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1.
Ann Vasc Surg ; 74: 80-87, 2021 Jul.
Article in English | MEDLINE | ID: mdl-33819598

ABSTRACT

BACKGROUND: Coronavirus disease 2019 (COVID-19) causes thromboembolic complications during or post-infection period despite a lack of conventional risk factors. The study aims to learn fundamental changes in COVID-19 patients who underwent embolectomy in terms of clinical characteristics and clot composition. METHODS: In a retrospective cohort study design, we evaluated 21 patients who underwent embolectomy in our clinic between March 12, 2020, and December 31, 2020. Demographics, characteristics, and laboratory values were abstracted and analyzed. Histopathological assessment was held in the pathology department. RESULTS: Of these 21 patients, 11 (52.3%) were SARS-CoV-2 positive and 10 (47.6%) were SARS-CoV-2 negative. There is no statistical difference in terms of anatomic distribution, diagnostic method, length of hospital stay, amputation or mortality levels. Thromboembolic material of COVID-19 patients include significantly less red blood cell (RBC) (21.2-32.6%; P= 0.01), more lymphocyte (14.1-2.6%; P< 0.001), and more leukocyte (27.1-22.1%; P= 0.05). There was no statistical difference between the fibrin ratio. CONCLUSIONS: Inflammatory cells are prominent in arterial thromboembolic material of COVID-19 patients. A combination of hyperinflammation and prothrombotic status may be responsible for this phenomenon.


Subject(s)
COVID-19/complications , Inflammation/pathology , Peripheral Arterial Disease/pathology , Thromboembolism/pathology , Adult , Aged , Aged, 80 and over , Amputation, Surgical , COVID-19/diagnosis , COVID-19/mortality , Embolectomy , Female , Humans , Inflammation/etiology , Inflammation/mortality , Inflammation/surgery , Length of Stay , Limb Salvage , Male , Middle Aged , Peripheral Arterial Disease/etiology , Peripheral Arterial Disease/mortality , Peripheral Arterial Disease/surgery , Retrospective Studies , Risk Assessment , Risk Factors , Thromboembolism/etiology , Thromboembolism/mortality , Thromboembolism/surgery , Time Factors , Treatment Outcome
2.
Turk Patoloji Derg ; 33(2): 144-149, 2017.
Article in English | MEDLINE | ID: mdl-28272673

ABSTRACT

OBJECTIVE: The aim of this study was to compare three different new bipolar energy modalities and classic bipolar in vivo for tissue thermal spread. MATERIAL AND METHOD: This prospective, randomized, single-blind study was conducted between Septemsber 2012 and July 2013. Eighteen patients aged 40-65 years undergoing hysterectomy and bilateral salpingectomy for benign etiology were included in the study. Before the hysterectomy operation began, it was marked nearly distal third cm started from uterine corn and proximal close third cm started from fimbrial bottoms by visualizing both fallopian tubes. The surgery was performed using one 5 mm applicator of PlasmaKinetics™, EnSeal®, LigaSure™ or classic bipolar energy modality. The time each device was used was standardized as the minimum time of the audible warning of the device for tissue impedance and as tissue vaporization on classic bipolar. Tissues were dyed by both H&E and Masson's Trichrome in the pathology laboratory. Thermal spread was compared. RESULTS: Evaluation of the damage on the uterine tubes by each device used revealed that LigaSure™ was associated with increased thermal injury compared to PlasmaKinetics™ (p=0.007). Apart from PlasmaKineticsTM (p=0.022), there was no statistically significant difference between the three devices in terms of thermal damage spread in the distal and proximal fallopian tubes. CONCLUSION: To reduce lateral thermal damage, Plasmakinetics™ may be preferable to Ligasure™ among the three different new bipolar energy modalities.


Subject(s)
Electrosurgery/instrumentation , Fallopian Tubes/surgery , Hysterectomy/instrumentation , Salpingectomy/instrumentation , Adult , Aged , Electrosurgery/methods , Female , Humans , Hysterectomy/methods , Middle Aged , Prospective Studies , Salpingectomy/methods , Single-Blind Method
3.
Int J Clin Oncol ; 20(1): 70-81, 2015 Feb.
Article in English | MEDLINE | ID: mdl-24532163

ABSTRACT

BACKGROUND: The neutrophil-to-lymphocyte ratio (NLR) is a strong predictor of mortality in patients with cancer. Similarly, a study in a large series has shown that the newly defined derived NLR (dNLR; neutrophil/leukocyte-lymphocyte ratio) also has prognostic value. The present study retrospectively evaluates the prognostic significance of NLR and dNLR in breast cancer. METHODS: Hematological parameters and clinicopathological data during diagnosis were retrospectively recorded for 1,527 patients diagnosed with breast cancer at Izmir Katip Celebi University Ataturk Research and Training Hospital from January 2006 to December 2011. The cut-off values were determined by calculating the NLR and dNLR of the patients. RESULTS: The cut-off values were determined as 4 and 2 for NLR and dNLR, respectively. The association between NLR and dNLR assessed by Spearman's rank correlation analysis was 0.935 (P < 0.001). There was a significant difference regarding disease free survival (DFS) and overall survival (OS) in patients with NLR <4 and NLR ≥4 (respectively, P < 0.00, P < 0.001). Similarly, there was a significant difference regarding DFS and OS in patients with dNLR <2 and dNLR ≥2 (respectively, P < 0.001, P < 0.001). Furthermore, NLR and dNLR demonstrated a significant association with the American Joint Committee on Cancer (AJCC) staging (P < 0.001). Assessment using the Cox proportional multivariate model showed that high NLR, pN, pT, luminal A-like, luminal B-like (HER2 positive), basal-like, and AJCC staging are independent prognostic factors. DISCUSSION: NLR was shown to be better than dNLR in terms of predicting prognosis in patients with breast cancer. However, large prospective studies are required to further demonstrate the prognostic significance of these two values.


Subject(s)
Breast Neoplasms/pathology , Lymphocytes/pathology , Neutrophils/pathology , Adult , Disease-Free Survival , Female , Humans , Middle Aged , Prognosis , Retrospective Studies
4.
Am J Emerg Med ; 30(9): 2081.e3-5, 2012 Nov.
Article in English | MEDLINE | ID: mdl-23158061

ABSTRACT

Spontaneous urinary bladder perforation is a rare and life-threatening condition similar to traumatic and iatrogenic perforation. The connection with the underlying bladder damage due to previous radiotherapy, inflammation, malignancy, obstruction, or other causes can be found in almost all cases. The symptoms are often nonspecific, and misdiagnosis is common. Here, we present a case of spontaneous urinary bladder perforation due to bladder necrosis in a diabetic woman. She presented to the emergency department with abdominal pain. Exploratory laparotomy was performed by surgeons and revealed necrosis of the anterior and lateral walls of the urinary bladder. Microscopic examination revealed necrotic changes throughout the bladder wall. Ghost-like cellular outlines were compatible with coagulative necrosis. Clusters of bacteria were also present in some necrobiotic tissues. Malignant cells were not present. It appears probable that the infection was due to local interference with the blood supply (arterial, capillary, or venous) combined with the systemic metabolic upset that led to the bladder condition. In our case, we observed partial necrosis of the bladder rather than distortion of the entire blood supply to the bladder as consequences of the microvascular effects of diabetes. Urinary bladder perforation must be considered in the differential diagnosis of patients presenting with free fluid in the abdomen/peritonitis, decreased urine output, and hematuria, and in whom increased levels of urea/creatinine are detected in serum and/ or peritoneal fluid aspirate.


Subject(s)
Urinary Bladder Diseases/etiology , Emergency Service, Hospital , Fatal Outcome , Female , Humans , Middle Aged , Necrosis , Rupture, Spontaneous , Urinary Bladder/pathology , Urinary Bladder Diseases/pathology
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