PubMed Health⌕ Search

Biomedical subjects

M Bulut

Publications and source records attributed to M Bulut.

At least 19 recordsLinked to original sources
PubMed2006

Childhood falls: characteristics, outcome, and comparison of the Injury Severity Score and New Injury Severity Score.

OBJECTIVES: The aim of this study was to determine the general characteristics of childhood falls, factors affecting on mortality, and to compare the Injury Severity Score (ISS) and the New Injury Severity Score (NISS) as predictors of mortality and length of hospital stay in childhood falls. METHODS: We retrospectively analysed over a period of 8 years children aged younger than14 years who had sustained falls and who were admitted to our emergency department. Data on the patients' age, sex, type of fall, height fallen, arrival type, type of injuries, scoring systems, and outcome were investigated retrospectively. The ISS and NISS were calculated for each patient. Comparisons between ISS and NISS for prediction of mortality were made by receiver operating characteristic (ROC) curve and Hosmer-Lemeshow (HL) goodness of fit statistics. RESULTS: In total, there were 2061 paediatric trauma patients. Falls comprised 36 (n = 749) of these admissions. There were 479 male and 270 female patients. The mean (SD) age was 5.01 (3.48) years, and height fallen was 3.8 (3) metres. Over half (56.6%) of patients were referred by other centres. The most common type of fall was from balconies (38.5%), and head trauma was the most common injury (50%). The overall mortality rate was 3.6%. The cut off value for both the ISS and NISS in predicting mortality was 22 (sensitivity 90.5%, specificity 95.4% for ISS; sensitivity 100%, specificity 88.7% for NISS) (p>0.05). Significant factors affecting mortality in logistic regression analysis were Glasgow Coma Scale (GCS) <9, ISS >22, and NISS >22. There were no significant differences in ROC between three scoring systems. The HL statistic showed poorer calibration (p = 0.02 v p = 0.37, respectively) of the NISS compared with the ISS. CONCLUSIONS: In our series, the head was the most frequent site of injury, and the most common type of fall was from balconies. Scores on the GCS, NISS, and ISS are significantly associated with mortality. The performance of the NISS and ISS in predicting mortality in childhood falls was similar.

Accidental Falls↗
PubMed2005

Medical experience of a university hospital in Turkey after the 1999 Marmara earthquake.

OBJECTIVES: This study aimed to provide an overview of morbidity and mortality among patients admitted to the Hospital of the Medicine Faculty of Uludag University, Bursa, Turkey, after the 1999 Marmara earthquake. METHODS: Retrospective analysis of the medical records of 645 earthquake victims. Patients' demographic data, diagnosis, dispositions, and prognosis were reviewed. RESULTS: A total of 330 patients with earthquake related injuries and illness admitted to our hospital were included and divided into three main groups: crush syndrome (n = 110), vital organ injuries (n = 57), and non-traumatic but earthquake related illness (n = 55). Seventy seven per cent of patients were hospitalised during the first three days after the earthquake. The rate of mortality associated with the crush syndrome, vital organ injury, and non-traumatic medical problems was 21% (23/110), 17.5% (10/57), and 9% (5/55), respectively. The overall mortality rate was 8% (50/645). CONCLUSIONS: In the first 24-48 hours after a major earthquake, hospital emergency departments are flooded with large numbers of patients. Among this patient load, those patients with crush syndrome or vital organ injuries are particularly at risk. Proper triage and prompt treatment of these seriously injured earthquake victims may decrease morbidity and mortality. It is hoped that this review of the challenges met after the Marmara earthquake and the lessons learned will be of use to emergency department physicians as well as hospital emergency planners in preparing for future natural disasters.

Adolescent↗
PubMed2004

Fatal descending necrotising mediastinitis.

Descending necrotising mediastinitis rarely develops and this variety of mediastinitis is a highly lethal disease. A case is reported of descending necrotising mediastinitis caused by an odontogenic infection. The importance is emphasised of prompt diagnosis and aggressive surgical mediastinal drainage for the survival of these patients. Most acute mediastinal infections result from oesophageal perforation, either secondary to oesophagoscopy or tumour erosion. Mediastinitis occasionally develops as descending necrotising mediastinitis originating from the complications of cervical or odontogenic infections. Descending necrotising mediastinitis usually has a fulminant course, leading commonly to sepsis and death.

Adolescent↗
PubMed2003

The utility of peritoneal drains in children with uncomplicated perforated appendicitis.

Peritoneal drainage in children with uncomplicated perforated appendicitis (UPA) is still controversial. Many pediatric surgeons prefer not to drain the peritoneal cavity in such cases. However, there is no randomized controlled study performed in children. We aimed to study the effects of peritoneal drainage in children with UPA in a randomized prospective trial. One hundred and forty consecutive patients with UPA were divided randomly into 2 groups. Group I (70 patients) consisted of cases with peritoneal drainage, and group II (70 patients) without drainage. UPA is defined as perforated appendicitis with no more discoloration of peritoneal fluid after peritoneal wash out. Cases with localized abscess in the peritoneum were excluded from the study. In all patients, the ages, duration of symptoms, nasogastric drainage and hospitalization, and complications after surgery were recorded. The duration of hospitalization and nasogastric draining time were significantly lower in patients without peritoneal drainage. There was no difference in postoperative complications between the two groups. The onset of oral intake after surgery was significantly earlier in group II patients. Placing drains in the peritoneum does not improve outcome in UPA. Therefore, we do not recommend routine drainage of children with UPA.

Appendicitis↗
PubMed2003

Congenital lobar emphysema: a clinicopathologic evaluation of 14 cases.

Controversy still exists concerning the diagnosis and treatment of congenital lobar emphysema (CLE). Although surgical removal of the affected lobe is the most commonly accepted form of treatment, detection of milder or even asymptomatic cases is usually followed by a more conservative management of patients, i. e. non-surgical treatment and follow-up. We therefore decided to evaluate our patients with CLE, placing special emphasis on treatment and diagnostic techniques. We also evaluated quantitative analyses of alveolar diameters. Fourteen children with CLE were analysed retrospectively, including age, sex, clinical picture, localisation, diagnostic and surgical modalities and histopathologic diagnosis. The alveolar diameters of affected lobes were compared with those of the lobectomised patients with other non-obstructive respiratory diseases. All children but one had severe respiratory distress as an initial symptom. All patients, except newborns, had a history of pulmonary infection. All cases underwent thoracic CT examination as the main radiologic method. In all of the patients, only one lobe was affected. We found an obvious mediastinal shift and atelectasis of adjacent lobes due to compression of the affected lobe. The affected lobe was therefore surgically removed in all of the children. In one case, we had to carry out a partial lobectomy to reduce the duration of the operation, due to an intraoperative fall of oxygen saturation. All of the children had an uneventful clinical course postoperatively. The alveolar diameters of the cases with CLE were significantly greater than those of the control patients. We think that the majority of cases with CLE have too severe respiratory distress to avoid surgical removal of affected lobe. Conservative management should be reserved only for patients with milder symptoms or no distress at all.

Child, Preschool↗
PubMed2002

Ultrasonographic follow-up of infantile hypertrophic pyloric stenosis after pyloromyotomy: a controlled prospective study.

Although the ultrasonographic assessment of hypertrophic pyloric stenosis (IHPS) has become the main radiological method for this disease, our knowledge about postoperative ultrasonographic follow-up is very limited. To evaluate the ultrasonographic outcome of the pylorus, we performed ultrasonographic measurements of the pylorus in 22 children with IHPS, before and after the operation in a prospective trial. The sonograms following surgery were undertaken at the end of the 1st postoperative week and of the 1st, 3rd and 6th month postoperatively. Three main ultrasonographic parameters were used: pyloric muscle thickness (MT), pyloric diameter (PD) and pyloric length (PL). The values of the pylorus, especially the "MT" measurements, began to decrease almost by the end of the first postoperative week, and were normal by the 3rd month in the majority of cases. However, the averages of the PL and PD values never returned to normal throughout the 6 months follow-up. There was a highly significant difference between the average values of pyloric muscle thickness at admission and at the 6th month after surgery (p < 0.001). Within one month after surgery, the ultrasonographic parameters returned to the levels of those in control infants. However, except for MT, they did not return to their normal ranges. Therefore, MT is the most useful parameter for ultrasonographic postoperative evaluation if the normal ultrasonographic values, as given in the literature, are used.

Female↗
PubMed2001

The effect of the genitofemoral nerve division on the contralateral descended testis in the unilateral cryptorchidism model.

It is widely accepted that there are degenerative changes and decreased spermatogenesis in the contralateral descended testis (CDT) in unilateral undescended testis (UUDT). While some investigators have postulated that the mechanism may be related to primary (congenital) or secondary (autoimmune, vascular, and neural) events, the exact mechanism of the damage to the CDT is still unknown. The present study was planned to investigate the role of the genitofemoral nerve (GFN) on the changes in the CDT. Forty male Wistar albino rats were divided into four groups of 10 each. During the newborn period a UUDT model was created and at the age of 30 days ipsilateral GFN division was done (group A). In addition, UUDT with intact GFN (group B), divided right GFN with bilateral scrotal testes (group C), and control (group D) groups were formed. When the animals reached early adulthood, they were killed and the testes were removed. Mean seminiferous-tubular diameter (STD) and germinal-ephitelium maturity was determined using modified Johnson testicular biopsy scores (TBS). The mean STD and TBS of the study groups did not show any differences suggesting that ipsilateral division of the GFN has no effect on the CDT in the UUDT model.

Animals↗
PubMed2001

[The analysis of traumatized patients who were admitted to the Uludag University Medical School Hospital after the Marmara earthquake].

The aim of this study was to analyze the victims of the Marmara earthquake who injured, especially had the crush syndrome. Our hospital received a total of 645 victims after the earthquake and admitted 330. Victims were classified into five different groups according to their diagnosis (crush syndrome, vital organ injury, vertebral and pelvic injuries, others and unknown) and their mortality rates were determined. Mortality was highest (21%) in the crush syndrome group. Second and third highest mortality were in the unknown (20%) and vital organ injury (20%) groups. The overall mortality rate was 8%. In conclusion the earthquake victims with crush syndrome and vital organ injury had the highest mortality and morbidity rates. Because of that so many departments (General Surgery, Emergency Medicine, Orthopedics Surgery, Plastic Surgery, Nephrology, Infection Disease etc.) had to be study in a great harmonious.

Crush Syndrome↗
PubMed1999

A case of incomplete Currarino triad with malignant transformation.

A case of an incomplete Currarino triad is reported. The baby underwent an emergency laparotomy due to a life-threatening intestinal obstruction caused by severe rectal stenosis. During the posterosagittal anorectoplasty (PSARP), a presacral teratoma was identified and resected. The tumor recurred three times; she initially responded to chemotherapy, but nonetheless died at the age of 4 years. In cases with evidence of anorectal stenosis, a presacral mass should be suspected. PSARP is the best choice of treatment for both the anorectal anomaly and excision of the presacral mass. The presacral region should be followed up closely for recurrence of the tumor.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1998

Operative complications of hernia repair in childhood.

In a training center, 1,131 inguinal hernias were repaired in 1,000 consecutive patients in 6 years. The documents of these patients were reviewed retrospectively for surgical complications. A total of 38 complications were encountered in 35 patients, including wound infection (1.9%), recurrence (0.9%), tethered testis (0.3%), bladder injury (0.3%), was deferens injury (0.2%), iatrogenic orchiectomy (0.1%), and postoperative death. Most of them occurred in the early years of the clinic, and nearly one-half were technical in nature. Careful training, stressing the importance of gentle handling of the tissues, and meticulous dissection with emphasis on learning groin anatomy should reduce the incidence of such complications.

Adolescent↗
PubMed1998

Division of the genitofemoral nerve and late orchiectomy: effects on the contralateral testis in ipsilateral testicular torsion.

Unilateral torsion of the spermatic cord has been demonstrated to damage the contralateral testis; however, the pathogenesis has not yet been examined in detail. The purpose of this study was to evaluate the influence of unilateral torsion on the contralateral testis in rats by performing ipsilateral division of the genitofemoral nerve (GFN) and/or late orchiectomy. Male 25-day-old, prepubertal Wistar albino rats were divided into five groups: (1) sham operation; (2) unilateral testicular torsion; (3) simultaneous unilateral testicular torsion and ipsilateral GFN division; (4) unilateral testicular torsion and orchiectomy on the 4th day after torsion; and (5) simultaneous unilateral testicular torsion and GFN ipsilateral division, and orchiectomy on the 4th day after torsion. Torsions performed were 720 degrees, all on the right testes. On day 55 after torsion, which represents the early postpubertal period of the rat, the contralateral testes were removed. Tubular biopsy score (TBS) was calculated, and seminiferous tubular diameters (STD) were measured. Student's t-test was used for statistical analysis. There was no contralateral testicular damage in the control group, but in all of the study groups destructive changes were found in the left gonad after torsion of the right testicle. The mean TBS of the study groups was higher than that of the control group. STD values were lower in the study groups, but the differences were not statistically significant between groups. In prepubertal rats, unilateral torsion causes histologically measurable changes in the contralateral testis. Ipsilateral division of the GFN and late orchiectomy did not cause any significant alterations in terms of contralateral damage. Further investigations are needed to determine the role of the GFN in testicular torsion.

Animals↗
PubMed1989

Pregastroschisis.

In this report, a patient with an interesting umbilical anomaly has been presented. There was a skin projection on the right side of the normal umbilical cord and a sac was extending from there. The sac contained some intestine and abdominal musculature was found normal. These findings revealed us to define the anomaly as "pregastroschisis".

Abdominal Muscles↗
PubMed1986

"High" anorectal anomalies treated by early (neonatal) operation.

Between 1973 and 1983, 18 patients with "high" anorectal anomalies were treated by one of the authors (N.V.F.) by immediate sigmoid loop-colostomy, followed by a sacroperineal or abdominosacroperineal pull-through operation as soon as possible thereafter. This was performed in seven patients between 1 and 14 days, in seven patients between 15 and 40 days, and in four patients between 60 and 120 days. Daily anal dilatations were started 7 to 10 days postoperatively and continued until the anus was soft and supple. The colostomy was then closed, the aim being to complete all treatment by the age of 3 to 4 months. Continence was assessed using Kiesewetter's criteria. Results in 70% were "good", 18% "fair", and 12% "poor". The clinical results are discussed together with the possible advantages of definitive surgery in the neonatal period for "high" anorectal anomalies.

Abnormalities, Multiple↗
PubMedDate not supplied

Tau protein as a serum marker of brain damage in mild traumatic brain injury: preliminary results.

The objective of this study was to investigate the diagnostic value of serum tau protein in determining the severity of traumatic brain injury in patients with mild traumatic brain injury (mTBI) and high-risk patients. Adult patients who presented to our emergency department (ED) with mTBI over 1 year were prospectively enrolled. Patients underwent cranial computed tomography (CT) and were subdivided into high- and low-risk groups, according to the probability of resultant intracranial injury. Serum tau levels of 60 patients and 20 healthy volunteers, who served as a control group, were measured. The mean age of the 60 patients (45 males, 15 females) was 32.5 years (range, 15-66 y). Mean Glasgow Coma Scale (GCS) score was 14+/-0.6. CT scans demonstrated intracranial injury in 11 patients (18.3%) and depressed fracture in 4 patients (6.7%). Serum tau levels of patients (188+/-210 pg/mL), compared with those of controls (86+/-48 pg/mL), were relatively higher; however, differences were not statistically significant (P=.445). Also, serum tau levels of high-risk patients (307+/-246 pg/mL) were significantly higher than those of low-risk patients (77+/-61 pg/mL) (P=.001). A total of 48 patients (80%) were accessible for follow-up after 6 months. Postconcussive syndrome was observed in 8 patients, 5 of whom had serum tau protein levels that were higher than those of the other 3 patients. However, no statistically significant difference was observed (P>.05). Investigators of the present study noted that serum tau levels in patients with mTBI were increased. Therefore, it is believed that this biomarker may prove helpful in identifying high-risk patients with mTBI. However, additional studies are needed to establish the diagnostic value of serum tau in detecting traumatic brain injury in patients with mTBI.

Adolescent↗
PubMedDate not supplied

Encopretic children: experience with fifty cases.

Fifty children with encopresis were admitted to the Pediatric Surgery Department of Sişli Children's Hospital between October 1, 1987 and January 1, 1990. Two treatment regimens were used. Thirteen patients received mineral oil and glycerine suppositories and 37 patients received rectal irrigations and Lactulose. Five patients were lost to follow-up and 40 patients have completed their six month treatment schedule. The results of our study suggest that encopresis is a complex abnormal motility disorder, requiring a multidisciplinary approach. Best results will be obtained by good parent-child-doctor cooperation and close follow-up.

Causality↗
PubMedDate not supplied

Fused pelvic kidney drained by a single ureter.

A case of fused pelvic (discoid) kidney drained by a superiorly inserted single ureter is presented. This is the twentieth case of fused pelvic kidney, and the fifth case in which drainage was carried out by a single ureter, to be reported in the English literature. The diagnosis and treatment of this condition is discussed and the relevant literature is reviewed.

Child, Preschool↗