Selçuk Tıp Dergisi Arşiv

Aneurysmorrhaphy is the procedure through which venous continuity is provided by resecting the thinned wall of aneurysm and fixing the remaining part. Aneurysmorrhaphy is the repairing method that we apply in priority. We believe that, the fixing of aneurysm by aneurysmorrhaphy before the complications comes out is important in terms of continuity of vein of AVF and long term use. A total of 33 cases of true aneurysm induced by and repaired through aneurysmorraphy method between 2010 and 2015 were included in the study. The localization of true aneurysm depending on AVF of the persons who were participated in this study included antebrachial of the radio-cephalic AVF in 11 patients, the antecubital region brachio-cephalic AVF in 20 patients and in the antecubital AVF brachio-basilica in 2 patients. Patients were followed for three years after aneurysmorraphy. Despite the fact that expansion occurred in repaired venous structure, no pathology was identified requiring intervention in in 30 cases. In three patients, recurrent expansion and problems were observed in the localization where aneurysmorraphy repairing was reapplied. Before any complication occurs, intervening in aneurysm and reduction of it without breaking the continuity of AV fistula are effective surgical methods.

To evaluate the five year survival outcomes of breast cancer patients treated at our department and to assess the prognostic factors that affect survival parameters. All patients underwent our department’s routine procedure for breast cancer. All patients received RT to the breast or chest wall using 3D conformal technique with 2 Gy fraction doses, five days a week with two opposite tangential fields. If necessary, ipsilateral supraclavicular fossa field was added to the treatment field. Anthracycline-based chemotherapy was primarily used, patients with estrogen receptor- positive disease received hormonal therapy and patients with Her-2 receptor-positive disease received trastuzumab. The primary end points of this study were to evaluate the overall survival (OS) and the disease-free survival (DFS) of the patients. The secondary end points of this study were to assess the prognostic factors that affect the survival outcomes. Statistical analysis were carried out using SPSS Statistic program version 13. Between 11.02.2010 and 01.05.2016, 559 patients with breast cancer who had been irradiated postoperatively were included in this retrospective study. 2 and 5 year OS rates were 97% and 84%; 2 and 5 year DFS rates were 97% and 71%, respectively. According to multivariate analysis, ≥70 year, to have triple (-) hormonal status, to have T3-4 disease, to have N2-3 nodal stage and to have locoregional recurrence or distant metastasis were the independent prognostic factors that affect OS. Also, to have N2-3 nodal stage and to have triple (-) hormonal status were independent prognostic factors that affect DFS. Breast cancer is the most common cancer among women. Its incidence has been increasing but mortality has been decreasing in the last 10-15 years. In the light of current treatment modalities, to know the prognostic factors that affect survival outcomes is very important for both choosing the most appropriate treatment modality and the prediciton of treatment response.

It is important to take into consideration of patient expectations and satisfaction in terms of the best utilization of required components that are necessary for the development of health services. The aim of this study was to evaluate the level of the patients’ satisfaction and detect factors affecting the satisfaction, who consulted to Department of Anesthesiology and Reanimation Clinic in Necmettin Erbakan University, Meram Faculty of Medicine. This study was performed on patients who were consulted to the Department of Anesthesiology and Reanimation Clinic, at the Necmettin Erbakan University, Meram Faculty of Medicine for time period of 4 months between November 2015 and February 2016. Within this period, 200 patients who applied to the clinic and accepted to participate in the study by approving informed consent form were included in the study. The survey form was filled by conducting face to face interview. The time duration between patients application to the clinic and their receiving anesthesia consent and ASA scores were recorded. Patient satisfaction coefficient was found as 90.32. Patients who indicated that they did not wait too long for the registration process and assay/analysis tests were 72% and 68.5%, respectively. 98% of the patients stated the physician and 96% of the patients stated the health staff were polite and respectful. The patients having university level and higher education illiterated lower satisfaction coefficients compared with the other levels of education (p = 0.01). The average time duration between patients application to the clinic and their receiving anesthesia consent was 3.00 ±1.014 hours. There was no statistically significant difference between the time duration for receiving anesthesia consent and the ASA score (p=0.08). It was determined that the patients who consulted to the anesthesiology clinic in our hospital had high satisfaction levels, and the patients with an education level of university and higher illutirated lower satisfaction levels compared with the other levels of education. It was concluded that studies that will shorten the waiting time for analysis / examination and the registration process would be useful to increase the level of satisfaction.

The prevalence of type 2 diabetes is increasing world wide and it is estimated to rise from 382 million today to 582 million by 2035. Although there are a number of therapies currently avaible to treat diabetes mellitus, glycemic control rates remain poor. Imeglimin, the first in a new-tetrahydrotriazine-containing class of oral antidiabetic agents and it has been shown to decrease hepatic glucose production, increase glucose uptake in skeletal tissue and improve insulin secretion in response to glucose. In this text, the efficacy and safety of imeglimin in the treatment of type 2 diabetes are reviewed.

Chickenpox is an infectious disease caused by varicella-zoster virus (VZV), characterized by egzentematous rash. The frequency of encephalitis in patients with chickenpox was determined as 0.1-0.2% and the incidence is higher in patients with depressed cell-mediated immune response. Mortality rates vary between 5% and 20%. Patients who survive have a high likely to develop of permanent neurological complications after encephalitis. In this study, we report a fivemonth old infant who was admitted with a seizure and diagnosed as encephalitis. Meningoencephalitis was detected by the cranial magnetic rezonans. Anticonvulsants and antiviral therapy were supplemented. Patient was taken to physical therapy program due to the development of the mental motor retardation and quadriparazi in the follow-up periods.Therefore, we aimed to emphasize with this case that the patients suffering from chickenpox in the first year of the life should closely be followed up for complications, and the encephalitis due to varicella can also be seen rarely.

Primary ovarian leiomyosarcomas, which are often encountered in post-menopausal women, are rare, their origin, etiology, histological and clinical features and optimal treatment plan have not been fully explained tumors. They constitute less than 3% of all ovarian tumors. Due to rarely observation and the lack of specific symptoms, ovarian leiomyosarcomas are often difficult to be recognized. In this article, a 66-year-old patient who was operated for ovarian mass and pathology resulted with ovarian leiomyosarcoma, was presented. Although ovarian tumors are rare, leiomyosarcomas ovarian gonadal stromal tumors should be kept in mind in the differential diagnosis.