The interval from the onset of clinical symptoms to the initial surgical intervention seems to be the most important prognostic factor with a significant impact on outcome. Given the significantly high mortality rate among diabetics, diabetes is also an independent prognostic factor. Despite the decreased number of idiopathic cases and extensive therapeutic efforts, Fournier's gangrene remains a surgical emergency, and early recognition with prompt radical debridement is the mainstays of management.
Background. Renal ischemia/reperfusion (I/R)-induced tubular epithelial cell injury, called ischemic acute renal failure, is associated with high mortality in humans. Protecting the kidney against I/R injury is very important during complicated renal operations, transplantation surgery, and anesthesia. Aim. The purpose of this study was to investigate and compare the efficiency of ketamine, thiopental, propofol, etomidate, and intralipid in reducing the injury induced by free radicals in a rat model of renal I/R. Method. Forty-two Wistar rats were divided into seven groups in our study. Rats in the sham group underwent laparotomy and waited for 120 minutes (min) without ischemia. Rats in the control group were given nothing with ischemia-reperfusion. Rats in the I/R groups were given ketamine (20 mg/kg), thiopental (20 mg/kg) propofol (25 mg/kg), etomidate (10 mg/kg) and 10% intralipid (250 mg/kg) intraperitoneally 15 min prior to the ischemia for 60 min, followed by reperfusion for 60 min. The blood samples and kidney tissues of the rats were obtained under anesthesia at the end of the reperfusion period. Biochemical malondialdehyde (MDA), superoxide dismutase (SOD), catalase (CAT), blood urea nitrogen (BUN), creatine (Cr), aspartate aminotransferase (AST) were determined, and histopathological analysis was performed with these samples. Results. MDA level was increased significantly in the control group (p < 0.05). Histopathological findings of the control group confirmed that there was renal impairment by tubular cell swelling, interstitial edema, medullary congestion, and tubular dilatation. MDA levels were lower in the ketamine, thiopental, and propofol groups compared to the control group (p < 0.05). In the thiopental and propofol groups, the levels of histopathological Effects of Intravenous Anesthetics in I/R Injury 291scores were significantly lower than control and etomidate groups in ischemia-reperfusion. Conclusion. Our results demonstrated that I/R injury was significantly reduced in the presence of propofol and thiopental. The protective effects of these drugs may belong to their antioxidant properties. These results may indicate that propofol and thiopental anesthesia protects against functional, biochemical, and morphological damage better than control in renal I/R injury.
The Turkish version of Eustachian tube dysfunction questionnaire-7 was found to be highly valid and reliable. This scale is recommended to use for screening of Eustachian tube dysfunction and evaluating treatment outcome.
The digital world and social media are becoming increasingly important. Social media connect people together in a visual manner. Profile photographs are required by most social networking sites. A trend toward the increasing popularity of selfies on social media has rendered people more aware of their appearance. A selfie is a photograph that one takes of oneself, usually employing a smartphone or webcam, which is then shared on social media. Thus, the demand for aesthetic procedures correcting imperfections such as a prominent nose has increased, for which the technique is a rhinoplasty. Patients with reasonable expectations, treated by skilled surgeons, are usually very happy with the results. Rhinoplasty does not cure low self-esteem, but does correct more visible imperfections of the face. Although some hope that a rhinoplasty will resolve many unwanted facial features besides nose problems, it can only change the size and shape of the nose, improving its form. However, in the age of the selfie, everyone wants to look better. Self-consciousness is increasing, as are concerns over grooming and appearance at work and social events. These issues have become more important in recent years with the increase in selfie-taking; people are now more aware of how their nose appears to others. In this review, we discuss whether selfie-taking has triggered a rise in rhinoplasties along with a detailed survey of the literature.
The mortality rate in patients operated for hip fractures is higher when compared to the mortality rate in patients of the same age group. Because most deaths caused by pulmonary insufficiency occurred in the first 3 months in which patients were not adequately mobilized, the main cause of death might be pulmonary embolism. Abnormal creatinine values might indicate insufficient kidney function as another reason of death. ASA classification is useful for determination of preoperative risk in the elderly patients with hip fractures.
Paramedian forehead flap is a workhorse for nasal reconstruction. However, vascular complications may lead to flap failure. The purpose of this study was to evaluate the blood flow objectively and determine the hemodynamic changes in paramedian forehead flap with respect to influential factors of age, gender, and smoking. Thirty patients who had paramedian forehead flap were followed up prospectively between 2010 and 2013. The blood flow was assessed by resistance index using Color Duplex-Doppler Ultrasonography. Resistance index was measured at the proximal and distal ends of each flap on the postoperative first day, first week, and second week. All data were analyzed using SPSS 15.0 for Windows. Fifteen patients were female and the mean of age was 60.9 years. Our results demonstrated statistically significant differences with gradual decreases in resistance to blood flow, when the resistance index values at the proximal and distal ends of paramedian forehead flap were compared (P < 0.001 and P < 0.001). Age, gender, and smoking did not have a negative impact on the resistance index values of paramedian forehead flap. To the best of our knowledge, this is the first study in which resistance in blood flow and hemodynamic changes of paramedian forehead flap were objectively determined using Color Duplex-Doppler Ultrasonography. The resistance index gradually decreases, although it is considerably high at the early postoperative interval. Age, gender, and smoking do not adversely influence the blood flow in a well-designed paramedian forehead flap.
Amaç: Çocu¤un geliflim dönemine paralel bir flekilde dil geliflim safhalar›n› göstermemesi ya da konuflmas›n›n yafl›tlar›na göre geride kalmas› durumunda konuflma gecikmesi düflünülmelidir. Konuflma gecikmesi bir tan›dan ziyade s›kl›kla çeflitli mental ve somatik hastal›kla-r›n bir belirtisi olabilir. Bu çal›flmada konuflma gecikmesi flikayeti ile çocuk psikiyatrisi poliklini¤ine baflvuran olgular›n sosyodemografik özellikleri, psikiyatrik tan›lar› ve konuflma gecikmesinde rolü olan faktörlerin incelenmesi amaçland›.Yöntem: 1 Kas›m 2014 -31 Ekim 2015 tarihleri aras›ndaki bir y›ll›k dönemde Çocuk ve Ergen Ruh Sa¤l›¤› ve Hastal›klar› Poliklini¤ine "konuflmama", "konuflma gecikmesi", "konuflmada gecikme", "cümle kuramama" flikayetleri ile baflvuran olgular›n dosyas› geriye dönük olarak de¤erlendirildi. Bulgular:Toplam 127 olgunun %22.8'i k›z, %77.2'si erkek, olgular›n ortalama yafl› 3.1±1.1 idi. Ortalama TV, tablet ve telefona maruziyet sü-resi günde 5.3±3.4 saatti. Okul öncesi e¤itime, ilkokula ya da özel e¤iti-me yaln›zca %14.1 olgu gidiyordu. Yafl›t iliflkileri sa¤layabilece¤i ortamlarda %38.2 olgunun bulunmad›¤›, %3.1 olguda çift dillilik oldu¤u, %23.6 olgunun aile öyküsünde geç konuflman›n oldu¤u ve %21.6's›n›n hiç anlaml› kelimesinin olmad›¤› saptand›. En s›k saptanan klinik bulgunun geliflimsel konuflma gecikmesi (%28.18); en s›k saptanan psikiyatrik tan›n›n ise yayg›n geliflimsel bozukluk (%23.64) oldu¤u tespit edildi. Yayg›n geliflimsel bozukluk tan›s› olan olgular ile di¤er tüm olgular karfl›laflt›r›ld›¤›nda TV ve di¤er görsel medya türlerine maruziyet aç›s›ndan gruplar aralar›nda istatistiksel olarak anlaml› fark saptanmad› [t(55)= 1.58, p=0.12].Sonuç: Konuflma gecikmesi flikayetinin alt›ndan farkl› tan›lar ç›kabil-mektedir. Bu olgular›n erken dönemde multidisipliner olarak de¤er-lendirilip olas› psikopatolojilerin saptanmas› ve uygun tedavi plan›n›n oluflturulmas› için çocuk ve ergen ruh sa¤l›¤› ve hastal›klar› uzmanlar› taraf›ndan de¤erlendirilmesinin önemli olaca¤›n› vurgulamaktay›z.Anahtar sözcükler: Çocuk geliflimi bozukluklar›, yayg›n, dil yetene¤inde geliflim kusurlar›, çocuk psikiyatrisi, çocukluk ça¤›nda tan›s› konulan ak›l hastal›klar›, televizyon. AbstractObjective: Speech delay should be considered in a child in case of not demonstrating the stages of language development in accordance with general developmental period or compared to the peers. Speech delay often may be a sign of a variety of mental and somatic diseases rather than a diagnosis. In this study, we aimed to investigate the demographic characteristics, psychiatric diagnoses and factors that play a role in speech delay in patients admitted to a child psychiatry outpatient clinic with a complaint of speech delay.Methods: Medical records of the patients who were admitted to the child and adolescent psychiatry outpatient clinic with complaints of "not talking", "speech delay", "language delay", "not forming a sentence" between November 1, 2014 and October 31, 2015 were retrospectively evaluated.Results: Of a total of 127 cases, 22.8%...
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