded. Statistical analysis was performed using SPSS 22.0 for Windows. Results: Maternal age, macrosomic sibling history, prenatal body mass index (BMI), weight gain during pregnancy were found to be significantly higher in the macrosomic group (p=0.047, p=0.001, p=0.003, and p=0.007, respectively). Gestational week and male gender ratio of infants were higher in the macrosomic group. In the macrosomic group, 1-minute Apgar score was significantly lower, but there was no significant difference in 5-minute Apgar score. The rate of positive pressure ventilation was higher in the macrosomic group (p=0.04). The incidence of clavicle fracture, caput succadeneum and ecchymosis was higher in the macrosomic group (p=0.004, p=0.005 and p=0.022, respectively), but there was no significant difference in plexus brachialis paralysis and cephal hematoma. While hypoglycemia and pathological weight loss were significantly higher in the macrosomic group (p=0.03, p=0.038, respectively), there was no difference between the groups in terms of other variables. Conclusion: Maternal age, history of macrosomic birth, high prenatal BMI, excess weight gain during pregnancy and gestational diabetes in the mother constitute risk for macrosomic birth. Birth trauma, hypoglycemia and pathological weight loss are common in these infants. For this reason, it is very important to carry out the physical examination of macrosomic infants carefully after birth and to closely monitor them with blood sugar and weight control. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to determine the effect of a reduction in the cardiothoracic ratio (CTR) on mortality in newborns with pneumothorax. Methods: Newborns with pneumothorax, who were admitted to our neonatal intensive care unit, were included in the study. The cardiothoracic ratio was calculated by dividing the transverse cardiac diameter by maximum internal thoracic diameter. Results: Of 7909 infants admitted to our neonatal intensive care unit from September 2006 to September 2017, a total of 82 (1.03%) newborns had pneumothorax. Patients who died had a lower CTR than surviving patients (0.39±0.056 and 0.44±0.048, respectively; p<0.001). It was found that the cut-off value was 0.4, area under the curve (AUC) value was 0.79, sensitivity was 68%, specificity was 87.7%, positive predictive value was 70.8%, and negative predictive value was 86.2%. Low birth weight, preterm birth, low maternal age, presence of respiratory distress syndrome, need for resuscitation at birth, and invasive mechanical ventilation were found to be significantly associated with mortality. However, among overall significant parameters, CTR and implementation of resuscitation at birth were the independent prognostic factors determined by regression analysis (p=0.001 and p=0.036, respectively). Conclusion: A CTR below 0.4% can be considered an important parameter indicating an increased risk of mortality in newborns with pneumothorax. [ABSTRACT FROM AUTHOR]

Aim: The most effective treatment for lung cancer is surgery. Morbidity rates remained almost constant over the years. However, morbidity rates have started to decline with better management of preoperative and postoperative procedures. We examined the causes and results of postoperative morbidity and mortality after resection surgery by years. Methods: Anatomical lung resections performed in our clinic from January 2013 to December 2017 were retrospectively reviewed. Patients who underwent bilateral lung resections and those with comorbid infections, such as abscess and tuberculosis, were excluded. Results: A total of 907 patients were included in the study. 79% of the patients were male and the median age was 56 years. The increase in malignant pulmonary resection rates by years was statistically significant (p<0.001). It was found that video-assisted thoracoscopic surgery (VATS) lobectomy rates increased (p<0.001), thoracotomy lobectomy (p=0.006) and pneumonectomy rates decreased (p<0.001). The rates of atrial fibrillation, prolonged air leakage and pneumonia were statistically significantly decreased (p=0.004, p<0.001 and p<0.001, respectively) and no change was observed in mortality rates (p=0.123). Conclusion: Our study showed that postoperative morbidity was significantly reduced in lung cancer. A recent increase in VATS lobectomy procedures may have an effect on this result, however, the relationship was not statistically significant. Thus, the increase in the success rates can be attributed to the improved experience of the team in our hospital in years as well as being a specialty hospital for chest diseases and thoracic surgery. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Pediatric Emergency & Intensive Care Medicine / Çocuk Acil ve Voğun Bakım Dergisi is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Aim: The aim of this study was to evaluate the risk factors and maternal-perinatal outcomes in patients with placental abruption attending a non-tertiary center. Methods: Fifty-three patients with placental abruption and 147 individuals with non-placental abruption were compared retrospectively. Age, gravidity, parity, concomitant medical problems (preeclampsia, hypertension, and diabetes), previous history of cesarean section and presence of proteinuria were compared between the groups. Multiple regression analysis was performed to determine risk factors for placental abruption. A p value of less than 0.05 was considered statistically significant. Results: The incidence of preterm delivery, need for intensive care unit for the newborn, peripartum mortality and low Apgar score was higher in the group with placental abruption (p<0.05). The incidence of preeclampsia, longer length of hospital stay, complications (especially disseminate intravascular coagulation), proteinuria and blood product transfusion was higher in the placental abruption group (p<0.05). Previous cesarean delivery, preeclampsia, concomitant medical problems and proteinuria were the risk factors for placental abruption (p<0.05). Conclusion: Pregnancy-related hypertensive disorders and previous cesarean section increase the risk of placental abruption. Placental abruption is associated with serious maternal and perinatal morbidity. [ABSTRACT FROM AUTHOR]

Aim: Prematurity is an important health problem affecting all segments of society. In this study, we aimed to evaluate the level of awareness of prematurity and related problems. Materials and Methods: A questionnaire consisting of fifteen questions was administered to medical faculty students, pediatric residents, and to laypersons by face to face interviews. The questionnaire applied in the scope of the study had 8 open-ended questions and 7 “yes-no” questions. Results: Of the 150 people who answered the questionnaire, 92 were health workers and the remaining 54 were people from the public. The groups with and without health workers had a similar rate of awareness of the World Prematurity Awareness Day (58.7% vs. 58.6% respectively, p=0.30). All of the health care workers defined prematurity correctly while 89.7% of the laypersons gave the correct definition (p<0.05). People from the public expected the survival of babies with higher birth weight and gestational age and this group was less informed about the short and long-term problems related to prematurity. In both groups, the awareness of physicians specializing in newborn care was low (17.4% vs. 13.8%, p=0.13). The level of awareness of the shortage of specialized physicians and nurses in neonatal care was significantly lower among laypersons than that of health care workers (p values <0.05). Conclusion: Although our study population knew what prematurity was, they lacked knowledge about the complications of prematurity, and the quality and adequacy of the health care teams involved in the care of premature babies. [ABSTRACT FROM AUTHOR]

Amaç: Sistemik skleroz (SSk) hastalarında organ hasarının deri tutulumu tipine göre farklarının ortaya konması ve takipteki değişiminin değerlendirilmesidir. Yöntem: SSk sınıflandırma kriterlerini karşılayan, ≥12 ay süreyle takibi olan 210 hasta (%91,9 kadın) retrospektif incelendi. Tanıda ve son vizitte hasar skoru [Scleroderma Clinical Trials Consortium Damage Index (SCTC-DI)] hesaplandı, sınırlı veya yaygın deri tutulumuna göre [sdSSk (%76,2) veya ydSSk (%23,8)] gruplandırılarak karşılaştırıldı. Hasar gelişimi ile ilişkili faktörler değerlendirildi. Bulgular: Ortalama yaş 52,9±12,3, takip süresi 101,1±70,6 ay ve Raynaud dışı semptom süresi 12,3±7,3 yıldı. Eklem kontraktürleri, BMI/kilo kaybı ve O2 tedavisi ihtiyacı takipte, HRCT'de >%20 tutulum ve eşlik eden FVC<%70 ise başlangıçta ve takipte ydSSk'de daha sıktı (Tablo 1). Total hasar skorları başlangıçta ve takipte ydSSk'de daha yüksek bulundu (3,1±2,8'e karşın 1,9±2,5, p=0,004 ve 9,7±5,9'a karşın 5,8±4,6, p<0,000) (Şekil 1). sdSSk varlığı başlangıçta respiratuvar ve kardiyovasküler (KVS) hasar, takipte ise yüksek hasar gelişimine karşı koruyucu bulundu. ydSSk'de şiş (puffy) parmakların varlığı respiratuvar hasar, takip süresi >5 yıl olması ise takipte artan kas-iskelet-deri ve respiratuvar hasar ile ilişkiliydi. sdSSk'de; takip süresi >5 yıl olması takipte artan kas-iskelet-deri, dijital ülser (DÜ) ve MKF proks.de deri kalınlaşması periferik vasküler, interstisyel akciğer hastalığı (İAH) ve anti-Scl70 varlığı respiratuvar hasar ile, İAH, DÜ varlığı ve takip süresi >5 yıl olması GİS hasarı ile ilişkili bulundu. sdSSk'de DÜ ve İAH varlığı takipte orta hasar (6-12 puan), telanjiektazi ve PAH varlığı ise yüksek hasar (≥13 puan) ile ilişkiliydi (Tablo 2). Hastaların %4,3'ü (n=9) takipte hayatını kaybetti. Başlangıçta ve takipte KVs. hasar mortalite ile ilişkili bulundu (%55,6'e karşın %5,5, p<0,000 ve %55,6'ya karşın %15,4, p=0,009). Sonuç: SSk hastalarında, yaklaşık 8 yıllık takip sırasında, organ hasarı sıklığının ve şiddetinin her iki deri tutulumu alt tipinde arttığı görüldü. İAH, DÜ, telanjiektazi ve PAH varlığı ve takip süresinin uzun olması hasarla ilişkili faktörler olarak öne çıktı. KVs. hasar mortalite ilişkili bulundu. Hasar bakımından riskli grupların tanımlanmasının, erken tedavi ile sağkalımda iyileşme sağlayabileceği düşünüldü. [ABSTRACT FROM AUTHOR]

Aim: Our aim was to evaluate morbidity and mortality rates, and relevant effective factors among babies delivered in our hospital between January 2009 and December 2011. Methods: We evaluated the neonatal care unit data on mortality and morbidity among babies delivered between January 1st 2009 and December 31st 2011, and analyzed epidemiological data of these babies born at gestational age of >22 weeks with a birth weight above 500 gr. Results: One thousand nine hundred five live babies and 32 stillbirths were delivered in the year 2011. Twelve babies died during early neonatal period. The rates of perinatal and early neonatal mortality, and stillbirth were found to be 2.27%, 0.61%, and 1.65%, respectively. The causes of perinatal death were stillbirths (68.1%), congenital malformations (11.3%), prematurity-related factors (9%), and other etiologies (11.6%) in order of decreasing frequency. The most frequent indications for hospitalizations were neonatal hyperbilirubinemia (35.3%), and suspected sepsis (13.4%), and other etiologies. Our median mortality rate among babies delivered before the 32nd weeks of gestation within three years was 14.5%. Conclusion: Providing adequate antenatal care for pregnants, realization of deliveries under optimal conditions, and delivery of sufficient postnatal care will dramatically decrease neonatal mortality rates. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Pediatric Emergency & Intensive Care Medicine / Çocuk Acil ve Voğun Bakım Dergisi is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: In our study, it was aimed to investigate the relationship between RIFLE classification and the risk factors such as acute renal failure incidence, kidney failure in terms of comorbid conditions, critical conditions before and after hospitalization, if any, genetic predispositions, drug use, scores on administration day to the hospital and mortality in intensive care unit patients. Material and Method: A total of 200 patients hospitalized in anesthesiology and reanimation intensive care unit (ICU) between March 1, 2012 and March 31, 2013 were prospectively evaluated. The patients with a history of established chronic renal failure or hemodialysis, under 18 years of age and the patients hospitalized in ICU less than 48 hours were excluded. Data of the patients regarding age, gender, body mass index (BMI), diagnosis at the hospitalization, history of any operation, smoking status, medications, durations of ICU stay and mechanical ventilation, SOFA and APACHE II scores on the 1st day, the worst RIFLE score during the hospitalization, medical status at the end were recorded. The patients whom creatinine levels were not increased significantly and/or GFR and urine output were not decreased were accepted as out of RIFLE. Results: Age, BMI, diagnosis at the hospitalization, smoking status, presence and duration of chronic disease, analgesia, antibiotic and diuretic usages, presences bleeding and hypotension episodes, mechanical ventilation and total ICU hospitalization durations, SOFA and APACHE II scores on the 1st day were found to be significantly related to RIFLE classification. Gender, history and type of operation, type of chronic disease, glucocorticoids, HES, radiocontrast drug administration, renal stone disease, familial renal disease history were not found significantly related. Increased RIFLE scores were found to be related with increased mortality. Conclusion: We concluded that recognizing the factors leading to renal injury/failure and usage of RIFLE classification in daily care of patients are important to decrease mortality and morbidity of ICU patients by increasing the awareness. [ABSTRACT FROM AUTHOR]

Objective: We aimed to examine the effect of admission time from emergency department (ED) to intensive care unit (ICU) on mortality, the length of ICU and hospital stays in intoxication patients. Material and Method: A retrospective medical record review of 129 patients were performed. Patients were divided into 2 groups based on admission time from ED to ICU: group I (≤2 hours) or group II (>2 hours). Patient demographic and clinical data were recorded. Results: There were 84 female and 45 male patients whose mean age was 30.48±13.57 years. The most common causes of intoxication were tricyclic antidepressants (34.5%), paracetamol (17.4%) and carbon monoxide (11.6%). At the time of ED presentation, 26.8% of patients had a Glasgow Coma Score (GCS) 8 or below. The admission time from ED to ICU was ≤2 hours in 44 patients (37.9%) and >2 hours in 85 patients (62.1%). Both groups were comparable in demographics, the causes of intoxication and the time of ED presentation. There were no statistically signif cant difference between group I (≤2 hours) or group II (>2 hours) according to the time of entubation, the length of ICU and hospital stays and mortality. The only parameter that was found to have a statistically significant effect on mortality was GCS at the time of ED presentation (p<0.05). Conclusion: In our study, expedited admission to ICU (≤ 2 hours) did not cause any statistically significant difference on outcome in intoxication patients. The only parameter that was found to have a statistically significant effect on mortality was GCS at the time of ED presentation. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study was to examine the risk factors for postoperative complications and mortality among patients with rectal cancer when treated by surgery in a non-specialized hospital. Methods: A retrospective review of all patients who underwent surgery for pathologically confirmed rectal cancer at our clinic between January 1999 and 2008 was conducted. A consecutive series of 75 primary rectal cancer patients was evaluated. Results: The factors that affected mortality and morbidity were advanced age, low albumin level, perioperative blood transfusion, and postoperative intensive care support (p<0.05). The factors that affected mortality were the presence of systemic disease, anemia, the need for preoperative nutritional support, and postoperative complications (p<0.05). Gender, smoking habit, American Society of Anesthesiologists (ASA) score, cleansing of the bowel, diverting ileostomy, and tumor stage did not demonstrate a statistically significant relationship with mortality and morbidity (p>0.05). Conclusion: Tumor-related factors and choice of procedure are not independently associated with mortality and morbidity after surgery for rectal cancer. Therefore, patient selection for surgery should focus on the clinical status of the patients. In spite of the fewness of the cases, our results are similar to those of specialized hospitals for rectal cancer surgery, i.e., the clinical status of the patients is the leading cause of mortality and morbidity. [ABSTRACT FROM AUTHOR]

Objective: In this study, we aimed to investigate the effective factors on morbidity due to small intestine penetrating injuries. Material and Methods: Between January 2006 and December 2010, 114 patients who underwent surgery due to penetrating small intestine injuries were retrospectively reviewed. Results: The mean age was 32.8±12.3years (15-77), and there were 96 patients, (84.2%) male and 18 (15.8%) female patients. The most common etiologic cause was gun-shot injuries (66.7%). Fifty-one (44.7%) patients had isolated small intestine injuries and 63 (55.3%) had small intestine and additional organ injuries. Colon was the most common additional organ injured (66.7%) Most commonly, 68 (59.7%) patients underwent primary suture. T Postoperative morbidity occurred in 30 patients (25%) and the most common complication was wound infection. The morbidity was significantly higher in the patients with small intestine and additional organ injuries (p=0.006). The morbidity was higher in patients who exhibited signs of peritonitis (p=0.048) and had colonic injuries (p=0.002). The number of blood transfusions was effective in mortality (p<0.001). The mean length of hospital stay was 6.9±2.9 (1-21) days, significantly longer in the patients who developed morbidity (p=0.002). Seven (6.1%) patients died due to hemorrhage in 6 patients and anastomotic leakage in 1 patient. Conclusion: Small intestine injuries significantly increase the postoperative morbidiy when accompanied by additional intraabdominal organ injuries, especially the colon. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to investigate the factors affecting morbidity and mortality by evaluating the demographical, etiological and clinical characteristics of patients with mechanical bowel obstruction.Materials and Methods: Data for 171 mechanical bowel obstruction patients were evaluated retrospectively. The patients were assessed in mortality (n=21), morbidity (n=55) and recovery (n=95) groups. Results: Of the patients, 70% were men; and 27.4% were ?55 years of age. While gender had no impact on mortality and morbidity, age did. Adhesion was observed to be the leading cause (45.6%) of mechanical bowel obstruction,followed by incarcerated hernia in 17.5%. Intestinal necrosis was associated with mortality but not with morbidity. Late presentation and multiple concomitant diseases had no impact on mortality but were associated with morbidity. The presence of a concomitant disease and leukocytosis or leukopenia had a significant impact on both mortality and morbidity. Conclusion: Older age and presence of a concomitant disease, leukocytosis or leukopenia were established to be associated with mortality and morbidity. Late presentation and multiple concomitant diseases were associated only with morbidity. The presence of intestinal necrosis was associated only with mortality. Establishing the risk factors well will be beneficial in lowering the incidences of morbidity and mortality. [ABSTRACT FROM AUTHOR]

Herein we report 2 cases of malignant lymphoma associated with Behçet's disease. Case 1, a 53-yearold man, was diagnosed as Behçet's disease at the age of 26 years, and was treated with cyclophosphamide and prednisolone. At 45 years of age, bilateral enlarged lymph nodes were observed in the patient's neck. Evaluation of a lymph node biopsy specimen showed Hodgkin's disease and chemotherapy was administered. Due to disease recurrence 7 years later, chemotherapy and radiotherapy were administered. Case 2, a 67-year-old male, was diagnosed as Behçet's disease at age 44 years and began colchicine treatment. At 60 years of age a mass in his left tonsillar fossa was noted. Evaluation of a left tonsil biopsy specimen showed malignant lymphoma. Radiotherapy and chemotherapy were subsequently administered. At the time this report was written both patients were disease-free. Malignant lymphoma associated with Behçet's disease is rare-only 17 cases have been published. In addition to the presented cases, the literature regarding malignant lymphoma associated with Behçet's disease is reviewed. [ABSTRACT FROM AUTHOR]

Objective: Approximately 25% of patients undergoing lung resection inevitably develop postoperative complications, most of which are being cardiopulmonary in origin. Frequency of these complications can only be reduced by predicting such cases that carry higher risk and taking preventive measures accordingly. Thus, exercise tests that allow evaluation of both respiratory and cardiac performance are being carried out more frequently in recent years. The purpose of this study was to evaluate the value of both stair climbing and 6-minute walking tests in predicting postoperative complications. Material and methods: Twenty-five consecutive patients in whom 17 (68%) of them were male with a mean age of 53,1±18,3 and undergoing lung resection were enrolled in this prospective study. All cases also underwent stair climbing and 6-minute walking tests irrespective of the results of their conventional spirometry or arterial blood gas analysis. Measurements of respiratory rate, systemic blood pressure and pulse rates before and at 1, 3, 5 and 10th minutes after both tests and 6-minute walking distance were recorded in a prospective database. Twenty (80%) patients were operated for carcinoma of the lung. Fifteen patients (60%) underwent lobectomy, 8 (32%) pneumonectomy and 2 (8%) wedge resection. Any cardiopulmonary complication occurring within the first 30 days after operation was considered as primary outcome of the study. Results: Six patients (24%) developed complications in the postoperative period. Of them, 3 patients had atelectasis and other 3 patients experienced fast atrial fibrillation requiring treatment. Development of a postoperative complication was not related to either gender, changes in systolic and diastolic blood pressures or breathing and pulse rates. Univariate analysis revealed that the mean heart rates at 3rd and 5th minutes were significantly higher (p=0,026 and p=0,035, respectively) in patients with complications. Heart rates of >120 min-1 and >115 min-1 at 3rd and 5th minutes after stair climbing test and a diastolic blood pressure of <65 mmHg at the end of 6-minute walking test were found to be good independent predictors for the development of a post-resection complication in a multivariate analysis (β=0,92 and p<0.03; β=0,91 and p<0.04; β=-0,88 and p<0,05, respectively). Conclusions: Although our study population was in a low risk group for cardiovascular and pulmonary diseases, quarter of all patients developed a postoperative cardio-pulmonary complication, thus emphasizing the importance of exercise testing in the detection of higher risk patients. Due to ease of their application and lack of need for sophisticated equipment, we therefore recommend these two tests to be performed even for low risk patients undergoing lung resection. [ABSTRACT FROM AUTHOR]

Giriş: Bu çalışmanın amacı, D vitamini seviyesinin, hastanede yatan toplum kökenli pnömoni hastalarının mortalitesi ve hastalık şiddeti ile ilişkisini belirlemektir. Gereç ve Yöntem: Bu retrospektif çalışmada, 2018-2019 döneminde hastanemiz yoğun bakım ünitesinde tedavi edilen 50 toplum kökenli pnömoni hastası incelendi. Demografik ve antropometrik özellikleri kaydedildi. D vitamini seviyesi, ELISA ile serum 25-hidroksivitamin D ile ölçülerek belirlendi. Bulgular: Hastaların D vitamin düzeyleri incelendiğinde; %46'sının (n=23) ciddi eksik, %22'sinin (n=11) eksik, %16'sının (n=8) yetersiz, %16'sının ise (n=8) yeterli düzeyde olduğu tespit edilmiştir. Serum D vitamini düzeyleri yeterli olan hastaların hepsi servise çıkarılmıştır. Serum D vitamini düzeyleri yetersiz olan grupta ise 16 (%38,09) hasta eks olmuştur. Serum D vitamini düzeyleri ile hastaların tedavi sonuçları arasında istatistikçe anlamlı bir farklılık saptanmıştır (p=0,043). Vitamin D seviyeleri azaldıkça yoğun bakımda kalma süreleri uzamaktadır. Ciddi eksikliği bulunan 9 hasta (%39,1) 14 gün ve üzeri yoğun bakımda kalırken eksikliği bulunan 9 hasta (%34,8) 7-14 gün süre ile yoğun bakımda tedavi almıştır. Sonuç: Çalışmamız sonucunda; ciddi D vitamini eksikliği olan hastalarda yoğun bakım yatış süresi daha uzun, mortalite oranı daha yüksek saptandı. D vitamini konsantrasyonu hastanede kalış süresi ile negatif korelasyon göstererek sağlık hizmetleri üzerindeki mali yükü artırmaktaydı. D vitamini eksikliğinin önlenmesinin, toplum kökenli pnömoni mortalite oranını düşürebileceği sonucuna vardık. [ABSTRACT FROM AUTHOR]