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Öğe Association between red cell distribution width and mea platelet volume with appendicitis: A myth or a fact?(Comenius University, 2015) Dinç, Tolga; Şenol, Kazım; Yıldız, Barış Doğu; Kayılıoğlu, Selami Ilgaz; Sözen, İsa; Coşkun, FarukOBJECTIVES: The aim of our study was to identify if there was a relation between red cell distribution width, mean platelet volume, platelet distribution width, leukocyte count and thrombocyte count at the time of presentation to hospital and acute appendicitis. BACKGROUND: Acute appendicitis is one of the most common surgical emergencies. Misinterpretation of symptoms and findings in acute appendicitis may lead to removal of normal appendix and delayed diagnosis can result in perforation and peritonitis. Many studies tried to delineate the relation between acute appendicitis and laboratory findings. Latest studies focused on components of complete blood count such as red cell distribution width and mean platelet volume. METHODS: This was a retrospective clinical study that enrolled 638 patients with abdominal pain and open appendectomy for acute appendicitis. Complete blood count results including red cell distribution width were retrieved from medical charts of patients and analyzed. RESULTS: There was no statistically significant difference between appendicitis, non pathological appendix and perforated appendicitis in terms of red cell distribution width or other blood count components except leukocyte level. CONCLUSION: Despite current findings in medical literature indicating predictive value of red cell distribution width in acute appendicitis; its utility for differential diagnosis might be overestimated (Tab. 1, Ref. 22).Öğe Comparison of fructus agni casti and flurbiprofen in the treatment of cyclic mastalgia in premenopausal women(2014) Dinç, Tolga; Coşkun, FarukObjective: Cyclic mastalgia is described as a diffuse, periodic and bilateral breast pain that can not be localized. Although there are several methods of treatment, the most efficient treatment method is still controversial. The aim of this study is to determine, compare and discuss the results of the patients under 40 years old age with a complaint of cyclic mastalgia and without any clinical signs, family history and ultrasonography finding, treated with fructus agni casti extract or flurbiprofen. Material and Methods: One hundred and fourteen premenapousal patients younger than 40 years old with a complaint of cyclic mastalgia and without any clinical, family or ultrasonography findings were analyzed prospectively. Fructus agni casti extract (Group 1) or flurbiprofen (Group 2) were administered to the patients. VAS scores were accepted as full recovery whit a score of zero, as significant healing when the score improved more than 50%, as mild-moderate healing when the improvement was less than 50% and as no healing in case of no improvement. Results: The mean age in group 1 was 28,29±5,81, and in group 2 was 29,09±4,49. The mean number of days with pain was 6,0±1,70 days in group 1, and was 6,3±1,63 in group 2. There was no significant difference in VAS scores between the two groups after treatment. Conclusion: Fructus agni casti extract and flurbiprofen are commonly used medications in the treatment of cyclic mastalgia. Both of these medications significantly reduce the complaints and have acceptable side-effects. There is no proven superiority over each other. Further clinical and laboratory studies are necessary to determine the ideal medication fort he treatment of cyclic mastalgia. © Telif Hakki 2014.Öğe Diagnostic challenge of primary and secondary omental torsions: Report of three cases(Edizioni Minerva Medica, 2015) Aydoğan, İhsan; Kayılıoğlu, Selami Ilgaz; Dinç, Tolga; Aktürk, Okan Murat; Sözen, İsa; Yıldız, Barış Doğu; Coşkun, FarukOmental torsion is a rare condition which usually requires surgical approach. Torsion is caused by the vascular insufficiency due to twisting of omentum along its long axis. This condition is rarely diagnosed preoperatively and may be misinterpreted as other causes of acute surgical abdomen. So, recognition by surgeons is important for differential diagnosis. We report three cases of primary omental torsion, and diagnostic and therapeutic management of patients. The resection of effected omentum segment is the most preferred treatment. However, conservative treatment may be the option for selected cases. Clinicians must be aware of clinical and radiological findings of omental torsion for accurate diagnosis. Laparoscopic approach may be used favorably for both, diagnosis and treatment.Öğe Kronik anal fissür tedavisinde, botoks ve lateral internal sfinkterotomi uygulanan hastaların tedavi sonuçlarının karşılaştırılması(2014) Dinç, Tolga; Ege, Bahadır; Karslı, Mehmet Fatih; Coşkun, FarukAmaç: Botoks, anal sfinkteri gevşeterek fissür iyileşmesine zemin hazırlayan bir tedavi metodudur. Çalışmamızın amacı; Kronik anal fissür tanısı alan hastalarda uygulanan botoks ve lateral interanal sifinkterotomi tedavilerinin etkinliklerini değerlendirmek ve komplikasyon oranlarını karşılaştırarak tartışmaktır. Yöntemler: Ankara Dr. Sami Ulus Hastanesine Genel Cerrahi polikliniğine başvuran, kronik anal fissür tanısı alan ve konservatif tedaviden fayda görmeyen toplam 66 hastadan, ulaşılan 60 erişkin hasta çalışma kapsamına alındı. Hastaların yaşları, cinsiyetleri, fissür lokalizasyonları, şikayetleri (ağrı, kanama, kaşıntı, kabızlık), şikayet süreleri, tedavi sonrası nüks, inkontinans durumları ve komplikasyonlar kayıt altına alındı. Hastalar lateral internal sfinkterotomi (LİS) uygulananlar ve botoks ile tedavi edilenler olmak üzere gruplandırıldı. Bulgular: Altmış hastanın, 38’i (%63,3) erkek, 22’si (%26,7) kadındı. Hastaların genel yaş ortalaması, 35,93 ± 11,45 (21 -60)’di. Ağrı, tüm hastalarda izlenen ortak şikayetti. Nüks açısından değerlendirildiğinde; botoks uygulanan grup-I’de 10 (%32,3) hastada, LİS uygulanan grup-II’de ise 1 (%3,4) hastada nüks saptandı. Grup-I’de inkontinans saptanmazken, grup II’de 3 (%10,39) hastada inkontinans saptanmıştır. İnkontinans saptanan 3 hastanın Cleveland Klinik Skorlama Sistemine göre de- ğerlendirilmesinde, 2 hastada gaz inkontinansı, 1 hastada orta derecede gaita inkontinansı saptanmıştır. Sonuç: Botilunum toksin enjeksiyonu, anal fissür tedavisinde, inkontinans gibi can sıkıcı komplikasyonların çok daha az izlendiği alternatif bir tedavi gibi görünse de, yüksek nüks oranları büyük dezavantaj olarak karşımıza çıkmaktadır. Deneyimli ellerde LIS, daha düşük komplikasyon oranları ve yüksek tedavi başarısı ile halen en önemli tedavi metodudur.Öğe Premenopozal kadınlardaki siklik mastaljide fructus agni casti ekstresi ile flurbiprofen tedavi sonuçlarının karşılaştırılması(Türk Cerrahi Derneği, 2014) Dinç, Tolga; Coşkun, FarukAmaç: Siklik mastalji, diffüz, periyodik, lokalize edilemeyen, genellikle iki taraflı olan meme ağrısı olarak tanımlanmaktadır. Tedavide birçok seçenek bulunsa da; hangi tedavinin daha etkin olduğu konusunda görüş birliğine varılamaması ilaç seçimini zorlaştırmaktadır. Çalışmamızda; 40 yaş altındaki premenopozal siklik mastaljisi olan, muayenesi normal, aile hikayesi olmayan, ultrasonografide patolojik bulguları saptanmayan kadınlardaki, fructus agni casti ekstresi ile flurbiprofenin tedavi sonuçlarının ortaya konulması, karşılaştırılması ve literatür eşliğinde tartışılması amaçlandı. Gereç ve Yöntemler: Polikliniğe, siklik mastalji şikayeti ile başvuran, 40 yaşın altındaki premenopozal, aile hikayesi olmayan, fizik muayenesinde ve meme ultrasonografide patolojik bulgu saptanmayan toplam 114 hasta prospektif olarak değerlendirilmeye alındı. Meme ağrısı tedavisinde, fructus agni casti ekstresi ile flurbiprofen iki seçenek olarak kullanılıp çalışmaya dahil edilen hastalara verildi. Üç ayın sonundaki VAS değerinin 0 olması tam iyileşme, VAS değerinde %50'den fazla azalma belirgin iyileşme, %50'den daha az azalma hafif-orta derecede iyileşme, VAS değerinin değişmemesi de iyileşmenin olmadığı şeklinde değerlendirildi. Bu hastalardan fructus agni casti ekstresi ile tedavi edilenler Grup 1, flurbiprofen ile tedavi edilenler Grup 2 olarak adlandırıldı.Bulgular: Grup 1'in yaş ortalaması 28,29±5,81, Grup 2'nin yaş ortalaması ise 29,09±4,49 olarak saptandı. Grup 1'deki ortalama ağrılı gün sayısı 6,0±1,70 gün; Grup 2'deki hastaların ki ise 6,3±1,63 gün olarak hesaplandı. Tedavi sonrasındaki VAS değerlendirme sonuçlarına bakıldığında; her iki grupta da belirgin iyileşme izlenirken, iki grup arasında tam iyileşen, belirgin iyileşen, hafif-orta derecede iyileşen ve iyileşme olmayan hastalar açısından istatistiksel olarak anlamlı fark saptanmadı. Sonuç: Fructus agni casti ekstresi ve flurbiprofen siklik mastalji şikayeti olan hastalarda sıklıkla başvurulan etken maddelerdir. Bu iki etken madde de, siklik mastalji şikayetlerini önemli ölçüde azaltmakta olup kabullenilebilir yan etkiye sahiptirler ve birbirine göre anlamlı üstünlükleri gösterilemedi. Bunların yanında; mastaljiyi tam ve kalıcı olarak iyileştiren, yan etkisi olmayan ideal ilaçların bulunması için klinik ve laboratuvar çalışmalarına ihtiyaç duyulmaktadırÖğe Prognostic value of preoperative inflammation-based prognostic scores on hospital mortality after gastric cancer surgery(Asian Pacific Organization for Cancer Prevention, 2014) Dinç, Tolga; Yıldız, Barış Doğu; Kayılıoğlu, Selami Ilgaz; Sözen, İsa; Tez, Mesut; Coşkun, FarukGastric cancer is the fourth most common malignancy worldwide. Poor prognosis in gastric cancer is linked with hypoalbuminemia. Previous studies demonstrated relationships between gastric cancer and chronic inflammation. The aim of this study was to assess the prognostic value of preoperative inflammation-based prognostic scores regarding hospital mortality after gastrectomy. Unlike other recent articles on the same topic; we could only verify prognostic value of prognostic nutritional index for in hospital mortality after surgery.Öğe Pyoderma gangrenosum after umblical hernia repair(Surgical Society of Northern Greece, 2015) Dinç, Tolga; Kayılıoğlu, Selami Ilgaz; Katar, Kağan; Yıldırım, Osman; Çete, Mükerrem; Ünal, Devrim Tuba; Coşkun, FarukPyoderma gangrenosum is an extremely rare condition, characterized with progressive necrotic skin ulcers and destructive inflammation. It can be defined as a neutrophilic dermatosis with sterile inflammation. Incidence of the disease is 3-10 per million. A surgical intervention may trigger this immunological condition. Herein we present pyoderma gangrenosum case, which occurred after umbilical hernia repair. © 2015, Surgical Society of Northern Greece. All rights reserved.Öğe Red cell distribution width, gamma glutamyl transpeptidase and anticoagulant use affect mortality in acute arterial mesenteric ischemia(SAGE Publications Ltd, 2015) Dinç, Tolga; Yıldız, Barış Doğu; Kayılıoğlu, Selami Ilgaz; Sözen, İsa; Çete, Mükerrem; Coşkun, FarukBackground: Despite advances in surgery and intensive care, mortality in acute mesenteric ischemia remains between 50% and 90%. In this study, we evaluated factors affecting mortality in acute arterial mesenteric ischemia. Methods: This is a retrospective cohort study involving 73 patients with an initial diagnosis of arterial acute mesenteric ischemia admitted to Ankara Numune Teaching Hospital between January 2008 and December 2013. We retrospectively collected data about demographic variables, co-morbidities, medications, extent of surgical resection, laboratory values, pathology results and outcome. Results: The mean age of the patients was 69.3±12.6. Thirty one patients were female (42.46%) and 42 (57.53%) were male. We divided the patients into two groups: Group 1 (n=40); those who died and Group 2 (n=33); those who were discharged. In multivariate analysis of high gamma glutamyl transpeptidase and red cell distribution width levels, the presence of anticoagulant use was statistically significant (p<0.05) in favor of Group 1. Conclusion: High red cell distribution width and gamma glutamyl transpeptidase levels and anti-coagulant use are factors affecting mortality in arterial acute mesenteric ischemia. The assessment of these variables could help predict the extent of arterial acute mesenteric ischemia and the mortality associated with it. © 2014 The Author(s).Öğe Spontaneous rectus sheath hematoma: an overview of 4-year single center experience(Springer India, 2015) Aktürk, Okan Murat; Kayılıoğlu, Selami Ilgaz; Aydoğan, İhsan; Dinç, Tolga; Yıldız, Barış Doğu; Çete, Mükerrem; Erdoğan, Ahmet; Coşkun, FarukRectus sheath hematoma is a clinical entity characterized by the presence of blood within rectus abdominis muscle sheath. The aim of this study was to analyze clinical characteristics, diagnostic approach, treatment strategy, and outcomes of patients with rectus sheath hematoma. Patients diagnosed and treated for spontaneous rectus sheath hematoma between March 2010 and March 2014 were included in the study. A total of 10 patients were diagnosed as spontaneous rectus sheath hematoma. The mean age was 66.5 ± 16.9 years, and the mean hospital stay was 4.4 ± 1.8 days. There was no mortality. Six patients were using anticoagulant or antiplatelet agents. Eight patients recovered after conservative treatment. Two patients underwent surgery. Spontaneous rectus sheath hematoma is associated with anticoagulant therapy. Cases with abdominal pain and a non-pulsatile abdominal mass particularly in elderly women should be kept in mind. Treatment is mostly based on supportive care to preserve hemodynamic stability. © 2015, Association of Surgeons of India.Öğe Thyroid nodules with atypia or follicular lesions of undetermined significance (AUS/FLUS): analysis of variables associated with outcome(Asian Pacific Organization for Cancer Prevention, 2014) Kayılıoğlu, Selami Ilgaz; Dinç, Tolga; Sözen, İsa; Şenol, Kazım; Katar, Kağan; Karabeyoğlu, Melih; Tez, Mesut; Coşkun, FarukBackground: The Bethesda System for Reporting Thyroid Cytopathology is one of the main classification systems for thyroid nodules. It expects that 7% of all fine needle aspiration biopsies will be reported as atypia or follicular lesions of undetermined significance, and 5-15% of these undetermined nodules are malignant. Our study is a retrospective analysis of variables that may be associated with outcome in patients with indeterminate thyroid nodules. Materials and Methods: Patients who underwent thyroidectomy in our institution between 2010 and 2014 were retrieved from the institutional records database. Patient demographics and medical histories were recorded. All ultrasonography reports were examined for nodule features and biochemical blood levels, hormone levels and complete blood counts were recorded. Results: A total of 103 patient cytopathology reports were regarded as belonging to the undetermined category. Some 35% of patients had malignant nodules. Median preoperative red cell distribution width (RDW) level was 13.6 inthe benign group, while it was 14.3 in patients with malignancy, demonstrating a significant correlation (p = 0.003). Only calcification presence was significantly different between benign and malignant groups on ultrasonography (p = 0.034). Conclusions: Ultrasonography is one of the primary tools for this matter. RDW levels may become another promising tool to predict malignancy.
