Aim: There is still no consensus on nonoperative management (NOM) for the treatment of patients withliver injury due to multiple trauma. In this study, we aimed to present our experience in patients whounderwent NOM in our hospital due to liver injury resulting fro m blunt trauma.Patients and Methods: The study was evaluated retrospectively in 104 patients due to blunt multipletraumato our hospital between 2008-2014 with applied liver injuries. Patients with successful NOM andthose who underwent laparotomy due to failure of NOM were group ed.Results: All of the 104 patients had solid organ injury due to blunt abdominal trauma, and 58 of these hadthorax trauma. NOM was successfully performed in 94 patients with liver injury due to blunt abdominaltrauma. The treatment was converted to surgery in 10 patients during conservative follow-up. Accordingto injury grades; 35 patients were graded as Grade 1, 23 patients as Grade 2, 24 patients as Grade 3, and12 patients as Grade 4. Data of 10 patients with liver trauma and NOM failed were compared with thoseof the NOM group.Conclusion: The development of complications increases in patients with high-grade injury or thoseaccompanied by thorax trauma. The rate of complications is high in patients who receive NOM in Grade4 injury.
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Objective: We aimed to investigate the association of systolic pulmonary artery pressure (sPAP), with pulmonary artery diameter (PAD), age, gender, disease duration, disease stages, extrapulmonary involvement, and spontaneous remission in patients with sarcoidosis. Materials and Methods: Diagnosed and followed-up in the chest diseases clinic between 2010-2020, 60 sarcoidosis patients were included. Patients’ demographic data, clinical course, information over treatment, radiological and echocardiographic examinations were recorded. sPAB was utilized to calculate mean PAP based on ECHO. PAD was measured by an experienced radiologist in thoracic CT. Associatons of PAP and PAD with other parameters were investigated.Results: sPAP and PAD were found as 29.68±5.73 mmHg and 28.20±5.75 mm. A significant correlation was detected between them (r=0.46 p<0.001). PADs were 39.7±4.6 and 27±4.9 in patients with and without PH (p<0.001). sPAPs were found as 27.52±3.77 and 31.03±6.35 among those with and without extrapulmonary involvement (p=0.01). No association was found between these parameters and others.Conclusion: A moderately strong positive correlation was detected between sPAP and PAD in sarcoidosis patients. PAD was significantly found higher in patients with PH than those without. This also shows that PAD, which can be easily measured during thoracic CT examination in sarcoidosis patients, can be a guide in predicting sarcoidosis-associated pulmonary hypertension (SAPH).
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Objective: To investigate neutrophil/lymphocyte (NLR), lymphocyte/monocyte (LMR), platelet/lymphocyte (PLR) ratios, and the value of these parameters in determining disease severity and progression in hospitalized COVID-19 patients.Materials and Methods: Study was conducted retrospectively with 182 in-patients and 91 controls due to COVID-19 between April-September 2020 in the chest diseases clinic. Hematological parameters and rates were compared with controls’ parameters. Correlations and differences between hematological parameters and other parameters were investigated.Results: Lymphocyte, monocyte, eosinophil, basophil, hemoglobin, thrombocyte, and LMR were significantly lower. NLR and PLR were higher. There were significant increases in hematological parameters and PLR on discharge. A positive correlation existed between radiological pneumonia severity score, and NLR (r=0.234, p=0.001) and PLR (r=0.128, p=0.042), and significant inverse correlation with LMR (r=-0.206, p=0.003). Positive correlations were detected between NLR (r=0.140, p=0.030) and PLR (r=0.125, p=0.046), and symptom-discharge time, and inverse correlation between LMR, and both symptom-discharge (r=-0.137, p=0.032) and hospital stay time (r=-0.135, p=0.034). A positive correlation existed between CRP, and NLR and PLR on admission and discharge. Conclusion: NLR, LMR and PLR were found as hematological predictors to be used with CRP in following-up COVID-19, showing a significant correlation with disease severity, monitoring responses to treatment and predicting prognosis.
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Yasemin DURDURAN ,
Bahar KANDEMİR ,
Lütfi Saltuk DEMİR ,
Mehmet ÖZDEMİR ,
İbrahim ERAYMAN ,
Mehmet UYAR ,
Esma KEPENEK KURT ,
Sedat KOÇAK ,
Hülya VATANSEV ,
Alper YOSUNKLAYA ,
Adil ZAMANİ ,
Cengiz KADIYORAN , Bahadır FEYİZOĞLU,
Necdet POYRAZ ,
Kadir KÜÇÜKCERAN , Funda GÖK,
Reyhan EVCİ ,
Özge METİN AKCAN ,
Mevlüt Hakan GÖKTEPE ,
Yasemin Derya GÜLSEREN , Pınar Didem YILMAZ, Fatma Gökşin CİHAN,
Celalettin KORKMAZ ,
Mustafa Kürşat AYRANCI ,
Soner DEMİRBAŞ ,
Sevgi PEKCAN ,
Sebnem YOSUNKAYA ,
Turgut TEKE ,
Mehmet BİÇER ,
Tevfik KÜÇÜKKARTALLAR
Aim: The first COVID-19 case in Turkey was detected on March 11, 2020 during the COVID-19 pandemic process. Epidemiological studies are needed to be prepared for other outbreaks and to be effective in the disease management process. Based on this reason, in this study it was aimed to determine the epidemiological characteristics of Covid 19 possible and definite cases who applied to the university hospital during the pandemic process. Materials and Methods: This retrospective epidemiological study was carried out by analyzing the data of Covid 19 possible and definite cases, who applied to the university hospital operating as a pandemic hospital between 11 March / 01 June 2020. The data were summarized with descriptive statistics, tables and graphs. Results: Of the 1,383 patients, who applied with the suspicion of COVID-19, 55.5% were men and 84.5% were adults. The median age of children is 4.0 (1.5-10) years old; adults were 52.0 (36.0-67.0) years old. The median time between the outset of complaints and the date of admission to the hospital was 2 (1-3) days. 87.4% of adults and 87.9% of children had symptoms that supported COVID-19 infection. Among cases 7.8% were health care workers. The median age of the fatal cases was 71 (64-82) years old, 79.5% were male, 77.7% were retired. The most common comorbide diseases in these cases were hypertension (28.2%) and malignancy (28.2%). The case fatality rate was found as 2.8% in all patients and 48.4% in patients hospitalized in the intensive care unit. Conclusions: As a result, Covid-19 affects all age groups. Hypertension and malignancy were the most common additional diseases in fatal cases. The risk of illness is higher in healthcare workers who have direct contact with the patients. According to our observations, preventive measures, rapid diagnosis and supportive treatment are valuable.
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Purpose: Electrocardiography (ECG) is the first-linediagnostic tool to evaluate cardiac involvement in anydisease and COVID-19 patients. The objective of thisstudy is to investigate the ventricular arrhythmia formingeffect of COVID-19 and to guide the treatment.Materials and Methods: A total of 74 patients (mean age52.63±17.85 years) under follow-up for asymptomaticCOVID-19 and 74 healthy volunteers (mean age50.71±6.02 years) were enrolled in the study. Heart rate,QRS duration, QT distance, T-wave morphology (Tp-einterval), Tp-e/QT ratio, and index of cardioelectrophysiological balance (iCEB) were analyzed andcompared to both groups.Results: The heart rate was higher, and the QT intervalwas shorter on ECG in the COVID-19 group. QTcinterval, Tp-e intervals, and Tp-e/QT ratio were notdifferent between groups. Furthermore, iCEB and iCEB-cvalues were not different between groups. A significantpositive but weak correlation was observed between CRPand troponin values in patients with COVID-19.Moreover, there was no correlation between troponinlevels and Tp-e/QT ratio and iCEB in patients withCOVID-19.Conclusion: The chronic cardiac effects of the COVID19 have not been elucidated. Prospective clinical trials withlong-term and a high number of patient populations areneeded to reveal this. Notably, patients with significantlyelevated troponin values should be followed up for longterm development of cardiomyopathy and arrhythmias.
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Objectives: Pulmonary function tests are a necessary and applicable method in the practice of family medicine.Our aim in this study was to determine the utilization rates of spirometry or peak-flow meter devices amongfamily physicians who work in Turkey and the factors that influence this usage.Materials and Methods: This descriptive study included physicians working in the family medicine system inTurkey. Surveys were sent to physicians via e-mail. When a sufficient number of responses(n=380) wereobtained in two months (May 2018-July 2018), the study was terminated.Results: Among the responding physicians, 81.50% (n=310) had a peak-flow meter and 1.50% (n=59) had aspirometer, while 11% (n=42) of the physicians had neither of these devices. On the other hand, 66.30%(n=252) of the physicians stated that they did not use the spirometer or peak-flow meter, 6.60% (n=25) usedthe peak-flow meter, and 3.70%(n=14) used the spirometer. When asked about the reasons for not using theexisting devices, the most common reason was that they thought that the tests were not effective in familymedicine and the second most common reason was not knowing how to use them. It was found that, 79.70%(n = 303) of physicians requested a course on spirometry and peak-flow meter.Conclusion: It was determined that the usage rates of peak-flow meter or spirometry devices, which arerequired in family medicine, are very low. In order to provide better service in primary care, more training isneeded, both in medical faculties and after graduation.
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Objective: Behçet’s disease (BD) is an episodic and chronic multisystemic disease. Many comorbid psychiatric disorders are frequently encountered in BD. In addition, it is reported that individuals with chronic diseases during the epidemic period are at risk for COVID-19 infection. Therefore, these situations may cause anxiety levels to increase and coping strategies to decrease overall psychological conditionsin patients with BD. However, individuals with both psychiatric complaints and comorbid inflammatory and chronic diseases such as BD are more prone to this stressful situation than healthy individuals. In the current study, we aimed to determine whether patients with Behçet’s Disease (BD) are psychologically more sensitive than healthy individuals and whether disease severity increase with the COVID-19 pandemic.Methods: One hundred and fifty-six patients with BD and 156 healthy volunteers were included in the study. All participants received Perceived COVID-19 Threat Form (PCTF), Suicide-Ideation Scale (SIS), Hospital Anxiety and Depression Scale (HADS), The Ability to Cope with Trauma (PACT), well-being index (PGWB) scales.Results: When the responses of the patient with BD and control groups to the psychiatric evaluation scales were examined; the mean scores of PCTF (p <0.001), SIS (p<0.001), HADS-depression (p<0.001) and HADS-anxiety (p<0.001) in patients with BD were significantly higher than the control group. Mean scores of PGWB (p<0.001) and PACT (p= 0.042) in the patient group were found to be lower. In therelationship analysis, BSAS scores were associated with PCTF scores (r=0.20, p=0.013), and PGWB scores were associated with PACT scores (r=0.53, p=0.001).Conclusion: COVID-19 pandemic affects the mental health of both male and female patients with BD significantly. In patients with BD, while disease severity was associated with the perceived COVID threat, psychological well-being was associated with existing psychiatric complaints and patients’ ability to cope with trauma. The findings of our study support that patients with BD may need more psychological support than ever during the COVID-19 pandemic.
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