TR Dizin İndeksli Yayınlar Koleksiyonu / TR Dizin Indexed Publications Collection
Permanent URI for this collectionhttps://hdl.handle.net/20.500.14365/4
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Article Factors Affecting Bilirubin Levels Following Drainage Proceduresin Obstructive Jaundice(2019) Aydın, Cengiz; Çapar, Ahmet Ergin; Günay, Süleyman; Karaca, Avni Can; Ustun, Mehmet; Karaca, CanIntroduction: Measuring serum bilirubin levels is easy and readily available invirtually every healthcare facility. It is practically used by physicians for thefollow up of the patients with obstructive jaundice.Despite its common use as amarker for follow up, the literature lacks clear data about its interpretation as aclinical marker.We don’t have clearly set prognostic rules and cutoff pointsespecially about the rate of bilirubin decrease following biliary drainageprocedures.We conducted a retrospective study to determine the likely factorsthat affect bilirubin levels following the interventional relief of obstructivejaundice.Material-Method: We retrospectively analyzed data from 73 patients withobstructive jaundice who underwent interventional drainage procedures over atime period of 4 years in a tertiary healthcare center.Results: Decrease in the bilirubin levels was most rapid in the first 48hour following the drainage. From the analyzed variables, only age andselected type of the drainage procedure significantly affected the rateof bilirubin decrease in our patient group. We failed to establish cutoffpoints that can accurately predict the patients with slower bilirubindecrease.Conclusion: Serum bilirubin level is an important and commonly usedmarker predicting the success of treatment and the prognosis of thepatients with obstructive jaudince. Type of drainage and the ageproven to significantly affect the rate of bilirubin decrease regardless ofunderlying pathologyArticle Management of Gallbladder Polyps: a Tertiary Center Experience(2019) Aydın, Cengiz; Üstün, Mehmet; Karaca, Avni Can; Karaca, CanObjective: The main purpose of the management of gallbladder polyps is to establish an early diagnosis and toprevent the development of gallbladder cancer.Methods: Fifty-six patients who underwent cholecystectomy with the diagnosis of gallbladder polyp betweenJanuary 2012 and September 2018, were retrospectively evaluated.Results: Twenty-one patients (39.3%) were female and 34 (60.7%) were male. The indications for cholecystectomywere ? 10 mm polyps in (n=22, 39.3%), increase in polyp size during follow-up (n=8, 14.3%), symptomatic polypssmaller than 10 mm (n=24, 42.9%), polyps smaller than 10 mm with concomitant risk factors (n=2, 3.6%).Histopathological examination of gallbladders revealed the presence of cholesterol polyps in 51 (91.1%), inflammatory polyps in 1 (1.8%), and adenoma in 1 (1.8%) patient. Three patients (5.4%) had no polyps and only gallstoneswere detected. Malignancy was not detected in any patient.Conclusion: The management of gallbladder polyps is still a controversial issue. The recommendations publishedin guidelines, can be used as a guide in the management of gallbladder polyps. The characteristics of symptomsand their response to cholecystectomy should be evaluated in symptomatic cases.Article Congenital Absence of Portal Vein Presenting With Macroscopic Hematuria: a Case Report With a Brief Review of the Literature(2021-08-17) Karaca, Avni Can; Yılmaz, Cahit Hüseyin; Karaca, CanCongenital absence of the portal vein is a rare clinical entity in which portal blood flow is partially or totally diverted to the systemic circulation. This condition causes a myriad of clinical symptoms and is associated with other congenital abnormalities mostly of cardiac and vascular origin. A 14-year-old male patient with type IB Abernethy malformation who presented with macroscopic hematuria was treated with live donor liver transplantation. The medical recordings of the patient were retrospectively reviewed, and the case was presented with a brief review of the literature. The patient had associating nut-cracker syndrome and liver masses that were revealed to be focal nodular hyperplasia. The patient is doing well in the postoperative course. Liver transplantation offers a safe and radical treatment for this very rare anatomic malformation. It not only corrects aberrant portal flow but also prevents other life-threatening complications such as hepatopulmonary syndrome and possible liver malignancies.Article Prospective Comparison of the Efficacy of Two Common Appendicitis Scoring Systems: Is Combination a Solution?(2020-06-10) Karaca, Avni Can; Akpınar, Göksever; Karaali, Cem; Ustun, Mehmet; Atıcı, Semra Demirli; Karaca, CanAim: The diagnosis of acute appendicitis mostly relies on history taking and physical examination findings supported by laboratory and imaging studies. A number of different diagnostic scoring systems have been developed to facilitate diagnosis, and their accuracies vary among patient populations. This prospective study aims to evaluate the accuracy of the two most frequently used scoring systems in the Turkish patient population and to analyse the possible diagnostic advantage of using these two systems in combination. Method: Patients admitted to the emergency department of a tertiary healthcare centre with acute abdominal pain who eventually underwent appendectomy between July 2018 and January 2019 were enrolled in the study. Alvarado and Raja Isteri Pengiran Anak Saleha Appendicitis (RIPASA) scores, as well as other laboratory parameters, were recorded for each patient. Using histopathologic examination as the gold standard, the sensitivity, specificity and positive and negative predictive values of each scoring system were calculated and combined using McNemar’s x2 test. Results: Data from a total of 203 patients were analysed. The sensitivity of the RIPASA system (95%) was far superior to that of the Alvarado system (35.6%). However, the Alvarado scoring system had much higher diagnostic specificity than the RIPASA system (80% vs 33.3%). The combined sensitivity and specificity of the tests rose to 88% and 62.5%, respectively. Conclusion: The RIPASA system has high sensitivity; however, the Alvarado system has high specificity for the Turkish population. Both the Alvarado and RIPASA scoring systems are useful clinical tools with different strengths. Using these two systems in combination increases diagnostic power by combining the strongest aspects of both tests.