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A Rare Cause of Small Bowel Obstruction: Congenital Peritoneal Encapsulation
(Acil Tıp Uzmanları Derneği, 2023) Dalbaşı, Erkan; Gedik, Ercan
Congenital peritoneal encapsulation (CPE) is a rare condition in which part or all of the small intestine is surrounded by an accessory peritoneal layer congenitally. Although it rarely causes small bowel obstruction, it is usually asymptomatic and the diagnosis is mostly made incidentally during surgery or autopsy. A 41-year-old male patient presented to the emergency department with diffuse and cramping pain lasting for approximately 8 hours. He had nausea and vomiting. No gas or faeces output for 72 hours. Abdominal computed tomography (CT) showed dilated abdominal small intestines and findings consistent with obstruction. The patient was hospitalized with the diagnosis of ileus. Decompression was performed with a nasogastric tube. It was decided to perform diagnostic laparoscopic surgery for the patient who did not respond to 24-hour observation and medical treatment. Laparoscopic examination revealed a thin membrane covering the small intestine from the terminal ileum to the middle of the jejunal segment on the right side of the abdomen. All adhesions were separated, the small intestines were released from the pressure of the accessory peritoneum and placed in the abdomen. The patient was discharged without complications on the 6th postoperative day. CPE should be considered in small bowel obstructions of unexplained etiology. Laparoscopic evaluation is effective in diagnosing CPE, but in cases where the long small bowel segment is affected, as in our case, we think that it would be appropriate to switch to open surgery to prevent morbidity, as well as the necessity of separating all bands
Acute necrotizing pancreatitis and coronavirus disease-2019 (COVID-19)
(NLM (Medline), 2021) Aday, Ulaş; Gedik, Ercan; Kafadar, Mehmet Tolga; Özbek, Erdal
Coronavirus disease-19 (COVID-19) is caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV- 2) and has resulted in increased mortality worldwide. Several studies have identified the involvement of the gastrointestinal tract, respiratory tract, and other tissues. Although it has been reported that the angiotensin-converting enzyme-2 receptor affected by SARS-CoV is expressed more in the pancreas than in the lungs, the issue regarding the occurrence of pancreatitis is controversial. SARS Cov-2 rarely causes acute necrotizing pancreatitis without significantly affecting the respiratory and other systems. This paper presents a patient who underwent laparotomy due to acute necrotizing pancreatitis and hemodynamic instability caused by COVID-19 without any known risk factors.
Antioxidant support in composite musculo-adipose-fasciocutaneous flap applications: An experimental study
(Taylor & Francis Ltd, 2014) Bozkurt, Mehmet; Kapi, Emin; Kulahci, Yalcin; Gedik, Ercan; Ozekinci, Selver; Isik, Fatma Birgul; Celik, Yusuf
Free radicals are chemicals that play roles in the etio-pathogenesis of ischaemia-reperfusion injury. Various antioxidants have been used in an attempt to mitigate the damage induced by these chemicals. In the present study, the antioxidative effects of grape seed extract (proanthocyanidin), tomato extract (lycopene), and vitamin C (ascorbic acid) on a composite re-established-flow inferior epigastric artery based rectus abdominis muscle-skin flap model on which experimental ischaemia was induced were investigated. The rats have been administered antioxidants for 2 weeks prior to the surgery and for 2 more weeks thereafter. Macroscopic, histopathological, and biochemical analyses were carried out at the decision of the experiment. It was found that flap skin island necrosis was significantly reduced in the proanthocyanidin, lycopene, vitamin C groups (p < 0.001). Statistical analyses showed significant decreases in inflammation, oedema, congestion, and granulation tissue in the proanthocyanidin and lycopene groups compared to the vitamin C and control groups (p < 0.001). When the viability rates of fat and muscle tissues were examined, significant improvements were found in the proanthocyanidin and lycopene groups in comparison to the other groups (p < 0.001). Serum antioxidant capacity measurements revealed significant differences in the lycopene group compared to all other groups (p < 0.001). It is concluded that lycopene and proanthocyanidin are protective antioxidants in rat composite muscle-skin flap ischaemia-reperfusion models.
Barsak kanaması ile seyreden bir tifo olgusu
(2004) Gedik, Ercan; Ayaz, Celal; Çelen, Mustafa Kemal; Geyik, Mehmet Faruk; Uluğ, Mehmet; Eraydın, Hakan
Tifoda rektal kanama nadir fakat morbidite ve mortalitesi yüksek bir komplikasyondur. Hikayesinden iki hafta önce arkadaş toplantısında çiğköfte ve marul yiyen 22 yaşındaki erkek hasta; Ateş, baş ağrısı, kuru öksürük ve iştahsızlık şikayeti ile yatırıldı. Yattığı sırada hematokriti (Htc) % 39,6 olan hastada Salmonella typhi enfeksiyonu düşünülerek siprofloksasin 500 mg. tablet 2x1 başlandı. Kan kültüründe S. typhi üredi. Masif rektal kanama gelişen hastanın Htc değeri % 23,9'a düşünce hastaya üç ünite kan verildi. Kanaması durmayan hasta genel cerrahi yoğun bakımına (GCYB) transfer edildi. Hastanın hematokrit değeri % 19,4'e düşünce acil olarak operasyona alındı. Hastanın tedavisi 21 güne tamamlanarak taburcu edildi. Enterostomi için ikinci operasyon planlandı.
Benign hematolojik hastalıklarda splenektomi sonuçlarımız
(2009) Baş, Birsel; Girgin, Sadullah; Gedik, Ercan; Taçyıldız, İbrahim Halil
Giriş Dalağın cerrahi hastalıklarının çoğunluğunu medikal tedaviye dirençli ve şiddetli seyreden benign hematolojik hastalıklar oluşturur. Bu çalışmada, benign hematolojik nedenlerle kliniğimizde splenektomi yapılan hastalar ve sonuçlarını sunmayı amaçladık. Materyal-Metod Hematolojik hastalık nedeniyle splenektomi yapılan 115 hasta retrospektif olarak incelendi. Yaş, cins, hematolojik hastalık nedeni, aksesuvar dalak varlığı ve yerleşimi, operasyon süresi, kan transfüzyonu sayısı, hastanede yatış süresi, uzun süreli takip sonuçları, morbidite ve mortalite açısından değerlendirildi. Bulgular Yaş ortalaması 41.08±17.90 olup, %67.8 hasta kadın ve %32.2 hasta ise erkek idi. En sık splenektomi yapılan hematolojik hastalık İTP (%56.6) idi. Ameliyat sırasında %26 hastada aksesuvar dalak tespit edildi. Anemi nedeniyle ameliyat edilen 6 hastaya safra taşı nedeniyle kolesistektomide yapıldı. Komplikasyon %9.56 hastada gelişti ve en sık görülen komplikasyon atelektazi idi. Postsplenektomik sepsis gelişen bir hasta kaybedildi. Sonuç Nüksleri önlemek için aksesuvar dalak gözden kaçırılmamalı, aşılama ve antibiyotik proflaksisi yanı sıra antikoagulan proflaksisi de bu hastalarda unutulmamalıdır.
Bilateral giant morgagni hernia causing cardiac shifting
(2009) Girgin, Sadullah; Gedik, Ercan; Onat, Serdar; Avcı, Alper
Yetmiş altı yaşında, 114 kg ağırlığında bayan hasta iki yıldır kötüleşen göğüs ağrısı ve efor ile nefes darlığı şikayetleri ile başvurdu. Öyküsünde travma yoktu. Düz ve kesitsel görüntülemede kardiyak posterior itilmeye neden olan dev anterior diyafragmatik herni saptandı. İleri tetkik ve tedavi için genel cerrahi bölümüne sevk edildi. Herniye bölümlerin redüksiyonu ve bilateral diyafragmatik defektin onarımı laparotomi kullanılarak yapıldı. Posterior kardiyak itilmeye neden olan bilateral dev Morgagni hernisi çok nadir bir olgudur.
Bilateral Giant Morgagni Hernia Causing Cardiac Shifting
(Ekin Tibbi Yayincilik Ltd Sti-Ekin Medical Publ, 2009) Avci, Alper; Girgin, Sadullah; Gedik, Ercan; Onat, Serdar
A 76-year-old woman weighing 114 kg presented with shortness of breath and worsening chest pain for 2-year duration. There was no history of trauma. Plain and cross-sectional imaging identified a giant anterior diaphragmatic hernia which caused cardiac posterior shifting. She was transferred to general surgery department for further investigations and treatment. Reduction of herniated contents and repairing of bilaterally diaphragmatic defect were performed via laparotomy. Bilateral, giant Morgagni hernia which causes cardiac shifting to the backward is extremely rare.
Blunt and penetrating bladder injuries
(Aves, 2010) Gedik, Abdullah; Gedik, Ercan; Tutus, Ali; Kayan, Devrim; Bircan, Kamuran
Objectives: We aimed to review our diagnostic and treatment protocols for patients with injured bladders by blunt and penetrating traumas. Materials and methods: Fifty-two patients with injured bladders hospitalized in the Urology and General Surgery clinics between January 1996 and January 2009 were retrospectively evaluated. Results: Of the patients 43 (81%) were males and 9 (19%) were females, and their ages were between 17 and 70 (mean 31.9 +/- 12.11). Twenty eight (54%) of the patients were injured by penetrating and 24 (46%) by blunt traumas. The mean transportation time to hospital was 155 +/- 34.12 (range 30-1440) min. Retrograde cystographies could only be done in 28 patients. In the remaining hemodynamically unstable 24 patients, bladder injuries were diagnosed during laparatomy. Totally 41 (79%) patients including all 28 penetrating injuries and 13 of 24 blunt injuries had intraperitoneal bladder rupture. The rupture was retroperitoneal in the remaining 11 (21%) patients injured by blunt traumas. Intraabdominal adjacent organ injuries were more frequent in intraperitoneally ruptured cases. In extraperitoneally ruptured patients bone fractures were the main adjacent pathologies. Intraperitoneal rupture of all 41 patients was sutured primarily and we replaced a cystostomy tube in 14 of these patients. In 7 of 11 cystographically diagnosed retroperitoneal ruptures we only replaced a urethral Foley catheter for treatment. In the remainining 4 patients the bladder was sutured primarily because wide rupture and diffuse extravasation. One patient was lost because of acute respiratory distress syndrome developed following surgery. Wound infections, pneumonia, intraabdominal abcess, enterocutaneous fistula, and evisceration were seen as postoperative complications in 4, 2, 1, 1, and 1 patients, respectively. Conclusions: When diagnosed early the success rate of treatment in bladder injuries was quiet high. The adjacent organ injuries were the main pathologies increasing the postoperative morbidity and mortality.
Blunt and penetrating renal injuries: 18-year experience
(Aves, 2009) Gedik, Abdullah; Gedik, Ercan; Deliktas, Hasan; Sahin, Hayrettin; Bircan, Kamuran
Objective: We evaluated patients who were treated for renal injuries. Materials and methods: A total of 203 patients (168 males, 35 females; mean age 31 +/- 9 years) who underwent treatment for renal injuries between January 1990 and August 2008 were evaluated with respect to etiology, diagnostic methods, the severity of injury, accompanying organ injuries, treatment, and complications. Renal injuries were graded according to the severity scale of the American Association for the Surgery of Trauma. Results: Penetrating injuries accounted for 60.1% (n= 122), and blunt trauma accounted for 39.4% (n= 80), while one patient had both. The majority of penetrating injuries were gunshot wounds (69.7%). Six patients (3%) had bilateral renal injury. Time to presentation ranged from 20 minutes to 10 days (mean 113 min). Emergency laparotomy was performed in 117 patients ((57.6%). Radiological investigation was made in 86 patients (42.4%), of whom 22 patients underwent laparotomy due to hemodynamic deterioration, and 64 patients (31.5%) were treated conservatively for grade I to III injuries (46, 15, and 3 patients, respectively). Isolated renal injury was seen in 74 patients (55 blunt, 19 penetrating), while 129 patients (63.6%) had accompanying intra-abdominal and 72 patients had extra-abdominal injuries. A total of 140 renal procedures were performed in 139 patients, including nephrorrhaphy (n= 54), partial nephrectomy (n= 5), nephrectomy (n= 74), and renal artery repair (n= 1). No renal pathology was detected in four patients (2.9%) and only a double J stent was placed in two patients. Perioperative mortality occurred in five patients (2.5%). The overall mortality rate was 16.8% (n= 34). The mean transfusion requirements were 3.4 +/- 0.8 units and 2.3 +/- 0.6 units, and the mean hospitalization times were 9.2 +/- 3.5 days and 13 +/- 2 days in patients treated surgically and conservatively, respectively. Conclusion: Nonoperative management of renal trauma in hemodynamically stable patients preserves renal function and reduces nephrectomy rates.
Comparison of pilat procedure and crystallized phenol applicayion in pilonidal sinus surgery
(Medical & Surgical Research Journals Group, 2021) Dalbaş, Erkan; Akgül, Ömer Lütfi; Tüzün, Abidin; Gedik, Ercan
Background: Pilonidal sinus disease (PSD) is an infectious, chronic and benign disorder of the sacrococcygeal area, predominantly encountered in young men. The surgical treatment of PSD has a wide range from minimally invasive interventions to complex flap techniques, however there is no agreement on the surgical approach. Minimally invasive procedures such as crystallized phenol (CP) application, sinusectomy, and pilonidal sinus tract ablation with laser (PiLAT) are easily applied, need a short hospital stay, cause less postoperative pain and minimal tissue loss, and have good cosmetic results. In this study, we aimed to compare the data of PSD patients treated with minimally invasive methods, namely CP and PiLAT. Material and Methods: The files of 245 PSD patients who were treated with the CP or PiLAT in our clinic between January 2016 and January 2020 were retrospectively reviewed. The patients were divided into two groups: 120 patients in the CP group and 125 patients in the PiLAT group. Both group were analyzed for age, gender, the number of sinuses, duration of surgery, severity of postoperative pain and need for analgesics, duration of antibiotic use, postoperative complications (infection, hematoma, seroma, cosmetic), time to return to daily activities, satisfaction for procedure, body mass index (BMI) and recurrence rates. Results: The patients in the PiLAT group were discharged the next day after the procedure, while the patients in the CP group discharged on the same day (p<0.001). The mean number of sinuses was 2.2 +/- 0.25 in the CP group and 3.6 +/- 0.81 in the PiLAT group, and the difference was statistically significant (p<0.001). The mean dressing time was 3.1 +/- 0.4 days in the PiLAT group, while it was longer, 9.5 +/- 2.1 days, in the CP group (p <0.001). Conclusion: CP and PiLAT procedures are minimally invasive methods that can be safely used in the treatment of PSD.
Does Adjuvant Antibiotic Treatment After Drainage of Anorectal Abscess Prevent Development of Anal Fistulas? A Randomized, Placebo-Controlled, Double-Blind, Multicenter Study
(Lippincott Williams & Wilkins, 2011) Sozener, Ulas; Gedik, Ercan; Aslar, Ahmet Kessaf; Ergun, Hakan; Elhan, Atilla Halil; Memikoglu, Osman; Erkek, Ayhan Bulent
BACKGROUND: The risk of fistula formation is a major concern after incision and drainage of an anorectal abscess. OBJECTIVE: Our objective was to the test the effects of antibiotic treatment on fistula formation after incision and drainage of anorectal abscesses. DESIGN: Randomized, placebo-controlled, double-blind study. SETTING: Multicenter trial at 3 teaching hospitals in Turkey. PATIENTS: Patients who underwent abscess drainage between September 2005 and January 2008 were evaluated for eligibility. Exclusion criteria included penicillin allergy, antimicrobial agent usage before enrolment, other infection, previous anorectal surgery, inflammatory bowel disease, suspicion of Fournier gangrene, secondary and recurrent anorectal abscesses, anal fistula at time of the surgery, immune compromised states, and pregnancy. INTERVENTION: Patients were randomly assigned to receive placebo or amoxicillin-clavulanic acid combination treatment for 10 days after abscess drainage. MAIN OUTCOME MEASURES: The primary end point was rate of anorectal fistula formation at 1-year follow-up. RESULTS: Of 334 patients assessed for eligibility, 183 entered the study (placebo, 92; antibiotics, 91). Data were available for per-protocol analysis from 151 patients (placebo, 76; antibiotics, 75) with a mean age of 37.6 years; 118 patients (78.1%) were men. Overall, 45 patients (29.8%) developed anal fistulas during 1-year follow-up. Fistula formation occurred in 17 patients (22.4%) in the placebo group and in 28 patients (37.3%) in the antibiotic group (P = .044). Risk of fistula formation was increased in patients with ischiorectal abscess (odds ratio, 7.82) or intersphincteric abscess (odds ratio, 3.35) compared with perianal abscess. CONCLUSION: Antibiotic treatment following the drainage of an anorectal abscess has no protective effect regarding risk of fistula formation.
Effect of a 50-Hz Sinusoidal Electromagnetic Field on the Integrity of Experimental Colonic Anastomoses Covered with Fibrin Glue
(Wroclaw Medical Univ, 2009) Girgin, Sadullah; Ozturk, Hayrettin; Gedik, Ercan; Akpolat, Veysi; Kale, Ebru; Ozturk, Hulya
Background. Low-frequency magnetic fields have been shown to affect biological processes. In this article the effects of 50-Hz sinusoidal magnetic field (MF) stimulation and application of fibrin glue on the healing of experimental colonic anastomoses were investigated. Material and Methods. Twenty-eight rats were divided into four groups. Group 1 underwent 2-cm left colonic resection and primary anastomosis. Group 2 underwent normal resection anastomosis and the area was covered with fibrin glue. Group 3 underwent normal resection anastomosis and the rats were exposed to a 50-Hz sinusoidal MF. Group 4 underwent normal resection anastomosis, the anastomosis area was covered with fibrin glue, and the rats were exposed to a 50-Hz sinusoidal MF. Investigations included bursting pressure measurement, hydroxyproline content, and histopathological changes. Results. Tissue hydroxyproline levels and anastomotic bursting pressures of groups 2, 3, and 4 were significantly higher than in group 1. Collagen deposition and fibroblast infiltration in groups 2, 3, and 4 had higher scores than in group 1. Furthermore, these results were significantly higher in group 4 rats than in the other groups. Histopathological examination of the anastomosis revealed significantly better healing patterns for group 4 than for groups 1, 2, and 3. Conclusions. A50-Hz sinusoidal MF stimulation and application of fibrin glue provided a significant gain in anastomotic healing in the large intestine. A combination of a 50-Hz sinusoidal MF and fibrin glue has significantly favorable effects on healing of experimental colon anastomosis (Adv Clin Exp Med 2009, 18, 1, 13-18).
Effects of Combined Pulse Electromagnetic Field Stimulation Plus Glutamine on the Healing of Colonic Anastomosis in Rats
(Springer, 2009) Girgin, Sadullah; Gedik, Ercan; Ozturk, Hayrettin; Akbulut, Veysi; Kale, Ebru; Buyukbayram, Huseyin; Celik, Salih
Purpose An experimental study was designed to investigate the effect of combined pulse electromagnetic field (PEMF) stimulation plus glutamine administration on colonic anastomosis. Methods Anastomosis of the left colon was performed in 28 rats, which were divided into four groups; Group 1: normal resection anastomosis plus oral 50 mg/kg/day glutamine; Group 2: normal resection anastomosis plus PEMF stimulation plus oral 50 mg/kg/day glutamine; Group 3: normal resection anastomosis plus PEMF stimulation; Group 4: normal resection anastomosis. On the seventh postoperative day, the animals were killed and the bursting pressure and tissue hydroxyproline concentration of the anastomosis were analyzed and compared. Results The mean anastomotic bursting pressure in Group 2 was significantly higher than in Groups 1 and 4. On the other hand, the mean anastomotic bursting pressure in Group 1 was significantly higher than in Group 4. The collagen deposition and the fibroblast infiltration were significantly increased on the seventh day in Group 3 compared the other groups. On the other hand, Groups 1 and 2 had higher scores for collagen deposition and fibroblast infiltration than Group 4. Conclusions In conclusion, burst pressures, hydroxyproline, and histologic features (fibroblast infiltration and collagen deposition) were improved in the PEMF group, and both PEMF and glutamine-enriched nutrition provide a significant gain in the strength of colonic anastomoses in rats.
Effects of Combined Pulse Electromagnetic Field Stimulation Plus Glutamine on the Healing of Colonic Anastomosis in Rats (vol 54, pg 745, 2009)
(Springer, 2010) Girgin, Sadullah; Gedik, Ercan; Ozturk, Hayrettin; Akpolat, Veysi; Kale, Ebru; Buyukbayram, Huseyin; Celik, Salih
[Abstract Not Available]
The evaluation of 250 patients with thoracoabdominal injuries
(Turkish Assoc Trauma Emergency Surgery, 2008) Ciftci, Fatih; Girgin, Sadullah; Gedik, Ercan; Onat, Serdar; Tacyildiz, Ibrahim Halil; Keles, Celalettin
BACKGROUND Prognostic factors affecting mortality and morbidity in thoracoabdominal injuries were evaluated. METHODS Two hundred and fifty patients (227 males, 23 females; mean age 30.1 +/- 5.11; range 15 to 71 years) who had been exposed to thoracoabdominal injuries and underwent laparotomy between June 1996 and November 2005 were investigated retrospectively. Patients were assessed according to age, sex, trauma-operation interval, shock, hospitalization period, number of injured organs, blood transfusion, timing of closed thorax drainage, thoracotomy, Abdominal Trauma Index, Injury Severity Score, Abbreviated Injury Score, Revised Trauma Score, and complications. RESULTS Mortality and morbidity ratios were 15.6% and 53.5%, respectively. The factors effective on mortality were trauma-operation interval >= 3 hours (p=0.03), presence of shock (p=0.03), increase in the rate of blood transfusion (p=0.001), injured organ number >= 3 (p=0.001), and not performing early-term closed thorax drainage (p=0.005). Trauma-operation interval <3 (p=0.02), increase in the rate of blood transfusion (p=0.02), injured organ number >= 3 (p=0.001), and not performing early-term closed thorax drainage (p=0.005) were the factors effective on morbidity. CONCLUSION It was determined that trauma-operation period >= 3 hours, number of injured organs >= 3, and increased number of blood transfusions increased both mortality and morbidity. However, presence of shock increased only mortality. On the other hand, application of closed thorax drainage within a reasonable time period was determined to decrease mortality and morbidity.
The evaluation of bacteriology in perianal abscesses of 81 adult patients
(Contexto, 2010) Ulug, Mehmet; Gedik, Ercan; Girgin, Sadullah; Celen, Mustafa Kemal; Ayaz, Celal
Objective: Treatment of perianal abscesses requires prompt surgical drainage and antimicrobial therapy. However, we should encourage the selective use of antimicrobial agents on a case-by-case basis, especially because there is no evidence that uncomplicated perianal abscesses can be safely treated only with drainage. For this reason, it is important to identify the causative organisms; therefore, we accessed the microbiological analysis of these patients. Patients and methods: In this study, 81 consecutive adult patients with perianal abscesses, who presented at a university hospital in Diyarbakir from January 2004 to December 2006, were included. Clinical and laboratory data, and results of microbiological analysis were recorded. Results: All specimens, except seven, yielded bacterial growth. Escherichia coli, Bacteriodes spp., coagulase-negative Staphylococci, and Staphylococcus aureus were the most common isolated organisms. Conclusion: In contrast to other investigators, this study demonstrated that aerobic organisms are the predominant isolates in these infections.
The evaluation of microbiology and Fournier's gangrene severity index in 27 patients
(Elsevier Sci Ltd, 2009) Ulug, Mehmet; Gedik, Ercan; Girgin, Sadullah; Celen, Mustafa K.; Ayaz, Celal
Objectives: The objectives of this study were to identify the causative microorganisms and factors associated with survival in patients with Fournier's gangrene and to determine the accuracy of the Fournier's gangrene severity index. Materials and methods: We retrospectively evaluated 27 patients with Fournier's gangrene who were treated and followed up at our hospital between January 2005 and December 2006. Biochemical, hematologic, and bacteriologic study results at admission and at the final evaluation, etiologic and predisposing factors at admission, physical examination findings, the timing and extent of surgical debridement, and antibiotic therapy used were all recorded. Results: The admission laboratory parameters that were significantly correlated with outcome included urea, creatinine, sodium, and potassium; at the final evaluation, in addition to these parameters, hematocrit, albumin, and bicarbonate levels were also significantly associated with outcome. The mean Fournier's gangrene severity index score (FGSIS) at admission for survivors was 5.04 + 2.49 compared with 13.6 + 4.61 for non-survivors. There was a strong correlation between the FGSIS and mortality (p < 0.0001). Escherichia coli and Pseudomonas aeruginosa were the most commonly isolated microorganisms. Conclusions: Patient metabolic status and predisposing factors are important in the prognosis of Fournier's gangrene. Hence, we believe that the FGSIS should be used clinically to evaluate therapeutic options and assess results. (C) 2009 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.
Genel cerrahi hastalarında preoperatif HBsAg, Anti-HCV, Anti-HIV seroprevalansı
(Dicle Üniversitesi Tıp Fakültesi, 2009) Girgin, Sadullah; Temiz, Hakan; Gedik, Ercan; Gül, Kadri
Amaç: Kan kaynaklı patojenlerle temas; sağlık çalışanları için çok ciddi bir mesleki risk oluşturmaktadır. Çalışmanın amacı elektif cerrahi öncesi hastalarda HBsAg, anti-HCV ve anti-HIV seroprevalansını belirlemektir. Gereç ve yöntem: Dicle Üniversitesi Tıp Fakültesi Genel Cerrahi Kliniği’ne Ocak 2007 ve Temmuz 2007 tarihleri arasında elektif cerrahi girişim uygulamak amacıyla yatırılan ameliyat hazırlığı döneminde 486 hastanın kan örneklerinde; HbsAg, anti-HCV ve anti-HIV testleri ELISA yöntemiyle çalışıldı. Aynı dönemde Dicle Üniversitesi Tıp Fakültesi Kan Bankası’na başvuran gönüllü kan vericilerinden (n=14354) kontrol grubu oluşturuldu. Bulgular: Preoperatif hastalarda HBsAg ve anti-HCV seroprevalansı sırasıyla %6.6, %1.6 olarak bulunmuştur. Kontrol grubunda ise HBsAg ve anti-HCV seroprevalansı sırasıyla %2.9, %0.7 olarak bulundu ve hasta grubuna göre istatistiksel olarak anlamlı derecede düşüktü. Bu sonuç; preoperatif hastalardaki HBsAg ve anti-HCV pozitiflik oranının, kan bankasından elde edilecek verilerden daha yüksek olması beklenilmesi gerektiği göstermektedir. Kontrol ve hasta gruplarının her ikisinde de anti-HIV pozitifliği saptanmamıştır. Sonuç: Kan ve vücut sıvılarıyla bulaşan hastalıklar hakkında tüm sağlık çalışanları eğitilmeli, HBV’ne karşı aşılanmalı, ameliyathanelerde infeksiyon geçişini engelleyecek evrensel önlemlerle ilgili standartlar hazırlanıp ciddiyetle uygulanmalı ve temas edilen her hastanın infekte olabileceği kabul edilmelidir.
Iloprost, a prostacyclin (PGI2) analogue, reduces liver injury in hepatic ischemia-reperfusion in rats
(Acta Cirurgica Brasileira, 2009) Gedik, Ercan; Girgin, Sadullah; Obay, Basra Deniz; Ozturk, Hayrettin; Ozturk, Hulya; Buyukbayram, Huseyin
Purpose: To evaluate the effects of iloprost a prostacyclin analogue on the hepatic IR injury in rats. Methods: Forty male Sprague-Dawley rats (250-300 g) were divided into four groups each containing 10 rats; -(1) controls: data from unmanipulated animals; (2) sham group: rats subjected to the surgical procedure, except for liver I/R, and given saline; (3) I/R group: rats that underwent liver ischemia for 45 min followed by reperfusion for 45 min; (4) I-R/Iloprost group: rats pretreated with iloprost (10 mu g kg(-1), i.v). Liver tissues were taken to determine SOD, CAT, GSH, and MDA levels and for biochemical and histological evaluation. Results: The plasma ALT and AST levels were increased in group 3 than in group 4. MDA values and the liver injury score decreased, while the SOD, CAT, and GSH values increased in group 4 compared to group 3. In group 3, hepatocytes were swollen with marked vacuolization. In group 4, there were regular sinusoidal structures with normal morphology without any signs of congestion. Conclusion: We demonstrated hepatoprotective effects of iloprost against severe ischemia and reperfusion injury in rat liver.
Impact of para-neurologic and para-mental premorbidities on burn injury patients
(Turkish Assoc Trauma Emergency Surgery, 2011) Bozkurt, Mehmet; Kapi, Emin; Gedik, Ercan; Kuvat, Samet Vasfi
BACKGROUND The aim of this article was to determine whether there are differences in the progression, mortality and morbidity of these premorbid patients compared to normal burn injury patients. METHODS In this study, 26 premorbid cases (8 males, 18 females; mean age: 30.8 years; range: 3-74 years) hospitalized in the Dicle University Burn Center between July 2007 and November 2009 were evaluated. RESULTS Appreciation of the pathophysiological basis of the premorbidity in burn patients is important. When the treatment for premorbid burn patients is planned, the associated co- or premorbidity must be kept in mind. To improve the outcome of the treatment, considerable attention must be paid to these patients. CONCLUSION This article gives an overview of the current literature regarding premorbid patients in the Turkish population and draws attention to this specific topic.

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