Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES最新文献

{"title":"Comparison of erector spinae plane block and rectus sheath block for postoperative analgesia in patients undergoing laparoscopic cholecystectomy: A retrospective non-inferiority study.","authors":"Mete Manıcı, Ilayda Kalyoncu, Merve Ümran Yılmaz, Ergün Mendeş, Derya Salim Uymaz, Emre Balık, Yavuz Gürkan","doi":"10.14744/tjtes.2024.77756","DOIUrl":"10.14744/tjtes.2024.77756","url":null,"abstract":"<p><strong>Background: </strong>Effective management of postoperative analgesia following laparoscopic cholecystectomy (LC) is critical to ensure optimal patient comfort and recovery. This study evaluates the effects of erector spinae plane block (ESPB) and rectus sheath block (RSB) on opioid consumption to determine non-inferiority.</p><p><strong>Methods: </strong>This retrospective study analyzed 44 patients aged 18 to 75 years who underwent LC at our hospital between December 2022 and March 2023, with American Society of Anesthesiologists (ASA) scores of I-II. Patients were divided into two groups: ESPB (n=24) and RSB (n=20). The ESPB group received a preoperative bilateral injection of 20 mL of 0.25% bupivacaine, while the RSB group received a postoperative bilateral injection of 20 mL of 0.25% bupivacaine. The primary outcome measure was opioid consumption within the first 24 hours postoperatively.</p><p><strong>Results: </strong>The demographic characteristics of the RSB and ESPB groups were similar. Opioid consumption during the first 24 hours was 6.29+-1.73 mg in the ESPB group and 6.60+-3.41 mg in the RSB group, with no statistically significant difference between the two groups (95% confidence interval [CI]: -1.64 to 1.02; p=0.717). When the equivalence margin was set at -2 mg, opioid consumption in the RSB group was found to be similar to that in the ESPB group. Fentanyl rescue analgesia in the postoperative care unit was required by three patients in the ESPB group and five patients in the RSB group (p=0.400). Visual Analog Scale (VAS) pain scores and the number of patients who developed nausea and vomiting in the first 24 hours postoperatively were similar between the groups (p>0.05).</p><p><strong>Conclusion: </strong>The erector spinae plane block and RSB demonstrated comparable analgesic efficacy. Rectus sheath block was found to be non-inferior to ESPB in LC surgery with respect to 24-hour opioid consumption. The groups were also similar regarding rescue analgesia, VAS scores, shoulder pain, and the frequency of nausea and vomiting.</p>","PeriodicalId":94263,"journal":{"name":"Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES","volume":"31 3","pages":"242-248"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11894234/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143575026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of traumatic peripheral nerve injuries in terms of Forensic Medicine.","authors":"Emre Gürkan Bulutluöz, Hüseyin Balandız, Sait Özsoy","doi":"10.14744/tjtes.2024.73076","DOIUrl":"10.14744/tjtes.2024.73076","url":null,"abstract":"<p><strong>Background: </strong>Traumatic peripheral nerve injuries are one of the leading causes of disability in young individuals. This study aims to evaluate cases of traumatic peripheral nerve injury from a forensic medical perspective and to identify their characteristic features.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 6,953 cases who presented to the Forensic Medicine Clinic of Gülhane Training and Research Hospital between September 1, 2016 and June 31, 2023. Among these, 393 cases with traumatic peripheral nerve injuries were included in the study. The age, gender, occupation, cause of trauma, scope of the legal case, injured peripheral nerves, associated bone fractures, muscle strength and sensory loss, functional recovery status, psychiatric diagnosis, and electromyography (EMG) results of the cases were examined. All medical reports of the cases were evaluated within the scope of relevant legal regula-tions.</p><p><strong>Results: </strong>This study analyzed 393 cases with ages ranging from 17 to 70 years (mean age: 28.2 years). Of these, 94.9% were security personnel. The most common causes of injury were explosive devices and firearm injuries. The most frequently damaged nerves were the peroneal, ulnar, and tibial nerves. According to EMG findings, partial axonal degeneration was detected in 82.79% of the injured nerves, while total axonal degeneration was identified in 17.21%. Injuries were most commonly observed in the elbow-forearm region. Full functional recovery was noted in 5.1% of the cases. Bone fractures, particularly in the knee-leg region, were present in 73.3% of the cases. Psychiatric disorders developed in 22.1% of the cases. Injuries were deemed permanent in 94.5% of the cases, and re-evaluation was required in 60.7% of the cases after 18 months post-injury. Permanent disability was identified in 94.9% of the cases.</p><p><strong>Conclusion: </strong>A detailed forensic evaluation of traumatic peripheral nerve injuries was conducted, highlighting their frequent occurrence in military conflict zones. A meticulous assessment of symptoms resulting from these injuries is necessary. Electromyography findings are effective in evaluating nerve injuries and should be integrated with physical examinations.</p>","PeriodicalId":94263,"journal":{"name":"Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES","volume":"31 3","pages":"269-275"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11894235/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143575044","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Might be over-evaluated: Predicting choledocholithiasis in patients with acute biliary pancreatitis.","authors":"Aykut Çelik, Cemalettin Ertekin, Leman Damla Ercan, İrem Gider, Feza Ekiz, Mehmet İlhan, Hakan Yanar, Mustafa Kayıhan Günay, Ali Fuat Kaan Gök","doi":"10.14744/tjtes.2024.36114","DOIUrl":"10.14744/tjtes.2024.36114","url":null,"abstract":"<p><strong>Background: </strong>The increase in liver cholestasis enzyme and bilirubin levels, especially due to pancreatitis, mimics choledocholithiasis. This study aimed to examine the relationship between demographic and laboratory cut-off values and the presence of choledocholithiasis in patients with acute biliary pancreatitis (ABP).</p><p><strong>Methods: </strong>Patients diagnosed with ABP in the Department of General Surgery at Istanbul Faculty of Medicine between January 2010 and December 2022 were retrospectively analyzed. The presence of stones in the common bile duct was determined based on the results of magnetic resonance cholangiopancreatography (MRCP), endoscopic ultrasound (EUS), and endoscopic retrograde cholangiopancreatography (ERCP). Demographic and laboratory values of patients with and without bile duct stones were compared. Cut-off values were determined using receiver operating characteristic (ROC) curve analysis, and logistic regression analysis and modeling was performed for each variable.</p><p><strong>Results: </strong>A total of 1,026 ABP patients were evaluated. Patients whose enzyme levels were not elevated and those who did not undergo MRCP were excluded. A total of 584 patients were included in the study, and choledocholithiasis was detected in 188 (32.2%) patients. In multivariate analysis, age, gamma-glutamyl transferase (GGT), alkaline phosphatase (ALP), and direct bilirubin (DB) were found to be statistically associated with choledocholithiasis. The cut-off values were determined as 65 years for age, 394 U/L for GGT, 173 U/L for ALP, and 1.42 mg/dL for direct bilirubin. In the group where all four parameters were below these cut-off values, suggesting a clean common bile duct, it was observed that the negative predictive value was 97%.</p><p><strong>Conclusion: </strong>Based on the demographic and laboratory data of patients with ABP, we were able to predict with more than 97% accuracy that the common bile duct was clean. Considering that our study only included patients who underwent MRCP due to elevated enzyme levels and suspicion of choledocholithiasis, the negative predictive value would be even higher if patients with acute biliary pancreatitis with normal enzyme levels were included. Additionally, no complications were observed in any of the patients during follow-up. This finding suggests that patients whose common bile duct is predicted to be clean can initially be monitored and supported with additional imaging methods if necessary. As a result, unnecessary imaging can be avoided, reducing costs and preventing the mortality and morbidity associated with unnecessary procedures.</p>","PeriodicalId":94263,"journal":{"name":"Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES","volume":"31 3","pages":"249-258"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11894233/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143575048","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictive factors of mortality in patients with abdominal trauma.","authors":"Ömer Faruk Turan, Didem Çankaya Gökdere, Murat Genç, Bensu Bulut, Medine Akkanöz, Hüseyin Mutlu, Ramiz Yazıcı","doi":"10.14744/tjtes.2025.64644","DOIUrl":"10.14744/tjtes.2025.64644","url":null,"abstract":"<p><strong>Background: </strong>Traumatic injuries, particularly abdominal trauma, are a major cause of mortality worldwide. This study aimed to evaluate predictive factors for mortality and morbidity in abdominal trauma patients using simple, rapid, and accessible clinical and laboratory parameters, with a focus on developing scoring systems for emergency department decision-making.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted in a Level 1 Trauma Center between October 2022 and March 2024. Patients aged 18 and older with abdominal trauma or multi-trauma were included, while cases with incomplete records, known chronic diseases, or a recent trauma history were excluded. Data on demographics, vital signs, laboratory results, imaging findings, clinical scores, and outcomes were collected. Logistic regression and receiver operating characteristic (ROC) analyses were performed to identify independent mortality predictors and their cut-off values.</p><p><strong>Results: </strong>Out of 693 patients, the mortality rate was 3.6%. The most common mechanisms of trauma were road traffic accidents (59.3%) and falls (23.4%). Independent predictors of mortality included age ≥54 years, Glasgow Coma Scale (GCS) ≤14, Injury Severity Score (ISS) ≥24, and Shock Index ≥1.08. ROC analysis revealed that GCS had the highest predictive value for mortality (area under the curve [AUC]: 0.828), followed by ISS, age, and Shock Index. Elevated levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), lactate, and creatinine were associated with worse outcomes, aligning with findings in the literature.</p><p><strong>Conclusion: </strong>Age, GCS, ISS, and Shock Index are strong predictors of mortality in abdominal trauma patients. Integrating these parameters into clinical decision-making can enhance risk stratification and improve patient management. Prospective multicenter studies and national trauma registries are necessary to refine trauma care and reduce mortality rates.</p>","PeriodicalId":94263,"journal":{"name":"Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES","volume":"31 3","pages":"276-282"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11894230/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143575055","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radiological outcomes of two non-surgical management methods for mid-shaft clavicle fractures in school-age children: No difference between figure-of-eight bandage and arm sling.","authors":"Ali Engin Daştan, Arman Vahabi, Volga Öztürk, Taha Ahmet Türkoğlu, Aytek Hüseyin Çeliksöz, Okan Tezgel, Levent Küçük, Erhan Coşkunol, Kemal Aktuğlu","doi":"10.14744/tjtes.2025.29946","DOIUrl":"10.14744/tjtes.2025.29946","url":null,"abstract":"<p><strong>Background: </strong>Although non-surgical management is a commonly used treatment for pediatric clavicle fractures, there is limited data in the literature regarding the most effective method. This study aims to compare the radiological outcomes of the figure-of-eight bandage versus the arm sling in the treatment of mid-shaft clavicle fractures in school-age children.</p><p><strong>Methods: </strong>Patients were divided into two groups based on the preferred conservative management method: Group 1 (arm sling) and Group 2 (figure-of-eight bandage). The degree of angulation and shortening was measured at initial admission and during follow-up. Demographic characteristics and radiological data were compared between the two groups.</p><p><strong>Results: </strong>Group 1 included 10 girls and 10 boys, while Group 2 included 12 girls and 17 boys (p=0.761). The mean shortening at initial presentation was 7.28+-6.06 mm in Group 1 and 6.65+-5.58 mm in Group 2 (p=0.625). At follow-up, the mean shortening was 6.24+-5.59 mm in Group 1 and 5.59+-4.91 mm in Group 2 (p=0.569). The mean angulation at initial presentation was 21.28+-10.05° in Group 1 and 20.41+-12.23° in Group 2 (p=0.752). At follow-up, the mean angulation was 14.45+-9.41° in Group 1 and 11.82+-10.27° in Group 2 (p=0.189). In intra-group comparisons, no significant difference was found between the initial shortening and follow-up shortening in either group (Group 1: p=0.062; Group 2: p=0.190). A significant reduction in angulation was observed in both groups during follow-up (p=0.001 for Group 1; p=0.001 for Group 2).</p><p><strong>Conclusion: </strong>The radiological outcomes of the figure-of-eight bandage and the arm sling in the treatment of mid-shaft clavicle fractures in school-age children are similar.</p>","PeriodicalId":94263,"journal":{"name":"Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES","volume":"31 3","pages":"303-309"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11894237/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143575062","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of pediatric gunshot wounds and emergency department dynamics in high-volume incidents.","authors":"Gulbin Aydogdu Umac, Remzi Cetinkaya, Mehmet Ozel, Habip Balsak, Sarper Yilmaz","doi":"10.14744/tjtes.2025.35961","DOIUrl":"10.14744/tjtes.2025.35961","url":null,"abstract":"<p><strong>Background: </strong>Pediatric gunshot injuries present significant challenges to emergency care, highlighting the need for precise strategies in the management of high-volume incidents. This study aims to assess pediatric gunshot injuries presenting to the emergency department in clusters and their outcomes, contributing to the development of a more detailed high-volume incidents classification based on patient numbers.</p><p><strong>Methods: </strong>A retrospective analysis was conducted at a level-one trauma center, focusing on pediatric gunshot admissions. Patients were segmented by admission type: single versus multiple simultaneous admissions from the same incident. Further analysis distinguished between incidents involving three or more victims and those with fewer victims to assess the impact on emergency care outcomes.</p><p><strong>Results: </strong>This study included 182 pediatric patients with gunshot injuries, with a median age of 16 years (IQR 13.75-17). Patients were analyzed using two grouping methods: the first divided patients into single admissions (n=103, 56.6%) and multi-victim presentations (n=79, 43.4%). In this comparison, multi-victim presentations had a lower rate of blood transfusions (RR: 0.58, 95% CI: 0.35-0.95) but similar mortality rates (RR: 0.88, 95% CI: 0.31-2.44). The second grouping method classified incidents with three or more victims (n=35, 19.2%) versus fewer victims (n=147, 80.8%). This analysis showed that incidents with three or more victims had a higher mortality rate (RR: 2.81, 95% CI: 1.08-7.31). The average ED stay was shorter for multi-victim presentations (54.1+-22.5 minutes) compared to solo presentations (65.2+-48.8 minutes).</p><p><strong>Conclusion: </strong>Findings indicate that pediatric gunshot incidents with three or more simultaneous victims, regardless of triage category, significantly affect mortality and ED stay lengths in a center with a single trauma team. This highlights the necessity of defining MCIs based on such patient volumes to optimize emergency care responses and improve outcomes. Establishing objective, outcome-focused criteria for high-volume incidents classification is crucial for enhancing patient care and resource allocation in these critical situations.</p>","PeriodicalId":94263,"journal":{"name":"Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES","volume":"31 2","pages":"167-177"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11843418/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143443074","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of lupeol on experimental testicular ischemiareperfusion damage in rats.","authors":"Abdurrahman Azzam, Ramazan Karabulut, Cem Kaya, Sibel Eryılmaz, Alparslan Kapisiz, Zafer Turkyilmaz, Mehmet Arda Inan, Gizem Yaz Aydin, Ali Atan, Kaan Sonmez","doi":"10.14744/tjtes.2024.09090","DOIUrl":"10.14744/tjtes.2024.09090","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Infertility and organ loss are possible outcomes of testicular torsion, a urological emergency. This study aimed to demonstrate the impact of lupeol on testicular ischemia/reperfusion damage.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Thirty adult male Spraque-Dawley rats were randomized into five groups: Control (C), Lupeol (L), Ischemia (Isc), Treatment 1 (T1), and Treatment 2 (T2). In the study groups, detorsion was applied to the left testicles by creating a 720-degree testicular torsion for 2 h. Additionally, in the T1 and T2 groups, 100 mg/kg of lupeol was injected intraperitoneally 30 minutes before and immediately after detorsion. At the sixth hour,aBACKGROUND: Infertility and organ loss are potential consequences of testicular torsion, a urological emergency. This study aimed to evaluate the impact of lupeol on testicular ischemia-reperfusion damage.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Thirty adult male Sprague-Dawley rats were randomly assigned to five groups: Control (C), Lupeol (L), Ischemia (Isc),Treatment 1 (T1), and Treatment 2 (T2). In the study groups, detorsion was applied to the left testicles following the induction of 720-degree testicular torsion for two hours. In the T1 and T2 groups, 100 mg/kg of lupeol was administered intraperitoneally 30 minutes before and immediately after detorsion. At the sixth hour, blood and testicular tissue samples were collected from each rat. Measurements included serum interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α), tissue glutathione (GSH), malondialdehyde (MDA), and caspase-3 levels. Histopathological analysis was performed to assess the Johnsen Tubular Biopsy Score (JTBS).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Levels of caspase-3 (2.74+-0.32), MDA (1.71+-0.26), IL-6 (4.92+-0.57), and TNF-α (113.18+-29.77) were elevated in Group Isc compared to Group C and showed a significant reduction in Group T2 (2+-0.67, 1.16+-0.36, 3.95+-0.17, and 106.13+-12.49, respectively) and particularly in Group T1 (1.65+-0.50, 0.95+-0.143, 80+-0.35, and 104.86+-8.42, respectively) (p=0.001). However, while TNF-αlevels decreased in both treatment groups, the difference was not statistically significant (p=0.768). GSH levels decreased in Group Isc(140.63+-25.71) but increased in Group T2 (211.58+-95.05) (p=0.753) and particularly in Group T1 (219.9+-48.21)(p=0.078). The JTBS was lowest in Group Isc (7.67+-0.25). However, improvements were observed in both treatment groups (8.93+-0.16 and 8.82+-0.22, respectively) (p=0.001).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;This study, the first to use lupeol in an experimental testicular torsion model, demonstrated its antioxidant, antiinflammatory, anti-apoptotic, histopathological damage-reducing, and protective effects. blood and testicular tissue samples were obtained from each rat. Serum interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α), tissue glutathione (GSH), malondialdehyde (MDA), and caspase-3 measurements were also obtained. Histopathologic","PeriodicalId":94263,"journal":{"name":"Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES","volume":"31 2","pages":"95-102"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11843417/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143443122","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predicting recurrence in primary spontaneous pneumothorax: The role of the Haller index in emergency department patients.","authors":"Ömerul Faruk Aydın, Ali Cankut Tatlıparmak","doi":"10.14744/tjtes.2025.75468","DOIUrl":"10.14744/tjtes.2025.75468","url":null,"abstract":"<p><strong>Background: </strong>Primary spontaneous pneumothorax (PSP) is a common condition encountered in emergency departments, typically affecting young, otherwise healthy individuals. Identifying patients at risk for recurrence is critical for optimizing management strategies and preventing complications. This study aimed to evaluate the predictive value of the Haller index in determining the risk of recurrence in patients diagnosed with PSP.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on patients diagnosed with PSP between January 1, 2019 and January 1, 2024, in the emergency department of a tertiary care hospital. Patients were categorized into two groups: those experiencing a single PSP episode and those with recurrent pneumothorax. Propensity score matching was employed to control for confounders, including age, gender, smoking status, and body mass index (BMI). The Haller index was calculated from chest computed tomography (CT) scans, and its predictive accuracy for recurrence was evaluated using Receiver Operating Characteristic (ROC) curve analysis.</p><p><strong>Results: </strong>A total of 182 patients were included in the study, with 91 patients in each group after propensity score matching. The Haller index was significantly higher in the recurrent pneumothorax group (2.72+-0.47) compared to the single pneumothorax group (2.15+-0.34), with a mean difference of 0.56 (95% confidence interval [CI]: 0.44-0.69, p<0.001). ROC analysis demonstrated an area under the curve (AUC) of 0.830 (95% CI: 0.768-0.882), with a Youden index of 0.50, sensitivity of 72.53%, and specificity of 76.92% for a cutoff value of >2.38.</p><p><strong>Conclusion: </strong>The Haller index is a strong predictor of recurrent pneumothorax in patients with PSP. Its integration into clinical assessments can help identify patients at elevated risk of recurrence, enabling tailored treatment strategies.</p>","PeriodicalId":94263,"journal":{"name":"Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES","volume":"31 2","pages":"155-160"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11843428/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143443092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of acute calculous cholecystitis in the emergency department: Evaluating the role of laboratory and radiological findings in a retrospective study.","authors":"Omer Faruk Turan, Emine Sarcan, Seyda Gedikaslan, Aybuke Soylu, Fatih Mehmet Aksoy, Abdullah Dodurga, Gul Sila Mutlu, Yusuf Yavuz, Jacek Smereka","doi":"10.14744/tjtes.2025.62703","DOIUrl":"10.14744/tjtes.2025.62703","url":null,"abstract":"<p><strong>Background: </strong>Acute calculous cholecystitis (ACC) is a significant cause of acute abdominal pain, accounting for 90-95% of gallbladder inflammations caused by gallstones. Its clinical presentation ranges from nonspecific abdominal pain to septic conditions associated with an acute abdomen. Timely and accurate diagnosis is critical in patient management, as delayed diagnosis or inadequate treatment can result in increased morbidity and life-threatening complications such as perforation or biliary peritonitis. This study aims to identify factors influencing the severity of ACC by analyzing the relationship between laboratory findings, radiological imaging, and pathology results in cases managed in the emergency department.</p><p><strong>Methods: </strong>This retrospective study was conducted at the emergency department of Etlik City Hospital, a tertiary care center. Patients diagnosed with acute cholecystitis were included in the study, while those under 18 years of age and those with choledocholithiasis were excluded. Patients' radiological findings, laboratory parameters, and pathological results were analyzed.</p><p><strong>Results: </strong>A total of 230 patients were included in the study. Patients with pericholecystic fluid exhibited significantly thicker gallbladder walls (p=0.002). A significant association was found between elevated white blood cell (WBC) counts and gallbladder wall thickness (p=0.035). However, no significant relationship was observed between liver function test results and gallbladder wall thickness.</p><p><strong>Conclusion: </strong>This study evaluated the diagnostic and management parameters utilized by clinicians in cases of acute calculous cholecystitis. The association between increased gallbladder wall thickness and pericholecystic fluid was highlighted as a key factor in diagnosis and follow-up. Although laboratory and imaging modalities provide supportive roles in diagnosis, their necessity may vary depending on the individual case. The study emphasizes the importance of a holistic approach that integrates clinical, laboratory, and radiological findings to optimize patient outcomes in the emergency department, avoid unnecessary interventions, and prevent delays in surgical treatment.</p>","PeriodicalId":94263,"journal":{"name":"Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES","volume":"31 2","pages":"161-166"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11843415/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143443078","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Melatonin as a shield against skeletal muscle damage: A study on ischemia-reperfusion injury.","authors":"Ertan Demirdaş, Gökhan Arslan, Hakan Kartal, Gökhan Erol, Tayfun Özdem, Başak Büyük Yavuz, Celalettin Günay, Bilgehan Savaş Öz","doi":"10.14744/tjtes.2025.44890","DOIUrl":"10.14744/tjtes.2025.44890","url":null,"abstract":"<p><p>We evaluated the protective effects of melatonin against skeletal muscle ischemia-reperfusion injury, a significant cause of skeletal muscle damage. Ischemia-reperfusion (I/R) injury occurs due to a temporary restriction of blood flow (ischemia) followed by its restoration (reperfusion), triggering oxidative stress, inflammation, and cell death. Although current treatments are limited, melatonin's antioxidant and anti-inflammatory properties suggest potential benefits.</p><p><strong>Methods: </strong>We studied 30 male mice divided into five groups: control, melatonin control, I/R, melatonin + I/R, and dimethyl sulfoxide control. After the designated treatments, we assessed muscle tissue for antioxidant capacity (total antioxidant status [TAS]), oxidative stress markers (total oxidative status [TOS] and malondialdehyde [MDA]), inflammation (myeloperoxidase [MPO]), and cell death (terminal deoxynucleotidyl transferase dUTP nick-end labeling [TUNEL] assay and histological analysis).</p><p><strong>Results: </strong>Melatonin significantly increased antioxidant capacity (TAS) compared to all other groups. Conversely, oxidative stress (TOS) was significantly lower in the melatonin + I/R group compared to the I/R group alone. Histological analysis revealed greater necrosis, edema, inflammation, and cell death in the I/R group compared to others. Interestingly, the melatonin + I/R group exhibited significantly less damage than the I/R group, highlighting melatonin's protective effect.</p><p><strong>Conclusion: </strong>This study demonstrates that exogenous melatonin effectively reduces oxidative stress, inflammation, and cell death in skeletal muscle tissue subjected to I/R injury. These findings suggest that melatonin may be a promising therapeutic agent for mitigating I/R-induced complications in skeletal muscle injury.</p>","PeriodicalId":94263,"journal":{"name":"Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES","volume":"31 2","pages":"103-111"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11843425/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143443079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}