Ulus Travma Acil Cer
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Ulus Travma Acil Cer · Jan 2020
Traumatic upper extremity injuries: Analysis of correlation of mangled extremity severity score and disabilities of the arm, shoulder and hand score.
The Mangled Extremity Severity Score is a decision-making tool for limb amputation after trauma. The Disabilities of the Arm, Shoulder and Hand questionnaire was developed to quantify posttraumatic functional deficits of the upper extremity. This study aims to determine the correlation between these two assessments. ⋯ The Disabilities of the Arm, Shoulder and Hand Score did not correlate significantly with the Mangled Extremity Severity Score.
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Ulus Travma Acil Cer · Jan 2020
Randomized Controlled Trial Comparative StudyComparison of epidural analgesia combined with general anesthesia and general anesthesia for postoperative cognitive dysfunction in elderly patients.
Cognitive dysfunction in the early postoperative course is common for the elderly population. Anesthetic management may affect postoperative cognitive decline. Effective analgesia, early recovery and modulation of the stress response are advantages of neuraxial blocks. This study aims to compare the effects of general anesthesia and the combination of general anesthesia with epidural analgesia for postoperative cognitive dysfunction (POCD). We hypothesized that neuraxial block combined with general anesthesia (GA) would have a favorable influence on POCD prevention. ⋯ General anesthesia and epidural analgesia combined with general anesthesia resulted in similar POCD in elderly patients undergoing abdominal surgery. However, in combined anesthesia group memory, language skills and visuospatial functions appeared to be better preserved. Effective pain control might contribute to preventing cognitive decline in some domains.
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Ulus Travma Acil Cer · Jan 2020
Comparative StudyLong-term comparative study of internal fixation with Kirschner wires or cannulated screws for displaced medial epicondyle fractures of the humerus in children: A 10-year follow-up of 42 cases.
The rationale behind the decision-making on which type of fixation to use in displaced medial epicondyle fractures is not well elucidated. This study aims to compare the long-term clinical and radiographic outcomes of internal fixation with either Kirschner wires (K-wires) or cannulated screws in children with displaced medial epicondyle fractures. ⋯ Two smooth K-wires for younger children and screw fixation for children near skeletal maturity may provide favorable clinical and radiological outcomes at long-term follow-up, with low morbidity and radiographic deformity.
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Ulus Travma Acil Cer · Jan 2020
Spontaneous abdomen and abdominal wall hematomas due to anticoagulant/antiplatelet use: Surgeons' perspective in a single center.
The incidence of abdominal wall hematomas increased after the introduction of anticoagulant and antiplatelet drugs in clinical practice. These patients are usually old, and they have more than one comorbidity. Most spontaneous hematomas tend to limit itself and conservative treatment with close follow up is usually enough, but surgery is an option that should be decided critically. Unnecessary surgical interventions could worsen the situation. The present study aims to analyze the results of patients under anticoagulant/antiplatelet treatment and with spontaneous abdominal wall hematomas from surgeons' perspective. ⋯ Early recognition, hospitalization of risky patients, close follow-up of hemodynamic parameters, patients' response to conservative treatment and minimal invasive methods are key points. Conservative care is the choice of treatment, but surgery must always keep in mind in hemodynamic unstable patients.
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Ulus Travma Acil Cer · Jan 2020
Case ReportsCastleman's disease presenting with mechanical intestinal obstruction: A rare case.
Castleman's disease (CD) is a lymphoproliferative disorder and the occurrence of CD in the small bowel is rare. In this study, we present one case of CD causing mechanical intestinal obstruction due to involvement of terminal ileum. A 50-year-old man was admitted to the hospital with signs and symptoms of mechanical intestinal obstruction without history previous surgery. ⋯ On abdominal exploration a tumor like mass that also held distal small intestine mesentery, and ileocecal valve causing complet intestinal obstruction was observed. Ileocecal resection and ileocolonic anastomosis were performed. CD is a rare entity and should be kept in mind during the differential diagnosis of mechanical intestinal obstruction provided that wall thickening in terminal ileum mimicking mass, and accompanying enlargement mesenteric lymph nodes observed during preoperative investigations or intraoperative exploration.