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Aim: This study aims to analyze the experience of a tertiary health center about the complications of hysterectomy within a period of five years. Materials and Methods: This is a retrospective review of 1311 hysterectomies which were performed for both benign and malignant indications between 1 January 2017 and 1 January 2023. Results: Complications occurred in 218 patients (16.6%) and the mortality rate was 0.5% (n=6). The rate of conversion into laparotomy was 2.8%. Bladder injury, colon injury, ileus and incisional hernia were significantly more frequent in women who underwent laparotomy (p=0.007, p=0.026, p=0.027 and p=0.010 respectively). Logistic regression analysis indicated hysterectomy technique as an independent prognostic factor for its complications (p=0.001). Ureter injury, bladder injury and colon injury were significantly less frequent in patients who had hysterectomy for gynecological malignancy (p=0.001, p=0.001 and p=0.015 respectively). Hospital stay was significantly longer in patients undergoing hysterectomy for laparotomy and gynecological malignancy (p=0.001 for both). Conclusion: Minimally invasive techniques such as laparoscopy or vaginal approach should be attempted whenever it is possible and feasible. Performing hysterectomy for benign pathologies should not be considered as a distraction from meticulous work during the preoperative preparation and postoperative monitorization periods. Similar attention should be also paid to patients who have chronic diseases. [ABSTRACT FROM AUTHOR]

Copyright of Turkish Journal of Trauma & Emergency Surgery / Ulusal Travma ve Acil Cerrahi Dergisi is the property of KARE Publishing 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 Praxis of Otorhinolaryngology / Kulak Burun Boğaz Uygulamaları is the property of Official Journal of ENT-HNS Society of Istanbul 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.)

Trois études prospectives randomisées ont démontré l'efficacité de l'autogreffe de cellules souches hématopoïétiques (CSH) dans la sclérodermie systémique (ScS) sur la survie. Ces résultats incitent à proposer cette thérapeutique à des patients qui ont maladie rapidement évolutive et qui ont des symptômes précoces mais pas d'atteinte viscérale évoluée. L'autogreffe de CSH peut ainsi être discutée chez les patients atteints de ScS cutanée diffuse avec une durée de la maladie depuis les premières manifestations viscérales (cutanées, cardiaques, digestives, pulmonaires, ou rénales) hors phénomène de Raynaud de moins de 5 ans. Pour autant, les indications de l'autogreffe de CSH dans la ScS validées à l'échelon Européen et dans le protocole national de diagnostic et de soins (PNDS) sont plus larges et certaines de ces indications sont discutables, en particulier chez les patients ayant une pneumopathie interstitielle diffuse aggravative. Ces indications sont discutées de façon argumentée, en prenant en compte le niveau de preuve et la toxicité de l'autogreffe de CSH. Three prospective randomized studies have demonstrated the efficacy of autologous hematopoietic stem cell (HSC) transplantation in systemic sclerosis (SSc) on survival. These results encourage us to offer this therapy to patients who have a rapidly progressive disease and who have early symptoms but no advanced visceral involvement. HSC autograft can thus be discussed in patients with diffuse cutaneous SSc with a duration of the disease since the first visceral manifestations (cutaneous, cardiac, digestive, pulmonary, or renal) excluding Raynaud's phenomenon of less than 5 years. However, the indications for HSC autograft in SSc validated at European level and in the national diagnostic and care protocol (PNDS) are broader and some of these indications are debatable, in particular in patients with worsening diffuse interstitial lung disease. These indications are discussed in a reasoned way, taking into account the level of evidence and the toxicity of the HSC autograft. [ABSTRACT FROM AUTHOR]

Copyright of Medical Journal of Ankara Training & Research Hospital is the property of Medical Journal of Ankara Training & Research Hospital 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 Turkiye Klinikleri Journal of Anesthesiology Reanimation is the property of Turkiye Klinikleri 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: Although surgical treatment of hip fracture provides favourable outcomes, comorbidities and preoperative optimization determine the recovery and rehabilitation period in elderly population. This study evaluated the role of anesthesiologic management for appropriate timing of surgery, and other patient-specific factors for surgical intervention. Methods: The study group comprised of 240 geriatric patients with acute hip fractures, who underwent surgery at an academic tertiary care unit. Preoperative, intraoperative and postoperative variables associated with anesthesiologic management were retrospectively evaluated. A 30-day mortality and morbidity were the primary and secondary outcomes. Results: The median time between the patient’s admission to the hospital and the time of surgery was 1 day. Approximately 29% patients stayed in intensive care unit postoperatively. The median length of hospitalization was 5 days, while the 30-day mortality rate was 1.3%. The American Society of Anesthesiologists (ASA) physical status was identified as the most common factor that significantly affected the 30-day mortality. Conclusion: To date, no consensus has been reached on the appropriate delay period for surgery of acute hip fractures. Our study demonstrates that the main factors determining the patient prognosis are ASA physical status score, and the functional status of the patients. Therefore, perioperative anesthesiologic management should be prioritized to provide optimization of these patients. [ABSTRACT FROM AUTHOR]

Copyright of Turkiye Klinikleri Journal of Dental Sciences is the property of Turkiye Klinikleri 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: 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 Turkish Journal of Trauma & Emergency Surgery / Ulusal Travma ve Acil Cerrahi Dergisi is the property of KARE Publishing 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 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 Ege Journal of Medicine is the property of Ege University, Faculty of Medicine 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.)

Copyright of Turkish Journal of Trauma & Emergency Surgery / Ulusal Travma ve Acil Cerrahi Dergisi is the property of KARE Publishing 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]

Copyright of Turkish Journal of Trauma & Emergency Surgery / Ulusal Travma ve Acil Cerrahi Dergisi is the property of KARE Publishing 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 Osmangazi Journal of Medicine / Osmangazi Tip Dergisi is the property of Eskisehir Osmangazi University 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: Anemia is associated with increased mortality and morbidity in all patients undergoing surgery. This study aimed to reveal to what extent anemia caused postoperative complications before hiatal hernia surgery. Material and Methods: One hundred and ninety-two patients operated for hiatal hernia in our clinic between 2015 and 2019 were analyzed retrospectively. Patients were compared according to demographics, preoperative laboratory values, preoperative Charlson comorbidity index score, hiatal hernia type, postoperative intensive care requirement, presence of postoperative complications, Clavien-Dindo score, blood transfusion need, and length of hospital stay. Results: Of the patients, 109 were female and 83 were male. The mean age was 50.1±9.1 years. Fifty-four (28.2%) of the patients were in the anemic group, and 138 (71.8%) were in the non-anemic group. There was no statistically significant difference between the groups in terms of gender distribution (p=0.663). When the groups were compared in terms of age distribution, it was found that the anemic group was older than the non-anemic group and the difference was statistically significant (p

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.)

Background: This study aims to evaluate the results of incarcerated anterior abdominal wall hernia cases in which we performed emergency surgery in light of the literature. Materials and Methods: The records of 124 patients who underwent emergency surgery for incarcerated anterior abdominal wall hernia between January 2016 and December 2019 were retrospectively reviewed. The patients' files, computer records, epicrisis reports, surgery reports, and outpatient clinic records were evaluated. Patients; Age, gender, hernia type, location, time of admission, previous hernia surgery history, affected organs, type of anesthesia applied, surgical techniques, resection status, length of hospital stay, morbidity, and mortality rates were recorded. Results: The mean age of 124 patients was 59.47 ± 17.75 (17-94) years. Of the patients, 64 (51.6%) were female, and 60 (48.4%) were male. The mean hospital stay was 4.12±3.52 (1-19) days. Thirteen (10.5%) patients had additional disease. General anesthesia was applied to 100 (80.6%) patients, and regional anesthesia was applied to 24 (19.4%) patients. 25 patients were operated on with the diagnosis of recurrence and 99 with the diagnosis of a primary hernia. The most frequently compressed organs in the hernia sac were the omentum (64.5%) and small intestine (32.2%). Bowel resection was performed in 16 of the patients. Mesh was applied to 90 patients during the operation. The most common hernia types were inguinal, umbilical, and incisional. 31 (13.7%) complications developed in 17 patients. Sepsis, wound infection, ileus, atelectasis, and respiratory failure were the most common. Mortality was developed in 6 (4.8%) of the patients. Conclusions: This study showed that additional disease increases morbidity in hernia cases, and intestinal resection due to strangulation increases morbidity and mortality. Therefore, patients presenting with an incarcerated hernia should be operated on as soon as possible before strangulation develops. [ABSTRACT FROM AUTHOR]

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]

Copyright of Turkish Journal of Trauma & Emergency Surgery / Ulusal Travma ve Acil Cerrahi Dergisi is the property of KARE Publishing 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.)

Purpose: We aimed to comparison of serum albumin and lactate level for predicting neonatal morbidities and mortality in preterm infants < 32 weeks of gestation. Materials and Methods: The medical records of babies were retrospectively analyzed. Patients were divided into three groups; plasma albumin levels ≤ 2.5 g/dL were defined as Group 1, 2.6-3 g/dL as Group 2 and ≥ 3 g/dL as Group 3. The babies < 28 weeks of gestation were analysed as a subgroup. Results: 300 infants with mean gestational age of 28.7 ± 2.4 weeks and mean birth weights 1240 ± 405 grams were included. In predicting mortality; the sensitivity of the albumin level within the first three days was 74.4% and the specificity was 73.2% (cut-off < 2.9 g/dL), the sensitivity of the lowest albumin level was 90.7% and the specificity was 70.1% (cut-off < 2.65 g/dL), the sensitivity of the lactate level was 67.4% and the specificity was 63.3% (cut off > 3.1 mmol/L). Analysis of < 28 weeks babies; the sensitivity of lowest albumin level was 80% and the specifity was 66.7% (cut-off < 2.45 g/dL) and the sensitivity of the albumin level within the first three days was 74.3% and the specificity was 72.6% (cut-off < 2.8 g/dL), and the sensitivity of lactate was 74.3% and the specifity was 64.2% (cut-off > 3.1mmol/L). Conclusion: Low serum albumin level appears to be more specific and sensitive than lactate in predicting mortality and may be considered to be added to mortality prediction scores. [ABSTRACT FROM AUTHOR]

La morbidité liée au lambeau de grand dorsal autologue (LMCD), au lambeau de grand dorsal à épargne musculaire (MSLD) et au lambeau de grand dorsal perforant (TAP) est sujet à controverse. Le but de cette étude était d'évaluer la morbidité grâce au Quick Dash, mesuré à 1 mois et 1 an post-opératoire, dans les suites d'une reconstruction mammaire par un des ces trois lambeaux. L'objectif secondaire était d'évaluer la qualité de vie des patientes grâce au Breast-Q. Trente-quatre patientes consécutives opérées d'une reconstruction mammaire ont été incluses dans cette étude prospective et monocentrique : 10 patientes dans le groupe LMCD, 12 dans le groupe MSLD et 12 dans le groupe TAP. À 1 mois et 1 an post-opératoire, la variation du Quick Dash était respectivement de 13,63 et 2,38 dans le groupe LMCD, de 3,41 et -1,13 dans le groupe MSLD et de 5,69 et 0 dans le groupe TAP. La satisfaction était plus élevée dans le groupe LMCD excepté pour l'aspect du dos. Les séromes en post-opératoire étaient fréquents en cas de LMCD, rares et peu abondants en cas de MSLD et très rares en cas de TAP. Cette étude confirme que la morbidité immédiate est moindre en cas de MSLD ou TAP qu'en cas de LMCD. En revanche, à distance de la chirurgie, la morbidité parait comparable quel que soit le lambeau. La satisfaction des patientes semble plus importante en cas de reconstruction par LMCD hormis à propos de l'aspect du dos. Morbidity following autologous latissimus dorsi flap (ALD), muscle sparing latissimus dorsi flap (MSLD) and thoracodorsal artery perforator flap (TAP) is controversial. The purpose of this study was to measure morbity using Quick Dash at 1 month and 1 year following breast reconstruction with one of these three flaps. The second objective was the evaluation of quality of life using Breast-Q. Thirty four consecutive patients who had undergone breast reconstruction were included in this monocentric and prospective study: 10 patients in the ALD group, 12 patients in the MSLD group and 12 patients in the TAP group. At 1 month and 1 year following surgery, the variation of Quick Dash was 13,63 and 2,38 in the ALD group, 3,41 and -1,13 in the MSLD group and 5,69 and 0 in the TAP group. Satisfaction whith breasts, psychosocial, sexual and chest well-being were higher in the ALD group. Satisfaction with back was higher in the MSLD and TAP groups. Back and shoulder well-being was comparable regardless of the flap. Seroma occurrence was very rare in case of TAP, rare and not abundant in case of MSLD and frequent in case of ALD. This study appears to confirm that immediate morbidity is less important with MSLD or TAP than ALD. Hoewever at one year following surgery, morbity seems to be comparable with the 3 flaps. Patients satisfaction seems to be higher with ALD except for the aspect of the back. [ABSTRACT FROM AUTHOR]

L'hypotrophie néonatale est responsable d'une morbidité et mortalité néonatale surtout dans les pays en développement. L'objectif de cette étude était de déterminer les facteurs associés dans le contexte de ressources limitées. Il s'agissait d'une étude de type cas-témoins réalisée de mars à novembre 2021 au service de néonatologie de la maternité Issaka Gazoby de Niamey. Les nouveau-nés hospitalisés au service, ainsi que leurs mères ont été étudiés. Les caractéristiques des mères, les données relatives aux nouveau-nés ont été étudiées. Les données ont été analysées grâce au logiciel Sphinx Plus2 version 5.0.0.82. Le test de Chi2 de Pearson et le test exact de Fisher ont été utilisés (p < 0,05). Sur 5310 nouveau-nés, 116 cas d'hypotrophie néonatale ont été retrouvés (2,2 %). Les cas étaient plus observés chez les mères qui n'ont pas d'activité professionnelle (66,38 %) [ p > 0,05]. Les principaux facteurs de risque significatifs étaient l'âge maternel (OR = 1,93; p = 0,02), la dénutrition maternelle (OR = 120,97; p < 0,01) et l'insuffisance du suivi des grossesses (OR = 1,64 et p = 0,01). Pour les caractéristiques des nouveau-nés, la prématurité a été retrouvée comme facteur de risque (OR = 7,57; p < 0,01). L'hypoglycémie, l'hypothermie et les décès étaient plus observés chez les nouveau-nés hypotrophes (p < 0,01). Les principaux déterminants maternels de l'hypotrophie néonatale étaient l'âge avancé, la dénutrition et l'insuffisance de suivi de la grossesse. Chez les nouveau-nés, il s'agissait de la prématurité. Les complications néonatales associées étaient l'hypoglycémie, l'hypothermie et les décès. Neonatal hypotrophy is responsible for neonatal morbidity and mortality especially in developing countries. The objective of this study was to determine the associated factors in the context of limited resources. This was a case-control study conducted from March to November 2021 in the neonatology department of Issaka Gazoby maternity hospital in Niamey. Newborns hospitalized in the department, as well as their mothers were studied. The characteristics of mothers and the data on the newborns were studied. Data were analyzed using the Sphinx Plus2 software version 5.0.0.82. Pearson's Chi2 test and Fisher's exact test were used (P < 0.05). Out of 5310 newborns, 116 cases of neonatal hypotrophy were found (2.2 %). The cases were more observed in mothers without professional activity (66.38 %) [ P > 0.05]. The significant risk factors were maternal age over 20 years (OR = 1.93; P = 0.02), maternal undernutrition (OR = 120.97; P < 0.01) and inadequate pregnancy follow-up (OR = 1.64 and P = 0.01). For newborn characteristics, prematurity was found to be a risk factor (OR = 7.57; P < 0.01). Hypoglycemia, hypothermia and death were more observed in hypotrophic newborns (P < 0.01). The main maternal determinants of neonatal hypotrophy were advanced age, undernutrition and inadequate pregnancy follow-up. In neonates, it was prematurity. Associated neonatal complications were hypoglycemia, hypothermia and death. [ABSTRACT FROM AUTHOR]

Copyright of Turkish Journal of Trauma & Emergency Surgery / Ulusal Travma ve Acil Cerrahi Dergisi is the property of KARE Publishing 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.)

Pregnant women may require Intensive Care Unit (ICU) at any stage of pregnancy for “obstetric” or “non-obstetric” causes. Many clinical situations can develop during pregnancy, such as hypertensive diseases, bleeding, venous thromboembolism, endocrine diseases, asthma, epilepsy, infection, and sepsis, which are common and require special management, however may not be critical. Most pregnancies with these complications have uneventful outcomes for both mother and fetus. Of 1-3% pregnancies with critical diseases require ICU care. Obstetric bleeding and hypertensive diseases are responsible for 55% of ICU admissions. However, the growing fetus is completely dependent on the mother for oxygenation, nutrition, and removal of other waste products. This “second guest” is always considered in the management of the pregnant patient. Optimal management of the mother often constitutes the best treatment for the fetus. It mostly involves multidisciplinary treatment by obstetricians, pediatricians, and anesthesiologists. During the pregnancy follow-up, delivery of the fetus may be necessary for maternal or fetal indications and should be planned. In this article, the determination of the physiological goals of the pregnant patient in the ICU, the general care principles, the follow-up of the treatment, and the follow-up of the fetus during all these stages will be discussed. [ABSTRACT FROM AUTHOR]

Copyright of Turkish Journal of Trauma & Emergency Surgery / Ulusal Travma ve Acil Cerrahi Dergisi is the property of KARE Publishing 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 Turkish Journal of Trauma & Emergency Surgery / Ulusal Travma ve Acil Cerrahi Dergisi is the property of KARE Publishing 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: Anemia is associated with increased mortality and morbidity in all patients undergoing surgery. This study aimed to reveal to what extent anemia caused postoperative complications before hiatal hernia surgery. Material and Methods: One hundred and ninety-two patients operated for hiatal hernia in our clinic between 2015 and 2019 were analyzed retrospectively. Patients were compared according to demographics, preoperative laboratory values, preoperative Charlson comorbidity index score, hiatal hernia type, postoperative intensive care requirement, presence of postoperative complications, Clavien-Dindo score, blood transfusion need, and length of hospital stay. Results: Of the patients, 109 were female and 83 were male. The mean age was 50.1±9.1 years. Fifty-four (28.2%) of the patients were in the anemic group, and 138 (71.8%) were in the non-anemic group. There was no statistically significant difference between the groups in terms of gender distribution (p=0.663). When the groups were compared in terms of age distribution, it was found that the anemic group was older than the non-anemic group and the difference was statistically significant (p<0.001). There was a significant difference between the groups in terms of the postoperative complications rate and it was more common in the anemic group (p<0.001). There was a significant difference between the groups in terms of the need for intensive care and blood transfusion in the postoperative period (p=0.020, p<0.001, respectively). Conclusion: Preoperative anemia increases postoperative complications in hiatal hernia surgery. Therefore, the presence of anemia should be investigated before hiatal hernia surgery and patients with anemia should be followed up closely postoperatively. [ABSTRACT FROM AUTHOR]

Copyright of Mersin Üniversitesi sağlık Bilimleri Dergisi is the property of Mersin University 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 Anatolian Clinic Journal of Medical Sciences is the property of Hayat Saglik ve Sosyal Hizmetler Vakfi 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.)

Purpose: The aim of this study was to determine the differences between the patients with postoperative complications and the patients without postoperative complications in cholecystectomy cases and to identify parameters that should be considered regarding complications. Materials and Methods: Patients who underwent cholecystectomy between January 2019 and July 2020 at Igdir State Hospital, Igdir, Turkey were identified retrospectively. The patients’ general characteristics were retrieved from their medical records. Patients who developed complications in the 30 days after surgery were considered the morbidity-positive group, and the patients without complications were considered the morbidity-negative group. The differences between the two groups were evaluated. Results: The study included 108 patients. The patients’ mean age was 46.44 years (range: 18‒83), and 85 (78.7%) were women. Male gender, age over 40 years, preoperative fever with the presence of haemangioma on ultrasonography (USG) and cystic canal closure using silk were associated with increased morbidity. Interestingly, umbilical hernia repair in the same surgery was associated with reduced morbidity. Conclusion: This study found that male gender, older age, and preoperative fever were associated with increased morbidity in cholecystectomy patients. Presence of preoperative haemangioma is a new parameter associated with increased morbidity. In addition, we recommend using silk sutures when closing the cystic duct during cholecystectomy and repairing the umbilical hernia, if present.

Aim: Although most defects can close by primary suturing after radical surgery of gynecological malignancies, different reconstruction options are available when large defects that require reconstruction occur. In this study, we present the treatment strategy and results for patients who underwent reconstruction after resection for gynecological cancer in the vulva and perineum. Material and Methods: A total of 18 patients who underwent reconstruction between May 2018 and July 2020 were included in this retrospective study. Demographics and clinical data, the resection operation, characteristics of the defect, and the reconstruction methods applied were evaluated. Postoperative treatment strategy and complication rates were evaluated. Results: The mean age was 62.3±13.2 (42-83) years. 88.9% of the patients had additional diseases. Pelvic exentration was performed in 5 (27.8%) patients, anterior resection in 2 (11.1%) patients and vulvectomy in 11 (61.1%) patients. The most common malignancy was squamous cell carcinoma, and mean defect size was 106±97 (12-476) cm2. Reconstruction was performed with a local fasciocutaneous flap in 16 (88.9%) patients, pedicled rectus myocutaneous flap in one (5.6%) patient, and skin graft in one (5.6%) patient. Wound complications occurred in 5 (27.8%) patients, partial flap necrosis in one (5.6%) patient, and recurrence in one (5.6%) patient in the long term. Conclusion: It is possible to reconstruction most of the vulva and perineal defects with local flaps after oncological resections, Considering the characteristics of the area and patient comorbidities, it should be kept in mind that prolonged wound problems may be seen, especially in vulvectomy patients.

Contexte : Les éclosions provoquent une morbidité et une mortalité importantes dans les établissements de soins de santé. Les méthodes de dépistage actuelles permettent de cerner des agents pathogènes respiratoires viraux spécifiques, mais l’approche de la gestion des éclosions reste générale. Objectifs : Notre objectif était d’examiner les tendances spécifiques aux agents pathogènes dans les éclosions respiratoires, y compris la façon dont le taux d’attaque, le taux de létalité et la durée de l’éclosion diffèrent par agent pathogène entre les hôpitaux, et les établissements de soins de longue durée et les maisons de retraite en Ontario. Méthodes : Les éclosions d’infections respiratoires confirmées dans les hôpitaux et les établissements de soins de longue durée ou les maisons de retraite de l’Ontario signalées entre le 1er septembre 2007 et le 31 août 2017 ont été extraites du Système intégré d’information sur la santé publique (SIISP). Les taux d’attaque médians, la durée des éclosions et les taux généraux de létalité des éclosions spécifiques à un pathogène ont été comparés dans les deux types d’établissements. Résultats : Au cours de la période de surveillance de 10 ans, 9 870 éclosions respiratoires confirmées ont été signalées dans les hôpitaux et les établissements de soins de longue durée ou les maisons de retraite de l’Ontario. La grippe était à l’origine de la plupart des éclosions (32 % dans les établissements de soins de longue durée et les maisons de retraite, 51 % dans les hôpitaux), mais ces éclosions étaient plus courtes et présentaient des taux d’attaque inférieurs à ceux de la plupart des éclosions non grippales dans les deux types d’établissements. Le métapneumovirus humain, bien que peu fréquent (moins de 4 % des éclosions), présentait des taux de létalité élevés dans les deux types d’établissements. Conclusion : Les taux d’attaque et les taux de létalité variaient selon l’agent pathogène, tout comme la durée de l’éclosion. L’élaboration de conseils propres à la gestion des éclosions, qui tiennent compte de l’agent pathogène et de l’établissement de soins de santé, pourrait être utile pour limiter la charge des éclosions respiratoires.

Introduction: in colon cancer surgery, anastomotic fistula (AF) is considered the most feared complication. The purpose of this study was to identify predictive factors associated with anastomotic fistula after colon cancer surgical resection and to describe the impact of this complication on mortality and postoperative length of stay. Methods: we conducted a retrospective, descriptive and analytical study in the Department of General Surgery at the Habib Bourguiba Hospital in Sfax, Tunisia from 1st January 2013 to 31 December 2020. Results: we collected data from the medical records of 163 patients who had undergone surgery for colon cancer. The average age of patients was 62.7 years with a sex ratio of 1.36. The postoperative course was uneventful in 64.4% of cases and complicated in 35.6% of cases. Surgical morbidity was mainly due to anastomotic fistulas (22 patients). This study demonstrated that predictors of the development of this complication were: diabetes p = 0.04, smoking p = 0.01, hypoalbuminaemia p = 0.01, preoperative haemoglobin less than 10g/dl, p < 0.01, anastomotic fistula located in the left colonic angle p = 0.02, perioperative transfusion p <0.01, and duration of surgery longer than 180 min p = 0.04. Moreover, the occurrence of anastomotic fistula was associated with specific mortality rate (9%) and significantly prolonged postoperative length of stay. Conclusion: the prevention of anastomotic fistulas should be part of a multimodal approach based on the correction of nutritional deficiencies and possible pre-operative anemia. [ABSTRACT FROM AUTHOR]

Copyright of Turkish Journal of Trauma & Emergency Surgery / Ulusal Travma ve Acil Cerrahi Dergisi is the property of KARE Publishing 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 Medical Journal of Istanbul Kanuni Sultan Süleyman / İstanbul Kanuni Sultan Süleyman Tıp Dergisi is the property of Logos Medical Publishing 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 Ege University School of Dentistry / Ege Üniversitesi Dis Hekimligi Fakültesi Dergisi is the property of Ege University Faculty of Dentistry 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: Indigenous Peoples are much more likely than non-Indigenous Peoples to be seriously injured or die in motor vehicle collisions (MVCs). This study updates and extends a previous systematic review, suggesting that future research ought to incorporate social--environmental factors. Methods: We conducted a systematic review and meta-analysis of the published and grey literature on MVCs involving Indigenous Peoples in Canada between 2010 and 2020. We focussed on personal (e.g. driving an old vehicle) and community social--environmental--economic factors (e.g. prevalent low socioeconomic status). Results: Eleven comparative cohorts that resulted in 23 at minimum, age-standardised, mortality or morbidity rate outcomes were included in our meta-analysis. Indigenous Peoples were twice as likely as non-Indigenous Peoples to be seriously injured (rate ratio [RRpooled] = 2.18) and more than 3 times as likely to die (RRpooled = 3.40) in MVCs. Such great risks to Indigenous Peoples do not seem to have diminished over the past generation. Furthermore, such risks were greater on-reserves and in smaller, rural and remote, places. Conclusion: Such places may lack community resources, including fewer transportation and healthcare infrastructural investments, resulting in poorer road conditions in Indigenous communities and longer delays to trauma care. This seems to add further evidence of geo-structural violence (geographical and institutional violence) perpetrated against Indigenous Peoples in yet more structures (i.e. institutions) of Canadian society. Canada's system of highways and road-ways and its remote health-care system represent legitimate policy targets in aiming to solve this public health problem. [ABSTRACT FROM AUTHOR]

Copyright of Turkish Journal of Trauma & Emergency Surgery / Ulusal Travma ve Acil Cerrahi Dergisi is the property of KARE Publishing 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 Turkiye Klinikleri Archives of Lung is the property of Turkiye Klinikleri 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: Endovascular aortic repair (EVAR) has been preferred increasingly surgical repair for abdominal aortic aneurysms (AAAs). This minimally invasive procedure has favorable effects in the early period but our purpose is to reveal the anatomical and non-anatomical risk factors affecting mortality and morbidity after EVAR in the prolonged period.Materials and Methods: A total of 96 patients ( 91m, 5 f) electively EVAR operated for infrarenal AAAs between September 2014 to January 2019 is included to the study. Preoperative and postoperative computed tomography (CT) scans is controlled periodly and determined individually. Demographic factors, anatomical properties of the AAAs and non-anatomical risk factors are assessed. Kaplan-Meier survival analysis was used to determine survival rates. Cox regression and hazard ratio (HR) was used to assess the relation of these determined factors on mortality and morbidity.Results: Mean follow up time was 27,45 ± 12,99 months. We found that aortic neck morphology has an statistically significant effect on mortality (p value: 0.046 and HR: 1,73 [ 1,01-2,96]). Aortic neck angle, cigarette smoking, obesity, Peripheral artery disease(PAD), coronary artery disease, chronic obstructive pulmonary disease have an increased hazard ratio on mortality ( HR in order; 1,39; 1,45; 3,33; 1,84; 1,87; 3,60). Increased creatinine level (p value: 0.003), precence of chronic renal failure (p value: 0.013)and diabetes mellitus (p value: 0.038) have an statistically significant negative effect on morbidity. Obesity and PAD have an increased hazard ratio on morbidity(HR in order; 4,58; 1,61). Conclusion: This study showed us survival after EVAR procedure is connected with several pre and postoperative factors. Preoperative datailed evaluation for the anatomical properties of aneurysm is important to achieve prolonged benefit and postoperative follow up is crucial.

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]

Aims/Objectives/Assumption: In Mali, malaria is the leading cause of death and consultations in health facilities. The objective of this study was to examine trends in morbidity and mortality among children aged 0 to 15 years and to establish accurate mapping of the distribution of cases in health areas of the Sélingué health district. Materials and method: A retrospective analysis of hospital records at the Sélingué district reference health center from 2010 to 2013 was conducted. Trend Chi2 and logistic regression were used, respectively, to compare changes in trends between health areas and to identify risk factors associated with malaria mortality. Results: Among the 1282 cases of malaria, the incidence of severe malaria gradually decreased from 96.75 ‰ (671 cases) in 2010 to 34.23 ‰ (291 cases) in 2011, 19.76 ‰ (168 cases) in 2012 and 19.43 ‰ (152 cases) in 2013. From 2010 to 2013, there was an average monthly variation in October of 26, 6% cerebralmalaria and 23.3% malaria anemia by the month of July of the same year. Spatial variation of anemic forms of malaria between health areas (p < 0.001) was observed from 2010 to 2013. From 2012 to 2013, there was an overall decrease in the frequency of hospitalizations, incidence and death rate for severe malaria. In multivariate analysis, in the final model, malaria lethality was associated with the duration of hospitalization for more than three days (OR = 0.124); the year of hospitalization from 2010 to 2012 (OR = 0.813); the absence of blood transfusion of the patient (OR = 0.282); at the age of the patient in children under one year (OR = 0.356) and at the emergency anti-malarial treatment instituted with artemether (OR = 3.006) adjusting for the form of malaria. On the other hand, malaria lethality was not related to the form of malaria (p = 0.072), sex (p = 0.390), residence (p = 0.308), prior treatment before hospitalization (p = 0.949). at fever in children (p = 0.153) adjusting for other variables in the model. Conclusion : Hospital case fatality remains high with a drop in the incidence of morbidity and mortality; a monthly variation in morbidity and mortality with two peaks, July - August and October- November and the emergency treatment instituted with artemether, the length of hospital stay could be identified as associated factors. [ABSTRACT FROM AUTHOR]