Northern clinics of Istanbul最新文献

{"title":"Changes in the frequency, presentation and surgical outcomes of complicated appendicitis during the pandemic.","authors":"Tunc Eren, Leyla Zeynep Tigrel, Abdullah Kayali, Ahmet Naci Emecen, Ayse Nur Toksoz Yildirim, Hasan Huseyin Mutlu, Ozgur Ekinci, Orhan Alimoglu","doi":"10.14744/nci.2024.58897","DOIUrl":"10.14744/nci.2024.58897","url":null,"abstract":"<p><strong>Objective: </strong>Coronavirus Disease 2019 (COVID-19) has affected every aspect of human life and all health care systems globally. The aim of this study was to investigate the effect of COVID-19 pandemic on the frequency, presentation and surgical outcomes of complicated appendicitis.</p><p><strong>Methods: </strong>Patients who underwent appendectomy for acute appendicitis one year before and one year after the declaration of the pandemic were investigated. Demographics and diagnostic findings as well as surgical and histopathological outcomes were recorded and statistically analyzed.</p><p><strong>Results: </strong>The study group of 409 patients was composed of 241 cases in the pre-pandemic group and 168 cases in the pandemic group revealing that the weekly total number of appendectomies decreased during the pandemic [pre-pandemic, median (IQR): 5 (3-6); pandemic, median (IQR): 3 (2-5); p=0.005]. The pandemic group was significantly associated with a longer time from emergency department admission to hospitalization, increased mean blood C-reactive protein levels and increased rate of postoperative complications (p=0.024, p=0.038 and p=0.004, respectively). Most importantly, pathological examinations revealed a higher number of complicated appendicitis cases in the pandemic group when compared to the pre-pandemic group [26 (15.5%) vs. 19 (7.9%), respectively] which corresponded to a 2.1-fold higher risk of being diagnosed with complicated appendicitis during the pandemic [OR: 2.1 (95% CI: 1.1-4.1), p=0.024].</p><p><strong>Conclusion: </strong>While fewer appendectomies were performed during the pandemic, the incidence of complicated appendicitis and postoperative complications increased considerably.</p>","PeriodicalId":94347,"journal":{"name":"Northern clinics of Istanbul","volume":"11 6","pages":"547-554"},"PeriodicalIF":0.0,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11622751/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142803951","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":"Advances in minimally invasive liver surgery.","authors":"Hilmi Anil Dincer, Ahmet Bulent Dogrul","doi":"10.14744/nci.2024.42744","DOIUrl":"10.14744/nci.2024.42744","url":null,"abstract":"<p><p>As in many surgical branches, minimally invasive methods are becoming increasingly prominent in hepatobiliary surgery. Nowadays, robotic and laparoscopic methods are among the hot topics in the current literature. Both laparoscopic and robotic surgery have better short-term results than open surgery in terms of the blood loss, need for blood transfusion, length of intensive care unit and hospital stay, and postoperative major complication rate. In addition to cosmetic benefits, minimally invasive methods have similar results to open surgery in terms of oncologic outcomes. Minimally invasive techniques for hepatocellular carcinoma, colorectal cancer liver metastasis and cholangiocarcinoma, which are the most common indications for surgery, also for donor and recipient surgeries in organ transplantation, can be safely applied in high-volume centers and by experienced surgeons. The use of robotic surgery is increasing especially in major hepatectomy operations. The main advantages of robotic surgery over laparoscopic surgery are less bleeding, less conversion rate and a shorter learning curve. However, there is a need for studies investigating the cost-effectiveness of robotic surgery, the production of devices such as robotic ultrasonographic dissectors, and the establishment of structured minimally invasive hepatobiliary surgery training programs. The aim of this review is to evaluate the recent findings and current evidence on minimally invasive hepatobiliary surgery.</p>","PeriodicalId":94347,"journal":{"name":"Northern clinics of Istanbul","volume":"11 6","pages":"586-592"},"PeriodicalIF":0.0,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11622747/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142803662","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":"Determination of nutritional status and protein-energy wasting in patients with diabetic nephropathy.","authors":"Elif Karakas, Hatice Colak, Fatma Esra Gunes, Berna Karakoyun","doi":"10.14744/nci.2023.66503","DOIUrl":"10.14744/nci.2023.66503","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to evaluate the nutritional status of patients with stage 3 and 4 diabetic nephropathy (DN; DN-3 and DN-4) and to explain the effect of DN stages on the prognosis of protein-energy wasting (PEW).</p><p><strong>Methods: </strong>Data from demographic characteristics, anthropometric measurements, biochemical findings, food consumption records, and the Subjective Global Assessment (SGA) screening tool of 49 patients (25 DN-3; 24 DN-4) who were followed at the nephrology department were collected. The criteria of the International Society of Renal Nutrition and Metabolism (ISRNM) were used to determine PEW.</p><p><strong>Results: </strong>56% of DN-3 and 66.7% of DN-4 have been diagnosed with diabetes for over 15 years. The groups differed in total body weight, body-muscle weight, creatinine, microalbuminuria, and eGFR values (p<0.05). Protein (g/kg) intake was only different between the groups (p<0.05). 18.4% of patients had SGA-B score, and 26.5% had PEW.</p><p><strong>Conclusion: </strong>Our study provides a general impression about the presence of PEW in DN patients not receiving dialysis in Turkiye. In patients with DN-3 and DN-4, daily energy and macronutrient intakes are adequate by recommendation. According to ISRNM criteria, the prevalence of PEW increased with advancing disease stage. PEW was observed to be more effective than SGA in assessing malnutrition.</p>","PeriodicalId":94347,"journal":{"name":"Northern clinics of Istanbul","volume":"11 6","pages":"560-568"},"PeriodicalIF":0.0,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11622758/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142804047","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":"Dodder (<i>Cuscuta</i> sp.) extract prevents cognitive deficits in a rat model of hepatic encephalopathy.","authors":"Omercan Albayrak, Bilge Nur Hatipoglu, Dilek Ozbeyli, Ali Sen, Turkan Koyuncuoglu, Ozge Cevik, Feriha Ercan, Fatma Kanpalta, Ahmet Dogan, Seren Ede Pazarbasi, Goksel Sener","doi":"10.14744/nci.2023.95776","DOIUrl":"10.14744/nci.2023.95776","url":null,"abstract":"<p><strong>Objective: </strong>In our study, the protective effect of dodder plant extract against encephalopathy induced by cholestatic liver disease model was investigated.</p><p><strong>Methods: </strong>Spraque Dawley rats were used in the study. For the cholestatic liver disease model, the bile duct ligation (BDL) was applied. The groups were determined as control, Cuscuta sp. (CUS), BDL and BDL + CUS. Double ligation was performed in the bile duct in the BDL groups. For the applications, saline (SF) was administered to the control and BDL groups for 28 days while 250 mg/kg of Cuscuta sp. extract was given by oral gavage to the CUS and BDL + CUS groups. At the end of the experiment, cognitive evaluations were made by applying new object recognition and Morris water maze tests. After these tests, blood-brain barrier (BBB) measurements were made in half of the groups. In the other half of the groups, brain tissue samples were taken by decapitation and transforming growth factor-beta (TGF-β), 8-hydroxydeoxyguanosine (8-OHdG) and sodium-potassium adenosine triphosphatase (Na⁺/K⁺-ATPase) measurements were made in the tissues. Histological examinations of the tissues were also performed.</p><p><strong>Results: </strong>Cognitive performance was low, and BBB permeability was found to be increased in the group with bile duct ligation. In addition, TGF-β and 8-OHdG levels were increased in tissues, while Na⁺/K⁺-ATPase enzyme activity was suppressed. Treatment with Cuscuta sp. increased cognitive performance and decreased BBB permeability. Other biochemical parameters examined were significantly (p<0.05-0.001) reversed and supported by histological findings.</p><p><strong>Conclusion: </strong>Our findings in the study suggest that dodder plant may be beneficial for the protection of cognitive performance and brain tissue in encephalopathy caused by cholestasis.</p>","PeriodicalId":94347,"journal":{"name":"Northern clinics of Istanbul","volume":"11 6","pages":"512-519"},"PeriodicalIF":0.0,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11622753/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142804073","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":"Postoperative physical activity limitations and balance changes on patients who have been operated for breast cancer.","authors":"Onur Zambak, Fikret Ezberci, Duygu Kurtulus, Huseyin Kerem Tolan, Hakan Cakit","doi":"10.14744/nci.2023.44538","DOIUrl":"10.14744/nci.2023.44538","url":null,"abstract":"<p><strong>Objective: </strong>The purpose of this study is to assess the postoperative physical activity limitations and balance changes in patients who have been operated on for breast cancer. Some physical activity limitations and balance disorders can be expected after breast cancer surgery.</p><p><strong>Methods: </strong>From 2008 to 2016, 112 patients who underwent breast cancer surgery were included in this study. The patients who have some neurological, physical, pulmonary or cardiac diseases were not included. Patients were invited to the hospital. Lack of balance and physical activity limitations were evaluated with a questionnaire including 17 questions.</p><p><strong>Results: </strong>On the postoperative frequency distribution of physical activities criteria out of 112 patients %33.1 (n=37) people got 4 points and over while %66.9 (n=75) people got less than 4 points. After the operation, since more than 75 people got less than 4 points, it is accepted as inadequate in terms of physical activity. Looking at balance changes, in patients with breast-conserving surgery (BCS)were approximately 5.94-0.82 where as average modified radical mastectomy (MRM)was 5.94-0.41. According to criteria on postoperated patients' balance changes, the value of f was 3.162, contrary to this, as the value of p was found 0.078. Differences between operation and balance changes were not significant.</p><p><strong>Conclusion: </strong>The patients who have had breast cancer surgery, physical activities were limited and life quality was down after the operation. On the other hand, there was no significant difference on balance changes depending on the operations.</p>","PeriodicalId":94347,"journal":{"name":"Northern clinics of Istanbul","volume":"11 6","pages":"541-546"},"PeriodicalIF":0.0,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11622755/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142804096","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":"The evaluation of cyclin D1 expression in prostate carcinoma cases.","authors":"Asude Aksoy, Selcen Vicdanli, Gokhan Artas","doi":"10.14744/nci.2023.79735","DOIUrl":"10.14744/nci.2023.79735","url":null,"abstract":"<p><strong>Objective: </strong>Cyclin D1 (CDDN1) is an important protein for mitotic cell cycle advancement through the G1 phase and contributes to the control of the cyclin-dependent kinases CDK4 and CDK6. We evaluated the relationship between CDDN1 expression and clinicopathological features in prostate cancer (PCa) cases and whether CDDN1 could be used as a prognostic biomarker for PCa cases in this study.</p><p><strong>Methods: </strong>This study comprised ninety cases; seventy-five had PCa and fifteen had benign prostatic hypertrophy (BPH) diagnoses (as the control group). The pathological specimens were stained immunohistochemically and categorized as a 'low' (L) or a 'high' (H) group for CDDN1 expression. The cases' clinicopathological features and survival rates were evaluated statistically, within a 95% confidence interval, p<0.05, retrospectively.</p><p><strong>Results: </strong>The median follow-up time was 75 (17-96) months, and the median overall survival (OS) was 87 months (CI 95%: 74.74-99.25). While the OS was 66 months (CI 95%: 49.61-82.38) in the H-CDDN1 group, the OS of the L-CDDN1 group was not yet reached. The OS of the L-CDDN1 group was longer in statistical significance (p=0.011). A Cox regression analysis revealed that the levels of CDDN1 expression, the values of lactate dehydrogenase, and post-treatment prostate specific antigen were found to be prognostic factors for OS in PCa cases (p<0.05).</p><p><strong>Conclusion: </strong>Our results suggest the overexpression of CDDN1 is a potentially useful but poor prognostic biomarker for PCa cases.</p>","PeriodicalId":94347,"journal":{"name":"Northern clinics of Istanbul","volume":"11 6","pages":"534-540"},"PeriodicalIF":0.0,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11622750/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142804208","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 corporate experiences during the accreditation process in the field of health - A qualitative study.","authors":"Tuncay Palteki, Nedim Havle, Demet Gokmen Kavak, Ayse Sibel Oksuz, Aykut Ilker Arslan, Ezgi Salar, Esengul Purkuloglu, Gamze Ozcan, Nesrin Aydemir, Ozlem Palancioglu, Yeliz Soy Kibriz","doi":"10.14744/nci.2023.28482","DOIUrl":"10.14744/nci.2023.28482","url":null,"abstract":"<p><strong>Objective: </strong>In our study, we attempted to determine the accreditation process experience of hospital senior managers accredited by the Turkish Health Care Quality and Accreditation Institute (TUSKA). Along with the institutions' accomplishments through the accreditation program, the major challenges they faced during the accreditation process were revealed.</p><p><strong>Methods: </strong>One of the qualitative research designs used was interpretive phenomenological analysis, which was carried out through semi-structured interviews with hospital senior managers.</p><p><strong>Results: </strong>In the study conducted with eight participants, 55 sub-themes emerged under 12 main themes. The participants expressed their opinions on a wide range of topics, from the achievements related to the accreditation process to the difficulties they encountered, from their strengths to the dissemination of accreditation throughout the country.</p><p><strong>Conclusion: </strong>It has been understood that the national hospital accreditations carried out in our country provide important gains to the institutions in management and clinical activities, while the expectations on incentives and other similar issues have not yet been met.</p>","PeriodicalId":94347,"journal":{"name":"Northern clinics of Istanbul","volume":"11 6","pages":"501-511"},"PeriodicalIF":0.0,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11622743/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142804147","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":"Post-menopausal status in primary antiphospholipid syndrome is associated with low HDL-C levels.","authors":"Jozélio Freire de Carvalho","doi":"10.14744/nci.2023.71363","DOIUrl":"10.14744/nci.2023.71363","url":null,"abstract":"","PeriodicalId":94347,"journal":{"name":"Northern clinics of Istanbul","volume":"11 6","pages":"600-601"},"PeriodicalIF":0.0,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11622757/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142804166","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 bladder capacity in pediatric patients with nocturnal enuresis using voiding diary and uroflowmetry: A retrospective study.","authors":"Sevim Yener, Zekeriya Ilce","doi":"10.14744/nci.2024.89990","DOIUrl":"10.14744/nci.2024.89990","url":null,"abstract":"<p><strong>Objective: </strong>This retrospective study was conducted in a tertiary hospital in Turkiye, it was aimed to evaluate the results of kidney and bladder ultrasonography, uroflowmetric study and volume frequency chart in children diagnosed with bedwetting at night.</p><p><strong>Methods: </strong>This study focused on patients aged 5-17 years who were treated for nocturnal enuresis in the single-center pediatric urology clinic of a tertiary hospital between 2017-2021. Patients' comorbidities, surgical history, urinary ultrasonography findings, uroflowmetry examination results, and two-day voiding diary were requested.</p><p><strong>Results: </strong>The number of pediatric patients diagnosed with enuresis nocturna was 956. Abnormal ultrasonography findings were observed in 13.9% of patients. Almost half of the patients had a positive family history, and 13.4% had a history of previous surgical procedures. While the voiding diary indicated that 54.2% of patients had bladder volumes equivalent to the expected bladder capacity, uroflowmetry examination revealed low bladder capacity in 65% of patients.</p><p><strong>Conclusion: </strong>This study underscores the significance of comprehensive evaluations, including detailed ultrasonography and voiding diary measurements, in pediatric patients with monosymptomatic enuresis nocturna. Our study suggests that bladder volume measured through a two-day weekend voiding diary may provide more effective information for estimating optimal bladder capacity compared to measurements obtained through uroflowmetry.</p>","PeriodicalId":94347,"journal":{"name":"Northern clinics of Istanbul","volume":"11 5","pages":"471-475"},"PeriodicalIF":0.0,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11487315/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142485079","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 the teratogenic effects of pregabalin usage during pregnancy: A multicenter case-control study.","authors":"Mert Kaskal, Busra Kuru, Ilknur Erkoseoglu, Huseyin Yilmaz, Baris Karadas, M Zafer Goren","doi":"10.14744/nci.2024.57702","DOIUrl":"10.14744/nci.2024.57702","url":null,"abstract":"<p><strong>Objective: </strong>Information regarding pregabalin use is limited. We aimed to assess the outcome of the patients who have taken pregabalin at a certain time during their pregnancies.</p><p><strong>Methods: </strong>31 patients used pregabalin treatment during pregnancy and 93 control patients were included in the study who applied to hospital between the years 2013-2022. In this multicenter case-controlled study, the outcome of the pregnancies and the health condition of the newborn in the pregabalin and control groups were evaluated.</p><p><strong>Results: </strong>Preterm delivery rates (5/27 (18.5%) vs. 5/87 (5.7%); OR 0.26, 95% CI 0.07-1.01, p=0.04) and lower birth weight (6/27 (22.2%) vs. 5/81 (6.6%); OR 4.34, 95% CI 1.20-15.65, p=0.016) were found higher in the pregabalin group compared to the control group. However, significant difference was not found between the birth dates of babies in pregabalin and control groups with the log-rank test (p=0.30). Spontaneous abortion rates were not significantly different (2/31 (6.4%) vs. 4/93 (4.3%); OR 1.52, 95% CI 0.26-8.72, p=0.63). Although major malformation rates in pregabalin were higher than those in controls (3/27 (11%) vs. 4/88 (4.5%); OR 0.38, 95% CI 0.07-1.82, p=0.21) the outcomes were statistically insignificant.</p><p><strong>Conclusion: </strong>Preterm delivery rates and lower birth weight were higher in pregabalin group. Also, it should not be ignored that chronic diseases of the pregnant women in pregabalin group may affect the outcomes poorly.</p>","PeriodicalId":94347,"journal":{"name":"Northern clinics of Istanbul","volume":"11 5","pages":"460-465"},"PeriodicalIF":0.0,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11487309/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142485081","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}