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Öğe The comparison of the effects of hot milk and hot water scald burns and factors effective for morbidity and mortality in preschool children(Springer Heidelberg, 2013) Aliosmanoglu, I.; Aliosmanoglu, C.; Gul, M.; Arikanoglu, Z.; Taskesen, F.; Kapan, M.; Onder, A.Scald burns are the leading cause of burns in children, especially in those younger than 5 years of age, however, they are easily preventable. Our aim in this study was to emphasise the importance and impact of scald burns caused by hot milk. A total of 334 patients below seven years of age were included in this study. Of these, 252 were admitted with acquired hot water scald burns (Group 1) and 82 with hot milk scald burns (Group 2) between August 2009 and September 2010. Demographic data of the patients were retrospectively investigated. The depth of the burns was determined to be higher in Group 2 (p < 0.001). The total burnt body surface area in Group 1 and Group 2 were 17.1 +/- A 12.3 and 16.3 +/- A 10.9 (p = 0.99), respectively. Skin grafting was performed in 23 patients in Group 1 and 16 patients in Group 2 (p = 0.01) and complications developed in three patients in Group 1 and in five patients in Group 2 (p = 0.01). The mean length of hospital stay was 9.1 +/- A 7.4 days in Group 1 and 14.9 +/- A 9.8 days in Group 2 (p < 0.001) and the mortality rates were similar between the two groups. More emphasis should be placed on the effects of hot milk scalding due to its ominous clinical course and the high healthcare costs associated with this type of scalding. We believe that taking simple precautions would help reduce the physical, psychological effects and financial consequences of hot milk scalds.Öğe Drug Interaction Between Tacrolimus and Ertapenem in Renal Transplantation Recipients(Elsevier Science Inc, 2012) Bora, F.; Aliosmanoglu, I.; Kocak, H.; Dinckan, A.; Uslu, H. B.; Gunseren, F.; Suleymanlar, G.To show drug interactions between tacrolimus and ertapenem, we retrospectively evaluated 13 renal transplant recipients who had been treated with ertapenem for urinary tract infections during prescription of a constant dose. The mean dose of tacrolimus to achieve desired therapeutic concentrations decreased significantly after beginning ertapenem. The decrease from 0.079 mg/kg to 0.043 mg/kg occurred 2 days after initiation of ertapenem (P < .005). These results suggest that ertapenem, which is not metabolized through the cytochrome (CYP) P450 3A metabolic pathway, interacts with tacrolimus by an unknown mechanism. This report recommends tacrolimus concentration monitoring and dose reductions when the two drugs are administered in combination.Öğe Effect of Prostaglandin E-1 on Wisconsin University and Histidine-Tryptophan-Ketoglutarate Preservation Solutions on Preservation Injury of the Perfused Liver(Elsevier Science Inc, 2013) Aliosmanoglu, I.; Sevmis, S.; Karakayali, H.; Kocbiyik, A.; Dagdeviren, A.; Haberal, A.; Haberal, M.Background. The aim of this study was to investigate the effects of prostaglandin E-1 (PGE-1) on preservation injury in livers perfused with the University of Wisconsin (UW) or histidine-tryptophan-ketoglutarate (HTK) solutions. Materials and methods. Five groups each including six rats included. Ringer's lactate RL (group 1), HTK (group 2), HTK + PGE-1 (group 3), UW (group 4), or UW PGE-1 (group 5). Liver tissue and preservation fluid samples were obtained from the perfused lives for pathological and biochemical examinations respectively at 0, 6 and 12 hours. Results. Upon biochemical examination, aspartate aminotrasnferase and alanine aminotransferase values were highest among the group with RL solution and lowest with PGE-1. Liver structure was found to be damaged immediately after RL solution, whereas it was preserved in the other four groups. Fewer cellular changes were reported at the end of 12 hours in the groups administered PGE-1 compared with the other groups. Conclusions. PGE-1 when applied before preservation protected liver functions, decreased pathologic injury, and delayed changes that occur under cold ischemic conditions.Öğe The effective risk factors on mortality in patients undergoing damage control surgery(Verduci Publisher, 2013) Kapan, M.; Onder, A.; Oguz, A.; Taskesen, F.; Aliosmanoglu, I.; Gul, M.; Tacyildiz, I.BACKGROUND: Damage control surgery is a life-saving procedure used in fatal injuries. Morbidity and mortality rate are high in these patients due to massive trauma. The aim of this study was to analyze the risk factors associated with mortality in abdominal traumas that underwent damage control surgery. PATIENTS AND METHODS: The retrospective study included 24 patients that underwent damage control surgery between January 2004 and September 2010. Age, gender, type of injury, period of time before admission, hemodynamic parameters, associated organ injury, injury severity score, surgical procedures performed, length of hospital stay, and complication and mortality rates were recorded. RESULTS: The study included 16 (66.7%) men and 8 (33.3%) women, with a mean age of 32.3 years. Median period of time before admission was 30.83 minutes. All the patients were present with hypothermia and acidosis at admission, while only 5 of them were hemodynamically stable. Mean 6.75 units of blood were transfused in all of them. Common etiological factors included gunshot (50%) and motor vehicle accident (25%). Hepatic injury (83.3%) was the most common organ injury. Mean injury severity score (ISS) was 28.88. Damage control surgery was performed in all the patients. Skin-only closure was applied in 17 (70.8%), while 7 (29.2%) patients received Bogota bag application. Definitive surgery was achieved through de-packing over 36-48 hours in average. Total mortality occurred in 11 (45.8%) patients. Period of time before admission, core temperature at admission, pH levels and amount of blood transfusion were statistically different in the mortality group. A total of 16 complications occurred in 10 patients. Among these, intraabdominal abscess (46.2%) was the most common. CONCLUSION: Hypothermia (< 35 degrees C), acidosis (pH < 7.2), instability related to systolic blood pressure, massive blood transfusion, and delayed admission are predictive factors for mortality.Öğe Effects of hepatitis B surface antigen (HBsAg) positivity of donors in HBsAg(+) renal transplant recipients: comparison of outcomes with HBsAg(+) and HBsAg(-) donors(Wiley, 2016) Yilmaz, V. T.; Aliosmanoglu, I.; Erbis, H.; Ulger, B. V.; Cetinkaya, R.; Suleymanlar, G.; Kocak, H.AimThe aim of this study was to determine the effects of hepatitis B surface antigen (HBsAg) positivity of the donors on graft survival and liver complications in HBsAg(+) renal transplant recipients. Patients and methodA group of 55 patients who underwent renal transplantation (RTx) in our hospital between 2001 and 2012 were included in the study. Patients were divided into 2 groups. Group 1 (n=50) consisted of HBsAg(+) renal transplant recipients (RTR) whose donors were HBsAg(-). In Group 2 (n=5), RTR and donors were both HBsAg(+). Lymphocyte cross matches, number of mismatches, donor types, renal replacement treatment modalities, drugs of induction treatment, and preoperative hepatitis B virus DNA titers of the groups were similar. In Group 1, 42 patients were taking lamivudine, 3 patients were taking entecavir, and 5 patients were taking tenofovir. All of the patients in Group 2 were taking lamivudine. Patient and graft survival rates, graft functions, acute hepatitis rates, acute rejection rates, and other clinical outcomes of the groups were compared. ResultsDemographic data of the groups were similar. Acute rejection rates (P=0.458), graft survival rates (P=0.515), and patient survival rates (P=0.803) were also similar. No significant difference was found between the groups in terms of acute hepatitis rate (P=0.511), glomerular filtration rate (calculated by Modification of Diet in Renal Disease formula) in the last follow-up (P=0.988), alanine aminotransferase levels (P=0.069), or delayed graft function rate (P=0.973). Rates of chronic allograft dysfunction and new onset diabetes mellitus after transplantation were similar. ConclusionOur study revealed that, RTx from HBsAg(+) donors to HBsAg(+) recipients is safe with antiviral treatment.Öğe Laparoscopic salvage for malfunctioning of peritoneal dialysis catheters(Edizioni Minerva Medica, 2012) Taskesen, F.; Arikanoglu, Z.; Uslukaya, O.; Aliosmanoglu, I.; Oguz, A.; Guzel, A.; Tas, I.Aim. The aim of this study was to emphasize the efficacy of the laparoscopic surgical method performed for elimination of catheter-induced mechanical complications developing in CAPD patients. Methods. Medical records of 31 patients who had undergone CAPD catheter implantation at the Dicle University Medical Faculty Hemodialysis Unit between January 2001 and June 2012 were examined retrospectively. Double-felted spiral Tenckhoff catheters were used in all patients for peritoneal access. Results. We performed a retrospective review of 31 patients who, over an 11-year period, underwent revision of a peritoneal dialysis catheter using laparoscopy. Chronic renal failure requiring dialysis occurred in 31 patients (12 males and 19 female). Ages ranged from 13 to 77 years (mean age 35.8 years). Conclusion. As a conclusion, CAPD is currently a choice to be frequently used in patients with ESRD. In the treatment of CAPD-associated mechanical catheter complications laparoscopic method may be preferred because of patient comfort, short hospital stay, and lesser postoperative complications.Öğe The Protective Effect of Ellagic Acid on Lung Damage Caused by Experimental Obstructive Jaundice Model(Acta Medical Belgica, 2013) Gul, M.; Aliosmanoglu, I.; Uslukaya, O.; Firat, U.; Yuksel, H.; Gumus, M.; Ulger, B. V.Aim : This study aimed to investigate protective effects of ellagic acid on lungs in an experimental obstructive jaundice model. Methods : Four groups were established, each consisting of ten randomly selected rats : Group 1: sham, Group 2: ellagic acid, Group 3 : obstructive jaundice, and Group 4 : obstructive jaundice + ellagic acid. Ellagic acid was administered orally at a dose of 60 mg/kg/day to group 2 and 4. The animals were sacrificed eight days later. The total oxidative status and the total antioxidant capacity in their lung tissue were determined, and malondialdehyde levels in their blood were measured. Histopathological changes in the lungs were examined. Results : In the obstructive jaundice group treated with ellagic acid, there was a decrease in malondialdehyde levels and a reduction in the total oxidative status and the oxidative stress index, whereas the total antioxidant capacity increased (p < 0.001). The histopathological examination showed that neutrophil leukocyte infiltration and edema formation decreased and destruction of lung parenchyma disappeared following the treatment with the ellagic acid (p < 0.05). Conclusion : This study shows that ellagic acid has a protective effect against oxidative damage in lung tissue in obstructive jaundice.Öğe Sigmoid colon torsion: mortality and relevant risk factors(Verduci Publisher, 2013) Onder, A.; Kapan, M.; Arikanoglu, Z.; Palanci, Y.; Gumus, M.; Aliosmanoglu, I.; Aldemir, M.INTRODUCTION: Sigmoid volvulus is an important acute intestinal obstruction, leading to high mortality and requiring urgent operation. The purpose of this study is to analyze risk factors for mortality in patients that were operated on due to sigmoid volvulus at our Department. MATERIALS AND METHODS: The retrospective study included 158 patients, who were operated on due to sigmoid volvulus between January 1994-December 2010, in terms of age, gender, complaints at admission, physical signs, period of symptoms before admission, associated diseases, laboratory and radiological parameters, hospital stay, morbidity, and mortality. RESULTS: The study consisted of 135 men (85.4%) and 23 women (14.6%), with a mean age of 62.54 years. Cardiovascular disease and respiratory disease were present in 34 (21.5%) and 42 (26.6%) patients, respectively. Urgent operation was undertaken in 125, while 33 received elective surgery. Abdominal distension and pain was evident in all the patients. Generalized tenderness was detected in 58.2%, while 70.9% had hyperactive bowel sound with tympanism. Plain radiograph revealed an impression of omega ans in all patients, while free air was detected in 11.4% of them. Risk factors for mortality included age (p = 0.008), delayed admission (p = 0.001), cardiovascular and respiratory diseases (p = 0.001), fluid-electrolyte imbalance (p = 0.001), presence of necrosis (p = 0.001), and major contamination (p = 0.001). Wound infection and intraabdominal abscess were more common in patients that developed mortality (p = 0.001 and p = 0.002). CONCLUSIONS: Complications like wound infection and intraabdominal abscess are more frequent in the patients with the risk of mortality. Delayed admission results in higher risk of mortality. Mortality rates can be reduced by early admission, preoperative intensive resuscitation, suitable antibiotics, and emergent and viable surgery.Öğe Splenic injuries: factors affecting the outcome of non-operative management(Springer Heidelberg, 2012) Boyuk, A.; Gumus, M.; Onder, A.; Kapan, M.; Aliosmanoglu, I.; Taskesen, F.; Arikanoglu, Z.The aim of this study was to evaluate the outcome of non-operative management (NOM) in patients with splenic injuries and to determine the predictive factors of NOM failure. Two hundred and six patients with splenic injury were admitted between January 2005 and April 2011. Of the 206 patients with splenic injury, 47 patients met the inclusion criteria of NOM. The mechanism of injury, grade of splenic injury, other intra- and extra-abdominal injuries, systolic blood pressure on admission, hemoglobin levels, number of transfusions, Injury Severity Score (ISS), Glasgow Coma Scale score, and hospitalization period were recorded. The patients were divided into two groups: those with NOM and those in whom the failure of NOM led to laparotomy. The patients were monitored for vital signs, abdominal findings, and laboratory data. NOM was abandoned in cases of hemodynamic instability, ongoing bleeding, or development of peritonitis. Independent predictive factors of NOM failure were identified. The patients managed non-operatively were compared with the patients for whom NOM failed. NOM was successful in 40 of 47 patients. There were differences between the two groups for ISS, hemoglobin levels, need for blood transfusion, and the number of associated extra-abdominal injuries. The grade of splenic injury was determined to be an important and significant independent predictive factor for the success of NOM of splenic injuries. The grade of splenic injury is an important and significant independent predictor factor for the success of NOM. NOM is not recommended in patients with high-grade splenic injury.Öğe A Successful Renal Transplantation Case After Stem Cell Transplantation(Elsevier Science Inc, 2015) Yilmaz, V. T.; Koksoy, S.; Ulger, B. V.; Salim, O.; Akbas, H.; Aliosmanoglu, I.; Erbis, H.Renal transplantation is the most effective treatment method for end-stage renal disease (ESRD). However, new treatment modalities are being investigated, such as immunotoleration, to avoid the acute and chronic side effects of immunosuppressant drugs. We report a case in which a man had undergone allogenic stem cell transplantation from his brother 16 years ago due to chronic myeloid leukemia, and who then developed ESRD due to arterial hypertension and underwent renal transplantation (Rtx) from the same brother. The patient was followed up without immunosuppression due to full chimerism.Öğe Unusual extraperitoneal rectal injuries: a retrospective study(Springer Heidelberg, 2012) Gumus, M.; Boyuk, A.; Kapan, M.; Onder, A.; Taskesen, F.; Aliosmanoglu, I.; Tufek, A.Rectal injuries, which are rarely encountered because of the anatomic characteristics, occur due to penetrating traumas. In the current study, we aimed to present experiences gleaned from our clinic concerning rarely encountered unusual rectal injuries, including those cases presented for the first time. Eleven patients who had been treated for unusual rectal injuries in the General Surgery Clinic of Dicle University between 2004 and 2011 were retrospectively reviewed. The reasons for rectal injuries included foreign bodies in four cases, sexual intercourse in three cases, iatrogenic injuries in two cases, electric shock in one case, and animal horns in one case. All cases had extraperitoneal rectal injuries and all injuries were grade 2 injuries, except for the electrical burn. Primary repair was adequate for the treatment of six patients. Four patients underwent primary repair and ostomy, whereas one of the patients underwent debridement and an ostomy. The patients recovered without complications, except for one patient with sphincter insufficiency. The results of the current study suggested that primary repair is adequate in the patients with low-energy injuries and early presentation, whereas an ostomy is required for those with late presentation and for those with high-energy and destructive injuries.
