The relationship between preoperative CEA and CA19-9 status and patient characteristics and lymph node involvement in early-stage colon cancer.

OBJECTIVE: Colon cancer is a primary human cancer that accounts for approximately one-tenth of all cancers and is one of the three most common cancers in incidence and mortality. This study investigated the relationship between serum preoperative carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9), patient characteristics and lymph node (LND) involvement in early-stage colon cancer. PATIENTS AND METHODS: A total of 154 patients who had undergone surgery for early-stage colon cancer were included in this study. Patient demographics regarding age and gender, laboratory parameters, tumor size, and tumor laterality were recorded. CEA and CA19-9 positivity was defined as patients whose tumor markers were above the cut-off values, and patients were grouped according to CEA and CA19-9 positivity. Patients were compared according to the CEA and CA19-9 status and pathological LND involvement. RESULTS: We found that patients in the CEA (+) and CA19-9 (+) groups were significantly older than the others. Our study detected LND involvement in histopathological examination in 25% of patients. LND pathological participation was significantly higher in the CEA (+) CA19-9 (+) group, and being age 65 years or older was found to be a risk factor for pathological LND involvement. CONCLUSIONS: Clinicians should pay more attention to LND involvement when both CEA and CA19-9 are elevated preoperatively in early-stage colon cancer patients. Preoperative CEA and CA19-9 status of patients is important in predicting LND involvement and, as a result, the prognosis of these patients.

Diurnal characteristics of heart rate variability in patients with sarcoidosis.

BACKGROUND: The aim of this study was to evaluate autonomic nervous system function by measuring heart rate variability (HRV) in patients with sarcoidosis without known cardiac manifestations. PATIENTS AND METHODS: The study comprised 61 participants, including 31 patients with sarcoidosis without known cardiac manifestations and 30 healthy volunteers. All participants underwent echocardiographic examination, 12-channel electrocardiography (ECG), and 24-h Holter monitoring. HRV parameters were determined and compared between the groups. RESULTS: There were no differences between groups with regard to age, body mass index, systolic and diastolic blood pressure, or heart rate at the time of admission. In the time domain analyses, the 24-h, daytime, and night-time standard deviations of all normal-to-normal R­R interval (SDNN) values were significantly lower in patients with sarcoidosis than those in the controls. The frequency domain analyses showed that 24-h and daytime low-frequency (LF) values, 24-h, daytime, and night-time high-frequency (HF) values were significantly lower in the patient group compared with the control group, whereas the night-time LF/HF ratio was significantly higher. CONCLUSION: Although Holter ECG is not a diagnostic tool for cardiac sarcoidosis, the HRV parameters, especially the night-time LF/HF values, may demonstrate increased sympathetic activation in patients with sarcoidosis.

Is pneumoconiosis a factor of severity in acute exacerbation of chronic obstructive pulmonary disease?

BACKGROUND AND AIM: Although working in a coal mine is a wellknown risk factor for chronic obstructive pulmonary disease (COPD), there insufficient data explaining the association between acute exacerbation of COPD (AECOPD) and coal worker pneumoconiosis (CWP). This study aimed to evaluate the features of patients with complicated CWP admitted for AECOPD and whether complicated CWP has any effect on increasing the severity of this disease. MATERIALS AND METHODS: This study was designed as a retrospective cohort study. A total of 106 hospitalized patients were identified to have CWP. Patients who did not perform spirometry and with simple CWP were excluded. A total of 51 patients with complicated CWP, was included in the study group. Comparison group was selected from the patients with AECOPD without pneumoconiosis. RESULTS: Patients with complicated CWP, when compared to patients without pneumoconiosis, had longer hospitalization times (12.96 ± 8.49 days, 9.67 ± 5.21 days respectively, p=0.021), a higher cost of hospitalization (€2029 ± 2724, €931 ± 820 respectively, p=0.003), and higher rates of infective microorganisms in respiratory secretions and/ or blood cultures (61.3%, 29.6% respectively, p=0.016). We found that significance of high cost was dependent on duration of hospitalization and culture positivity. The most frequently encountered infective microorganism in both groups with complicated CWP and without pneumoconiosis was pseudomonas aeruginosa. CONCLUSIONS: Preventive measures for CWP in regions with high prevalence of coal mining have a very important role in the fight against COPD, which has significant morbidity and mortality rates.

[Comparative assessment of risk factors and hospital results in male and female patients underwent to coronary artery bypass surgery].

There are controversial data on relatively unfavorable effect of female gender on postoperative mortality of patients underwent to coronary artery bypass grafting (CABG). In order to assess risk factors and hospital outcomes after elective CABG we studied retrospectively data on patients who had undergone CABG in Sani Konuogly medical center (Gasiatep, Turkey) during the period from March 2002 to March 2010. For elimination of unfavorable effect of old age we included into analysis data from patients younger than 65 years. In accordance with study aim all patients (n=2692) were divided into two gender groups 1966 men (mean age 54,01 years) and 726 women (mean age 54.35 years). Diabetes (48.3 and 26.9%; p=0.0001), arterial hypertension (76.6 and 28.4%; p=0.00001), and obesity (50 42%; p=0.03) were more frequent among women while smoking (44.5 and 10.3%; p=0.0001), hyperlipidemia (37.6 and 21.5%; p=0.0002), and history of myocardial infarction (31.3 and 17.3%; p=0.06) were more often registered among men. Mortality was insignificantly higher in women (1.6 and 0.9%; p=0.06). Perioperative Q-wave myocardial infarction was more frequent among men than among women (1.5 and 0.4% respectively; p=0.04). It is necessary to conduct prospective well controlled study for exclusion of gender influences on perioperative outcomes in patients subjected to CABG .

Analysis of pediatric burns in a tertiary burns center in istanbul, Turkey.

INTRODUCTION: The factors and demographic features of pediatric patients with burns in eastern and western cultures differ from each other. In this retrospective study, our aim was to identify the demographic features of pediatric burns presenting to our tertiary burn center catering to a large population from Istanbul. METHODS: The demographic data and information of 358 children with burns admitted to the GMM HTH burn center in Istanbul over a 7-year period (2001-2008) were retrospectively reviewed. RESULTS: 48 children with burn injuries were hospitalized in our burn center during the study period. Out of the total of 358 patients, 33.79% (121) were infants and toddlers, 39.66% (142) were in early childhood and 26.53% (95) belonged to the late childhood age group. Males were predominantly affected, the total male to female ratio being 1.3:1. 297 (82.9%) of the 358 subjects resided in urban environments and 61 (17.1%) lived in rural areas. Scalds accounted for more than half (88.16%) of all burns, followed by contact (4.96%), flame (3.43%), electrical (1.52%), chemical (1.52%) and sunburn (0.38). Boiling water was the commonest agent, followed by hot tea. The three most frequent areas of burns were the upper limb (126 cases, 31.18%), followed by the lower limb (105 cases, 25.9%), and the trunk (94 cases, 23.26%). The majority (74%) of the patients had burns covering up to 10% of TBSA, and in 98.8% of the patients' the burn size was less than 30% of TBSA. CONCLUSION: This study demonstrates that the epidemiological features of pediatric burn patients, based on a review of such patients admitted to our burn center, differ in many aspects between eastern and western populations. Scalds occurring in a domestic setting, with mild to moderate burns, caused the vast majority of hospital admissions. It is necessary to improve the preventive programs and strategies in order to reduce the incidence of pediatric burn trauma.

A geriatric patient with major burns:case report.

As is predictable, mortality and morbidity among geriatric patients are higher in patients with major burns. Decreased radiopulmonary reserves and malnutrition characterized by protein/energy deficiency and ageing of skin are predisposing factors which increase mortality and morbidity. In this study, we present a 90-yr-old patient with 46% total body surface area of 2nd-3rd degree burns. We had to overcome difficulties which can be seen in elderly patients and which succeeded in our treatment.

Persistent left superior vena cava: the anatomical and surgical importance.

OBJECTIVE: Persistence of the left superior vena cava (PLSVC) is a congenital anomaly resulting from failure of degeneration of the left cardinal vein. The prevalence of this anatomical variant is approximately 0.3% in the general population. The aim of this study was to determine the prevalence of the persistence of the left superior vena cava in order to avoid potential complications. SUBJECTS AND METHODS: The study was conducted during a five-year period in 152 patients (64 males, 88 females) aged 1-65 years who underwent cardiac surgery for congenital heart diseases. RESULTS: The persistence of the left superior vena cava was found in 5 of 152 patients (3.3%). All persistent left superior vena cavae opened into the coronary sinus. Furthermore, the coronary sinus was enlarged in all patients. The right superior vena cava was absent in one of the five cases (20%) in this study. CONCLUSION: This anatomical variant must be recognized to avoid the potential complications.

Persistent left superior vena cava: the anatomical and surgical importance / Vena cava superior izquierda persistente Importancia anatómica y quirúrgica

OBJECTIVE: Persistence of the left superior vena cava (PLSVC) is a congenital anomaly resulting from failure of degeneration of the left cardinal vein. The prevalence of this anatomical variant is approximately 0.3in the general population. The aim of this study was to determine the prevalence of the persistence of the left superior vena cava in order to avoid potential complications. SUBJECTS AND METHODS: The study was conducted during a five-year period in 152 patients (64 males, 88 females) aged 1-65 years who underwent cardiac surgery for congenital heart diseases. RESULTS: The persistence of the left superior vena cava was found in 5 of 152 patients (3.3). All persistent left superior vena cavae opened into the coronary sinus. Furthermore, the coronary sinus was enlarged in all patients. The right superior vena cava was absent in one of the five cases (20) in this study. CONCLUSION: This anatomical variant must be recognized to avoid the potential complications.

Objetivo: La persistencia de la vena cava superior (PVCSI) es una anomalía congénita que se presenta como resultado de un fallo degenerativo en la vena cardinal izquierda. La prevalencia de esta variante anatómica es aproximadamente 0.3% en la población general. El objetivo de este estudio es determinar la prevalencia de la persistencia de de la vena cava superior izquierda a fin de evitar complicaciones potenciales. Sujetos y métodos: El estudio fue realizado durante un periodo de cinco años en 152 pacientes (64 varones, 88 hembras) de 1 65 años, que fueran sometidos a cirugía cardíaca debido a enfermedades cardiacas congénitas. . Resultados: Se halló persistencia de la vena cava superior izquierda en 5 de 152 pacientes (3.3%). Todas las venas cavas superiores izquierdas desembocan en el seno coronario. Además, el seno coronario de todos los pacientes presentaba un ensanchamiento. No habia vena cava superior en uno de los cinco casos (20%) de este estudio. Conclusión: Esta variante anatómica tiene que ser reconocida a fin de evitar potenciales complicaciones.

The short -term effects of an exercise programme as an adjunct to an orthosis in neuromuscular scoliosis.

The purpose of this study was to investigate the effects of a 4 week physiotherapy programme on patients who were given a spinal orthosis for neuromuscular scoliosis. This study was planned as a single group pre- and post-intervention repeated measures design. All patients were given a polyethylene spinal orthosis with an anterior opening. Fifteen (15) patients with neuromuscular diseases and a mean age of 12.46 years were evaluated. An exercises programme consisting of postural training, muscle strengthening and stretching exercises with special emphasis on respiratory exercises was given as an adjunct to orthotic treatment. The degree of impairment in forced vital capacity was 17.56% upon wearing an orthosis, it decreased to 9.28% following therapy (p < 0.05). There was also a statistically significant increase in muscle strength, balance duration and a significant decrease in limitation of range of motion. The results of the study imply that the conservative treatment of neuromuscular scoliosis should include an exercise programme as an adjunct to an orthosis, both to reduce the compromising effect of an orthosis on respiratory function and to support the patient's physical capacities.

Orthotic management of the lower limb in children with hereditary motor sensory neuropathy (HMSN).

The lower limbs of 55 paediatric patients, with the diagnosis of hereditary motor sensory neuropathy (HMSN) referred to the Orthotics and Biomechanics Department of Hacettepe University, were assessed for appropriate orthotic intervention. Since in the natural history of HMSN symptoms and complaints are variable there is a wide range of interventions possible. The biomechanics of deforming forces and the consequential incidence of deformities in these 55 children, its orthotic implications and the efficacy of orthotic applications are discussed in detail.

Reconstruction of contour and anterior wall defects of frontal bone with a porous polyethylene implant.

Frontal bone contour defects cause marked facial deformity, which is instantly obvious to the observer. The aetiology is usually post-traumatic either following a traffic accident or a gunshot injury. The contour deformity of the frontal bone was reconstructed using Medpor porous polyethylene in 12 consecutive patients during a period of 2 years. In four of the patients, we used a coronal approach, whilst using the old incision scar and laceration for access in the remainder. In two of the patients it was not necessary to fix the implant at all, but the remainder were fixed with lag screws because of implant mobility. The aetiology, the technique used, and the results obtained are presented.