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51.
Oruğ T Arda K Tosun O Ozçay N Atan SA 《HPB : the official journal of the International Hepato Pancreato Biliary Association》2004,6(1):49-51
Background
The incidence of acute pancreatitis after renal transplantation ranges around 1%, and the mortality rate is nearly 65%. Dynamic computed tomography (CT) scan and amylase levels are valuable in the diagnosis of this rare complication.Case outline
A 29-year-old man was hospitalised with cytomegalovirus (CMV) pancreatitis after renal transplantation. An initial CT scan showed an enlarged pancreas with hypodense, heterogeneous consistency and with peripancreatic, perihepatic, mesenteric and pelvic fluid collections. After initial conservative management, follow-up CT revealed pancreatic necrosis and abscess formation. The patient underwent necrosectomy and repeated drainage of abscess facilitated by a Bogota bag, but he died 60 days after admission and five surgical procedures.Discussion
CMV pancreatitis after renal transplantation is rare and frequently fatal. In the presence of an acute abdomen after renal transplantation, the diagnosis of pancreatitis should be considered. Dynamic CT scan and measurement of amylase levels are recommended. 相似文献52.
Tekcan M Koksal IT Tasatargil A Kutlu O Gungor E Celik-Ozenci C 《Journal of andrology》2012,33(1):122-132
The aim of this study was to evaluate whether the poly(adenosine diphosphate[ADP]-ribose) polymerase (PARP) pathway is activated by experimental left varicocele. Rats underwent partial ligation of the left renal vein to induce experimental varicocele, and left testes were analyzed 13 weeks after surgery. Tubule degeneration was evaluated by Johnsen score. Expression of 4-hydroxy-2-nonenal (4-HNE)-modified proteins, PARP-1, and poly(-ADP-ribose) (PAR) was detected by immunohistochemistry and Western blot. The degree of apoptosis within testes was determined by terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate nick end labeling. Light microscopy revealed testicular damage comprising various degrees of seminiferous tubule degeneration. Germ cell apoptotic index and 4-HNE, PAR, and PARP-1 expression in germ cells increased after varicocele induction. Increased oxidative stress and PARP overactivation in testes might be important with regard to impaired testicular function associated with varicocele. 相似文献
53.
H. Leblebicioglu A. N. Yalcin V. D. Rosenthal I. Koksal F. Sirmatel S. Unal H. Turgut D. Ozdemir G. Ersoz C. Uzun S. Ulusoy S. Esen F. Ulger A. Dilek H. Yilmaz O. Turhan N. Gunay E. Gumus O. Dursun G. Yýlmaz S. Kaya H. Ulusoy M. Cengiz L. Yilmaz G. Yildirim A. Topeli S. Sacar H. Sungurtekin D. Uğurcan M. F. Geyik A. Şahin S. Erdogan A. Kaya N. Kuyucu B. Arda F. Bacakoglu 《Infection》2013,41(2):447-456
Purpose
To evaluate the impact of the International Nosocomial Infection Control Consortium (INICC) multidimensional approach on the reduction of ventilator-associated pneumonia (VAP) in adult patients hospitalized in 11 intensive care units (ICUs), from 10 hospitals, members of the INICC, in 10 cities of Turkey.Methods
A prospective active before-after surveillance study was conducted to determine the effect of the INICC multidimensional approach in the VAP rate. The study was divided into two phases. In phase 1, active prospective surveillance of VAP was conducted using the definitions of the Centers for Disease Control and Prevention National Health Safety Network, and the INICC methods. In phase 2, we implemented the multidimensional approach for VAP. The INICC multidimensional approach included the following measures: (1) bundle of infection control interventions, (2) education, (3) outcome surveillance, (4) process surveillance, (5) feedback of VAP rates, and (6) performance feedback of infection control practices. We compared the rates of VAP obtained in each phase. A time series analysis was performed to assess the impact of our approach.Results
In phase 1, we recorded 2,376 mechanical ventilator (MV)-days, and in phase 2, after implementing the multidimensional approach, we recorded 28,181 MV-days. The rate of VAP was 31.14 per 1,000 MV-days during phase 1, and 16.82 per 1,000 MV-days during phase 2, amounting to a 46 % VAP rate reduction (RR, 0.54; 95 % CI, 0.42–0.7; P value, 0.0001.)Conclusions
The INICC multidimensional approach was associated with a significant reduction in the VAP rate in these adult ICUs of Turkey. 相似文献54.
Leblebicioglu H Yilmaz H Tasova Y Alp E Saba R Caylan R Bakir M Akbulut A Arda B Esen S 《European journal of epidemiology》2006,21(1):25-31
Objective: The aim of our study was to establish the etiology of and risk factors for infective endocarditis (IE) and determine the
prognostic factors for adverse outcome during hospital admission in a Turkish population. Material and Methods: Between January 2002 and January 2004, the clinical and laboratory features of 112 consecutive adult patients (>18 years)
with diagnosis of IE who were referred to the infectious diseases clinics/departments of 17 teaching hospitals in Turkey were
evaluated. Cases of IE were defined according to the modified Duke Criteria. Mortality was defined as death occurring within
30 days or during hospital stay period. Univariate and multivariate analyses were performed to predict the factors related
to fatal outcome. Results: A total of 112 consecutive patients presented with 101 definite and 11 probable IE episodes were defined according to the
modified Duke Criteria. The mean age was 45.2±19.9. Fifty percent of the patients were male. Ninety (60.4%) of the 112 patients
had risk factors for IE and 48 (42.9%) of them had ≥2 risk factors. On the other hand, 49.1% of patients had cardiac risk
factors. Blood cultures were positive in 94 (83.9%) cases. Staphylococci were the most common agents (50.0%), followed by
streptococci (28.7%) and enterococi (16.0%). Native cardiac valves were detected in 93 (83%) of the episodes of suspected
IE. Valvular involvement was present in 103 (92%) patients; the mitral valve, alone or in combination with other valves, was
affected in 70 (62.5%) of the patients. Echocardiography detected vegetations in 105 patients (93.8%). The mortality rate
was 28.6%. Three factors were independently associated with mortality: haemodialysis OR: 14.5 (95% CI: 1.5–138.2), mobile
vegetation OR: 4.8 (95% CI: 1.5–15.4) and mental alteration OR: 4.1 (95% CI: 1.1–15.6). Conclusion: Mortality is still high in IE. Our data indicate that patients with altered mental status, mobile vegetation, or on haemodialysis
had poorer prognosis.
Atahan Cagatay, Istanbul University Istanbul Medical School, Turkey; Funda Ergin, Baskent University, Medical School, Turkey;
Hurrem Bodur, Ankara Numune Hospital, Turkey; Gulsen Ozkaya Sahin, Hacettepe University, Medical School, Turkey; Irfan Sencan,
Abant Izzet Baysal University, Duzce Medical School, Turkey; Saban Gurcan, Trakya University, Medical School, Turkey; Elif
Doyuk, Osmangazi University, Medical School, Turkey; Bilgiul Mete, Istanbul University Cerrahpasa, Medical School Turkey;
Oral Oncul, Gulhane Academy, Medical School, Turkey 相似文献
55.
Non-invasive management of fetal goiter during maternal treatment of hyperthyroidism in Grave's disease 总被引:1,自引:0,他引:1
There is an increased risk of fetal goiter in patients who have a history of Grave's disease and undergo propylthiouracil (PTU) treatment during pregnancy. In this report, we describe a case of a fetal goiter detected by antenatal ultrasound at the 26th week of gestation in a mother treated with PTU for Grave's disease. A 32 x 38 x 20 mm fetal goiter was detected, each lobe measured 30 x 18 x 18 mm and estimated volume was 10 cm3. Subsequently, fetal thyroid function was assessed by umbilical fetal blood sampling. Cord blood showed elevated serum TSH (40.2 mU/l) and normal concentrations of free T4 (9.5 pmol/l) and free T3 (2.6 pmol/l). There were no other ultrasonographic signs of fetal hypothyroidism. Based on the above findings, the mother's PTU dosage was reduced to 50 mg daily from a total of 150 mg and weekly ultrasonographic examinations were performed. Six weeks after the initial ultrasound, a complete regression of the fetal goiter was noted. At the 34th week of gestation, the patient was delivered due to intrauterine growth restriction and oligohydramnios and gave birth to a male, weighing 1,920 g. The newborn thyroid was not palpable and thyroid ultrasonography was normal. Cord blood TSH was normal (8.4 mU/l) and free T4 was within lower normal limit (9.03 pmol/l). Ten days later, newborn thyroid function was normal and the baby did well afterwards. In conclusion, after the evaluation of fetal thyroid status, selected cases with fetal goiter can be initially managed without intrauterine treatment. 相似文献
56.
Arda B Yamazhan T Sipahi OR Islekel S Buke C Ulusoy S 《International journal of antimicrobial agents》2005,25(5):414-418
We evaluated retrospectively, 10 MRSA meningitis cases in our hospital that occurred between January 1999 and June 2004. All were post-neurosurgical and were considered to have hospital-acquired meningitis. Fever, leukocytosis, variable conscious levels were the most common findings. Six patients were treated with regimens including teicoplanin, and four with vancomycin. Mean duration of treatment was 23.5+/-18.8 days (range, 3-60 days). One patient died. In cases of MRSA meningitis, intravenous vancomycin is the mainstay of therapy. However, six of these 10 patients were successfully treated with regimens including teicoplanin, suggesting that this agent may be an alternative to vancomycin in the therapy of these cases. 相似文献
57.
Mehmet Salih Bilal Arda
zyüksel Mustafa Kemal Avar ener Demiroluk Osman Küükosmanolu Yalm Yaln 《Congenital heart disease》2019,14(3):464-469
Objective: Management of the patients with transposition of the great arteries and
intact ventricular septum may be challenging beyond the newborn period. Herein, we
would like to present our alternative strategy for training the left ventricle in these
patients.
Methods: Six patients with transposition of the great arteries and intact ventricular septum were evaluated in our clinic. Two of them were palliated with Glenn procedure and pulmonary banding as a definitive treatment strategy at other centers. Four patients were operated on and a bidirectional cavopulmonary anastomosis in combination with pulmonary artery banding was performed (stage‐1: palliation and ventricular training) in our center. In four out of these six patients, arterial switch operation was performed with takedown and direct re‐anastomosis of the superior vena cava to right atrium after an interstage period of 21‐30 months (stage‐2: anatomical repair).
Results: Any mortality was not encountered. The left ventricular mass indices increased from 18‐32 to 44‐74 g/m2 in patients undergoing the anatomical repair. All of the patients were uneventfully discharged following the second stage. The mean follow‐up period was 20 months (9‐32 months) following stage 2. All of the patients are doing well with trivial neoaortic regurgitation and normal biventricular function.
Conclusions: Bidirectional cavopulmonary anastomosis with pulmonary artery banding may be a promising left ventricle training approach in ventriculoarterial discordance when compared to the traditional pulmonary artery banding with concomitant systemic‐to‐pulmonary artery shunt procedures which still carry a significant interstage morbidity and mortality. 相似文献
Methods: Six patients with transposition of the great arteries and intact ventricular septum were evaluated in our clinic. Two of them were palliated with Glenn procedure and pulmonary banding as a definitive treatment strategy at other centers. Four patients were operated on and a bidirectional cavopulmonary anastomosis in combination with pulmonary artery banding was performed (stage‐1: palliation and ventricular training) in our center. In four out of these six patients, arterial switch operation was performed with takedown and direct re‐anastomosis of the superior vena cava to right atrium after an interstage period of 21‐30 months (stage‐2: anatomical repair).
Results: Any mortality was not encountered. The left ventricular mass indices increased from 18‐32 to 44‐74 g/m2 in patients undergoing the anatomical repair. All of the patients were uneventfully discharged following the second stage. The mean follow‐up period was 20 months (9‐32 months) following stage 2. All of the patients are doing well with trivial neoaortic regurgitation and normal biventricular function.
Conclusions: Bidirectional cavopulmonary anastomosis with pulmonary artery banding may be a promising left ventricle training approach in ventriculoarterial discordance when compared to the traditional pulmonary artery banding with concomitant systemic‐to‐pulmonary artery shunt procedures which still carry a significant interstage morbidity and mortality. 相似文献
58.
Hakan Leblebicioglu Gulden Ersoz Victor Daniel Rosenthal Ata Nevzat-Yalcin Özay Arıkan Akan Fatma Sirmatel Huseyin Turgut Davut Ozdemir Emine Alp Cengiz Uzun Sercan Ulusoy Saban Esen Fatma Ulger Ahmet Dilek Hava Yilmaz Ali Kaya Necdet Kuyucu Ozge Turhan Nurgul Gunay Eylul Gumus Oguz Dursun Melek Tulunay Mehmet Oral Necmettin Ünal Mustafa Cengiz Leyla Yilmaz Suzan Sacar Hülya Sungurtekin Doğaç Uğurcan Mehmet Faruk Geyik Ahmet Şahin Selvi Erdogan Bilgehan Aygen Bilgin Arda Feza Bacakoglu 《American journal of infection control》2013
59.
In this study, we reviewed the computed tomography (CT, n=9) and magnetic resonance (MR, n=5) imaging findings of 11 patients with pathologically confirmed cerebral hydatid disease. Among our patients, there were 10 cases of Echinococcus granulosus and 1 case of Echinococcus multilocularis. Common CT and MR imaging findings of E. granulosus lesions were well-defined, smooth thin-walled, spherical, homogeneous cystic lesions with no contrast enhancement, no calcification, and no surrounding edema. E. multilocularis lesions showed calcified round, solid pattern with definite margins, contrast enhancement, and surrounding edema. 相似文献
60.