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1.
J Clin Neurosci ; 110: 74-79, 2023 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-36822073

RESUMO

PURPOSE: To investigate the effect of the coexistence of fetal-type posterior communicating artery (fPCA) and anterior cerebral artery (ACA) A1 segment agenesis/hypoplasia on the rupture of an anterior communicating artery (AComA) aneurysm. MATERIALS AND METHODS: A total of 216 patients consecutively presenting with AComA aneurysms between January 2014 and December 2021 on digital subtraction angiography were evaluated. Patients without three-dimensional rotational angiography images, those aged under 18 years, those with suspected mycotic aneurysms, and those with dissecting and giant aneurysms were excluded from the study. The aneurysms were divided into two groups as ruptured and non-ruptured. Hemodynamic filling patterns were classified into four different types. RESULTS: The study included 192 AComA aneurysms, 44.8% (n = 86) ruptured and 55.2% (n = 106) non-ruptured. According to hemodynamic filling patterns, in type 1, the frequency of non-ruptured aneurysms was statistically significantly higher than that of ruptured aneurysms (39.5% vs 18.9%; p = 0.001). In type 4, where fPCA and ACA A1 segment agenesis/hypoplasia coexists, the frequency of ruptured aneurysms was significantly higher than that of non-ruptured aneurysms (10.5% vs 22.7%; p = 0.026). The most common aneurysm size range was 4-7 mm (n = 85; 44.3%). There was no statistically significant difference in size between the ruptured and non-ruptured aneurysms (p = 0.627). CONCLUSION: According to the hemodynamic filling classification, we observed that the presence of type 4 filling pattern, i.e., the coexistence of ACA A1 segment agenesis/hypoplasia and fPCA, increased the risk of rupture in AComA aneurysms.


Assuntos
Aneurisma Roto , Aneurisma Intracraniano , Humanos , Adolescente , Idoso , Aneurisma Intracraniano/complicações , Aneurisma Intracraniano/diagnóstico por imagem , Artéria Cerebral Posterior , Aneurisma Roto/complicações , Aneurisma Roto/diagnóstico por imagem , Artéria Cerebral Anterior/diagnóstico por imagem , Imageamento Tridimensional/métodos , Fatores de Risco , Angiografia Cerebral/métodos , Estudos Retrospectivos
2.
Am J Otolaryngol ; 44(1): 103678, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36335660

RESUMO

OBJECTIVES: A surgery to be performed on a previously operated neck includes difficulties such as increased risk of complications and prolonged operation time. The aim of the present study is to analyze the benefit of pre-anesthetic ultrasound-guided injection of methylene blue into parathyroid adenomas and abnormal lymph nodes to simplify their safe and satisfactory extraction. METHODS: We analyzed the case series records of 14 patients who were operated for reoperative neck surgery due to recurrent thyroid cancer (8 patients) and parathyroid adenoma (6 patients) and in the technique; 0.2 ml of a 1:5 dilution of 1 % methylene blue solution was injected directly onto the target during real-time ultrasound guidance before the operating room. RESULTS: In adenomas, ultrasound-guided methylene blue injection was successfully applied in all cases, an average of 33.1 min before entering the operating room (range = 28-38 min). There were no complications related to dye injection. For patients with recurrent thyroid tumors, preoperative ultrasound-guided methylene blue injection was successfully applied in all patients, on average 27.5 min before entering the operating room (range = 20-35 min). No complications occurred due to dye injection. The blue stained lesion was easily identified during surgery. CONCLUSIONS: We analyzed the feasibility of the injection process, the certainty of defining pathological lymph nodes, and the complications of the procedure. Preoperative administration of methylene blue preserved its intraoperative efficacy and maintained the easy the detection of reoperative or primary pathologies. The present study suggest that methylene blue dye injection is a safe, sufficient, and quietly effective method for identifying recurrent tumors and parathyroid adenomas in scarred reoperative neck surgeries. Our cases had comparatively short operative times and lower complication rates.


Assuntos
Neoplasias das Paratireoides , Neoplasias da Glândula Tireoide , Humanos , Neoplasias das Paratireoides/diagnóstico por imagem , Neoplasias das Paratireoides/cirurgia , Azul de Metileno , Recidiva Local de Neoplasia , Neoplasias da Glândula Tireoide/diagnóstico por imagem , Neoplasias da Glândula Tireoide/cirurgia , Neoplasias da Glândula Tireoide/patologia , Ultrassonografia de Intervenção
3.
Turk Neurosurg ; 2022 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-35713258

RESUMO

AIM: The aim of this study is to examine the relationship between the morphological features of A.carotis interna (ICA) and symptoms affecting cerebral blood circulation including type 2 diabetes mellitus (T2DM) and hypertension (HT). MATERIAL AND METHODS: In this study, retrospective morphometric analysis of ICA measurements from 100 patients (45-60 years old) was performed on Computed Tomographic Angiography (CTA) images. The images were divided into four groups: patients with HT (group 1), patients with T2DM (group 2), patients with HT and T2DM (group 3), and healthy control group (group 4). Length and diameter measurements of the cervical, petrous, cavernous and terminal segments of the ICA were made by using 3D CTA images and recorded. The measurements of the male and female patients were compared by Mann Whitney-U test and the the groups were compared by using Kruskall Wallis H test. RESULTS: It was found that, there were statistically significant differences between male and female patients in terms of right and left petrous, cavernous and terminal segments of the ICA in Group 1, right and left cervical left cavernous in Group 3, left cervical, right and left petrous, cavernous and right cavernous in Group 4 (p 0.05). According to the Kruskall Wallis H test analysis results, it was determined that there was no statistically significant difference between the patients in 4 groups for all segment measurements (p 0.05). CONCLUSION: As a result; It was determined that ICA was more affected by hypertension than diabetes. In addition, we think that being knowledgeable of morphometric measurements of ICA will guide the radio-anatomical evaluations and increase the level of microanatomical knowledge in surgical treatment.

4.
Eur Arch Otorhinolaryngol ; 279(11): 5389-5399, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-35596805

RESUMO

PURPOSE: To create a new artificial intelligence approach based on deep learning (DL) from multiparametric MRI in the differential diagnosis of common parotid tumors. METHODS: Parotid tumors were classified using the InceptionResNetV2 DL model and majority voting approach with MRI images of 123 patients. The study was conducted in three stages. At stage I, the classification of the control, pleomorphic adenoma, Warthin tumor and malignant tumor (MT) groups was examined, and two approaches in which MRI sequences were given in combined and non-combined forms were established. At stage II, the classification of the benign tumor, MT and control groups was made. At stage III, patients with a tumor in the parotid gland and those with a healthy parotid gland were classified. RESULTS: A stage I, the accuracy value for classification in the non-combined and combined approaches was 86.43% and 92.86%, respectively. This value at stage II and stage III was found respectively as 92.14% and 99.29%. CONCLUSIONS: The approach presented in this study classifies parotid tumors automatically and with high accuracy using DL models.


Assuntos
Aprendizado Profundo , Imageamento por Ressonância Magnética Multiparamétrica , Neoplasias Parotídeas , Inteligência Artificial , Diagnóstico Diferencial , Humanos , Glândula Parótida/diagnóstico por imagem , Glândula Parótida/patologia , Neoplasias Parotídeas/patologia
5.
Pol Przegl Chir ; 95(3): 1-5, 2022 Nov 18.
Artigo em Inglês | MEDLINE | ID: mdl-36805993

RESUMO

AbstractAim:Inflammatory markers are effective in determining the prognosis of malignant diseases. The aim of this study is to investigate the relationship of HALP and LCR with tumor response after neoadjuvant chemoradiotherapy and their effects on prognosis in patients with locally advanced rectal cancer. METHODS: 88 patients who received nCRT with the diagnosis of LARC were included in the study. First, all patients were divided into 2 groups: patients with pathological and clinical complete response (pCR+cCR) group 1 and patients with non-complete response group 2. The 82 patients who underwent surgery were divided into two groups according to the TRG Dworak: good response and poor response groups. Inflammation markers such as HALP and LCR were obtained using biochemical parameters. RESULTS: HALP and LCR were higher in the complete response group than in the none-complete response group (p<0.05). When TRG 3-4 (good response group) and TRG 0-1-2 (poor response group) were compared, HALP and LCR were higher in the good response group (p<0.05). The cut-off point for the HALP value was 30.17, the sensitivity was 88.2%, and the specificity was 43.7%. The cut-off point for the LCR value was 0.402, the sensitivity was 88.2%, and the specificity was 63.4%. It was found that HALP and LCR calculated prior to neoadjuvant CRT could not predict overall survival. CONCLUSIONS: We believe that inflammatory markers such as HALP and LCR can effectively identify rectal cancer patients who respond best to nCRT.


Assuntos
Proteína C-Reativa , Neoplasias Retais , Humanos , Terapia Neoadjuvante , Neoplasias Retais/terapia , Inflamação , Linfócitos
6.
Radiol Case Rep ; 17(2): 310-313, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-34876956

RESUMO

Carotid blowout syndrome is a rare clinical conditions with a high mortality rate, especially in patients with head and neck tumors who have received radiotherapy and chemotherapy. We present our patient who had hemangioendothelioma of the neck for 5 years and therefore received radiotherapy, fistulized to the skin on the neck and active bleeding out of the fistula area. In the radiological imaging of the patient, vessel wall irregularities in the common carotid artery (CCA) and accompanying pseudoaneurysm with a diameter of 3 cm were detected, and endovascular treatment was performed. After the patient passed the balloon occlusion test, first the proximal internal carotid artery was closed with coils. Then, the balloon was inflated proximal to the CCA and a 10% diluted glue-lipiodol mixture was injected into the entire diseased CCA bed. Closure of the distal with coil and proximal with balloon prevented the risk of off-target embolization of the glue.

7.
Int J Clin Pract ; 75(11): e14746, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34428317

RESUMO

BACKGROUND: The known primary radiological diagnosis of Chiari Malformation-I (CM-I) is based on the degree of tonsillar herniation (TH) below the Foramen Magnum (FM). However, recent data also shows the association of such malformation with smaller posterior cranial fossa (PCF) volume and the anatomical issues regarding the Odontoid. This study presents the achieved result regarding some detected potential radiological findings that may aid CM-I diagnosis using several machine learning (ML) algorithms. MATERIALS AND METHODS: Midsagittal T1-weighted MR images were collected in 241 adult patients diagnosed with CM, eleven morphometric measures of the posterior cerebral fossa were performed. Patients whose imaging was performed in the same centre and on the same device were included in the study. By matching age and gender, radiological exams of 100 clinically/radiologically proven symptomatic CM-I cases and 100 healthy controls were assessed. Eleven morphometric measures of the posterior cerebral fossa were examined using 5 designed ML algorithms. RESULTS: The mean age of patients was 29.92 ± 15.03 years. The primary presenting symptoms were headaches (62%). Syringomyelia and retrocurved-odontoid were detected in 34% and 8% of patients, respectively. All of the morphometric measures were significantly different between the groups, except for the distance from the dens axis to the posterior margin of FM. The Radom Forest model is found to have the best 1.0 (14 of 14) ratio of accuracy in regard to 14 different combinations of morphometric features. CONCLUSION: Our study indicates the potential usefulness of ML-guided PCF measurements, other than TH, that may be used to predict and diagnose CM-I accurately. Combining two or three preferable osseous structure-based measurements may increase the accuracy of radiological diagnosis of CM-I.


Assuntos
Malformação de Arnold-Chiari , Imageamento por Ressonância Magnética , Adolescente , Adulto , Malformação de Arnold-Chiari/diagnóstico por imagem , Forame Magno , Humanos , Aprendizado de Máquina , Tecnologia , Adulto Jovem
8.
Z Naturforsch C J Biosci ; 76(9-10): 417-424, 2021 Sep 27.
Artigo em Inglês | MEDLINE | ID: mdl-34047146

RESUMO

Although radical treatment of Alzheimer's and Parkinson's disease is not possible yet, it is aimed to slow the course of the disease and increase the life quality of individuals with the drugs used in the clinic at the present time. Successful results have been achieved in the use of cholinesterase inhibitors and monoamine oxidase inhibitors together in these neurodegenerative diseases. In this study, indane ring which are in the structure of anticholinesterase effective molecules and 2-hydrazinothiazole structure whose inhibitory activities reported on monoamine oxidase-B (MAO-B) were combined; 4-(substituted phenyl)-2-[2-(3-phenyl-2,3-dihydro-1H-inden-1-ylidene) hydrazinyl]thiazole derivatives (3a-3i) were synthesized as dual inhibitors. The structures of the compounds were verified by IR, 1H-NMR, 13C-NMR, and HRMS spectroscopy. When enzyme inhibition activities were evaluated, it was determined that the compounds 3a (42.33%) and 3d (42.39%) on acetylcholinesterase (AChE) enzyme; compounds 3g (75.42%) and 3h (60.33%) showed inhibition on MAO-B enzyme at most, at 10-3 M concentration.


Assuntos
Inibidores da Colinesterase/farmacologia , Inibidores da Monoaminoxidase/farmacologia , Monoaminoxidase/efeitos dos fármacos , Tiazóis/química , Humanos , Inibidores da Monoaminoxidase/química , Análise Espectral/métodos , Relação Estrutura-Atividade
11.
Interv Neuroradiol ; 27(5): 638-647, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33779378

RESUMO

BACKGROUND: The objective of the present study is to analyze the outcomes of patients with subarachnoid hemorrhage (SAH) in the acute phase after treatment with Y-stent-assisted coiling (YSAC) embolization. METHODS: This retrospective study assessed of 30 patients with acutely ruptured wide-neck aneurysms following YSAC treatment between April 2013 and October 2019. The demographic data, aneurysm occlusion grade, procedural and periprocedural complications, and clinical outcomes were assessed. RESULTS: The procedure was completed in 30 cases (90.1%) and technical failure occurred in 3 cases (9.1%). Immediate control angiography revealed that total occlusion Raymond-Ray Class 1 (RR1) was achieved in 21 (70%), neck filling (RR2) in eight (26.6%) and sac filling (RR1) in one (3.3%) aneurysm. Upon angiographic follow-up, RR1 occlusion was observed in 15 (71.4%) patients, RR2 in three (14.3%) patients and RR3 in three (14.3%) patients. In-stent thrombus developed in five (16.6%) patients; procedural ischemic events were observed in four (13.3%) patients; and two (6.6%) patients were symptomatic. A periprocedural asymptomatic intracranial hemorrhage was detected in two patients. At discharge, 17 (56.6%) patients were in good clinical condition, six (20%) were in a severe disability condition, and seven (23.3%) patients had died. At the final follow-up visit (mean: 18.9 months), 16 (76,2%) of 21 patients were in a good clinical condition and five (23.8%) had severe disabilities. CONCLUSIONS: Y-stent assisted coiling in might be a feasible and promising option for treatment in acute phase in selected wide-necked ruptured intracranial aneurysms.


Assuntos
Embolização Terapêutica , Aneurisma Intracraniano , Hemorragia Subaracnóidea , Angiografia Cerebral , Humanos , Aneurisma Intracraniano/diagnóstico por imagem , Aneurisma Intracraniano/terapia , Estudos Retrospectivos , Stents , Hemorragia Subaracnóidea/diagnóstico por imagem , Hemorragia Subaracnóidea/terapia
12.
Turk Neurosurg ; 31(1): 67-72, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33491169

RESUMO

AIM: To determine the effectiveness of diffusion tensor imaging (DTI) in diagnosing cervical spondylotic myelopathy (CSM) in patients with no findings detected in conventional magnetic resonance imaging (MRI). MATERIAL AND METHODS: Fifty-four patients who presented for cervical MRI between January 2016 and June 2016, with symptoms such as neck pain, paresis, and numbness in hands, were included in the study. The patients were split into four groups based on their degrees of spinal stenosis. The obtained data were examined using special software and color-coded fractional anisotropy (FA), and apparent diffusion coefficient (ADC) maps were formed. Through these maps, using regions of interest (ROIs), FA and ADC values were calculated and the contribution of these values to the diagnosis was evaluated statistically. RESULTS: When all grades of cervical spinal canal stenosis were compared, a statistically significant negative correlation between spinal canal stenosis degree and FA values, and a positive correlation between stenosis degree and ADC values were noted (p < 0.001). In the comparison of stenotic levels and non-stenotic levels for the grade 2 patient group, there was a statistically significant decrease in FA values and an increase in ADC values in stenotic levels compared with prestenotic and poststenotic levels (p < 0.05). CONCLUSION: DTI and quantitative FA and ADC measurements are candidate imaging techniques for the diagnosis of early-stage CSM, which shows no findings in conventional MRI, and determining the degree of spinal cord injury.


Assuntos
Imagem de Tensor de Difusão/métodos , Compressão da Medula Espinal/diagnóstico por imagem , Estenose Espinal/etiologia , Espondilose/diagnóstico por imagem , Adulto , Vértebras Cervicais/patologia , Feminino , Humanos , Interpretação de Imagem Assistida por Computador/métodos , Masculino , Pessoa de Meia-Idade , Compressão da Medula Espinal/etiologia , Espondilose/complicações
13.
Turk Neurosurg ; 31(2): 261-267, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33372260

RESUMO

AIM: To estimate the rupture risk of anterior communicating artery (AComA) and AComA-related aneurysms according to their localization, angiographic architecture, and morphological features. MATERIAL AND METHODS: In this study, 124 patients with AComA and AComA-related anterior system aneurysms were retrospectively evaluated. The aneurysms were classified according to their morphological appearance and angiographic architecture. The size, size ratio, angiographic architecture, and aneurysmal dome orientation of ruptured and non-ruptured aneurysms were compared using digital subtraction angiography (DSA) 3D images. RESULTS: There was a significant relationship between rupture risk and the size ratio (p=0.043), morphological properties of the aneurysm (p < 0.001), aneurysm dome orientation (OR 1.29, 95% CI 1.32-6.818), and aneurysm type according to the angiographical architecture (p < 0.005). CONCLUSION: In determining the rupture risk of AComA and AComA-related aneurysms, size alone is not a sufficient parameter with aneurysm morphology proving to be more efficacious. Grouping of aneurysms according to angioarchitecture, and its significant correlation with aneurysm rupture, may help to understand the underlying mechanisms in the formation and rupture of aneurysms. From this, more specific treatment protocols can be created, helping to improve the clinical evaluation of AComA aneurysms.


Assuntos
Aneurisma Roto/diagnóstico por imagem , Angiografia Digital/métodos , Artéria Cerebral Anterior/diagnóstico por imagem , Imageamento Tridimensional/métodos , Aneurisma Intracraniano/diagnóstico por imagem , Adulto , Idoso , Angiografia Cerebral/métodos , Círculo Arterial do Cérebro/diagnóstico por imagem , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco
14.
Pediatr Emerg Care ; 37(3): e100-e104, 2021 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-30702650

RESUMO

OBJECTIVES: The aim of this study was to compare the role of computed tomography (CT) in the diagnosis of open-globe trauma and intraocular foreign body (IOFB) in pediatric and adult age groups. METHODS: Medical records of cases with open-globe trauma at Inonu University Hospital's Ophthalmology Emergency Service were retrospectively evaluated. Preoperative orbital CT images of the cases obtained at emergency services and their clinical and/or surgical findings were compared in pediatric and adult groups. RESULTS: We included 47 eyes of 47 cases aged 18 years and below (pediatric group) and 85 eyes of 82 cases over 18 years (adult group). The mean ± SD age was 10.80 ± 5.11 years (range, 2-18 years) in the pediatric group and 46.34 ± 19.01 years (range, 19-82 years) in the adult group. Computed tomography images revealed 21.7% of the cases with corneal lacerations, 55.5% with scleral lacerations, and 91.6% with corneoscleral lacerations in the pediatric group, whereas the respective numbers were 48.4%, 66.6%, and 61.9% in the adult group. The detection rates of corneal penetrations and vitreous hemorrhage with CT were significantly lower in the pediatric group than in the adult group (P < 0.05). The CT scans diagnosed 66.6% of the pediatric cases and 90% of the adult cases with an IOFB. CONCLUSIONS: Corneal lacerations and IOFBs can be missed, especially in the pediatric group, because the eye is smaller in adults. Pediatric patients with a history of ocular trauma should undergo an examination under general anesthesia followed by surgical exploration if necessary.


Assuntos
Corpos Estranhos no Olho , Ferimentos Oculares Penetrantes , Adolescente , Adulto , Criança , Pré-Escolar , Corpos Estranhos no Olho/diagnóstico por imagem , Corpos Estranhos no Olho/cirurgia , Ferimentos Oculares Penetrantes/diagnóstico por imagem , Ferimentos Oculares Penetrantes/cirurgia , Humanos , Estudos Retrospectivos , Tomografia Computadorizada por Raios X , Acuidade Visual
15.
Rev. nefrol. diál. traspl ; 40(4): 303-324, dic. 2020. tab, graf
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-1377107

RESUMO

ABSTRACT Introduction: In some countries, organ donation is not widespread enough due to medical, cultural, ethical and socioeconomic factors. Living-donor kidney transplant constitutes the main source of kidney donation. Aim: To evaluate the causes of cancellation of living-donor kidney transplant and improve the effectiveness of transplant programs. Methods: Medical records of possible donors and recipients who were evaluated for living-donor kidney transplant at a tertiary medical center between November 2010 and September 2019 were reviewed retrospectively. Results: Evaluations were performed on 364 potential donors and 338 living-donor kidney transplant recipients; 207 of the latter (61.24%) underwent living-donor kidney transplant. Immune disorders represented the majority of cancellations (38.84%). Fifty-six donors (15.38%) were rejected mainly due to renal disorders (39%). Conclusion: Timely referral of patients to transplant centers must be guaranteed in order to overcome immune problems. Transplant centers should invest in programs adequate both for their resources and for their patients: paired kidney exchange, desensitization protocols, future research, etc.


RESUMEN Introducción: En algunos países la donación de órganos no es suficiente debido a factores médicos, culturales, éticos y socioeconómicos. El donante vivo de riñón constituye la principal fuente de donación de riñones. Objetivo: Evaluar las causas de cancelación de los donantes vivos de riñón y mejorar la eficacia de los programas de trasplante. Material y métodos: Se evaluaron retrospectivamente los registros médicos de posibles donantes y receptores para trasplante de riñón con donante vivo en un centro terciario, entre noviembre de 2010 y septiembre de 2019​​. Resultados: Se evaluaron 364 donantes potenciales y 338 receptores de trasplante de riñón con donante vivo; 207 receptores (61,24%) se sometieron a trasplante de riñón con donante vivo. Los problemas inmunológicos ocasionaron la mayoría de las cancelaciones (38,84%). A cincuenta y seis donantes (15,38%) se les negó la donación, principalmente debido a problemas renales (39%). Conclusión: La derivación oportuna de los pacientes a los centros de trasplante debe garantizarse para superar las barreras inmunológicas. Los centros de trasplante deberían invertir en programas adecuados, tanto por sus recursos como por los pacientes: protocolos de desensibilización, trasplante renal cruzado, investigación futura, etc.

16.
Ulus Travma Acil Cerrahi Derg ; 26(5): 760-764, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32946093

RESUMO

BACKGROUND: This study aimed to investigate the superiority of C-reactive protein (CRP) lymphocyte ratio (CLR) in acute appendicitis (AA) and perforated appendicitis (PA) compared to routine laboratory parameters in patients where radiological tests were insufficient to clarify the diagnosis. METHODS: In this cross-sectional and retrospective study, the patients were divided into two groups as PA and AA. Age, sex, length of hospital stay, leukocytes, neutrophil, lymphocyte, CRP, and CLR were recorded at the time of diagnosis. Regression analyses were performed for the parameters, which were found to be statistically significant in univariate analysis. RESULTS: One hundred thirty-one patients were included in this study (111 patients in the AA group, and 20 patients in the PA group). Age (p=0.03), gender (p<0.001), length of hospital stay (p<0.001), CRP (p<0.001), NLR (p=0.004) and CLR (p<0.001) were significantly different between both groups. However, only CLR was found as a significant risk factor in PA cases (p=0.016). The ROC analysis showed the highest AUC value in CLR (0.83). The cut-off value for predicting PA was found 0.45. CONCLUSION: This study provided that the CLR is an important parameter for the differentiation of AA and PA patients. Besides, it is a valuable predictor in the preoperative risk classification of these patients.


Assuntos
Apendicite , Proteína C-Reativa/análise , Contagem de Linfócitos/estatística & dados numéricos , Doença Aguda , Adulto , Apendicite/classificação , Apendicite/diagnóstico , Apendicite/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Adulto Jovem
17.
J Craniofac Surg ; 31(4): e324-e326, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31895864

RESUMO

Carotid artery pseudoaneurysm are a rare complication of deep neck infections, especially in the antibiotic era. Although it is rare, it may result in life-threatening conditions. Here, the authors present a case of pseudoaneurysm of the carotid artery caused by parapharyngeal abscess and causing massive oropharyngeal bleeding and treat with endovascular approach in a 40-year-old woman presenting with neck swelling and fever.


Assuntos
Abscesso/cirurgia , Lesões das Artérias Carótidas/cirurgia , Artéria Carótida Primitiva/cirurgia , Hemorragia/cirurgia , Doenças Faríngeas/cirurgia , Abscesso/complicações , Adulto , Lesões das Artérias Carótidas/etiologia , Procedimentos Endovasculares , Feminino , Hemorragia/etiologia , Humanos , Doenças Faríngeas/complicações
18.
Transplant Proc ; 51(7): 2498-2500, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31405737

RESUMO

INTRODUCTION: Mucormycosis is a severe infection in renal transplant recipients. Here, we report a case of maxillary sinus mucormycosis in a patient who presented with a facial pain complaint. CASE: A 51-year-old female patient with renal transplantation due to autosomal dominant, polycystic kidney disease and diabetic nephropathy was admitted to our hospital with facial pain and minimal edema of the left half of her face on the 8th month of transplantation. On physical examination, there was only tenderness and slight edema on the left half of the face. On the paranasal computed tomography, extensive soft tissue densities involving septations, filling the left maxillary sinus, extending to the nasal cavity, and obliterating the left osteometeal unit were observed. Because facial pain was not relieved by antibiotics and several, potent analgesic drugs on the second day, mucormycosis infection with bone involvement was suspected. A left maxillary sinus excision was performed. Microscopic examination of the debridement specimen revealed necrotic bone interspersed with fungal hyphae, and culture isolated Rhizopus oryzae. Liposomal amphotericin B was started. The patient was on tacrolimus, prednisolone, and mycophenolate mofetil. Tacrolimus was switched to cyclosporine to regulate serum glucose levels. The left maxillary sinus was washed with liposomal amphoterin B daily and curetted with intervals. The patient started dialysis because of severe renal function loss. The patient was discharged on the 96th day of liposomal amphotericin B. CONCLUSION: It should be kept in mind that mucormycosis may be present in the sinuses even if there is no evidence for nasal, oral, and dental examination in renal transplant patients with facial pain.


Assuntos
Hospedeiro Imunocomprometido , Transplante de Rim/efeitos adversos , Sinusite Maxilar/imunologia , Mucormicose/imunologia , Anfotericina B/uso terapêutico , Antifúngicos/uso terapêutico , Dor Facial/etiologia , Feminino , Humanos , Sinusite Maxilar/complicações , Sinusite Maxilar/microbiologia , Pessoa de Meia-Idade , Mucormicose/complicações , Mucormicose/tratamento farmacológico , Rhizopus/isolamento & purificação
19.
Diagn Interv Radiol ; 25(4): 310-319, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31199287

RESUMO

PURPOSE: Active bleeding due to abdominal trauma is an important cause of mortality in childhood. The aim of this study is to demonstrate the advantages of early percutaneous transcatheter arterial embolization (PTAE) procedures in children with intra-abdominal hemorrhage due to blunt trauma. METHODS: Children with blunt abdominal trauma were retrospectively included. Two groups were identified for inclusion: patients with early embolization (EE group, n=10) and patients with late embolization (LE group, n=11). Both groups were investigated retrospectively and statistically analyzed with regard to lengths of stay in the intensive care unit and in the hospital, first enteral feeding after trauma, blood transfusion requirements, and cost. RESULTS: The duration of stay in the intensive care unit was greater in the LE group than in the EE group (4 days vs. 2 days, respectively). The duration of hospital stay was greater in the LE group than in the EE group (14 days vs. 6 days, respectively). Blood transfusion requirements (15 cc/kg of RBC packs) were greater in the LE group than in the EE group (3 vs. 1, respectively). The total hospital cost was higher in the LE group than in the EE group (4502 USD vs. 1371.5 USD, respectively). The time before starting enteral feeding after first admission was higher in the LE group than in the EE group (4 days vs. 1 day, respectively). CONCLUSION: Early embolization with PTAE results in shorter intensive care and hospitalization stays, earlier enteral feeding, and lower hospital costs for pediatric patients with intra-abdominal hemorrhage due to blunt trauma.


Assuntos
Traumatismos Abdominais/complicações , Embolização Terapêutica/métodos , Prevenção Secundária/normas , Ferimentos não Penetrantes/terapia , Traumatismos Abdominais/diagnóstico por imagem , Traumatismos Abdominais/economia , Adolescente , Transfusão de Sangue/estatística & dados numéricos , Transfusão de Sangue/tendências , Criança , Pré-Escolar , Nutrição Enteral/estatística & dados numéricos , Nutrição Enteral/tendências , Feminino , Hemorragia/etiologia , Hemorragia/mortalidade , Humanos , Tempo de Internação/estatística & dados numéricos , Tempo de Internação/tendências , Masculino , Estudos Retrospectivos , Prevenção Secundária/estatística & dados numéricos , Tomografia Computadorizada por Raios X
20.
Ulus Travma Acil Cerrahi Derg ; 25(3): 238-246, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31135937

RESUMO

BACKGROUND: Knowledge of the utility of angiographic embolization (AE) in pediatric cases of blunt abdominal solid organ trauma injuries is limited. The current study is an examination of AE as an effective and reliable method to control bleeding in patients with persistent bleeding due to blunt trauma-induced abdominal solid organ injury. METHODS: This was a retrospective examination of patients <17 years of age who had experienced blunt abdominal solid organ injury and who presented at a single institution within 4 years. A statistical analysis of the data was performed. RESULTS: The mean length of intensive care unit stay was 4 days for those who underwent embolization (n=11), and the mean length of hospital stay was 12 days. The average pre-AE blood loss, as measured by the decrease in hematocrit (%) from admission to embolization, was -7.33+-5.3% (p<0.001). The average post-AE blood loss, as measured by the change in hematocrit 72 hours post AE, was 2+-0.97% (p>0.05). All of the patients were discharged with a full recovery. CONCLUSION: AE was a safe and effective method to control solid organ hemorrhage in pediatric patients with blunt abdominal injuries.


Assuntos
Traumatismos Abdominais , Angiografia , Embolização Terapêutica , Hemorragia , Traumatismos Abdominais/diagnóstico por imagem , Traumatismos Abdominais/epidemiologia , Traumatismos Abdominais/terapia , Adolescente , Criança , Hemorragia/diagnóstico por imagem , Hemorragia/epidemiologia , Hemorragia/terapia , Humanos , Tempo de Internação/estatística & dados numéricos , Estudos Retrospectivos
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