Leukocytoclastic vasculitis after the third dose of CoronaVac vaccination

Clinical Rheumatology -     

Are Fibrinogen and Complete Blood Count Parameters Predictive in Incarcerated Abdominal Hernia Repair?

Therapeutic delays in cases of external incarcerated hernias typically result in increasing morbidity, mortality, and health expenditures. We investigated the diagnostic role of blood fibrinogen level, white blood count (WBC), mean platelet volume (MPV), and platelet distribution width (PDW) in patients with incarcerated hernia. Two groups, each containing 100 patients, were studied. Group A underwent elective, and group B underwent incarcerated and urgent external hernia repair. We observed high fibrinogen and WBC levels but low MPV and PDW values for patients in group B. Contrary to our expectations, we found lower MPV and PDW values in the complicated group than in the elective group. The morbidity rate and cost burden were higher in group B, and the results were statistically significant. Early operation should be recommended for patients with incarcerated external hernias if their fibrinogen and WBC levels are high.Key words: Incarcerated external hernia, Fibrinogen, Complete blood countExternal strangulated hernia is one of the most common causes of intestinal obstruction especially in the elderly. Delay in treatment may be dangerous.¹ Andrews found that the need of bowel resection rate was 27% and the mortality rate was 21% when diagnosis was delayed more than 48 hours; whereas these rates were 7% and 1.4% when diagnosis was obtained in the first 24 hours.² In addition to increased morbidity and mortality rates, a delay in the treatment of strangulated external hernias is associated with extended hospital stays and an increased need for intensive care, thereby resulting in increased health costs. Of course, clinical signs and symptoms are the most important evidences in diagnosis of incarcerated hernias. In order to make correct diagnosis, we also have powerful weapons such as radiologic imaging methods. However, these clinical and radiologic evidences show complications, especially intestinal perforation due to incarceration. Awareness of probable complications is essential. In this regard, we sometimes need simple methods to alert us. The white blood count (WBC), mean platelet volume (MPV), platelet distribution width (PDW), and blood fibrinogen level have been shown to be valuable predictive parameters for ischemic events in different parts of the body.^3–9 There are probable ischemic tissues and organs in incarcerated hernia sac. So, in this study, we aimed to investigate the effectiveness of these simple blood tests in diagnosis. Generally, there is no problem in diagnosis, but sometimes the delay in treatment results in additional morbidity such as a need for bowel resection.     

Management of post-traumatic arterial priapism in children: Presentation of a case and review of the literature

In this article, a 9-year-old boy with arterial priapism is presented. The patient was managed with the conservative measures including imipramine hydrochloride and a favorable outcome was achieved after 2 months of follow-up. The pathophysiology, diagnostic tools and treatment alternatives are discussed.     

Role of preoperative plasma CA 15-3 and carcinoembryonic antigen levels in determining histopathologic conventional prognostic factors for breast cancer

Abstract Breast cancer is one of the leading causes of cancer death among women all over the world, with about one million new breast cancer cases diagnosed per year. This large number of cases make the diagnosis, treatment, and determination of the factors affecting the survey extremely important. The aim of this study was to evaluate the importance of the preoperative plasma CA 15-3 and carcinoembryonic antigen (CEA) levels when determining the conventional histopathologic prognostic factors (tumor grade, lymphatic infiltration, stromal invasion, vessel invasion, tumor necrosis, elastosis, and number of positive lymph nodes in levels I and II). We believe that with this protocol doctors can add to their knowledge about the prognosis of patients. After examining the serum tumor marker levels and the histopathology results of 29 patients and submitting them to statistical calculations, we strongly believe that preoperative serum CA 15-3 levels can be taken into consideration when evaluating the prognosis because the CA 15-3 level is directly and positively correlated with the gold standard prognostic factor: the number of level I and II positive lymph nodes. Electronic Publication     

Ergonomic problems encountered by the surgical team during video endoscopic surgery

BACKGROUND: The aim of this study is to analyze the problems related to the ergonomic conditions faced by video endoscopic surgical teams during video endoscopic surgery by means of a questionnaire. METHODS: A questionnaire was distributed to 100 medical personnel, from 8 different disciplines, who performed video endoscopic surgeries. Participants were asked to answer 13 questions related to physical, perceptive, and cognitive problems. RESULTS: Eighty-two questionnaires were returned. Although there were differences among the disciplines, participants assessment of various problems ranged from 32% to 72% owing to poor ergonomic conditions. CONCLUSIONS: As the problems encountered by the staff during video endoscopic surgery and the poor ergonomic conditions of the operating room affect the productivity of the surgical team and the safety and efficiency of the surgery, redesigning of the instruments and the operating room is required.     

Reliability,validity, and cross-cultural adaptation of the Turkish version of the Bristol Rheumatoid Arthritis Fatigue Multi-Dimensional Questionnaire

Up to 98% of rheumatoid arthritis (RA) patients experienced fatigue. It is an important physical and cognitive symptom which has overwhelming, uncontrollable, and unpredictable affects throughout their whole life. RA fatigue composes of complex and multi-dimensional components which are pain, stress, depression, inflammation, and disability. The acknowledgement of fatigue is important, and fatigue should be measured in all RA trials alongside the core set. The aim of this study was to determine reliability and validity of Turkish version of Bristol Rheumatoid Arthritis Fatigue Multi-Dimensional Questionnaire in RA patients. One hundred RA patients were evaluated in the study. Exclusion criteria were determined as patients with cognitive impairment, illiterate patients, unable to understand and speak Turkish, under the age of 18, and over the age of 75. To validate Turkish version of Bristol Rheumatoid Arthritis Fatigue Multi-Dimensional Questionnaire (BRAF-MDQ) (BRAF-MDQ-T), all participants answered BRAF-MDQ-T, Multidimensional Assessment of Fatigue (MAF) scale, and Short Form-36 vitality (SF-36 VT). BRAF-MDQ-T was applied again 7 days later for test–retest reliability. Validity, internal consistency, and test–retest results were based on a sample of 100 patients. Internal consistency reliability of BRAF-MDQ-T was Cronbach α?=?0.95 which was excellent. The correlation between the total scores of the BRAF-MDQ-T scale and the total scores of MAF-T was statistically significant (r?=?0.82, p?<?0.001). The correlation between the total scores of the BRAF-MDQ-T scale and the subscale scores of SF–36 VT was statistically significant (r?=???0.64, p?<?0.001). The BRAF-MDQ-T is a valid and reliable scale for the assessment of fatigue in Turkish rheumatoid arthritis patients.