Acta Medica最新文献_第4页

Feasibility of microsurgery in rural area as part of compulsory health service in Turkey: Replantation, free conventional, perforator, thin, and super thin flaps 显微外科手术在土耳其农村地区作为义务医疗服务的一部分的可行性:再植、免费常规皮瓣、穿孔皮瓣、薄皮瓣和超薄皮瓣

Acta Medica Pub Date : 2023-09-28 DOI: 10.32552/2023.actamedica.926

Ahmet Hamdi Sakarya

{"title":"Feasibility of microsurgery in rural area as part of compulsory health service in Turkey: Replantation, free conventional, perforator, thin, and super thin flaps","authors":"Ahmet Hamdi Sakarya","doi":"10.32552/2023.actamedica.926","DOIUrl":"https://doi.org/10.32552/2023.actamedica.926","url":null,"abstract":"Objective: Region six in Turkey, an underdeveloped area with limited doctors, lacks experienced healthcare professionals, teamwork, assistants, and instruments, which limits the performance of complex procedures. It is generally discouraged to attempt complex microsurgery in these regions. This study aims to demonstrate the feasibility of microsurgery and provide guidance for ambitious young plastic reconstructive surgeons performing microsurgery in underdeveloped areas as part of a compulsory service program. Material and Methods: A retrospective analysis was conducted on patients who underwent free flaps, replantation, and revascularization surgeries performed by the author, the sole plastic surgeon in the rural area, between August 2018 and August 2020. The analysis included operation notes, outpatient clinic notes, as well as pre-operative and post-operative pictures. Results: A total of thirty-six microsurgical operations were performed on thirty-two patients. Two out of nineteen (10.5%) replantation attempts and one out of seventeen (5.8%) free flaps experienced failure. Among the flaps harvested, four were thin and four were super-thin. Furthermore, three out of five (60%) pediatric flaps encountered serious non-surgical complications, while most systemic complications were infection-related. All complications were effectively managed without the need for dispatch. Conclusion: Microsurgery can be safely performed during the compulsory work period in the region six. Tips such as open-loop anastomoses, staff training, and easy means of flap monitoring can facilitate microsurgery. However, it may be prudent to consider avoiding such procedures in pediatric patients due to potential non-surgical complications and challenges with the dispatch system.","PeriodicalId":7100,"journal":{"name":"Acta Medica","volume":"12 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":"135427390","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}

引用次数: 0

An effective technique in nerve defect repair: Analysis of sliding epineural tube graft technique and comparison with autologous nerve graft and turn-over epineural tube graft techniques 一种有效的神经缺损修复技术:滑动神经管移植技术的分析及与自体神经移植和翻转神经管移植技术的比较

Acta Medica Pub Date : 2023-09-28 DOI: 10.32552/2023.actamedica.924

Murat Kara, Uğur Koçer, Ramazan Arslan, Koray Gürsoy, Seçil Vural, Ayşegül Fırat

{"title":"An effective technique in nerve defect repair: Analysis of sliding epineural tube graft technique and comparison with autologous nerve graft and turn-over epineural tube graft techniques","authors":"Murat Kara, Uğur Koçer, Ramazan Arslan, Koray Gürsoy, Seçil Vural, Ayşegül Fırat","doi":"10.32552/2023.actamedica.924","DOIUrl":"https://doi.org/10.32552/2023.actamedica.924","url":null,"abstract":"Objective: Autologous nerve graft (ANG) is the standard of care in the reconstruction of nerve gaps. However, scarification of a donor nerve, donor-site complications (wound complications, sensory dysfunction, neuroma, etc.) and unpredictable results lead surgeons to search for alternative techniques. Epineural tube graft (ETG) is a good option in the repair of nerve gaps. At this point, the present study aims to analyze the utility of the sliding epineural tube graft (SETG)technique in the reconstruction of nerve gaps. Materials and Methods: Thirty Wistar albino rats were divided into five groups according to the repair technique of a 7 mm nerve defect created on the right sciatic nerve. In Group 1 the defect was left unrepaired as a negative control group. The defect was repaired with ANG in Group 2, with turn-over ETG (TETG) in Group 3, with one-directional SETG (O-SETG) in Group 4 and with bi-directional SETG (B-SETG) in Group 5. On the 12th week of the experiment, electrophysiologic, gross macroscopic and microscopic evaluation of muscle function and microscopic assessments of muscle and nerve samples were performed. The left limb and proximal nerve segment of the defect area were used as the control side. Results: Electrophysiologic, macroscopic (wet muscle weight) and microscopic (axonal count, muscle fiber thickness was superior in the ANG group compared with TETG and SETG techniques. B-SETG showed poor results in all of the aforementioned findings. TETG and O-SETG techniques showed similar neuromuscular functions. Conclusion: Although the ANG technique has some disadvantages depending on the sacrification of a donor nerve and donor side, it has significantly superior reconstructive outcomes compared to ETG techniques. However, since the ETG techniques provide acceptable results, they should be in surgeons’ treatment repertoire because of the unique features of the microsurgical intervention.","PeriodicalId":7100,"journal":{"name":"Acta Medica","volume":"63 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":"135426435","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}

引用次数: 0

Ambulatory management of a patient with bartter syndrome under general anesthesia 全身麻醉下bartter综合征患者的门诊治疗

Acta Medica Pub Date : 2023-09-28 DOI: 10.32552/2023.actamedica.898

Remek Kocz, Elizabeth Koch

引用次数: 0

Affective neuroscience personality differences between medical school students and engineering school students 医学院学生与工学院学生情感神经科学人格差异研究

Acta Medica Pub Date : 2023-09-28 DOI: 10.32552/2023.actamedica.882

Yasemin Hoşgören Alıcı, Jamal Hasanli, Selvi Ceran

{"title":"Affective neuroscience personality differences between medical school students and engineering school students","authors":"Yasemin Hoşgören Alıcı, Jamal Hasanli, Selvi Ceran","doi":"10.32552/2023.actamedica.882","DOIUrl":"https://doi.org/10.32552/2023.actamedica.882","url":null,"abstract":"Objective: Medical and engineering faculty students both choose their majors from the field of science. But the educational process differs between the two majors. In this study we aimed to investigate the personality traits that might affect this preference. Affective Neuroscience Personality Scales (ANPS) could be particularly useful in studying the traits linked to the affective formation of the individual. Materials and Methods: We prepared an online survey form collecting the sociodemographic and clinical data and the ANPS. We investigated the relationship between affective personality traits determined by the ANPS and the selection of the major. Also, we examined the affective personality traits that may influence the development of psychiatric illness in our sample. Results: 219 medical students and 222 engineering students participated the study. Participants’ ages ranged between 18 and 33 (Median=21; IQR=3). Among participants 60,5% were female, 34,7% has a psychiatric illness, 11,3 % had a chronic illness, and 16,8% has a family history of psychiatric illness. ANPS total and subscale scores weren’t different between the groups. The SADNESS subscale scores were associated with the occurrence of the psychiatric illness. Conclusion: The lack of difference between the two groups may indicate that affective personality profile is not a decisive factor in this choice. Our limitations are the small sample size, the lack of representation of our sample and the scarcity of data about other factors that might affect this preference. SADNESS was associated with psychiatric disorders in both groups.","PeriodicalId":7100,"journal":{"name":"Acta Medica","volume":"14 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":"135427395","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}

引用次数: 0

Evaluating the modified NUTRIC score as a prognostic tool in the intensive care unit for COVID-19 patients 评估改良的NUTRIC评分作为COVID-19患者重症监护病房的预后工具

Acta Medica Pub Date : 2023-09-28 DOI: 10.32552/2023.actamedica.911

Görkem Tutal Gürsoy, Nuriye Kayalı Şendur, Yıldız Hayran, Levent Yamanel, Hesna Bektaş

{"title":"Evaluating the modified NUTRIC score as a prognostic tool in the intensive care unit for COVID-19 patients","authors":"Görkem Tutal Gürsoy, Nuriye Kayalı Şendur, Yıldız Hayran, Levent Yamanel, Hesna Bektaş","doi":"10.32552/2023.actamedica.911","DOIUrl":"https://doi.org/10.32552/2023.actamedica.911","url":null,"abstract":"Objective: The modified NUTRIC Score (mNUTRIC) score is a screening test designed for evaluating patients in intensive care units. In this study, our aim is to assess the ability of this test to predict mortality, length of hospital stay, and the need for mechanical ventilation in COVID-19 patients in the intensive care units. Materials and Methods: In our retrospective study, we evaluated 67 patients admitted to our COVID-19 intensive care unit between October and November 2020. We analyzed their entry scores and conducted general follow-up assessments. Results: In our study, we found that mortality assessment revealed a significant association between older age (p<0.001), the need for mechanical ventilation (p=0.001), and the presence of dysphagia (p<0.001) in patients who did not survive.Statistically significant findings indicate that patients classified as having high mNUTRIC scores had higher rates of 28-day mortality, the need for mechanical ventilation, and the presence of dysphagia compared to those classified as having low nutritional scores. When patients with neurodegenerative diseases were evaluated as a separate group, no significant association was found between high nutritional scores and mortality, the need for mechanical ventilation, or length of hospital stay. Conclusion: The evaluation of nutritional risk in patients being monitored in intensive care is an important step in patient management. The modified NUTRIC score is a preferable assessment test due to its ease of use.","PeriodicalId":7100,"journal":{"name":"Acta Medica","volume":"13 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":"135426284","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}

引用次数: 0

Gartland Type III Supracondylar humerus fractures in children: Impact of fracture level on outcomes Gartland III型儿童肱骨髁上骨折:骨折程度对预后的影响

Acta Medica Pub Date : 2023-09-28 DOI: 10.32552/2023.actamedica.888

Sancar Bakircioglu, Ulas Can Kolac, Mert Polat, Abdulsamet Emet, A. Mazhar Tokgozoglu, M. Cemalettin Aksoy, Saygin Kamaci

{"title":"Gartland Type III Supracondylar humerus fractures in children: Impact of fracture level on outcomes","authors":"Sancar Bakircioglu, Ulas Can Kolac, Mert Polat, Abdulsamet Emet, A. Mazhar Tokgozoglu, M. Cemalettin Aksoy, Saygin Kamaci","doi":"10.32552/2023.actamedica.888","DOIUrl":"https://doi.org/10.32552/2023.actamedica.888","url":null,"abstract":"Objective: Functional limitation or radiological failure after the treatment may rarely be seen after the surgical treatment of Gartland type 3 supracondylar humerus fractures (SCHF). The present study aims to investigate whether the level of fracture relative to the isthmus of the humerus affects the outcomes. Materials and Methods: Children who underwent closed reduction and percutaneous pinning (CRPP) due to Gartland typle III SCHFs between 2010 and 2017 were investigated. There were 108 elbows treated with a mean age of 6.1 years (range, 1.4 to 11.2 yrs.). The radiological (Carrying Angle, Baumann Angle, Humerocapitellar Angle), clinical (Flynn grade with elbow range of motion) and complications were used to evaluate outcomes including fracture level. A reference line connecting medial epicondyle, olecranon fossa and lateral epicondyle was drawn on Anteroposterior (AP) and lateral x-rays. The level of the fracture line was decided based on the reference line. Low fractures included the fractures below or involving the reference line, whereas high fractures included those above the reference line. Results: There were 80 High and 28 Low fractures according to A reference line connecting medial epicondyle, olecranon fossa and lateral epicondyle and passing through the isthmus. Fractures below the humeral isthmus had significantly low Flynn grade (p:0.049) at the latest follow-up of 2.1 years (range, 1 to 5.1 yrs.). There was no statistically significant difference regarding postoperative sixth week Baumann`s angle, carrying angle and humerocapitallar angle between low and high fracture groups. Conclusions: The present study demonstrates the importance of fracture analysis. Surgeons may consider more stable pin configuration in the low type fractures and future research should aim to analyze the SCHF in terms of fracture morphology.","PeriodicalId":7100,"journal":{"name":"Acta Medica","volume":"13 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":"135427392","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}

引用次数: 0

Comparison of the effects of intravenous analgesic agents used in the intraoperative period on pentraxin-3 levels in patients undergoing on-pump coronary artery bypass surgery 术中静脉注射镇痛药物对无泵式冠状动脉搭桥术患者戊曲辛-3水平影响的比较

Acta Medica Pub Date : 2023-09-28 DOI: 10.32552/2023.actamedica.933

Murat İzgi̇, Murat Tümer, Bilge Çelebioğlu

{"title":"Comparison of the effects of intravenous analgesic agents used in the intraoperative period on pentraxin-3 levels in patients undergoing on-pump coronary artery bypass surgery","authors":"Murat İzgi̇, Murat Tümer, Bilge Çelebioğlu","doi":"10.32552/2023.actamedica.933","DOIUrl":"https://doi.org/10.32552/2023.actamedica.933","url":null,"abstract":"Objective: The aim of this study was to compare the effects of fentanyl, dexmedetomidine, and remifentanil on serum pentraxin 3 levels in patients undergoing on-pump coronary artery bypass surgery. Materials and Methods: In this retrospectively designed study, 36 patients who underwent elective on-pump coronary artery bypass surgery for coronary artery disease in the Cardiovascular Surgery Clinic of our hospital between 01.01.2020 and 31.12.2021 and whose serum pentraxin 3 levels were studied in the pre-operative and post-operative period were included. Patients were divided into 3 groups as fentanyl (Group F), dexmedetomidine (Group D), and remifentanil (Group R) based on the analgesic agent used during the intraoperative period. The data of the patients were obtained by scanning their files and information in the hospital automation system. Results: Demographic characteristics, duration of anesthesia, cardiopulmonary bypass duration, and aortic cross-clamp duration were similar. When serum pentraxin 3 levels were evaluated within groups, the difference between pre-operative and post-operative results was significant. In the intergroup evaluation, only the results obtained from Group F in the pre-operative period were significant compared to the other groups, but there was no significant difference between the results obtained in the post-operative period. Conclusion: When the data of this study were evaluated, it was determined that the analgesic agent used in the intraoperative period of on-pump coronary artery bypass surgery did not significantly affect post-operative serum pentraxin 3 levels.","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":"135426434","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}

引用次数: 0

Sleep medicine practices in pediatric patients during the COVID-19 pandemic COVID-19大流行期间儿科患者的睡眠医学实践

Acta Medica Pub Date : 2023-03-28 DOI: 10.32552/2023.actamedica.764

Birce Sunman, Nagehan Emiralioğlu, Beste Özsezen, Dilber Ademhan Tural, Halime Nayir Büyükşahin, İsmail Güzelkaş, Ebru Yalçın, Deniz Doğru, Nural Kiper, Uğur Özçelik

{"title":"Sleep medicine practices in pediatric patients during the COVID-19 pandemic","authors":"Birce Sunman, Nagehan Emiralioğlu, Beste Özsezen, Dilber Ademhan Tural, Halime Nayir Büyükşahin, İsmail Güzelkaş, Ebru Yalçın, Deniz Doğru, Nural Kiper, Uğur Özçelik","doi":"10.32552/2023.actamedica.764","DOIUrl":"https://doi.org/10.32552/2023.actamedica.764","url":null,"abstract":"Objectives: The COVID-19 pandemic required precautions for infection control in sleep centers. Our aim was to assess the impact of the COVID-19 pandemic on sleep medicine practices. Methods: Data of patients undergoing polysomnography and positive airway pressure titration studies prior to (2019) and during the pandemic (2020) were analyzed. In addition, the effect of taking appropriate precautions and performing SARS-CoV-2 polymerase chain reaction testing on the safety of sleep medicine practices was investigated. Results: The median age of the patients who underwent sleep studies (polysomnography + positive airway pressure titration studies) in 2019 was 7 (2.5-11.5) years (164 male, 147 female), whilst it was 9 (4-12) years (127 male, 84 female) in 2020. During the outbreak, the frequency of sleep studies increased from 3% (311 tests/10068 total number of outpatient visits in 2019) to 3.7% (211 tests/5666 in 2020). In contrast, the frequency of positive airway pressure titration studies declined from 31.8% (99 positive airway pressure titration studies/311 sleep studies) to 21.8% (46 positive airway pressure titration studies/211 sleep studies) in 2020 compared to 2019. Down syndrome was found to be the most common indication both in 2019 (20.9% of all tests) and 2020 (13.7%). Conclusions: Polysomnographies were performed at a high rate despite the pandemic. However, positive airway pressure titration studies were avoided except for urgent indications because of the potential for aerosolization. In this study, it was shown that sleep studies can be performed safely when necessary precautions are taken.","PeriodicalId":7100,"journal":{"name":"Acta Medica","volume":"2017 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135721857","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}

引用次数: 0

[Extrauterine abdominal pregnancy]. 【腹外妊娠】。

Acta Medica Pub Date : 1961-01-01

F C DEFFIS

引用次数: 0