Background
Laparoscopic ventral mesh rectopexy (LVMR) is considered to be the gold standard for managing rectal prolapse. Nevertheless, concerns have been expressed about the use of this procedure in ...elderly patients. The aim of the current study was to examine the perioperative safety of primary LVMR operations in the oldest old in comparison to younger individuals and to assess our hospital policy of offering LVMR to all patients, regardless of age and morbidity.
Methods
A retrospective study analysed demographic information, operation notes, meshes utilised, operation times, lengths of hospital stay (LOS) and American Society of Anesthesiologists (ASA) scores of patients who underwent LVMR at Elisabeth-TweeSteden Hospital between 2012 and 2023.
Results
Eighty-seven female patients underwent LVMR. Nineteen patients were 80 years of age or older (OLD group); the remaining 65 patients were under the age of 80 (YOUNG group). The difference between the groups in terms of age was statistically significant. ASA scores were not significantly different. No mortality was observed. There was no statistically significant difference between the groups in terms of LOS, operation time or morbidity. Moreover, the postoperative morbidity profile was excellent in both groups.
Conclusion
LVMR seems to be a safe operation for the “oldest old” patients with comorbidity, despite a single-centre, retrospective trial with limited follow-up. The present study suggests abandoning the dogma that “frail patients with rectal prolapse are not suitable for laparoscopic ventral mesh rectopexy.”
The most widespread blocks within the Cretaceous ophiolitic mélange (North Anatolian ophiolitic mélange) in Central Anatolia (Turkey) are pillow basalts, radiolarites, other ophiolitic fragments and ...Jurassic-Cretaceous carbonate blocks. The pillow basalts crop out as discrete blocks in close relation to radiolarites and ophiolitic units in Cretaceous ophiolitic mélange.
The geochemical results suggest that analyzed pillow basalts are within-plate ocean island alkali basalts. The enrichment of incompatible elements (Nb, Ta, Light REE, Th, U, Cs, Rb, Ba, K) demonstrates the ocean island environment (both tholeiites and alkali basalts) and enriched MORB. Dated calcareous intrafills and biodetrital carbonates reveal an age span of Callovian-Early Aptian. The thin-shelled protoglobigerinids, belonging to the genus Globuligerina, in the calcareous intrafills between pillow basalt lobes indicates a Callovian-Barremian age interval, most probably, Valanginian to Late Barremian. The volcanic and radiolarite detritus-bearing orbitolinid-Baccinella biodetrital carbonates dated as Late Barremian-Early Aptian in age, were probably deposited around atolls and have a close relationship with the ocean island pillow basalts.
The results collectively support the presence of a seamount on the Neo-Tethyan oceanic crust during the Valanginian-Late Barremian and atolls during the Late Barremian-Early Aptian interval. The presence of an oceanic crust older than that seamount along the Northern Branch of Neo-Tethys is conformable with the geodynamic evolution of the Tethys.
Rapid drug desensitization (RDD) induces a temporary tolerance to biologics which induce hypersensitivity reactions (HSRs). Data are limited regarding the use of RDD outside the USA. Our purpose was ...to report our data on RDD to rituximab, infliximab, cetuximab, and trastuzumab.
The study was conducted as a retrospective chart review of patients with symptoms of HSRs to biologics. HSRs were classified as grades I, II, and III, based on their severity. Skin-prick tests/intradermal tests (IDTs) were performed with the implicated biologics. The 12-step RDD protocol was used.
The study group comprised 11 women and 6 men (mean age: 47 ± 11.7 years). Fourteen patients experienced HSRs to rituximab; 3 had HSRs to cetuximab, infliximab, and trastuzumab, respectively. HSRs to cetuximab, infliximab, and trastuzumab occurred during the first infusion and were all grade III. Twelve of the 14 patients with rituximab hypersensitivity had a reaction during the first infusion; 10 patients had grade II reactions and 4 had grade III reactions. Respiratory symptoms were the most frequent presentation of HSR. Skin tests with rituximab were performed on 10 patients; only 3 resulted in positive IDTs (with 1:100 dilutions) and the other tests were negative as were those performed with the other biologics. Of 96 RDDs, 89 desensitizations were performed with rituximab, 5 with cetuximab, 1 with infliximab, and 1 with trastuzumab. There were 12 (13.5%) breakthrough reactions, all of which were associated with rituximab and were less severe than the initial reactions.
RDD was found to be safe and effective in the largest case series of RDDs with biologics in our country, Turkey.
The Aladağ Unit is one of the main tectonic units in the Tauride Belt, located in southern Turkey. It includes a continuous Paleozoic carbonate sequence encompassing the mid-Carboniferous boundary, ...with outcrops being especially well exposed in the Hadim region. The boundary succession lithology is mainly composed of carbonates with intercalated quartz arenitic sandstone layers. Based on foraminifers, four biostratigraphic zones have been defined in the interval from the Upper Serpukhovian to the Lower Bashkirian. These zones are, in ascending order: the
Eostaffella
ex gr.
ikensis
—
E. postmosquensis
Zone (Zapaltyubinsky Horizon, Upper Serpukhovian); the
Plectostaffella jakhensis
—
P. bogdanovkensis
Zone, and the
Millerella marblensis
Zone (Bogdanovsky Horizon, lower Bashkirian); and the
Semistaffella
sp. Zone (Syuransky Horizon, lower Bashkirian). The mid-Carboniferous boundary occurs between the
Eostaffella
ex gr.
ikensis
—
E. postmosquensis
Zone and the
Plectostaffella jakhensis
—
P. bogdanovkensis
Zone. Boundary beds are characterized by eight, repeatedly occurring microfacies types, namely: (1) coated crinoidal packstone; (2) coated bioclastic grainstone; (3) oolitic grainstone; (4) oolitic packstone-grainstone; (5) intraclastic grainstone; (6) mudstone-wackestone; (7) quartz-peloidal packstone; and 8) quartz arenitic sandstone. Based on microfacies stacking patterns, various types of shallowing-upward cycles have been recognized. Depositional sequences and sequence boundaries are correlatable with those described from North America and Russia and Carboniferous global sea-level curves. The duration of cycles has been estimated as 100 ky, suggesting that cycle periodicities correspond to the Milankovitch eccentricity band.
This is the first study from Turkey where radiolarians from calcareous sequences of the Sakarya Continent are tested in the delineation of the Jurassic-Cretaceous boundary. The Sakarya Continent, ...which comprises the southern part of northwest Turkey, was a Jurassic-Early Cretaceous carbonate platform micro-continent distant from terrestrial sediment influx. It was a site of pelagic carbonate deposition with abundant calcareous and siliceous microfossil input. Among 44 measured stratigraphic sections of the JurassicLower Cretaceous deposits of the Sakarya Continent, four continnous sections (MK, KEL, AC, CD) which encompass the Tithonian-Berriasian boundary were selected for study. However, due to poor preservation and calcification of radiolarian faunas, only section KEL produced rich and wellpreserved radiolarians. This section is 600 meters in thickness and spans the upper Tithonian-lower Berriasian interval. In addition to radiolarians, section KEL contains abundant calpionellids, calcareous nannofossils, benthic foraminifera and calcareous algae. The upper part of this stratigraphic section is made up of the Sogukcam Limestone which lithologically resembles the Biancone and Maiolica formations in the Umbria-Marche Region of Italy. The best preservation and richest radiolarian faunas were observed from the Sogukcam Limestone in section KEL. This is significant because many radiolarian studies as well as studies on magnetostratigraphy, calcareous nannofossils and calpionellid biostratigraphy in the Tethyan realm have been carried out on the Biancone and Maiolica formations. The rapid sedimentation rate, pelagic microfacies and well preserved non-calcified radiolarian faunas make section KEL ideal for the investigation of the Jurassic-Cretaceous boundary with radiolarians. The correlation between radiolarian faunas and co-occurring calpionellids and calcareous nannofossils in section KEL can be compared with similar biostratigraphic studies from the Biancone and Maiolica formations in Italy. The calcareous nannofossils in section KEL sometimes attain rock forming abundance, and the first appearance of nannoconids as well as their first abundance peak are recognized in this section. Throughout the present study, the boundary between Calpionellid standard zones A and B is considered as the Tithonian-Berriasian boundary. The close sampling interval, 15-20 meters, provides excellent resolution in documenting the first Occurrences of numerous Cretaceous radiolarian species. These first occurrence datum points for radiolarian taxa are not concurrent. Due to the refined resolution of dating, a stepwise appearance of Cretaceous radiolarian faunas in section KEL is clearly observed; however, radiolarians do not delineate the Jurassic-Cretaceous boundary because a marked synchronous faunal turnover does not exist.
The best preserved Permian-Triassic boundary beds in Turkey are found in the Hadim region of the central Taurides. The succession is exposed in one of the allochthonous units of the Tauride Belt, the ...Aladag Unit, whose stratigraphy includes beds ranging from the Devonian to the Cretaceous systems. In the Aladag Unit, the Permian-Triassic boundary beds are entirely composed of carbonates. The Permian portion of these beds belongs to the Paradagmarita Zone, whereas the lowermost Triassic contains the Lower Griesbachian marker Rectocornuspira kalhori. The uppermost Permian carbonates, composed of meter-scale upward shallowing subtidal cycles, are characterized by oolitic limestones of regressive character at the top and are overlain sharply by Lower Triassic stromatolites. Cyclic Upper Permian carbonates are interpreted as highstand sytems tract deposits of the last third-order sequence of the Permian System. The Permian-Triassic boundary is an unconformity corresponding to both erosional and non-depositional hiatuses. The gap at the Permian-Triassic boundary partially corresponds to the shelf-margin systems tract and partly to the transgressive systems tract of the overlying third-order sequence. Stromatolites are interpreted as transgressive systems tract deposits. Special issue International Conference on Paleozoic Foraminifera, Paleoforams 2001 Edited by Demir Altiner (Guest Editor)
PDF
