Echinococcus disease is endemic in sheep-and cattle-raising areas world wide. Its prevalence is also high in the Mediterranean region including Turkey.
To determine the presentation, approach to ...surgical treatment and outcome of hydatid disease in an endemic region.
From January 1989 to December 1998 288 patients, aged between 1 and 71 years with a mean age of 31 years (134 female, 154 male), were operated on for pulmonary hydatidosis. Clinical charts of the patients were reviewed retrospectively in a tertiary referral hospital.
Of 288 patients, 30 patients were asymptomatic, the rest (89%) were symptomatic, cough and chest pain being the most common symptoms. Fifty-three patients (18%) had associated liver hydatid cysts. Bilateral lung hydatid cysts were present in 18 patients (6%). Recurrent hydatid cysts were observed in 33 patients (11%). Seventy-seven patients (27%) presented with complicated hydatid cysts. Postoperative morbidity was observed in 3 patients bronchopleural fistula (2), infection of the cyst space (1) and postoperative mortality in 1 patient who presented with hydatid lung disease associated with liver and brain cysts. In the remaining 98. 6%, no complications were noted.
In conclusion, hydatidosis is still an important public health problem in Turkey and in an endemic country such as Turkey hydatid lung disease should be considered initially in a patient presenting with a corresponding chest roentgenogram and a compatible epidemiologic history. Surgery is indicated in all symptomatic and/or enlarging or infected cysts. When necessary lobectomy or wedge resection can be the procedure of choice. Single-stage combined resection is preferred in hydatid lung disease with associated liver hydatid cysts. Total postoperative complication and mortality rate is low and we recommend a close follow-up of the operated cases to diagnose postoperative recurrence early in its course.
The aim of this study was to investigate cortical plasticity in potential transplant candidate patients with facial lesions and to analyze cortical reorganization after tissue loss using functional ...magnetic resonance imaging. The study included 10 healthy 4 facial lesion patients. The volar surfaces of the index finger and the thumb and the perioral area of the lower face were stimulated by means of a cotton swab and images were recorded on a 3T functional MRI system. The areas in the somatosensory cortex representing the hand and face differ in size, shape, density and position due to experience-related plasticity. The distances between the peaks of the represented hand and face areas were calculated in order to examine the ongoing cortical plasticity while ignoring these differences. As a result, the peak intensity distances were observed to be larger than the control group depending on the case with facial lesions.
Aim: The aim of this study was to compare the efficacy of the pre-emptive and intraoperative use of intravenous acetaminophen in post-circumcision pain in children.
Methods: The records of patients ...who had undergone circumcision were retrospectively evaluated using our database in the Samsun University, Samsun Training and Research Hospital, Department of Pediatric Surgery, Turkey, from May 2021 to May 2022. Patients were divided into two groups based on administration of pre-emptive (Group 1) and intraoperative (Group 2) acetaminophen. Baseline characteristics, vital signs, outcomes, and Face, Legs, Activity, Cry, and Consolability (FLACC) scale scores were then compared between the groups.
Results: Two hundred four patients, 95 (46.6%) in Group 1 and 109 (53.4%) in Group 2, were enrolled in the study. No significant difference was determined in terms of mean body mass index, age, length of stay in the recovery room, operative time, or length of hospital stay. Vital findings exhibited no difference in preoperative, induction, intraoperative, or postoperative recordings. Significant differences were observed between the groups’ mean pain scores 30 minutes after surgery (p = 0.024). However, no such significant differences were observed at one and three hours after surgery (p = 0.063 and p = 0.708, respectively). Rescue analgesia was performed in 13 (13.7%) cases in Group 1 and 17 (15.6%) in Group 2 (p = 0.7).
Conclusions: Pre-emptive intravenous acetaminophen reduced pain 30 minutes after circumcision. Pre-emptive and intraoperative use of acetaminophen resulted in similar and acceptable efficacy in pain relief one and three hours after surgery.
Amaç: Bu çalışmanın amacı, çocuklarda postoperatif sünnet ağrı palyasyonunda intravenöz asetaminofenin preemptif ve intraoperatif kullanımının etkinliğini karşılaştırmaktır.
Yöntemler: Samsun Üniversitesi, Samsun Eğitim ve Araştırma Hastanesi, Çocuk Cerrahisi Anabilim Dalı'nda Mayıs 2021-Mayıs 2022 tarihleri arasında veri tabanımız kullanılarak sünnet yapılan hastaların kayıtları geriye dönük olarak değerlendirildi. Hastalar asetaminofen uygulama zamanına göre preemptif (Grup 1) ve intraoperatif (Grup 2) olmak üzere iki gruba ayrıldı. Çocukların sosyodemografik özellikleri, klinik ve vital bulguları ile Yüz, Bacaklar, Aktivite, Ağlama ve Teselli Edilebilirlik (FLACC) ölçeği gruplar arasında karşılaştırıldı.
Bulgular: Çalışmaya Grup 1'de 95 (%46,6) ve Grup 2'de 109 (%53,4) olmak üzere toplam 204 hasta alındı. Gruplar arasında yaş ortalaması, vücut kitle indeksi, derlenme odasında kalış süresi, ameliyat süresi ve hastanede kalış süreleri açısından anlamlı fark saptanmadı. Vital bulgular, preoperatif, indüksiyon, intraoperatif ve postoperatif dönemlerde farklılık göstermedi. Grupların ameliyattan 30 dakika sonra ortalama ağrı skorları arasında anlamlı fark gözlendi (p = 0.024). Ancak ameliyattan bir ve üç saat sonraki ortalama ağrı skorları arasında anlamlı fark gözlenmedi (sırasıyla, p = 0,063 ve p = 0,708). Grup 1'de 13 (%13,7) ve Grup 2'de 17 (%15,6) hastaya ek analjezi uygulandı (p=0,7).
Sonuç: Çocuklarda sünnet sonrası intravenöz asetaminofen kullanımı güvenlidir ve iyi tolere edilmektedir. Her ne kadar preemptif asetaminofen, postoperatif ilk 30 dakikada daha üstün bir analjezi sağlasa da, ameliyattan sonra ki birinci ve üçüncü saatlerde, asetaminofenin preemptif ve intraoperatif kullanımının ağrının giderilmesinde benzer ve kabul edilebilir bir etkinliğe sahiptir.
Transcranial Magnetic Stimulation is a noninvasive magnetic stimulation of the motor cortex and motor pathways. Responses obtained from the target muscles through TMS can be evaluated ...electrophysiologically. There are 20 healthy volunteers who use the right hand actively in the study. There are active right hand 20 healthy volunteers in the study. Two sEMG electrodes are placed in the Abductor Pollicis Brevis (APB) and Orbicularis Oris (O.oris) muscles. APB muscle constitutes a hand representative in the cortical motor mapping. O.Oris muscle constitutes a face representative in the cortical motor mapping. The position, amplitude and latency values of muscular action potentialsinduced by magnetic stimulation are determined by signal processing methods. The results are mapped on 3-D human model. When the right-hand representation map is examined, the hot spot of the APB muscle is found as the C1. While the motor potential of the hot spot is 6.89(±1.67) mV, the latency time is 20.98(±0.87) ms. When the right-face representation map is examined, the hot spot of the O.Oris muscle's found as the F5. While the motor potential of the hot spot is 2.83(±1.81) mV, the latency time is 4.95(±0.05) ms. Moreover, the face representation intersects with the hand representation at some points and is active at distances close to the hand representation.
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