Makale Arama

Familial Mediterranean Fever (FMF) is characterized by attacks and inflammation of serous membranes. After discovery of MEVF mutations, several studies have been carried out about the effect of genotype to phenotype, a number of them showed relationship between genotype and phenotype, but some of them not. The aim of our study was to investigate the relationship between genotype and clinical features in children with FMF. This study was performed with 131 patients who have FMF diagnosis. The demographic data, clinical findings, mutations were investigated retrospectively. 52.7% of our patients were boys, 47.3% were girls. Distribution of the age of diagnosed was different from age of onset of symptoms (p=0.00). The most frequent symptom was abdominal pain (94.7%) and it is followed by fever (91.6%), arthralgia (65.6%) and chest pain (27.5%). Infection, stress, menstruation and physical training triggered the attack in some patients. Respectively, the most common mutations were M694V (50.4%), M680I (26.7%) and 148Q (11.5%). No mutation was detected in 14.5% of our patients. Nausea and vomiting were less in M694V homozygous patients, and arthralgia was higher in E148Q heterozygous patients (p<0.05). We had 3 patients with colchicine-resistant who were siblings. In our study, a significant relationship between phenotype and genotype was not observed. It is difficult to recognize the disease in infancy period, FMF should be considered in patients with frequently admitted to hospital in order to avoid complications.

Aim: The aim of this study is to compare the prophylactic administration of ondansetron with haloperidol to determine its effects in reducing postoperative nausea and vomiting after middle ear surgery. Material and Method: Forty patients scheduled for middle ear surgery under general anesthesia were randomly allocated in two groups to receive either haloperidol IV 2 mg (Group I) or ondansetron IV 4 mg (Group II) 5 minutes before induction of anesthesia. Standart general anesthesia was applied. During postoperative 24 hours nausea-vomiting was evaluated by using verbal descriptive scala. Results: The nausea-vomiting score was not statistically different between the groups (p>0.05). The incidence of nausea-vomiting and the need for rescue antiemetics were not statistically significant (p>0.05). There was no difference of side effects between the groups (p>0.05). Conclusion: It was concluded that haloperidol 2 mg is as effective as ondansetron 4 mg for the prevention of postoperative nausea and vomiting in patients undergoing middle ear surgery.

Prophylactic medication with antiemetic drugs for nausea and vomiting in high risk patients are recomended in may publications. In our study we evaluated the antiemetic actions 13 hours postoperative of ondansetron and droperidol on 58 patients. Complications were similar in all three groups (p>0.05). Nausea and vomiting were more frequent during the 7. and 10. hours in the ondansetron, I. to 7. hours in the droperidol and 0-1 hours in the control groups (p<0.05). With these results we cocluded that ondansetron prophylaxis is effective in high risk patients.

The study compares the recovery charecteristics of desflurane and isoflurane in children undergoing tonsillectomy and/or adenoidectomy. Forty children 4-12 year of age were studied and thirty minutes prior to the induction of anesthesia, ali patients received 0.5 mg/kg midazolam orally. They were randomly assigned to receive 1-1.5 % isoflurane (group I) and 6-7 % desflurane (group II) for maintenance of anesthesia afterpatients given 2-2.5 mg/kg propofol and 10 pg/kg alfentanyl for anesthesia induction. Before surgery, patients received 20 mg/kg paracetamol rectally for postoperative analgesia. Dexamethasone 150 pg/kg was given to reduce the incidence of postoperative nausea and vomiting. Administration of anesthetic agents was terminated at the end surgery. At the end of operation extubation and recovery time determined. Extubation time was defined as the time from discontinuation of anesthetics to extubation. Recovery time was measured from the time the anesthetics were discontinued until the patients achieved a score of 8 on the Aldrete score. Agitation was evaluated by using the three-point score. Extubation and recovery time were significantly faster in the desflurane group than isoflurane group (p<0.05). İncidence of agitation was similar for both groups. As a result, desflurane provides a faster recovery than isoflurane in short-term surgery on children.

Meckel’s diverticulum is a rare cause of mechanical intestinal obstruction in adults. Due to non-specific symptoms and preoperative diagnosis of this rare condition, surgeons should keep in mind. A 28-year-old male patient was admitted to our emergency department with abdominal pain, nausea and vomiting for about 8 hours before onset. The patient was diagnosed as acute small bowel obstruction and underwent emergency surgery. At operation a torsioned ileum due to Meckel’s diverticulum 60 cm proximal to ileocecal valve and small bowel distention proximal to this site was seen. Ileum was detorsioned and Meckel’s diverticulum resection was performed. The patient was discharged on postoperative day 3. Histopathologic specimen were reported as Meckel’s diverticulum in 3x2x1cm size.

Mesenteric panniculitis is a situation which effects adipose tissue of the mesentery with inflammation and fibrosis. There may be symptoms like stomachache, nausea, vomiting or asymptomatic. Trauma, abdominal surgery, infection are the main causes and recently its association with the malignancy has been increased. We reported asymptomatic mesenteric panniculitis in a patient with chronic lymphocytic leukemia that hasn’t been experienced before in the literature.

The aim of this study is to investigate the effects of sevoflurane and propofol anesthesia on postoperative nausea vomiting and recovery in the middle ear surgery. The patients undergoing to middle ear surgery were randomly divided into two groups as Group S ( n=19) and Group P ( n=19). AH the patients are premedicated with 0.1 mg/kg İM midazolam and the induction was done with sevoflurane in Group S and 2.5 mg/kg İVpropofol in Group P. After the blockage with vecuronium 0.1 mg/kg, entübation was performed. Anesthesia maintenance was done with sevoflurane 1-3% in Group S and 8 mg/kg /h IV propofol infusion in Group P and 70% N2O/O2 inhalation in both. At the end of the operation, after quitting the anesthetics, the extubation times, spontaneous eye opening and recovery times were recorded. Postoperative nausea vomiting were evaluated in 2nd, 6th, 12th,18th and 24th hours. There were no significant differences found betvveen the groups according to spontaneous eye opening and recovery times ( p>0.05 ). Nausea-vomiting rate was found to be high in 0-2, 2-6, 12-18 hours in Group S ( p<0.05), but there was no difference in 6-12 hours ( p>0.05). Nausea-vomiting was not seen in any of the groups in 18-24 hours. İn conclusion no differences were found betvveen these anesthesia methods according to postoperative recovery, although nausea-vomiting rates appearently lovver in Group P. For this reason propofol anesthesia was decided to be an alternative for the middle ear surgery which has a high incidence ofpostoperative nausea and vomiting.

Tuberculosis is still an important public health problem in the World, especially, in undeveloped and developing countries. In this study, the primary diagnosis of intestinal tuberculosis was reported from a 14 months old female patient. The patient applied to our clinic with complaints of refusing breastfeeding, fever, abdominal distention, vomiting and loss of weight, then, the patient was taken to emergency operation due to the acute abdomen. In the operation, cheese-shaped lesions on whole intestines were macroscopically observed. Its histopathological examination revealed intestinal tuberculosis. Tuberculosis treatment for patient who were not diagnosed in the early stage was lost. In this study, details related with clinical findings, diagnosis and curation were reported with the aim of making an awareness on this rare case.

In this study: the effect of and tolerability to long actinz Verapamil SR 240 mg treatment on ',ordu, mild, moderate and malignant hypenension were in-vestigated.7'he drug was giyen orally once a day. If there was a necessity, a Jose o f 360 mg was used. At the end of Iliis study Verapamil SR 240 mg was found effective in most of thepaıients. Afier theVe-rapamil SR 240 mg treatınent, the patients diastolic blood pressure was ender 90 mın lig. Cardiac and ex-tracardiac tolercllıility to Verapamil SR 240 mg iher-apı. was excelknt. AV-block wasn't seen. In some of the patients, there were Side ellects such as headache, fiıtigue. flushing, nausea, vomiting and dizziness.

Nt. N (native nephrectomy) is not a frequently performed procedure following transplantation because the kidneys have important endocrinal functions in the organism. Therefore, native kidneys should not be displaced following transplantation. A 48-year-old female patient presented to the ER (emergency room) with complaints of abdominal pain, nausea, vomiting and fever. The patient’s history revealed that she had undergone cadaveric renal transplant about 30 months ago. Examination showed that there was comprehensive sensitivity and rebound all about the abdomen. Her urinary sediment contained an ample amount of leucocytes and erythrocytes. The patient who did not show any improvement regarding the sepsis indications in spite of liquid replacement and appropriate antibiotheraphy was taken into surgery. The patient received bilateral Nt. N from the midline incision. Bilateral Nt. N is a rare procedure. Sepsis and acute abdomen problems brought about by recurrent native renal infections of the patient were successfully treated by bilateral Nt. N . We think that for this case native nephrectomy should have been performed under better conditions before development of sepsis and acute abdomen conditions due to recurrent renal infections.

Aim: We aimed to evaluate surgical procedure carried out to an 8 years old child, clinically diagnosed as Henoch-Schönlein Purpura (HSP), undergoing intussusception repair, because of allergic vasculitis, erythamatose maculopapuler rashes, rectal bleeding, abdominal pain and intussusception, under the light of literature data. Case Report: An eight years old and a male child was consultated because of his biliary vomiting, nausea and diffuse maculopapuler rushes which were localised especially in lower extremites. The symptoms of HSP were observed at histopathologic examination of skin. On examination, the symptoms of acute abdomen, which were characterised with diffuse tenderness and distansion, hipoactive intestinal sounds and abondant biliary drainage from nasogastric tube, were identified. The pneumatic and hydrostatic reductions were not performed because of the risk of perforation due to severe peritonitis and his poor general condition. The patient was operated on after preoperative resuscitation. During the explorative laparatomy, edema and the symptoms of insufficient vascularisation in all intestinum were present. Also, it was observed that approximately 20 cm’s intestinal segment which begins from 10 cm proximal of ileocaecal valve, had been necrotic and ileostomy was carried out after resecting this segment. Meanwhile, it was observed that the whole intestine was edematous and localised blood circulation was distorted in some areas. The patient was operated on to make bridectomy when evisceration and brid ileus occurred on postoperative eleventh day, and the ileostomy was closed at the same session. The patient was delivered with complete recovery 16 days after closing of ileostomy. Conclusion: Although HSP is rarely seen as the cause of acute abdomen, too serious complications of this disease must be kept in mind.

Langerhans cell histiocytosis is a group of idiopathic disorders characterized by the abnormal proliferation of specialized bone marrow-derived Langerhans cells. In this report, we present a rare case of Langerhans cell histiocytosis with CT and MRI in a 2 yearold-boy who developed symptomatic diabetes insipidus and multiple bone ,cranial, lung and spleen metastases during the disease course. A 2-year-old male patient was hospitalized due to complaints of cough, fever, vomitting, diarrhea, achromasia, weakness and rash. Chest X-ray revealed reticulonodular infiltration in both lung fields. Thorax CT revealed diffuse micro and macro nodular type infiltration in both lung parenchyma. On CT and MRI revealed common lytic lesion of skull, vertebra and iliac bone. There are infundibular thickening and absence of posterior pituitary intensity on MRI of pituitary gland. The spleen involvoment is determined by abdominal CT. The diagnosis is confirmed with biopsy of iliac bone. Langerhans cell histiocytosis should be in the differential diagnosis in children having widespread lung, bone, pituitary gland, and spleen involvement on MRI and CT.

 Moyamoya disease is an entity, which is caused by obstruction or stenosis in the area between the internal carotid artery, and anterior and middle cerebral arteries, identified angiographically, and does not have an exactly known etiology. The most frequent symptoms of onset are hemorrhage in adults and ischemia in children. In this paper, we present a case of Moyamoya disease which was diagnosed with a 21 year old male patient who was admitted to our emergency department with headache, nausea vomiting and left hemiparasi complaints and whose radiological findings showed right basal ganglia hemorrhage.

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Esophageal achalasia in childhood especially in whom below one year of age is a rare lesion and difficult to diag- nose. An 11 months age female infant has been treated successfully by pneumatic dilatation, after returning of the esophagus to it’s normal calibre there was no complications seen in the barium study that performed later. After a follow up period of 12 months there was no vomiting or feeding problems or recurrence of the achalasia.

The viruses that cause viral gastroenteritis can lead to sporadic and epidemic outbreaks in humans. Common viral enteritis agents are Rotavirus, Nörovirus, and Adenovirüs. In this study it was aimed to investigate viral agents in diarrheic patients in Konya region. From patient who has diarrhea and abdominal pain, 300 stool samples which sent from various clinics, outpatient clinic and intensive care units to central clinical microbiology laboratory of our Hospital, were included in the study. Of these samples, were 52 (17.3%) positive for Rotavirus, 8 (2.6%) positive for adenovirus, and 35 (11.7%) positive for Norovirus. while it was detected the highest positivity to Rotavirus in November and February; Norovirus was higher in August and September. Although the differences observed in seasonal and age group, viral gastroenteritis agents could be detected in each geographical region, and sometimes can cause serious infections up to death. For this reason, routine diagnosis of common viral agents of gastroenteritis must be available and should be used in the diagnosis of gastrointestinal infections in hospital laboratories.

Foreign body aspirations (FBA), which have high mortality and morbidity rate, are common pediatric emergency issues occured in childhood. FBA is seen more frequently among children under 3 years old. If there is no history of sudden-onset choking and cough, it can be ignored and the patient may come with recurrent pulmonary infections and its related complications. In this report, 10-monthold boy patient who was brought with complaints of sudden-onset of cough, vomiting and wheezing after eating a kind of broad bean ( termiye) was presented. Diagnosis was established on the history, physical examination, the chest X-ray and bronchoscopy. The foreign body (termiye) was located in the right inferior bronchus and removed. This case emphasizes that the presence of a foreign body aspiration must be kept in mind in childhood. Because foreign body aspiration is a serious problem that may lead to complications or even to death.

Aim: Gastric diverticula are uncommon and usually asymptomatic. Only one case of pyloric obstruction secondary to a gastric diverticulum was published in the literature. A case treated for pyloric obstruction secondary to a gastric diverticulum and the related literature are reviewed. Case report: The 66-year-old female, treated for peptic ulcus along three month, consulted to our hospital complaining about vomiting after eating something for last 15 days. Having examined upper gastrointestinal system, diverticulum was found on at lesser curvature, located adjacent to and partially including the pylor. Patient was treated with endoscopic balloon dilatation. Conclusion: Even if simple resection was suggested for symptomatic gastric diverticula, pyloric stenosis secondary to a gastric diverticulum can be cured with endoscopic balloon dilatation was reosanable.

In this study we evaluated the efficiency and reliability of spinal anesthesia during extracorporeal shock wave lithotripsy (SWL) after the ineffective ureteroscopic lithotripsy (URL). In our clinic for 4 years, all of 17 patients who were applied SWL under spinal anesthesia (Group 1) were received to study. Also, 17 patients were administered sedo-analgesia with midazolam and fentanyl (Group 2) were included randomly into the study. Group 1 patients were transported to the SWL unit with monitoring and observance of anesthetist under spinal block after ineffective URL. The diameter of the stones, the level of the maximal energy, SWL, fluoroscopy and recovery times, the rate of stone free were recorded. The pain assessment was performed with verbal pain scale (VPS). Any patients showed hypotension, bradycardia, desaturation and nause-vomiting. There were no significant differences related to the diameter of the stones, SWL and flouroscopy times, the rate of stone free between groups. The maximal energy was 56.7 mjoule in Group 1, 47.6 mjoule in Group 2 (p

Aim: Hyperemesis gravidarum (HG) refers to a disorder of early pregnancy that manifests with extreme, difficult-to-treat nausea and vomiting. Its pathogenesis is largely obscure, and studies investigating its link with anxiety depression have remained inconclusive. Herein, we aimed to study the depression and anxiety levels of a Turkish population of pregnant women with hyperemesis gravidarum. Patients and Methods: This was a prospective sectional study conducted at our Department of Obstetrics and Gynecology between January 2011 and June 2013. There were 50 pregnant women with HG and 50 healthy pregnant women without any history of nausea and vomiting, who were matched with the study group for age, parity, and body mass index. All subjects underwent baseline laboratory investigations including serum TSH. Results: The two groups were comparable with regard to the demographic and obstetric parameters and baseline laboratory investigations although the HG group had significantly greater mean serum AST and TSH levels (p=0.015 and p=0.0001, respectively). Additionally, the HG group had significantly greater BDI and BAI scores compared to the controls (p= 0.0001). Conclusion: Our results have shown that psychological stress may be one of the causes of HG. For this reason, emotional states as well as medical conditions of HG patients during pregnancy should be considered. However, these results should be confirmed by prospective and clinical studies.

Aim: Dexamethasone is used for prevention of postoperative nausea and vomiting (PONV). Most important side effect of steroid use is adrenal suppression. In this study we aimed to evaluate the effects of single dose of 2, 4, 8 mg dexamethasone on adrenal glands by measuring serum cortisol levels, and also in preventing postoperative nausea and vomiting. Material and Method: Forty patients scheduled for elective total nasal reconstruction under general anesthesia were included to the study. Patients were randomly divided into four groups. Immediately before the induction of anesthesia 2 ml intravenous serum physiologic to group S, 2 mg dexamethasone to group D2, 4 mg dexamethasone to group D4, 8 mg dexamethasone to group D8 were applied. Blood sampling was done from the patients at preoperative visit day (t0), preinduction and before dexamethasone injection (t1), after induction at 2. (t2), 6.(t3), 9. (t4),12. (t5),18.(t6), 24.(t7) and 72. (t8) hours for measurement of serum cortisol levels. Results: Demographic data, anesthetic and surgical times were similar in the groups. The 8 mg and 4 mg dexamethasone doses were found to be more effective than the control and D2 groups in prevention of PONV. In 4 and 8 mg groups no increase was observed in the cortisol levels. In 8 mg group there was significant suppression in cortisol levels between 9.and 24.hours of induction. Conclusion: Both 4 and 8 mg dexamethasone doses are effective for prevention of PONV. Because 8 mg dexamethasone causes suppression of serum cortisol levels, we think that the application of 4 mg dexamethasone is safer than 8 mg.

Pregnancy habits of motIzers and their relation to child ınortality have been studied between March and May of 1991. Mothers between 15-24 years of age, consanquinity, the intervals less than 2 years betwe-en pregnancies, pregnancy less than 38 weeks, igno-rance of tetanus immunization, meals largely related cereal nutrition and lackiness of nutritive balance, weight gain less than 9 kg, lack of prenatal health care, multiple pregnancy increased infant and child monality rate and this increase was statistically me-aningffil (p<0.05). Unspecified illnesses during pregnancy and vomiting, increase in food intake pa-rallel pregnx2ncy, and undesirable pregnancy diri not affect infant and child monality significantly.

Cyclic vomiting syndrome (CVS) is characterized by recurrent episodes of nausea and vomiting. Age at onset of symptoms ranges between 4–6 years and there is a female predominance. CVS attacks are generally associated with psychosocial or physical triggers. In last years a shared pathophysiology between migraine and CVS has suggested. Children with CVS and their mothers have elevated rates of anxiety disorders. In this report, we presented a 5-year-old girl who referred to our out-patient clinic because of recurrent vomiting episodes. Because of her anxiety symptoms and vomiting attacks, escitalopram, a selective serotonin reuptake inhibitor, was initiated and she had significant improvement during treatment.

Aim: In this case report, it is aimed to discuss the ‘HaNDL Syndrome’ with the relevant literature. Case Report: A 20 year-old woman was admitted to the emergency department with left-sided, severe, throbbing headache accompanied with nausea, vomitting, sonophophia and phonophophia. Approximately 30 minutes after the pain emerged, she had suffered numbness and mild paresis on the right side of the body including the right side of her face accompanied with difficulty in speech which improved in approximately 20-25 minutes. She reported that 2 weeks prior these symptoms, she had suffered severe nausea and diarrhea that had lasted for 3 days. A diagnosis of viral gastroenteritis had been made and supportive therapy had been advised by a doctor. In the clinic, spinal tap was performed which revealed lymphocytic pleocytosis and mild elevation of protein level (49 mg/dL). Brain computerized tomography and the contast MR were normal. After the exclusion of other conditions which may cause CSF pleocytosis and severe headache; a diagnosis of HaNDL Syndrome was made. Conclusion: Recognition of this bening syndrome, is important as performing a diagnostic angiography may cause severe complications.

Invagination is the condition whereby a segment of intestine becomes drawn into the lumen of the proximal bowel. İnvagination in adults is a rare situation and the causes are different from childhood group. A 33 years old female patient admitted to emergency service with abdominal pain , nousea and vomiting. In ultrasonography and abdominal computed tomography suspected from invagination so the patient was operated urgently.In operation a masswas palpated and segmental resection was applied. Post-operative 7 th day , the patient was discharged from hospital without any complication. In pathological evaluation well-differentiated adenocarcinoma was detected in all polyps. Although invagination is a rare condition in adult patients when suspected from invagination the possibility of malign tumor should be considered. According to this , wide segmental resection is advised.

During 1996 and 1999, we applied MVAC in 27 patients whose final stage bladder tumor depends on pathological and radiological bases at urological department. 15.4 % had complete response, 34.6 % had partial clinical response, 34.8 % hadn’t any clinical response and 19.7% had progression. One of the patient died due to a wide spreed tumor metastasis and neutropenic sepsis during the treatment. The most common side-effects were nausea- vomiting, transient renal failure, leucopenia, and trombocytopenia. M-VAC therapy showed it’s beneficial effect by decreasing the stage so providing TUR possibility and other alternative surgical procedurs.

The case, is applied to infectious Dseases Clinic with some complainıs as a headache, fever, nausea, vorniiing after traffic accident and mandibular operation, was evaliated r,s a Pseudomonas meningitidis. We published because it is rare and important.

Aim: Mesenchymal tumors of the gastrointestinal tract other than gastrointestinal stromal tumors are rare and most of them are benign. The aim of this study to reveal the clinical and pathological features of non-gastrointestinal stromal tumor mesenchymal tumors of the gastrointestinal tract.

Materials and Methods: All gastrointestinal endoscopic and surgical resection materials, between 2008-2018, were retrospectively reviewed. Cases diagnosed with mesenchymal tumor other than gastrointestinal stromal tumors were included.

Results: Twenty four lipomas, 14 inflammatory fibroid polyps, six leiomyomas, four lymphangiomas, four hemangiomas, four schwannomas, two neuromas, two malignant melanomas, one leiomyosarcoma, one granular cell tumor and one Kaposi sarcoma were detected. The median ages of the cases were 61 years (29-87), the median tumor size was 1.5 cm (0.2-14). Thirty seven (58.7%) cases were female and 26 (41.3%) were male. They caused nonspecific symptoms. No recurrence or metastasis was detected after excision in benign tumors regardless of the pathological diagnosis.

Conclusion: Non-gastrointestinal stromal tumor mesenchymal tumors of the gastrointestinal tract are mostly small and benign tumors that can be seen at any age and are frequently seen in women. The most common ones are lipomas and inflammatory fibroid polyps. Most gastric tumors cause dyspeptic complaints and intestinal tumors cause abdominal pain, nausea or vomiting, as well as some of the intestinal tumors lead to serious, even fatal clinical situations such as acute and chronic bleeding, obstruction, perforation, volvulus or intussusception. For benign tumors’ treatment, excision is sufficient, they do not exhibit recurrence or metastasis.

Superior Mesenteric Artery Syndrome (SMAS), is a rare clinical case. In this article, a-20-year old man with SMAS is reported and showed laparotomies associated with a long history of repeated vomiting and weight losses. After resuscitation, he was treated surgically and subsequently recovered well. In this paper the diagnostic difficulties of SMAS were discussed.

A hundred consecutive patients undergoing various surgery ender general anesthesia were giyen 1.25 mg. Droperidol, 10 ıng. Metoclopramide , 100 mg. Dra-mamine or a sahne placebo intravenously in a doubly - blind random fashion 5 minutes before the end of anesthesia to prevent postoperatiw nausea and vomiting during the first 24 hours postoperativei y. Significantly (p< 0.01 ), fewer of patients giyen droperidol were nauseated and vomited (6.6 %) in comparison with patient giyen saline (incidence of nausea and vomiting was 46 %).1ncidences of nausea and vomiting were sirnilar in patients giyen Metocloprarnide,Dramamine or h is concluded that Droperidol is effectiye in the prevetion and treatment of postoperative nausea and vomiting after general anesthesia but that Metoclopramide or Dramaınine are not.