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Biomedical subjects

Asim Cingi

Publications and source records attributed to Asim Cingi.

7 recordsLinked to original sources

Whey feeding suppresses the measurement of oxidative stress in experimental burn injury.

PURPOSE: Burns cause thermal injury to local tissue and trigger systemic acute inflammatory processes, which may lead to multiple distant organ dysfunction. We investigated the protective effect of dietary whey supplementation on distant organs in a rat model. METHODS: Forty-eight rats were divided into six groups of eight: groups 1 and 2 were the controls, fed a standard diet and a whey-supplemented diet, respectively; groups 3 and 4 were fed a standard diet and subjected to burn injury; and groups 5 and 6 were fed a whey-supplemented diet and subjected to burn injury. We measured the oxidative stress variables, as well as glutathione in the liver and kidney, and histologically examined skin samples obtained 4 h (groups 3 and 5) and 72 h (groups 4 and 6) after burn injury. RESULTS: Glutathione (GSH) levels remained the same in the liver but were slightly elevated in the kidneys after burn injury in the rats fed a standard diet. Whey supplementation caused a significant increase in hepatic GSH levels 4 h after burn injury. Moreover, there was a significant rebound effect in the liver and kidney GSH levels after 72 h and whey supplementation potentiated this effect. Hepatic and renal lipid peroxide levels were also increased 4 h after burn injury in the rats fed a standard diet. Whey supplementation significantly suppressed the burn-induced increase in hepatic and renal lipid peroxide levels. Histological examination revealed that although whey supplementation resulted in decreased subepidermal inflammation, the indicators of wound healing and collagen deposition were not improved. CONCLUSION: Whey pretreatment suppressed hepatic and renal oxidative stress measurements after experimental burn injury.

Animals↗

Left-sided paraduodenal hernia: report of a case.

Paraduodenal hernias are rare congenital malformations consisting of incomplete rotation of the midgut, which may lead to intestinal obstruction or simply be detected as an incidental finding at autopsy or laparotomy. We report a case of left paraduodenal hernia diagnosed preoperatively by computed tomography and operated on in an emergency setting for signs of peritoneal irritation. A misdiagnosis had been made when the patient suffered his first attack 6 months earlier and he had been treated for familial Mediterranean fever. We reduced the small bowel loops from the left paraduodenal hernia sac with ligation and transection of the inferior mesenteric vessels. The patient was discharged from hospital on postoperative day 4 after an uneventful recovery.

Adult↗

Enterostomy site hernias: a clinical and computerized tomographic evaluation.

PURPOSE: Parastomal hernia continues to be an important clinical problem with a reported incidence of up to 50 percent. In studies using computerized tomography in selected cases for detection of parastomal hernia, physical examination alone was underestimating the true incidence. Also after closure of the enterostomy, the ostomy site could still be a potential area of herniation. In this study in addition to physical examination, we used computerized tomography to determine the true incidence of parastomal hernia and ostomy closure site hernias. METHODS: We examined patients with enterostomies and with closed enterostomy sites both with physical examination and computerized tomography for the detection of hernias, hernia content, and relation to rectus muscles. Risk factors for hernia formation, such as age, gender, body mass index, associated medical problems, and surgical site infections, were determined. RESULTS: Evaluation of 23 patients with ostomies resulted in 52 percent incidence of parastomal hernia, whereas the addition of tomography examination gave a corrected incidence of 78 percent. In a second subset of 23 patients with closed ostomies, although 26 percent of the patients were found to have ostomy site hernias with physical examination alone, this incidence increased to 48 percent when combined with computerized tomography. The potential risk factors for hernia formation, such as body mass index, surgical site infection, and ostomy site whether pararectus or transrectus, were not proven to have a significant role in this study. CONCLUSIONS: Parastomal hernia and closed ostomy site incisional hernias have a high incidence, and computerized tomography has been shown to be a valuable diagnostic tool.

Enterostomy↗

Use of resterilized polypropylene mesh in inguinal hernia repair: a prospective, randomized study.

BACKGROUND: Inguinal hernia repair consumes considerable health-care resources worldwide. Open mesh repairs are commonly used and the feasibility of using a resterilized mesh, which is a general practice in certain countries, has not been evaluated. STUDY DESIGN: In this randomized prospective study, original and resterilized meshes were used in two groups of patients with unilateral inguinal hernia. Microbiologic changes, textile mechanical properties, overall complication rates, and cost-effectiveness of resterilized mesh were investigated. A time period of 3 years was determined for patient enrollment to this pilot feasibility study, with the goal of 100 patients in each group. RESULTS: Ninety-one patients were enrolled in the original group and 93 in the resterilized mesh group. Median followup was 735 and 739 days and calculated interquartile ranges were 454 and 513 days, respectively. Average tensile strength of the original polypropylene mesh changed slightly with resterilization, as maximum load decreased from a mean of 66.6 to 58.2 N/cm. Overall complication rates were similar in the two groups. The 6.6% infection rate in the original mesh group was not statistically different from the 7.5% rate in the resterilized group (p = 0.80, relative risk = 0.88, 95% confidence interval, 0.31-2.51). There was only one recurrence in the original mesh group in the 21st month. Use of a resterilized mesh decreased the overall cost of operation by decreasing the cost of mesh from 15.9% to 8.3% of the total amount. CONCLUSIONS: Use of a resterilized mesh for inguinal hernia repair is feasible without considerable changes in infection and recurrence rates.

Adolescent↗

Early prediction of normocalcemia after thyroid surgery.

Hypocalcemia is the principal factor that determines length of hospital stay after thyroid surgery. Seventy-nine patients who underwent thyroidectomy were prospectively evaluated in order to define risk factors for postoperative hypocalcemia. Serum samples were taken postoperatively at 8, 14, 24, and 48 hours to measure total calcium levels. The slope of change in serum calcium level between each sample time was calculated. Patients were also examined for age, gender, surgical indications, type and extension of surgery, thyroid function, presence of substernal extension, initial operation versus reoperation, and application of parathyroid autotransplantation. All comparisons were made between hypocalcemic and normocalcemic groups. Hypocalcemia occurred in 15 (19%) patients. In univariate analysis, type and extent of thyroidectomy, serum calcium levels at each time point, as well as the slope of change in serum total calcium levels between 8 and 14 hours were found to be significantly predictive of normocalcemia. All patients who underwent hemithyroidectomy and who had a positive or neutral slope of calcium change after surgery remained normocalcemic. By multivariate logistic regression analysis, only the slope of change in calcium levels within the first 14 postoperative hours independently predicted calcium status after thyroidectomy. All patients who undergo unilateral thyroid surgery who have a positive/neutral slope of change in serum total calcium levels within the first 14 hours after surgery can be safely discharged early if they have no other risks.

Adolescent↗

Laparoscopic cholecystectomy: is it a conscious preference among Turkish patients with symptomatic gallstones?--prospective study.

Laparoscopic cholecystectomy (LC) has the advantages of early return to full daily activity, early return to work, and better cosmetic result, as well as quickly resolving pain. Yet how this information about the procedure influences a patient's attitude toward laparocopy is not known. In this study we analyzed the factors that play role in the decision-making process of patients who choose laparoscopic surgery, and we also evaluated patients' knowledge of laparoscopy and their expectations. A questionnaire was used in evaluating 98 patients suffering from symptomatic cholelithiasis scheduled for elective laparoscopic cholecystectomy between January 2001 and January 2002. Females constituted 81% of the study population. Most of the patients (56%) were housewives. While 45% of the patients had an educational status of primary school degree only, 14% had graduated from a university. Forty-three patients described their level of knowledge about laparoscopy as "low" (had only heard about laparoscopy). In 61% of the patients the surgeon was the sole decision maker about the type of the operation. Almost none of the patients had a preference for the time of discharge from the hospital after surgery, and only three of the actively working patients offered a time interval for return to work. From this study we concluded that most patients have inadequate information about laparoscopic surgery, that the type of operation is dictated mostly by the surgeon, and that early discharge and early return to work are not important for many patients.

Aged↗

Factors related to post-treatment chronic pain in breast cancer survivors: the interference of pain with life functions.

The frequency and the intensity of chronic pain, as well as the related factors, were assessed in a cohort of breast cancer patients. The life functions were also questioned in patients who have post-treatment chronic pain. The scope of this retrospective study was a cohort of surgically-treated breast cancer patients with unilateral early stage disease who were under regular follow-up. Patients were eligible if they completed their treatments at least 6 months before and were free of disease. Patients who had a previous history of chronic pain syndrome, chronic debilitating disease, psychiatric diagnosis, and other cancers were excluded. All data regarding their demographics and treatments were recorded. Chronic pain was defined as the pain at treatment-related regions for a duration of at least three months after completion of treatment. Turkish version of "Brief Pain Inventory (Short Form)" was given to the patients with chronic pain in order to assess their pain intensity and life functions. The factors related to chronic pain were compared between patients with and without chronic pain. Eighty-five eligible female patients were included in the study. Thirty-nine (46%) patients declared that they had chronic pain. The mean VAS scale score was 4.1 +/- 2.4 cm in these patients. The mean age of patients with chronic pain (54.3 +/- 12.6 years) was significantly less than that of the ones without pain (60.4 +/- 13.6 years; p = 0.035). Radiotherapy was found to be significantly related to chronic pain (p=0.049; OR: 2.60; 95% CI 1.07-6.30). The VAS scores were 1.5 +/- 2.7 cm, 1.9 +/- 3.2 cm, 1.3 +/- 2.7 cm, 0.9 +/- 2.5 cm for general activity, mood, relations with other people, and sleep, respectively. Although almost half of the early stage breast cancer patients experienced post-treatment chronic pain, they rated the intensity of their pain as mild to moderate. Younger age and receiving radiotherapy were found to be significant contributing factors. The interference of post-treatment chronic pain with life functions was small. Overall, mood was found to be the most affected life function among all.

Activities of Daily Living↗