There are numerous occupational pollutants originating from a wide variety of industrial areas and working environments. These pollutants can be brought inadvertently from workplace to home in various ways and may negatively affect the health of household. In the literature, this situation was known as para-occupational exposures in the past but today it is referred as take-home exposures. In this review article; transport pathway, the diversity of take-home exposures, the population at risk and occupational security deficits were examined and precautions in reducing the take-home exposures were
discussed. At the same time, take-home exposures were considered as an important public health problem and the contribution of social inequalities to the extent of the problem was also evaluated. It is aimed to help researchers to have a comprehensive view of take-home exposures and to support preventive efforts.
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Introduction: In this retrospective study, the indications and success, complication and mortality rates of local and regional flaps used in head and neck reconstruction were investigated. Methods: Patients operated for head and neck reconstruction
between the years 2014 and 2019 were included in this retrospective study. Results: A total of 41 patients were included in the study. The mean patient age was 60.3±20.6 (range: 8-89). In 39.0% (n=16) of patients, the pectoralis major muscle flap was used for reconstruction. In 17.1% (n=7) of patients, the local advancement flap was used. In all, 29% (n=12) of patients had squamous cell carcinoma, 19.5% (n=8) had basal cell
carcinoma, and 14.6% (n=6) of patients had tracheoesophageal fistula. The overall complication rate was 29.2%. The mortality rate was 2.4% (n=1). Conclusion: In this retrospective study, it was objectively demonstrated that local regional pedicle flaps can be used safely in the repair of head and neck defects with correct patient analysis, wound site and defect evaluation, and flap planning
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Introduction: The purpose of this study was to compare
prostate-specific antigen (PSA), PSA density (PSAd), the prostate
imaging-reporting and data system (PI-RADS) score, and lesion
dimension (four parameters) in clinically significant prostate
cancer (PCa) detection.
Methods: This study included 154 patients who underwent
multi-parametric prostate magnetic resonance imaging
(mpMRI) and 12 quadrant systematic prostate biopsy between
01/2018 and 03/2019. Two radiologists used the PI-RADS
version 2.1 to describe the MRI findings by consensus. A Gleason
score ≥3+4 was assessed as clinically significant PCa. Areas
under the curve (AUC) were calculated using receiver operating
characteristics. Youden’s index was used to determine ideal
cutoffs. DeLong’s test was used to evaluate statistically
significant differences between the four parameters.
Results: The median age was 66 (±6.9) in this cohort. The
median PSA level was 7.8 ng/dL (±18.4, 1.6-109.3), the median
PSAd was 0.146 ng/mL/cm3
, and the median lesion dimension
was 12 mm. In MRI, the number of cases with the PI-RADS
scores from 1 to 5 were 34, 6, 11, 38, and 65, respectively. In
terms of pathology, there was no tumor in 44 patients’ samples,
while insignificant cancer and clinically significant PCa were
seen in 33 and 77, respectively. The AUC values of PSA, PSAd,
PI-RADS score, and lesion dimension were 0.684, 0.731, 0.856,
and 0.858, respectively. The optimal cutoffs were ≥10 ng/mL for
PSA, ≥0.22 ng/mL/cm3
for PSAd, ≥4 for the PI-RADS score and
≥10 mm for lesion dimension. DeLong’s tests showed that the
PI-RADS score and lesion dimension were significantly superior
to PSA and PSAd. There was no significant difference between
the PI-RADS score and lesion dimension. Conclusion: The PI-RADS score and lesion dimension had
higher accuracy than PSA and PSAd in clinically significant
PCa detection. Lesions ≥10 mm were associated with the risk
of clinically significant PCa, and this should be considered in
reporting.
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Introduction: Acute non-variceal upper gastrointestinal
bleeding (ANVUGIB) is an important public health problem
with high rates of morbidity and mortality. ANVUGIB results
in hypovolemia, hypotension, and shock, increasing cardiac
oxygen use and may cause elevated serum levels of cardiac
troponin (cTn). In this study, we aimed to evaluate whether
elevated cTnI has clinical significance in patients with ANVUGIB.
Methods: A total of 62 patients diagnosed with ANVUGIB
whose serum cTnI levels were studied at the time of admission
and follow-up in our clinic from January 2015 to January 2016
were included in the study. Patients with acute cardiac diseases
that may cause elevated cTn were excluded from the study.
Results: Forty-three of the patients were male (69.4%), and the
mean age of all patients was 71.52±13.30 years. The mean
cTnI level was 0.042±0.097 in all patients, with cTnI levels
higher than the reference value in nine (14.5%) patients. In
logistic regression analysis, the factors found to contribute to
cTnI were tachycardia, chronic kidney disease, and coronary
artery disease. In receiver operating characteristic analysis, cutoff values of 0.025 and 6.5 were found for cTnI and the Rockall
score, respectively. In addition, cTnI and the Rockall score were
shown to affect survival [log-rank (Mantel-Cox) test: p=0.011;
log-rank (Mantel-Cox) test: p=0.014; respectively].
Conclusion: We believe that serum cTnI levels studied during
the first admission will be found useful as a biomarker in
addition to the other existing risk determination systems,
in order to identify patients at risk, even if findings of acute
coronary syndrome are not observed in patients presenting
with ANVUGIB
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Introduction: This study is an experimental setup to examine
the effects of splenectomy, applied to multi-trauma patients
who are commonly seen in emergency traumatology
practices and on fracture healing processes with respect to
histopathological, biomechanical, and radiological aspects.
Methods: Further, 32 male Sprague Dawley rats (10 months
old; average weight 394.5±28.3 g) are included in the study.
In a dark environment, rats are fed at 22 °C for 12 hours
with standard rodent food ad libitum. They are divided into
two groups: splenectomy (total splenectomy and long bone
fracture healing) and control (only long bone fracture healing
n=16). Four months after surgery, rats are killed, and callus
tissues in fractured femurs were examined histopathologically,
radiologically, and biomechanically.
Results: In the radiological analysis of the femur materials
in relation to the case and control groups, there was no
substantial difference in the Goldberg classification score
(p˃0.05). Similarly, no substantial difference was observed
(p˃0.05) in histopathological examinations and biomechanical
analysis conducted in femur samples.
Conclusion: When all of the results obtained in our study
are evaluated together, it was concluded in the rats to which
splenectomy is applied that this did not affect fracture healing
histopathologically, biomechanically, and radiologically,
despite the modification of immune modulators.
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Introduction: Insulinoma is the most common functional
neuroendocrine tumor of the pancreas. There are different
methods for the preoperative localization of insulinoma, such
as Computed Tomography (CT) scan, Magnetic Resonance
Imaging and Endoscopic Ultra Sonography (EUS). In this study,
we report on the clinicopathological features of insulinoma in
43 patients.
Methods: The hospital records of 43 patients with suspicion of
insulinoma based on biochemical diagnostic criteria, referred
to İmam Khomeini Complex Hospital, Tehran, Iran between
2006 and 2016, were reviewed retrospectively.
Results: Of the 43 studied patients, 28 were female. The mean
age of the patients was 45.4±13.3 years. The most frequent
clinical presentation of insulinoma was neurogenic and
neuroglycopenic symptoms (81.4%). Mean glucose, insulin,
and C-peptide in patients with hypoglycemic crisis were
39.13±13.15 mg/dL, 32.15±32.53 μUI/mL, and 4.77±2.88
ng/mL, respectively. Mean tumor size was 2.13±1.22 cm. The
most common site of insulinoma was the tail of the pancreas.
Surgery was the treatment of choice and performed in 31
patients. Of 21 tumors studied microscopically, 7 were invasive.
Conclusion: In non-diabetic patients with manifestations
of hypoglycemia, a diagnosis of insulinoma should be
considered. During the past decade, the diagnostic delay for
insulinoma has been reduced in our country by improving
imaging technologies. EUS and CT scan are the best modalities
for localization and size measurement of insulinoma. Tumor
size has decreased compared with pre
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Patients with traumatic intracranial subarachnoid hemorrhage
(SAH) rarely develop spinal subarachnoid hemorrhage (SSAH)
without direct spinal injury. We present the case of a 76-yearold male patient with traumatic intracranial SAH and subdural
hematoma, back pain and weakness in the both lower
limbs radiating to the legs three days after the trauma. After
worsening of pain and numbness, the patient underwent a
lumbar magnetic resonance imaging 7 days after the trauma,
in which blood was seen in the spinal canal in the lumbosacral
region. The bleeding was considered SSAH because of the
liquid level. The patient underwent conservative treatment
because the patient was found to be at high cardiac risk and
the neurological deficit was mild. In patients with traumatic
intracranial hemorrhage and delayed pain or neurological
deficits, SSAH should be suspected in the first period of trauma
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Introduction: On admission to the intensive care unit (ICU), functional and general health stata are important baseline characteristics of critically ill patients with chronic obstructive
pulmonary disease (COPD). The measurement of total psoas muscle area (PMA) is under investigation to determine physical frailty and sarcopenia, especially encountered in the elderly, to predict adverse outcomes and mortality in patients requiring inhospital and ICU management. We aimed to assess the clinical value of total PMA for the prediction of mortality in COPD patients requiring ICU management of acute exacerbations. Methods: The clinical data of 62 patients whose abdominal computed tomography (CT) scans were available in the hospital Picture Archiving Communication System were collected. The
mean duration of stay in the ICU was 7.7±8.8 and 9.4±12.3 days in survivors and non-survivors. The main causes of mortality in non-survivors were respiratory failure and cardiac arrest. For measurements from CT scans, images of the caudal end of the third lumbar vertebra were used. Right and left PMAs were measured to obtain the total PMA and density. Results: Of 62 patients, 20 (32.2%) were non-survivors (male: 13, female: 7), and 42 were survivors (male: 32, female: 10). There was no significant difference between non-survivors and survivors regarding total PMA and density values (p>0.05). In non-survivors and survivors, females had lower total PMA (p<0.05). There was no significant association between clinical and PMA data (p>0.05).
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Introduction: Despite a faster recovery, low complication rate, and good functional results, it has been reported that unicondylar knee arthroplasty (UKA) may have high revision
rates. Aseptic loosening and pain are the most common causes of UKA revision. The use of cementless and hybrid UKA has been presented as a solution to improve the fixation of
prosthetic components. The main purpose of this study was to compare the early clinical outcomes and quality of fixation of cementless and hybrid UKA radiologically.
Methods: A retrospective study was established with patients who received 37 cementless and 41 hybrid UKA in a minimum 2-year follow-up period. The patients’ clinical outcomes were evaluated using the Oxford knee score, EuroQol-5 dimensions, EuroQol-visual analog scale, knee injury and osteoarthritis outcome score, and knee range of motion. The fixation of UKA components was evaluated with the varus-valgus angle
of the tibial-femoral component, and the incidence of the radiolucent (RL) line at both the tibial and femoral componentbone interface on the radiograph. Results: There was no significant difference in any clinical outcome measurement (p>0.05). There was no significant difference between the varus-valgus and flexion-extension angles of the femoral and tibial components in both groups (p>0.05). There were significantly more tibial RL in the hybrid group than in the cementless group (p=0.025). There was no
significant difference in the incidence of RL at the femoral
component-bone interface (p=0.691). Conclusion: The cementless group showed significantly less tibial RL than the hybrid group in UKA. Although there were no clinically significant differences between cementless and hybrid UKAs, cementless UKA may be preferred to prevent possible prosthesis loosening
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Introduction: Roasted and spicy food (mainly hot pepper)
consumption is very common in Southeastern Anatolia. Smoked
and spicy diets and Helicobacter pylori (H. pylori) infection are
known risk factors for gastric cancer. The aim of this study
was to investigate the effects of eating habits on the gastric
mucosa, to investigate the rate of H. pylori positivity, and to
examine the association of these factors with histopathological
features in this region.
Methods: Histopathological findings in endoscopic biopsies of
943 consecutive patients were retrospectively evaluated.
Results: More than half of the patients were female (54%;
n=505), and the median age was 47±17.27 (range: 18-96).
The most common non-gastritis histopathologic diagnosis
was gastric carcinoma (2.5%; n=24), followed by polypoid
lesions (1.6%; n=16). The vast majority of patients (92%) had
chronic gastritis, and neutrophilic activity was present in 61%
(n=537). The frequencies of atrophy, intestinal metaplasia, and
regenerative mucosal changes were significantly correlated
with the severity of neutrophilic activity (p<0.05). Patients
with atrophy and intestinal metaplasia were significantly
older than those without atrophy and intestinal metaplasia
(p<0.001; mean age: 47 and 46 vs 56 and 55, respectively).
More than 50% were infected with H. pylori (57%; n=542), and
H. pylori positivity was associated with the presence of chronic
and chronic active gastritis, as well as lymphoid hyperplasia
(p<0.001). In contrast, erosion, atrophy, and neuroendocrine
cell hyperplasia were less common in patients with H. pylori
gastritis (p<0.05).
Conclusion: H. pylori infection and spicy food consumption
are key risk factors for gastritis in Southeastern Anatolia.
Prospective epidemiological studies are needed to better
demonstrate the causal interaction between dietary factors
and gastritis.
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