Acta Medica最新文献

{"title":"Cutaneous arteritis: Description based on Chapel Hill Conference Consensus 2012 and a case report","authors":"B. Ceren Uludoğan, N. Şule Yaşar Bilge","doi":"10.32552/2023.actamedica.965","DOIUrl":"https://doi.org/10.32552/2023.actamedica.965","url":null,"abstract":"","PeriodicalId":7100,"journal":{"name":"Acta Medica","volume":"23 10","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134907997","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":"HCV-related cryoglobulinemic vasculitis/Cryoglobulinemic vasculitis: Definition based on Chapel Hill Conference Consensus 2012 and case report","authors":"Bahar Özdemir Ulusoy, Abdulsamet Erden","doi":"10.32552/2023.actamedica.970","DOIUrl":"https://doi.org/10.32552/2023.actamedica.970","url":null,"abstract":"","PeriodicalId":7100,"journal":{"name":"Acta Medica","volume":"49 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135013364","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":"Single organ vasculitis: Description based on Chapel Hill Conference Consensus 2012 and a case report","authors":"Gizem Sevik, Haner Direskeneli","doi":"10.32552/2023.actamedica.969","DOIUrl":"https://doi.org/10.32552/2023.actamedica.969","url":null,"abstract":"","PeriodicalId":7100,"journal":{"name":"Acta Medica","volume":"61 3","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134907984","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":"Revisiting anatomical structures of the superior orbital fissure using with interactive 3D-PDF model","authors":"Hilal Akdemir Aktaş, Şahin Hanalioğlu, Osman Tunç, İlkan Tatar","doi":"10.32552/2023.actamedica.907","DOIUrl":"https://doi.org/10.32552/2023.actamedica.907","url":null,"abstract":"The superior orbital fissure is an important cleft that connects the orbit with the middle cranial fossa. The upper border of this fissure is formed by the lesser wing of the sphenoid bone, anterior clinoid process, and optic strut. The lower border is formed by the greater wing of the sphenoid bone. The oculomotor, trochlear, ophthalmic, abducens nerves and orbital veins pass through this small slit. The aim of this study was to review anatomical structures of the superior orbital fissure, through a 3D-PDF model that simplifies the understanding of complex anatomy of this region. According to the literature, any major artery does not pass through it, but it is closely related to the internal carotid artery. There are numerous intracranial-extracranial anastomoses around it. While extracranial branches originate from the maxillary artery, intracranial branches arise from the inferolateral trunk or the ophthalmic artery. Nerves and vascular structures related with this fissure can be damaged due to post-traumatic sphenoid fractures, infectious diseases, aneurysms, carotid-cavernous fistulas, and neoplasms. Surgeries involving the superior orbital fissure are quite complex as there are many important anatomical structures in this region. The radiological anatomy of this fissure in normal and pathological conditions is still an under-studied subject in the literature. There is a need for more detailed studies related to the superior orbital fissure enriching with anatomic models and including pathological conditions. The 3D-PDF model of the superior orbital fissure is an innovative tool to enhance the knowledge of the anatomical structures related with this region. Better understanding of this critical region is necessary to perform safe and successful surgical procedures.","PeriodicalId":7100,"journal":{"name":"Acta Medica","volume":"19 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135426286","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":"Knowledge of isolation precautions among the healthcare workers in the emergency department of a university hospital","authors":"Ahmet Sertçelik, Volkan Arslan, Eda Karadogan, Hanife Uzar, Banu Cakir, Gokhan Metan","doi":"10.32552/2023.actamedica.934","DOIUrl":"https://doi.org/10.32552/2023.actamedica.934","url":null,"abstract":"Objectives: Prevention and control of healthcare-associated infections are important for patients and personal safety and for fighting against antimicrobial resistance. In order to achieve the goal of zero infection, it is necessary to know and apply standard and transmission-based precautions. The aim of this study was to evaluate the knowledge of healthcare professionals working in the Adult Emergency Department of university hospital about isolation precautions. Methods: A cross-sectional study was conducted in the Emergency Department of Hacettepe University Hospital between May 16, 2023 to June 23, 2023. Data were collected electronically with a standardized data collection form specially prepared for this study to examine the knowledge about isolation precautions. Each correct answer was calculated as one point. Participants could receive a score between a minimum of 0 and a maximum of 20. Results: The 90 healthcare workers who agreed to participate in the study had a median age of 24 years and 40% were male. The median knowledge score was 13 (IQR = 4). The knowledge score of two pregnant healthcare workers was significantly higher than non-pregnant ones (p=0.04). 93.3% of the participants stated that they received education for isolation precautions. There was no significant difference in knowledge scores between those who received education and those who did not (p=0.02). Knowledge of isolation precautions to be followed in clinical scenarios (1.1% - 54.4%) and personal protective equipment to be used correctly (3.3% - 21.1%) was low. Conclusion: The knowledge of healthcare professionals working in the Adult Emergency Department of university hospital about isolation precautions is at a moderate level. Periodical education programs on clinical scenarios is important regarding raising awareness.","PeriodicalId":7100,"journal":{"name":"Acta Medica","volume":"98 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135426287","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":"Transarterial embolization for delayed bleeding after percutaneous nephrolithotomy","authors":"Fatma Gonca Eldem, Ferdi Çay, Ahmet Güdeloğlu, Bora Peynircioğlu","doi":"10.32552/2023.actamedica.917","DOIUrl":"https://doi.org/10.32552/2023.actamedica.917","url":null,"abstract":"Objectives: The study aimed to evaluate the effectiveness and reliability of transarterial embolization (TAE) in managing delayed bleeding after percutaneous nephrolithotomy (PNL). Materials and Methods: Patients presenting to our hospital’s emergency department with hematuria following PNL and treated with TAE were included in the retrospective analysis. Demographic, clinical, and radiological data were collected. Technical and clinical success rates of TAE were calculated. The impact of the embolization procedure on kidney function was determined using angiographic images, and pre- and post-procedure serum creatinine levels. Results: A total of 13 patients included in the study presented with intermittent visible hematuria. The average interval between hematuria onset and PNL was 11.92±7.27 days. No hemodynamic instability was observed in any patient. CT angiography identified vascular pathology in 11 patients (84.6%), who subsequently underwent renal angiography for TAE without conservative treatment. Pseudoaneurysms were found in 7 patients (63.6%), and both pseudoaneurysms and arteriovenous fistulae in 4 patients (36.4%). Technical success was achieved in all embolization procedures. Hematuria resolved in all patients during follow up with a clinical success rate of 100%. Renal parenchymal loss after embolization was <%10 in 8 patients (72.7%), %11-24 in 2 patients (18.2%), and %25-50 in 1 patient (7.7%). There was no significant difference in serum creatinine levels before (mean 1.09±0.53 mg/dl) and after (mean 1.06±0.71 mg/dl) TAE (p=0.5). No major procedure related complications were observed. Conclusions: TAE is an effective and safe method for the treatment of delayed bleeding following PNL. CT angiography facilitates diagnosis and treatment planning for patients with hematuria after discharge. Early TAE for patients with identified vascular pathology can increase technical and clinical success rates.","PeriodicalId":7100,"journal":{"name":"Acta Medica","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135427399","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":"Meningococcal septicemia in a young immunocompetent girl","authors":"Ermira Muco, Arta Karruli, Dhimiter Kraja","doi":"10.32552/2023.actamedica.906","DOIUrl":"https://doi.org/10.32552/2023.actamedica.906","url":null,"abstract":"Meningococcal septicemia is a bloodstream infection caused by Neisseria meningitis. Clinical manifestations vary, from mild disease to severe meningococcaemia which may present first with high fever, severe myalgia, headache, skin and mucosal petechiae and can progress rapidly to septic shock with multi-organ dysfunction syndrome (MODS). Case presentation: A 17-year-old immunocompetent girl was admitted to the Infectious Disease ward, Mother Theresa University Hospital with a 3-4-days history of headache, vomiting, diarrhea, fever, cough, arthralgia. She had hypotension, tachypnea, tachycardia, pharyngeal erythema and generalized ecchymotic spots. She was transferred immediately to the Intensive Care Unit. Laboratory findings showed decrease of hemoglobin, platelet count, albumin; increase of AST, ALT, LDH, CPK. Neisseria meningitidis was cultured from cerebrospinal fluid. Latex agglutination test resulted positive for N. meningitidis Gr B. She was immediately treated with Ceftriaxone, hydrocortisone, i.v. fluids, albumin, dopamine/dobutamine, fresh frozen plasma, platelet mass, bicarbonate, cryoprecipitate. The meningococcal rash began to spread rapidly taking on the appearance of ecchymotic lesions. Her clinical condition worsened rapidly and was placed under mechanical ventilation and died within 31 hours of admission to the hospital as a result of septic shock. Conclusions: Young patients presenting with fever, severe myalgia, headache, skin and mucosal petechiae must be tested for Neisseria meningitis. This infection is a medical emergency that requires rapid diagnosis, immediate antimicrobial therapy and intensive care support as it may be deadly in a matter of hours. People including health workers who have been in prolonged and close contact with the patient should receive antibiotic prophylaxis.","PeriodicalId":7100,"journal":{"name":"Acta Medica","volume":"25 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135426288","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":"Prognostic importance of systemic immune inflammation index in chronic obstructive pulmonary disease","authors":"Basak Celtikci, Esen Sayin Gulensoy","doi":"10.32552/2023.actamedica.932","DOIUrl":"https://doi.org/10.32552/2023.actamedica.932","url":null,"abstract":"Objective: Chronic obstructive pulmonary disease (COPD) is associated with various immunopathophysiological pathways. Therefore, several inflammatory, hematological and immunological biomarkers are essential for diagnosis, prognosis, and survival of COPD. Among these inflammatory markers, such as C-reactive protein (CRP), neutrophil, lymphocyte and platelet counts were shown to have strong correlations with prognosis, survival and mortality. Recently, a novel inflammatory marker stated as systemic immune-inflammation index (SII) were presented as the most accurate in predicting inflammatory status and prognosis in various clinical settings. We aimed to investigate whether SII can be a useful tool for predicting prognosis and survival in COPD patients. Material and Methods: We aimed to evaluate retrospectively the effect of SII (the ratio of platelet and lymphocyte multiplication to neutrophil count) on the course of the COPD in 270 patients. The effect of hemogram values, spirometric measurements, such as FEV1, and CRP on the number of attacks in COPD patients seen in the outpatient clinic and the effect of SII on clinical or intensive care hospitalization in COPD patients were evaluated. Whether the SII correlates with symptoms and one-month survival in COPD patients were evaluated. FEV1 and CRP values, duration of hospitalization, smoking and modified Medical Research Council (mMRC) scales were correlated among each other. Results: mMRC was significantly correlated with FEV1(%) and FEV1(lt) levels, and CRP. The effects of mMRC, FEV1/FVC and smoking on survival in COPD patients were also significantly shown. CRP values were significantly correlated with WBC, neutrophil and lymphocyte counts, and SII values. Unfortunately, SII values were non-significantly correlated with FEV1 values, duration of hospitalization, smoking and mMRC, due to earlier stage and small number of cases. Conclusion: We investigated the clinical significance of SII on prognosis of COPD patients. SII might assist the identification of high-risk patients with low FEV1 and high CRP values. This study sheds light on future research on SII as a prognostic marker.","PeriodicalId":7100,"journal":{"name":"Acta Medica","volume":"72 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135427400","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":"Evaluation of small airway dysfunction in patients with pneumoconiosis, a cross-sectional study","authors":"Asuman Aslan Kara, Adem Koyuncu, Gülden Sarı, Ceprail Şimşek","doi":"10.32552/2023.actamedica.928","DOIUrl":"https://doi.org/10.32552/2023.actamedica.928","url":null,"abstract":"Objective: Pneumoconiosis is an irreversible, progressive parenchymal lung disease caused by inhalation of mineral dust. Inhaled particles in the working environment can cause inflammation and fibrosis in the lung, affecting all respiratory tracts, including the large and small airways. Our study aimed to evaluate the frequency and risk factors of small airway dysfunction (SAD) in patients diagnosed with pneumoconiosis. Methods: The study population consisted of 331 patients diagnosed with pneumoconiosis between 01/01/2018 and 31/05/2023. Pneumoconiosis was diagnosed with a history of occupational inorganic dust exposure, radiologic findings compatible with pneumoconiosis, and exclusion of other diagnoses. Two readers evaluated the chest radiographs of the patients according to the International Classification of Pneumoconiosis Radiographs of the International Labor Organization. SAD was defined as at least two FEF50, FEF75, and FEF25-75 measurements below 65% of their predicted values. Results: SAD was found in 47.7% of the patients. There was a statistically significant difference between age and the prevalence of SAD, but there was no statistically significant difference between smoking status and the prevalence of SAD. It was observed that 41.9% of the patients with pneumoconiosis who had never smoked had SAD. As the cigarette pack-years increased, the incidence of SAD increased. SAD was presented 38.7% in Stage 1, 50.7% in Stage 2, and 57.6% in Stage 3 pneumoconiosis cases. SAD was seen in 35.1% of pneumoconiosis cases without PMF. In pneumoconiosis patients with PMF, the frequency of SAD increased with increasing opacity size. Conclusion: It was found that the frequency of SAD increased as the stage of pneumoconiosis increased. In patients with pneumoconiosis, SAD was observed in both smokers and never smokers, independent of large airway obstruction. Therefore, early small airway dysfunction should be considered when monitoring the health of patients with pneumoconiosis.","PeriodicalId":7100,"journal":{"name":"Acta Medica","volume":"71 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135426285","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":"Use of molnupiravir in patients who developed SARS-CoV2-Infection during hospitalization","authors":"Gülçin Telli Dizman, Yahya Çakır, Gamze Korubük, Gökhan Metan, Serhat Ünal","doi":"10.32552/2023.actamedica.936","DOIUrl":"https://doi.org/10.32552/2023.actamedica.936","url":null,"abstract":"Background: Molnupiravir is an oral anti-viral that inhibits SARS-CoV-2 replication and reduces viral load. We aimed to investigate mortality rates and the factors affecting mortality in patients receiving molnupiravir who were hospitalized for reasons other than COVID-19 in a tertiary care university hospital. Methods: Patients who received molnupiravir for COVID-19 according to Turkish Ministry of Health guidelines and were hospitalized for reasons other than COVID-19 were included in the study. Demographic and clinical characteristics of patients were compared according to survival status defined as 30-day mortality. Results: The mortality rate of 101 patients with Covid-19 was found to be 6.93 %. The rates of corticosteroid use, oxygen support, and mechanical ventilation requirement were significantly higher in patients who died within 15 days of the PCR positivity. Although not statistically significant, the ratio of concomitant bacterial pneumonia was higher in patients who did not survive. Also, the mortality rate was lower in patients who were vaccinated three doses or more without statistical significance. Conclusion: In patients who were hospitalized for other reasons and received molnupiravir treatment with a diagnosis of COVID-19, the development of respiratory failure was the only demographic factor that was statistically different in terms of mortality.","PeriodicalId":7100,"journal":{"name":"Acta Medica","volume":"36 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135426436","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}