Araştırma Çıktıları
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Item Analysis of factors affecting baseline SF-36 Mental Component Summary in Adult Spinal Deformity and its impact on surgical outcomes(TURKISH ASSOC ORTHOPAEDICS TRAUMATOLOGY, 2018-01-01) Mmopelwa, Tiro; Ayhan, Selim; Yuksel, Selcen; Nabiyev, Vugar; Niyazi, Asli; Pellise, Ferran; Alanay, Ahmet; Perez Grueso, Francisco Javier Sanchez; Kleinstuck, Frank; Obeid, Ibrahim; Acaroglu, Emre; Grp, European Spine StudyObjectives: To identify the factors that affect SF-36 mental component summary (MCS) in patients with adult spinal deformity (ASD) at the time of presentation, and to analyse the effect of SF-36 MCS on clinical outcomes in surgically treated patients. Methods: Prospectively collected data from a multicentric ASD database was analysed for baseline parameters. Then, the same database for surgically treated patients with a minimum of 1-year follow-up was analysed to see the effect of baseline SF-36 MCS on treatment results. A clinically useful SF-36 MCS was determined by ROC Curve analysis. Results: A total of 229 patients with the baseline parameters were analysed. A strong correlation between SF-36 MCS and SRS-22, ODI, gender, and diagnosis were found (p < 0.05). For the second part of the study, a total of 186 surgically treated patients were analysed. Only for SF-36 PCS, the un-improved cohort based on minimum clinically important differences had significantly lower mean baseline SF-36 MCS (p < 0.001). SF-36 MCS was found to have an odds ratio of 0.914 in improving SF-36 PCS score (unit by unit) (p < 0.001). A cut-off point of 43.97 for SF-36 MCS was found to be predictive of SF-36 PCS (AUC = 0.631Item An international multi-institutional analysis of operative morbidity in patients undergoing elective diverticulitis surgery(ASSOC MEDICA BRASILEIRA, 2022-01-01) Altinel, Yuksel; Cavallaro, Paul; Ricciardi, Rocco; Ozben, Volkan; Ozturk, Ersin; Bleday, Ron; Aytac, Erman; Bordeianou, Liliana; Stu, Members Turkish DiverticulitisOBJECTIVE: We investigated surgical complications of elective surgery for diverticulitis in international multi-institution to identify a prediction model for potential opportunities of quality improvement. METHODS: We identified 1225 patients who underwent elective surgery for diverticulitis between January 2010 and January 2018. The data were obtained from the National Surgical Quality Improvement Program and the Turkish Diverticulitis Study Group Collaborative, retrospectively. RESULTS: We observed that the presence of chronic obstructive pulmonary disease (OR: 3.2, 95\%CI 1.8???5.9, p<0.001) or abscess at the time of surgery (OR: 1.4, 95\%CI 1.2???1.7, p??0.001) is associated with a higher rate of minor complications, while comorbidities such as dyspnea (OR: 2.8, 95\%CI 1.6???4.9, p??0.001) and preoperative sepsis (OR: 4.1, 95\%CI 2.3???7.3, p??0.001) are associated with major complications. The centers had similar findings in minor and major complications (OR: 0.8, 95\%CI 0.5???1.4, p=0.395). The major independent predictors for complications were malnutrition (low albumin) (OR: 0.5, 95\%CI 0.4???0.6, p<0.001) and the American Society of Anesthesiology score (OR: 1.7, 95\%CI 1.2???2.4, p=0.002). CONCLUSION: Regarding the major and minor complications of diverticulitis of elective surgery, the malnutrition and higher American Society of Anesthesiology score showed higher impact among the quality improvement initiatives.Item An extrapulmonary manifestation of lymphangioleiomyomatosis: A rare case report(ELSEVIER SCI LTD, 2017-01-01) Tumay, L. Volkan; Guner, Osman Serhat; Zorluoglu, AbdullahLymphangioleiomyomatosis (LAM) is a rare and fatal disease which occurs almost exclusively in young women. The disease often affects lungs and most of the patients die from respiratory failure. It is often initially misdiagnosed as asthma or chronic obstructive pulmonary disease. The most common presentations of pulmonary LAM (P-LAM) include dyspnea and coughing. Chylothorax and spontaneous pneumothorax may be seen in advanced cases. Although rare, it may present with extrapulmonary LAM (E-LAM). Renal angiomyolipomas and abdominal lymphadenopathies (LAPs) are common in E-LAM cases. Pelvic retroperitoneal masses are very rare and often require exploratory laparotomy. Herein, we report a 36 year-old female case of a rare extrapulmonary manifestation of LAM who was treated with abdominal and thoracic surgery, radiotherapy and finally sirolimus. (C) 2017 The Author(s). Published by Elsevier Ltd on behalf of IJS Publishing Group Ltd.Item Posterior Approach Alone Versus Combined Anterior and Posterior Approach in the Management of Vertebral Tuberculosis(TURKISH NEUROSURGICAL SOC, 2019-01-01) Demirel, Mehmet; Akgul, Turgut; Pehlivanoglu, Tuna; Karademir, Gokhan; Bayram, Serkan; Dikici, Fatih; Sar, CuneytAIM: To compare posterior surgery alone versus combined anterior and posterior surgery for the management of spinal tuberculosis. MATERIAL and METHODS: Data from 31 consecutive patients who underwent surgery for spinal tuberculosis were analyzed retrospectively. Patients were divided into two groups as group A (posterior surgery alone) or group B (combined anterior and posterior surgery), and groups were compared in terms of invasiveness of the procedure, spinal deformity, fusion, neurological status, and postoperative complications. RESULTS: Group A included 16 patients (mean age: 56 years, range: 29-75) with a mean follow-up period of 29 months (range 12-60) while group B included 15 patients (mean age: 60 years, range: 35-73) with a mean follow-up period of 28 months (range 12-60). Procedurally, average operation time and mean length of hospitalization were shorter, and mean blood loss was lower in group A (p<0.05) compared to group B. Postoperative bone fusion took significantly (p<0.05) longer time in group A (10.5 +/- 2.1 months)than in group B (9.3 +/- 3.1 months), and all patients with a neurological deficit recovered completely during the postoperative period. No significant differences were observed between two groups with respect to postoperative complications (p>0.05). CONCLUSION: Combined anterior-posterior surgery may not be required for treating vertebral tuberculosis as posterior surgery alone appears to be sufficient.Item Treatment strategies in the left main coronary artery disease associated with acute coronary syndromes(ELSEVIER SCIENCE BV, 2015-01-01) Karabulut, Ahmet; Cakmak, MahmutSignificant left main coronary artery (LMCA) stenosis is not rare and reported 3 to 10\% of patients undergoing coronary angiography. Unprotected LMCA intervention is a still clinical challenge and surgery is still going to be a traditional management method in many cardiac centers. With a presentation of drug eluting stent (DES), extensive use of IVUS and skilled operators, number of such interventions increased rapidly which lead to change in recommendation in the guidelines regarding LMCA procedures in the stable angina (Class 2a recommendation for ostial and shaft lesion and class 2b recommendation for distal bifurcation lesion). However, there was not clear consensus about the management of unprotected LMCA lesion associated with acute myocardial infarction (MI) with a LMCA culprit lesion itself or distinct culprit lesion of other major coronary arteries. Surgery could be preferred as an obligatory management strategy even in the high risk patients. With this review, we aimed to demonstrate treatment strategies of LMCA disease associated with acute coronary syndrome, particularly acute myocardial infarction (MI). In addition, we presented a short case series with LMCA lesion and ST elevated acute MI in which culprit lesion placed either in the left anterior descending artery or circumflex artery. We reviewed the current medical literature and propose simple algorithm for management. (C) 2015 The Authors. Production and hosting by Elsevier B.V. on behalf of King Saud University.