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751.
Gokce M Altan I Unal S Kuskonmaz B Aytac S Cetin M Tuncer M Gumruk F Gurgey A 《Blood coagulation & fibrinolysis》2012,23(5):434-439
The objective of this study was to evaluate the underlying diseases, thrombus localization, and other risk factors in pediatric patients with recurrent thrombosis in order to obtain a sense of early awareness of the possible recurrences. We retrospectively evaluated both inherited and acquired thrombophilic risk factors in children with recurrent thrombosis that were diagnosed and treated at Hacettepe University, School of Medicine, Department of Pediatric Hematology, Ankara, Turkey. Both congenital and acquired risk factors associated with recurrent thrombosis, and treatment modalities were analyzed in detail. Among 569 children with thrombosis, 32 (5.6%) presented with recurrent thrombosis. Median age at first presentation in these 32 patients [11 women (34.4%) and 21 men (65.6%)] was 132 months. In all, 29 (90.6%) of the 32 patients had an underlying chronic disorder: the most common of which was congenital heart disease [n = 11 (34.4%)]. At presentation intracardiac localization, including the entrance of the inferior and superior vena cava, was observed in 10 of the patients (31.2%). Thrombosis recurred at the same location in 15 (47%) patients and at a different location in 17 (53%). Median time interval between the first and second episode of thrombosis was 6.5 months (range: 1-180 months). Considering both acquired and congenital thrombophilic factors, three (9.3%) patients, four (12.5%) patients, and 14 (43.8%) patients had five, four, and three risk factors, respectively. More than half of the patients had elevated plasma FVIII (>150 IU/dl) and D-dimer (>0.5 mg/ml) levels. Thrombectomy was performed in three patients with organized, chronic intracardiac thrombus. Tissue plasminogen activator (t-PA) was used more frequently to treat recurrence than the first event (15.6 vs. 28.1%) and consequently the complete resolution rate was higher (40 vs. 77.7%) at the second event. Thrombi partially resolved in 11 of the patients during the initial episode and in 10 patients during recurrence (34 vs. 32%). In all, 29 (87.5%) patients were using prophylaxis at the time of recurrence. [coumadin (n = 16), low molecular weight heparin (n = 12) and aspirin (n = 1)]. In total, four patients (12.5%) died because of their underlying disorders and six (18.7%) developed postthrombotic syndrome during the follow-up. Recurrent thrombosis should be expected, especially in cases with congenital heart disease, incomplete thrombus resolution, and elevated plasma FVIII/D-dimer levels. In the light of this knowledge we suggest aggressive treatment for pediatric patients with a high risk of recurrent thrombosis. 相似文献
752.
Enver?ArpaciEmail author Serdar?Altun Erkan?Orhan Atilla?Eyuboglu Nilgun?Markal?Ertas 《World journal of surgery》2018,42(11):3568-3574
Backgrounds
Pilonidal sinus is a common chronic disease of the sacrococcygeal region. Although many surgical methods have been described for treating pilonidal sinus disease, controversy still exists as to the best surgical technique. The aim of this study is to present a new modified advancement flap technique named “omega flap” for the treatment of pilonidal sinus disease.Materials and methods
This study included 18 patients with pilonidal sinus who were treated between March 2012 and August 2014. All cases underwent oval excision and omega advancement flap reconstruction. Defect size, postoperative complications, postoperative pain, painless sitting time, patient satisfaction and recurrence were evaluated retrospectively.Results
All patients were discharged on the first postoperative day. There was no flap necrosis. No recurrence and no major complication were observed during follow-up period. The outcomes were also satisfactory regarding functionally and aesthetically, and the patients were satisfied with the results.Conclusions
Presented method has a different geometry than classical advancement flap methods. Our technique provides two-layered repair with minimal tension and off-midline closure for the reconstruction of pilonidal sinus defect. It is easily performed, reliable, associated with no recurrens and good aesthetic results.753.
Magnetically controlled growing rod in 13 patients with early-onset scoliosis and spinal improvement
Burak Akesen Armağan Can Ulusaloğlu Teoman Atici Enver Ipek 《Acta orthopaedica et traumatologica turcica》2018,52(6):438-441
Objective
The aim of this study was to examine the use of magnetically controlled growing rods as a method of providing spinal improvement while preventing thoracic insufficiency in patients with early-onset scoliosis (EOS).Methods
Of a total of 13 patients, 4 patients underwent a dual magnetic rod implantation, while 9 patients had a single magnetic rod procedure. The study group comprised 12 (93%) female and 1 (7%) male patients. Six patients (46%) had an idiopathic form of scoliosis, in 4 (30%) it was congenital, and in 3 (23%) it was neuromuscular scoliosis. The patients' Cobb angles, thoracic kyphosis, T1-T12 and T1-S1 distance prior to and following the treatment were compared.Results
The mean Cobb angle before surgery was 53.780, whereas it decreased to 39.290 postoperatively (p < 0.001). The mean thoracic kyphosis angle was 400 before and 29.790 after surgery (p < 0.001). The mean T1-S1 distance was 32.14 cm before and 36.36 cm after surgery (p < 0.001). The mean T1-T12 distance was 18.69 cm before and 20.64 cm after surgery (p < 0.001).Conclusion
The use of magnetic rods is an effective method of EOS treatment. It allows for spinal growth while managing the progression of the scoliosis.Level of evidence
Level IV, therapeutic study. 相似文献754.
755.
Enver Mirza Selman Belviranli Ali Osman Gundogan Mehmet Adam Refik Oltulu 《Eye (London, England)》2023,37(4):660
ObjectivesTo investigate whether SARS-CoV-2 causes morphological changes in the corneal sub-basal nerve plexus (CSNP) of post-COVID-19 patients using in vivo confocal microscopy (IVCM).MethodsA total of 70 participants were included in the study and were divided into three groups. Post-COVID-19 patients with neurological manifestations were considered Group 1 (n = 24), and post-COVID-19 patients without neurological manifestations were considered Group 2 (n = 24). Healthy control participants were considered Group 3 (n = 22). The parameters of the CSNP, including nerve fibre density (NFD), nerve branch density (NBD), and nerve fibre length (NFL), were investigated in all participants using IVCM. Additionally, corneal sensitivity was tested by corneal esthesiometry.ResultsThe mean NFD, NBD, and NFL values of Group 1 (16.12 ± 4.84 fibre/mm2, 27.97 ± 9.62 branch/mm2, and 11.60 ± 2.89 mm/mm2) were significantly lower than those of Group 2 (19.55 ± 3.01 fibre/mm2, 40.44 ± 7.16 branch/mm2, and 15.92 ± 2.08 mm/mm2) and Group 3 (25.24 ± 3.75 fibre/mm2, 44.61 ± 11.80 branch/mm2, and 17.76 ± 3.32 mm/mm2) (p < 0.05 for all). Except the mean NFD value (p < 0.001), there were no significant differences in terms of the mean NBD and NFL values between Group 2 and Group 3 (p = 0.445, p = 0.085). The value of the mean corneal sensitivity was significantly higher in Group 3 (59.09 ± 1.97 mm) compared to Group 1 (55.21 ± 1.02 mm) and Group 2 (55.28 ± 1.18 mm) (p < 0.001, p < 0.001) but there was no significant difference between Group 1 and Group 2 (p = 1.000).ConclusionIn post-COVID-19 patients, the mean parameters of CSNP were lower than in the control group. These differences were more pronounced in patients who had neurological manifestations of COVID-19.Subject terms: Viral infection, Corneal diseases 相似文献
756.
Admir Kurtcehajic Enver Zerem Ervin Alibegovic Suad Kunosic Ahmed Hujdurovic Jasmin A Fejzic 《World Journal of Clinical Cases》2023,11(4):725-737
Portal vein aneurysm (PVA) is a rare vascular abnormality, representing 3% of all venous aneurysms in the human body, and is not well understood. It can be congenital or acquired, located mainly at the level of confluence, main trunk, branches and bifurcation. A PVA as an abnormality of the portal venous system was first reported in 1956 by Barzilai and Kleckner. A review from 2015 entitled “Portal vein aneurysm: What to know” considered fewer than 200 cases. In the last seven years, there has been an increase in the number of PVAs diagnosed thanks to routine abdominal imaging. The aim of this review is to provide a comprehensive update of PVA, including aetiology, epidemiology, and clinical assessment, along with an evaluation of advanced multimodal imaging features of aneurysm and management approaches. 相似文献
757.
758.
Enver Zerem Admir Kurtcehajic Suad Kunosi? Dina Zerem Malko?evi? Omar Zerem 《World journal of gastroenterology : WJG》2023,29(18):2747-2763
Acute pancreatitis(AP) is an inflammatory disease of the pancreas,which can progress to severe AP,with a high risk of death.It is one of the most complicated and clinically challenging of all disorders affecting the abdomen.The main causes of AP are gallstone migration and alcohol abuse.Other causes are uncommon,controversial and insufficiently explained.The disease is primarily characterized by inappropriate activation of trypsinogen,infiltration of inflammatory cells,and destruction of secreto... 相似文献