{"title":"Management of Pediatric Intussusception: Review of the Treatment Algorithm (Retrospective Study)","authors":"Samir HASAN, Ülgen ÇELTİK, Emre DİVARCI, Orkan ERGÜN, Geylani ÖZOK, Ahmet ÇELİK","doi":"10.5336/medsci.2022-95180","DOIUrl":"https://doi.org/10.5336/medsci.2022-95180","url":null,"abstract":"Objective: In large series, the clinical features, management steps, and treatment results of intussusceptions have been studied. Material and Methods: Retrospective study including intussusception patients in a single center between 2008-2021. Results: There were 406 patients: 353 (86.9%) patients with ileocolic, 30 (7.4%) patients with small bowel, and 23 (5.7%) patients colocolic intussusception. In small bowel intussusceptions, 60% (18/30) of patients were treated surgically and in 40% (12/30) spontaneous reduction happened. Pathological lead points (PLPs) were found in 23.3% (7/30) of patients. In colocolic intussusception, the nonoperative reduction was used in 22/23 patients with a 90.9% success rate. The rate of PLPs was 4.3% (1/23). In ileocolic intussusception, spontaneous reduction happened in 18% (64/353) of cases. Nonoperative reduction was used as initial treatment in 272/353 patients with 79% (215/272) success rate and surgical management was used in 22.2% (78/353) of patients. The recurrence rate was 17.2% (61/353) with 85 attacks. Nonoperative reduction was used in 65/85 of attacks with 93% success rate. PLPs rate in different age groups was: 3.8% (0-2 years), 8% (2-5 years) and 17.4% (>5 years) (p value5 years old the frequency of Burkitt lymphoma was remarkable 10.8%. Conclusion: Although the first-line approach in small bowel intussusceptions is surgical exploration, the frequency of spontaneous reduction is high in cases with short segments (5 years old with ileocolic intussusceptions because of the high incidence of PLPs and Burkitt's lymphoma.","PeriodicalId":485899,"journal":{"name":"Türkiye klinikleri tıp bilimleri dergisi","volume":"61 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135052590","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Denizay AVCI, Ülgen ÇELTİK, Mustafa Orkan ERGÜN, Emre DİVARCI, Geylani ÖZOK, Ahmet ÇELİK
{"title":"Comparison of the 'Patient Management and Outcomes' of the Pediatric Patient Groups Who Had Appendectomy During the COVID-19 Pandemic Period and the Pre-Pandemic Period in Terms of the Efficiency of the Management Plan: Cross-Sectional Research","authors":"Denizay AVCI, Ülgen ÇELTİK, Mustafa Orkan ERGÜN, Emre DİVARCI, Geylani ÖZOK, Ahmet ÇELİK","doi":"10.5336/medsci.2022-95123","DOIUrl":"https://doi.org/10.5336/medsci.2022-95123","url":null,"abstract":"Objective: The restrictions in national policies applied in hospital and patient admissions during the coronavirus disease-2019 pandemic have been observed to have caused delays and additional problems in patient management. The aim of this study was to compare the number and rates of negative appendectomy and complicated appendicitis in patients who underwent appendectomy before and during the pandemic in our clinic. Material and Methods: Patients who presented with abdominal pain to our clinic or were consulted between January 2019 and May 2021 were evaluated retrospectively. The cases were categorized into two groups pre-pandemic (1.1.2019-29.2.2020) and pandemic period (11.3.2020-31.5.2021). In both periods, patients underwent laparoscopic appendectomy. In addition, patients were grouped as negative, non-complicated, and complicated according to pathology results. Results: 324 patients were hospitalized during the pre-pandemic period due to ''abdominal pain.'' Exploration was done in 184 (M-F: 59%-41%) patients with suspected appendicitis. On histopathological examination, negative appendectomy was found in 16 (8.7%), noncomplicated in 113 (68.48%), and complicated in 55 (31.52%) of the patients who were operated on. Post-pandemic period, 232 patients were hospitalized due to abdominal pain. Exploration was done in 162 (M-F: 59%-41%) patients. On histopathological examination, negative appendectomy was found in 11 (6.8%), non-complicated in 100 (66.23%), and complicated in 51 (33.7%) of the patients who were operated on. Conclusion: According to the results of the data, no adverse effects were observed on complications or misdiagnosis due to the changing patient management regarding inpatient follow-up and surgical intervention in our clinic during the pandemic period.","PeriodicalId":485899,"journal":{"name":"Türkiye klinikleri tıp bilimleri dergisi","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135052591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Relationship of Liver Enzymes to Homeostatic Model Assessment Insulin Resistance in Non-Alcoholic Fatty Liver Disease Patients: A Meta-Analysis and Systematic Review","authors":"Putu Ijiya DANTA AWATARA, Levrita Nindya POETRI, Jonny Karunia FAJAR, Syifa MUSTIKA","doi":"10.5336/medsci.2023-97079","DOIUrl":"https://doi.org/10.5336/medsci.2023-97079","url":null,"abstract":"Studies have assessed that the liver enzymes were proven having the association with insulin resistance (IR) in patients with liver disease; however, there were conflicting findings across the reports. The purpose of this study was to assess the association between liver enzymes and Homeostatic Model Assessment Insulin Resistance (HOMA-IR) in patients with non-alcoholic fatty liver disease (NAFLD). We conducted a meta-analysis between April 2022 and August 2022. Data were obtained from articles in PubMed, ScienceDirect, Cochrane Library, and Taylor & Francis. Using a Z test, the liver enzymes and the HOMA-IR among patients with NALD were compared. We included 683 patients with elevated liver enzymes and 3.579 patients with normal liver enzymes, retrieved from five papers. HOMA-IR score appeared higher in patients with NAFLD with elevated alanine aminotransferase (ALT) than in patients with normal ALT [ALT, mean difference (MD): 1.02; 95% confidence interval (CI): 0.49, 1.54]. Conversely, the aspartate aminotransferase (AST), alkaline phosphatase (ALP), and gamma-glutamyl transferase (GGT) had no crucial impact in affectting the HOMA-IR when compared between patients with NAFLD and control [(AST, MD: 0.81; 95% CI: 0.21, 1.40), (GGT, MD: 0.77; 95% CI: 0.20, 1.34), and (ALP, MD: 0.90; 95% CI: 0.22, 1.57)]. IR assessed using HOMAIR has a significant association with abnormal liver enzymes in patients with NAFLD.","PeriodicalId":485899,"journal":{"name":"Türkiye klinikleri tıp bilimleri dergisi","volume":"24 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135052251","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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