Tıp Fakültesi / Faculty of Medicine

Permanent URI for this collectionhttps://hdl.handle.net/11727/1403

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    Factors Affecting Recurrence of Idiopathic Granulomatous Mastitis
    (2022) Tasci, Halil Ibrahim; Turk, Emin; Erinanc, Ozgur Hilal; Erkan, Serkan; Gundogdu, Ramazan; Karagulle, Erdal; https://orcid.org/0000-0003-2269-4798; 35108784; AAJ-2989-2021
    Objective: To investigate factors that may have an effect on recurrence by retrospectively analysing the data of patients who were followed up and treated for idiopathic granulomatous mastitis in this clinic. Study Design: Analytic study. Place and Duration of Study: Department of General Surgery, Faculty of Medicine, Baskent University, Konya and Adana Practice and Research Hospitals between January 2010 and January 2021. Methodology: The data of patients who were histopathologically diagnosed with granulomatous mastitis were retrospectively analysed. The patients included in the study were divided into two groups: Recurrence (Group 1) and non-recurrence (Group 2). Patients with underlying etiological factors that may cause granulomatous inflammation such as infection, trauma, tuberculosis, sarcoidosis, and autoimmune disease were excluded from the study. The effects of other parameters (involvement area, followup duration, the time from the onset of complaints to diagnosis, side of involvement, breastfeeding, oral contraceptive use, redness, ulceration and/or discharge, preoperative histopathological diagnosis, diagnosis by any of the preoperative imaging techniques, preferred treatment method) on recurrence, were statistically analysed. Results: Furthermore, the analysis results showed no significant difference between the groups with and without recurrence with regard to any of the other variables such as follow-up period, size of the involvement area, presenting complaints, breast-feeding,preferred treatment alternative (steroid, steroid + surgery, surgery), and preferred surgical technique (p>0.05). The time from the onset of complaints to diagnosis was significantly longer in the recurrence group (p=0.001). In addition, the frequency of oral contraceptive use was statistically significantly higher in the recurrence group (Odds ratio=7.6, p=0.044). Conclusion: The results of this study suggest that early diagnosis could prevent recurrence in patients with idiopathic granulomatous mastitis. Prospective randomised controlled studies are needed to support this thought.
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    A Rare Type of Eosinophilic Gastroenteritis: Eosinophilic Ascites
    (2015) Unler, Gulhan Kanat; Ozgur, Gulsum Teke; Erinanc, Ozgur Hilal; Gokturk, Huseyin Savas
    Eosinophilic gastrointestinal diseases are a group of inflammatory disorders characterized by signs and symptoms associated with eosinophil infiltration of the gastrointestinal tissues with the absence of any secondary cause of eosinophilia such as parasitic infection, vasculitis and malignancy. Eosinophilic gastrointestinal diseases are rare and eosinophilic ascite is probably the least common and least reported form. We reported a case of 24-year old women presented with eosinophilic ascites and we want to point out a rare cause of ascites that can be managed appropriately.
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    Herpes Zoster Brachial Plexopathy: Direct Steroid Injection
    (2017) Araz, Coskun; Askin, Suna; Yilmaz, Cem; 0000-0002-2353-8044; 0000-0002-4927-6660; 27560523; AAK-2948-2021; AAJ-4576-2021
    Herpes zoster (shingles) is a viral disease, characterized by painful skin eruptions and neuropathic sensory symptoms. Motor involvement and brachial plexus involvement in herpes zoster are rare conditions. Together with antiviral medication and pain therapy, palliative and supportive modalities take an important role in the treatment of herpes zoster. It is well documented in previous reports that oral or intravenous steroid administrations may be additive in management. In this case report, positive effects of direct steroid injection onto the brachial plexus via ultrasonography guidance in a patient with motor weakness due to herpes zoster involvement of brachial plexus is presented.
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    Ultrasonografi eşliğinde yapılan subakromiyal steroid enjeksiyonu ile körleme yapılan subakromiyal steroid enjeksiyonu etkililiğinin karşılaştırılması
    (Başkent Üniversitesi Tıp Fakültesi, 2017) Akbari, Najibeh; Çetin, Nuri
    Omuz ağrısının en sık sebebi subakromiyal sıkışma sendromudur (SASS). Birçok çalışma ile SASS’ta steroid enjeksiyonunun faydası gösterilmiş olsa da enjeksiyon yeri ve enjeksiyonun uygulanış yöntemi açısından çalışmalar arasında farklılıklar bulunmaktadır. Bizim çalışmamızın amacı SASS hastalarında ultrason (US) eşliğinde yapılan steroid enjeksiyonunun klinik iyileşme, ağrı, fonksiyonel durum açısından körleme omuz steroid enjeksiyonu ile karşılaştırmak, hangi uygulamanın daha etkin ve güvenilir olduğuna karar vermektir. SASS tanılı toplam 29 hasta 2 gruba randomize edildi: 14 hastaya US eşliğinde subakromiyal steroid enjeksiyonu (US eşliğinde enjeksiyon grubu - UEE), 15 hastaya da körleme subakromiyal steroid enjeksiyonu yapıldı (körleme enjeksiyon grubu - KE) KE grubunda 1 hasta takibi bıraktı. Enjeksiyon öncesi ve 4 hafta sonrasında vizüel analog skala (VAS), aktif fleksiyon eklem hareket açıklığı (EHA), aktif abdüksiyon EHA, Constant- Murley skoru ve Disability of the Arm, Shoulder, Hand (DASH) skoru elde edildi. VAS skoru KE grubunda başlangıçta 8,5 (4-10), enjeksiyondan 4 hafta sonra 2 (1- 7) (p=0,001), UEE grubunda başlangıçta 9 (4-10), enjeksiyondan 4 hafta sonra 1 (1-7) (p=0,001) olarak saptandı. Gruplar arasında VAS skoru değişimi açısından anlamlı farklılık yoktu. Aktif fleksiyon EHA; KE grubunda başlangıçta 140 (70-165), enjeksiyondan 4 hafta sonra 170 (140-180) (p=0,001), UEE grubunda başlangıçta 150 (80-170), enjeksiyondan 4 hafta sonra 180 (130-180) (p=0,001) olarak saptandı. Gruplar arasında aktif fleksiyon EHA değişimi açısından anlamlı farklılık yoktu. Aktif abdüksiyon EHA; KE grubunda başlangıçta 130 (70-160), enjeksiyondan 4 hafta sonra 170 (140-180) (p=0,001), UEE grubunda başlangıçta 150 (80-170), enjeksiyondan 4 hafta sonra 180 (135-180) (p=0,001) olarak saptandı. Gruplar arasında aktif abdüksiyon EHA değişimi açısından anlamlı farklılık yoktu. Constant-Murley skoru KE grubunda başlangıçta 37 (13-80), enjeksiyondan 4 hafta sonra 85 (53-97) (p=0,001), UEE grubunda başlangıçta 39 (19-73), enjeksiyondan 4 hafta sonra 95 (49-100) (p=0,001) olarak saptandı. Gruplar arasında Constant-Murley skoru değişimi açısından anlamlı farklılık yoktu. DASH skoru KE grubunda başlangıçta 117 (62-141), enjeksiyondan 4 hafta sonra 51 (31-83) (p=0,001), UEE grubunda başlangıçta 110 (45-145), enjeksiyondan 4 hafta sonra 35 (30-86) (p=0,001) olarak saptandı. Gruplar arasında DASH skoru değişimi açısından anlamlı farklılık yoktu. Her iki grupta da enjeksiyondan 4 hafta sonra yapılan tüm klinik değerlendirme parametrelerinde anlamlı iyileşme saptandı. Her iki grupta da enjeksiyon sonrasında herhangi bir yan etki gözlenmedi. Sonuç olarak SASS hastalarında subakromiyal körleme steroid enjeksiyonu ile US eşliğinde enjeksiyon arasında klinik değerlendirme parametreleri açısından anlamlı farklılık saptanmadı. Bu sebeple subakromiyal steroid enjeksiyonu yapılırken US kullanımının gereksiz olduğunu düşünüyoruz. The most common cause of shoulder pain is subacromial impingement syndrome (SIS). Although many studies have demonstrated the benefit of steroid injection in SIS, there are differences between studies in terms of injection site and method of administration of the injection. The aim of our study is to compare ultrasound-guided subacromial steroid injections and blind subacromial steroid injections in terms of clinical improvement, pain and functional status and to decide which application is more effective and safe. A total of 29 patients with SIS were randomized into 2 groups: 14 patients received a subacromial steroid injection with ultrasound guidance (US-guided group - UGG), and 15 patients received a subacromial steroid injection without ultrasound guidance (blind group - BG). One patient lost to follow up in BG. The visual analog scale (VAS), active flexion range of motion (ROM), active abduction ROM, Constant-Murley score and Disability of the Arm, Shoulder, Hand (DASH) score were obtained before the injection and at 4 weeks after the injection. The VAS score decreased from 8,5 (4-10) before the injection to 2 (1-7) at 4 weeks after the injection in the BG (p=0,001) and from 9 (4-10) to 1 (1-7) in the UGG (p=0,001). The decrease in the VAS score was not significantly different between the groups. Active flexion ROM increased from 140 (70-165) before the injection to 170 (140-180) at 4 weeks after the injection in the BG (p=0,001), and from 150 (80-170) to 180 (130-180) in the UGG (p=0,001). The increase in the active flexion ROM was not significantly different between the groups. Active abduction ROM increased from 130 (70-160) before the injection to 170 (140-180) at 4 weeks after the injection in the BG (p=0,001), and from 150 (80-170) to 180 (135-180) in the UGG (p=0,001). The increase in the active abduction ROM was not significantly different between the groups. The Constant-Murley score increased from 37 (13-80) before the injection to 85 (53-97) at 4 weeks after the injection in the BG (p=0,001), and from 39 (19-73) to 95 (49-100) in the UGG (p=0,001). The increase in the Constant- Murley score was not significantly different between the groups. The DASH score decreased from 117 (62-141) before the injection to 51 (31-83) at 4 weeks after the injection in the BG (p=0,001) and from 110 (45-145) to 35 (30-86) in the UGG (p=0,001). The decrease in the DASH score was not significantly different between the groups. In both groups, significant improvement was observed in all clinical evaluation parameters performed 4 weeks after injection. No side effects were observed in both groups after injections. In conclusion, there were no significant differences in clinical evaluation parameters between blind subacromial steroid injections and ultrasound-guided injections in SIS patients. For this reason, we think that ultrasound use is unnecessary when subacromial steroid injection is performed.