BackgroundOrganizing pneumonia (OP) can be idiopathic or secondary to some clinical situations. If an etiological cause is not present, this phenomenon is called cryptogenic OP. Secondary OP is associated with various diseases that are known to induce the OP.ObjectivesThe aim of this study was to evaluate the clinical features of the cases with OP and compare the patients diagnosed by bronchoscopic transbronchial biopsy with patients diagnosed by surgical lung biopsy.Patients and methodsMedical records of 41 patients diagnosed with OP between 2004 and 2014 were reviewed retrospectively.ResultsTotally, 41 patients with OP were identified. In all, 39.02% of the cases were diagnosed by bronchoscopic methods, and 60.97% of the cases were diagnosed by surgical procedures. Although the frequency of ground glass opacities, consolidations, and micronodules was higher in the group diagnosed by bronchoscopy, mass-like lesions were more common in the cases diagnosed by surgery. Bronchoscopy, performed in 30 patients totally, had a diagnostic efficacy of 53.33%. Diagnostic value of bronchoscopy was significantly higher in cryptogenic OPs. Although diffuse radiological pattern was more common in “successful bronchoscopy” group, frequency of focal pattern was higher in “failed bronchoscopy” group. Ground glass opacity in successful bronchoscopy group and mass-like lesions in failed bronchoscopy group reached significant differences.ConclusionThere were significant differences between the diagnostic procedures in terms of radiological patterns. This is the first study about the relationship between the diagnostic methods and the characteristics of OP.
Bu çalışmada mediastinal paratiroid adenom eksizyonu yapılan hastaların demografik özellikleri, ameliyat öncesi adenom yerleşimi, adenomun büyüklüğü ve yerleşim yerine göre seçilen cerrahi teknikler ve klinik sonuçlar değerlendirildi. Ça lış ma pla nı: Ocak 2011-Haziran 2019 tarihleri arasında kliniğimizde mediastinal paratiroid adenom eksizyonu yapılan toplam 11 hastanın (4 erkek, 7 kadın; ort. yaş 52.6 yıl; dağılım 25-65 yıl) tıbbi kayıtları retrospektif olarak incelendi. Demografik özellikler, şikayetler, ameliyat öncesi serum kalsiyum, fosfor ve parathormon düzeyleri, ameliyat öncesi görüntüleme yöntemleri, cerrahi yöntem, adenomun yerleşim yeri ve büyüklüğü, hastanede kalış süresi ve hastaların drenaj süresi ve miktarı dahil olmak üzere veriler kaydedildi. Bul gu lar: Adenom yedi hastada anterior mediastende ve dört hastada orta mediastende yerleşmiş idi. Paratiroid adenomun en uzun çapı dikkate alınarak hesaplanan ortalama çap 21.1 mm idi. Ortalama drenaj süresi median sternotomi yapılan iki hastada 3.5 gün, torakotomi uygulanan bir hastada beş gün, video yardımlı torakoskopik cerrahi yapılan üç hastada 1.2 gün ve robotik cerrahi yapılan beş hastada 0.6 gün idi. So nuç:Video yardımlı torakoskopik cerrahi ve robotik yardımlı cerrahi gibi minimal invaziv yaklaşımlar, mediastinal paratiroid adenom eksizyonunda güvenli ve etkili yaklaşımlardır. Anah tar söz cük ler: Mediastinum, minimal invaziv cerrrahi, paratiroid adenomu, robotik cerrahi.
Bu çalışmada, Türkiye genelinde pektus deformitelerinin demografik özellikleri ve ailesel kalıtımı araştırıldı. Ça lış ma pla nı: Ocak 1996-Aralık 2018 tarihleri arasında polikliniğimize pektus ekskavatum ve pektus karinatum ile başvuran toplam 5098 hastanın (5028 erkek, 70 kadın; ort. yaş 23.6 yıl; dağılım, 2-56 yıl) demografik özellikleri retrospektif olarak incelendi. Yedi bölgeye ve 81 ile göre hastaların ülke genelinde dağılımı yapıldı. Klinik kayıtlardan ve telefon görüşmelerinden elde edilen hasta verileri kullanılarak, ailesel kalıtım araştırıldı. Bul gu lar: Hastaların 3330'unda (%65.3) pektus ekskavatum ve 1768'inde (%34.7) pektus karinatum deformitesi olup, pektus ekskavatum-pektus karinatum oranı 1/1.9 idi. Güneydoğu Anadolu bölgesinde pektus ekskavatum oranı, genel ortalamadan daha düşük ve Marmara bölgesinde daha yüksek idi (sırasıyla, p= 0.009 ve p= 0.037). Güneydoğu Anadolu bölgesinde pektus karinatum oranı genel ortalamadan daha yüksek ve Marmara bölgesinde daha düşük idi (sırasıyla, p= 0.001 ve p= 0.003). Kastamonu, Çankırı, Karabük ve Sinop pektus deformiteli olguların en sık karşılaşıldığı iller idi. Pektus ekskavatumlu hastaların %39'unda ve pektus karinatumlu hastaların %43'ünde aile öyküsü pozitif idi. Tüm bölgeler aile öyküsü varlığı açısından benzer bir dağılım gösterdi. So nuç:Bu çalışma Türkiye'de pektus deformitelerinin dağılımını bildiren ilk çalışma olup, Türkiye'nin bazı bölgeleri ve illerinde pektus deformitelerinin yüksek oranda olması ailesel kalıtımı göstermektedir.
Background: Severe postoperative pain may occur following thoracotomy. The sources of this pain often include multiple muscle incisions, chest drains and possible rib injury. The management of this pain is extremely important for rehabilitation in the postoperative period. Thoracic epidural analgesia (TEA) represents the "gold standard" of pain control. However, this approach has serious problems such as hypotension, urinary retention, and hematoma. The erector spinae plane block (ESPB) is a novel regional analgesia technique and it is a simple, safe and effective method that can be applied as an alternative. The aim of this study was to assess the analgesic effectiveness of the ESPB and TEA techniques after thoracotomy. Materials and Methods:This retrospective, single-center study conducted between October 2018 and September 2020. We evaluated 83 patients who received ESPB, TEA and conventional (non-regional) technique. Demographic data, operation type and duration, postoperative visual analog scale (VAS) scores, opioid consumption were obtained from anesthesia and clinical patient follow-up forms. Results:The study included 83 patients who underwent thoracotomy and were divided into three groups as group ESPB (28), group TEA (33) and group control (22) who did not apply any regional analgesia method. The VAS scores at the 8 th , 24 th and 48 th hours postoperatively, were found to be significantly lower in the ESPB and TEA groups compared to the control group (p<0.05). ESPB and TEA groups had similar levels of VAS scores and opioid consumption (p>0.05). Opioid consumptions of ESPB and TEA groups was significantly lower than that in the control group (p<0.05). Conclusion:ESPB, which provides a similar level of analgesia with TEA in the management of postoperative analgesia in thoracotomy, can be considered a good alternative regional analgesia technique especially in patients with additional comorbidities such as obesity and spinal deformity.
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