Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES
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Ulus Travma Acil Cerrahi Derg · Jun 2023
Value of fecal calprotectin in prediction of acute appendicitis based on a proposed model of machine learning.
The aim of this study is to apply random forest (RF), one of the machine learning (ML) algorithms, to a dataset consisting of patients with a presumed diagnosis of acute appendicitis (AAp) and to reveal the most important factors associated with the diagnosis of AAp based on the variable importance. ⋯ A prediction model was developed for AAp with the ML method in this study. Thanks to this model, biomarkers that predict AAp with high accuracy were determined. Thus, the decision-making process of clinicians for diagnosing AAp will be facilitated, and the risks of perforation and unnecessary operations will be minimized thanks to the timely diagnosis with high accuracy.
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Ulus Travma Acil Cerrahi Derg · Jun 2023
Case ReportsNeo-glans reconstruction with dartos flaps covered with buccal mucosal graft after total glans amputation during circumcision: novel technique.
Penile glans amputation is a rare and catastrophic complication of circumcision. Reconstruction of the penile glans was indicated following amputation. Our report discusses a novel technique for reconfiguration of the amputated penile glans of a 5-year-old male admitted 6 months following a complicated circumcision. ⋯ The patient's glans-like cosmetic structure was observed during follow-up, and the patient was urinating normally. This is the first surgical repair technique to use this method in the literature. The use of a dartos flap covered with a buccal mucosal graft is a successful and simple procedure with acceptable cosmetic and functional results for the late reconfigurating a neoglans shape after a glans penis amputation when the penile size is suitable.
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Ulus Travma Acil Cerrahi Derg · Jun 2023
Clinical outcomes of obstructive colorectal cancer patients during the coronavirus disease 2019 pandemic.
The coronavirus disease 2019 (COVID-19) pandemic has affected all aspects of clinical care including diagnosis and treatment of colorectal cancers (CRCs) globally, including in Türkiye. During the initial peak of the pandemic, elective surgeries and outpatient clinics were restricted in addition to the government-imposed lockdown, resulting in a decrease in the number of colonoscopies being performed and patients admitted to inpatient wards for treatment of CRCs. In this study, we aimed to investigate whether the pandemic has affected presentation characteristics and outcomes of obstructive colorectal cancer in this period. ⋯ Although the results of our study indicate a significant increase in emergency presentation and a decrease in elective admissions of CRCs during the pandemic, patients treated during the COVID period were not at a significant disadvantage in terms of post-operative outcomes. Further efforts should be made to decrease risks related to an emergency presentation of CRCs for future adverse events.
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Ulus Travma Acil Cerrahi Derg · Jun 2023
Risk factors for deep neck infection in patients with sore throat and neck pain.
Deep neck infection (DNI) is a potentially life-threatening disease because infections spread quickly, causing se-rious complications. Therefore, more attention is needed than other neck infections, but there are many difficulties due to isolation guidelines in the period of coronavirus disease 2019 pandemic. We investigated the early predictability of DNI through patient symptoms at the first emergency department encounter. ⋯ Among patients with sore throat or neck pain, patients with dysphagia, foreign body sensation, severe pain, and submandibular pain are more likely to have DN. DNI can cause serious complications; therefore, patients with the above symptoms should be closely observed due to the potential for significant complications.
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Ulus Travma Acil Cerrahi Derg · Jun 2023
Low-dose thrombolytic therapy versus unfractionated heparin in patients with intermediate-high risk pulmonary embolism.
Patients with intermediate-high risk pulmonary embolism (PE) who have acute right ventricular dysfunction and myocardial injury without overt hemodynamic compromise may be candidates for thrombolytic therapy (TT). In this study, we aimed to compare the clinical outcomes of low-dose prolonged TT and unfractionated heparin (UFH) in intermediate-high risk PE patients. ⋯ Prolonged TT regimen with low dose, slow infusion of tissue plasminogen activator was found to be associated with a lower risk of hemodynamic decompensation and pulmonary hypertension in patients with acute intermediate-high-risk PE compared to UFH.