Browsing by Publisher "Elsevier USA"
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Item Correlation of the Volume Control Parameters with Health Related Quality of Life in Renal Transplant Patients(Elsevier USA, 2015) Colak H.; Sert I.; Ekmekci C.; Tugmen C.; Kurtulmus Y.; Kursat S.; Töz H.Introduction Transplantation is the most effective treatment strategy for end-stage renal failure. We aimed to investigate the correlation of volume control parameters with health-related quality of life (HRQoL) in renal transplantation patients during the pre- and post-transplantation periods. Material and Methods Seventy-seven patients who underwent renal transplantation from deceased donors between January 2011 and January 2013 were included in the study. The biochemical markers, complete blood count, and creatinine levels were measured during pretransplantation and at post-transplantation month 6. The Turkish version of the Short Form 36 (SF-36) health survey questionnaire was used for the assessment of HRQoL. Blood pressure (BP) and echocardiographic measurements were used to evaluate the volume status. Results Significant improvements were achieved in all echocardiographic measurements, biochemical parameters except Ca++, and SF-36 questionnaire domain scores (DSs) except vitality in the post-transplantation period. Systolic BP (SBP), the left atrium index, vena cava inferior collapsibility index (VCCI), and diastolic BP were associated with vitality (P =.02,.03,.05, and.04, respectively); SBP was associated with social functioning (P <.01) and role emotional (P <.01); and left ventricular mass index was associated with mental health (P =.05) DSs during the pretransplantation period. In the post-transplantation period, VCCI, left ventricular mass index, and SBP were associated with general health (P =.02,.05, and.05, respectively); VCCI and SBP were also associated with mental health (P =.05 and.01, respectively); and left atrium index was associated with role emotional (P =.05) DSs. Conclusion Concomitant improvement in the volemic status may contribute to improvements in HRQoL after renal transplantation. © 2015 Elsevier Inc. All rights reserved.Item Bentall Operation in a Patient with Severe Hemophilia A and Marfan Syndrome by Use of a Biologic Composite Graft(Elsevier USA, 2016) Yildirim F.; Ozbakkaloglu A.; Ozturk T.; Tetik O.We describe a patient with severe hemophilia A and Marfan syndrome who underwent an elective Bentall operation. Because of the severe hemophilia, anticoagulation could not be given postoperatively; thus, a biologic Valsalva conduit graft was used. During the procedure, factor VIII was given as a bolus dose just before incision, then by continous infusion intraoperatively to maintain the factor VIII activity level between 200% and 300%. Minimal postoperative bleeding occurred. The infusion was continued postoperatively at a lower dose until all chest tubes, pacing wires, and invasive catheters were removed. The patient was discharged on postoperative day 7 without adverse events. © 2016 The Society of Thoracic Surgeons.Item Central Precocious Puberty Secondary to Adrenocortical Adenoma in a Female Child: Case Report and Review of the Literature(Elsevier USA, 2017) Ersoy B.; Kizilay D.; Cayirli H.; Temiz P.; Gunsar C.Background Pediatric adrenocortical tumors are rare but significant causes of virilization and peripheral precocious puberty (PPP). Case A 4-year-old girl presented with development of breast, pubic hair, and facial acne. Her bone age was advanced, and her gonadotropin level did not elevate in a gonadotropin-releasing hormone (GnRH) test. High levels of dehydroepiandrosterone sulfate, estradiol, and testosterone, and detection of a tumor in the left adrenal gland of the abdomen using computed tomography led to a diagnosis of PPP due to adrenal tumor. Adrenal adenoma was diagnosed with pathology after the tumor was removed. Ultrasonography detected multicystic ovaries before surgery. Although the androgen levels decreased, high estrogen levels persisted after complete tumor resection. Approximately 1 year after the surgery, the patient's breast development persisted, bone age progressed rapidly, and gonadotropin levels increased in a GnRH test. Central precocious puberty was diagnosed, and treatment with GnRH analogues was started. Summary and Conclusion Adrenal adenoma might present with isosexual PPP as well as virilization in girls. The ovaries should be carefully assessed in these patients. Prolonged exposure to androgen and estrogen might cause ovarian multicysts leading to persistence of high estrogen levels and initiation of central precocious puberty. © 2017 North American Society for Pediatric and Adolescent GynecologyItem Impact of Secondary Insults in Brain Death After Traumatic Brain Injury(Elsevier USA, 2019) Heppekcan D.; Ekin S.; Çivi M.; Aydın Tok D.In addition to primary injury in severe head trauma, secondary systemic insults that aggravate the brain injury may result in fatal neurologic outcome. We aim to evaluate the correlation between brain death and secondary systemic insults in 100 patients with severe traumatic brain injury (TBI) admitted to the intensive care unit. We collected data on hypotension and hypoxemia at the time of admission to intensive care unit and data on hypotension, hypoxemia, hypocarbia, hypercarbia, shock, anemia, hyperglycemia, and hyperthermia within the first 24 hours. In addition, we recorded the category of TBI according to computed tomography findings. Twenty-six patients (26%) who developed brain death were significantly younger than survivors. Early hypotension (odds ratio [OR], 10.24; 95% confidence interval [CI], 3.64–28.78; P = .000) and early shock (OR, 8.31; 95% CI, 2.65–26.01; P = .000) were significantly more frequent among brain-death patients. The most featured factor that independently predicted the development of brain death in patients with severe TBI was the existence of hypotension (B–2.74; 95% CI, 0.016–0.252; P = .000). The most common type of injury among brain death patients was a surgically evacuated mass lesion. Although all critical care principles are applied to prevent secondary systemic brain insults, when brain death occurs, the prevention of hypotension will become significant in preserving organs in better condition for procurement. © 2019 Elsevier Inc.Item The Utility of Myometrial and Cervical Ultrasound Shear Wave Elastography in the Diagnosis of Ectopic Pregnancy(Elsevier USA, 2020) Akbas M.; Koyuncu F.M.We aimed to assess the potential utility of myometrial and cervical elasticity measurement in the diagnosis of ectopic pregnancy (EP), which could facilitate the diagnosis process. Myometrial and cervical elasticity values were measured in women with EP, women with early intrauterine pregnancy (IP) and non-pregnant women. Transabdominal point shear wave elastography (pSWE) was used for elasticity measurements. A reliability study was performed in 20 patients of the non-pregnant group. Cervical pSWE showed poor reliability and high measurement failure rate; thus, we excluded cervical elasticity assessment from the study. In this study, 32 women with EP, 28 women with early IP and 38 non-pregnant women were enrolled for myometrial elasticity assessment by pSWE. Myometrial elasticity values were statistically significantly lower in EP (8.31 kPa [5.1–27]) and early IP (8.83 kPa [4.5–46.2]) groups than in non-pregnant women (14.85 kPa [5.1–28]) (p = 0.003). However, myometrial pSWE results were not significantly different between EP and early IP groups. In light of this data, quantitative assessment of the uterus elasticity using pSWE does not seem to be an adequate diagnostic method for EP. © 2020 World Federation for Ultrasound in Medicine & Biology