Tıp Fakültesi / Faculty of Medicine

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

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Subject: search.filters.subject.Ascites

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    Factors Affecting Mortality and Morbidity of Patients With Cirrhosis Hospitalized for Spontaneous Bacterial Peritonitis
    (2015) Ensaroglu, Fatih; Korkmaz, Murat; Geckil, Ali Umit; Ocal, Serkan; Koc, Bengisu; Yildiz, Ozgun; Atalay, Fatma Busra; Tas, Emine Gul; Haberal, Mehmet; 0000-0003-3719-9482; 0000-0002-9333-782X; 0000-0002-3462-7632; 26640933; ABH-4817-2020; AAM-1330-2020; AAJ-8097-2021
    Objectives: Spontaneous bacterial peritonitis, unless originating from surgery or an intra-abdominal source, is an infection diagnosed by neutrophil counts greater than 250/mm(3) in ascites. Spontaneous bacterial peritonitis is the most common infection among patients hospitalized with cirrhosis, with a prevalence of 9% and a risk of development among all patients with cirrhosis within 1 year of 10%. No valid parameters have been defined to predict the mortality related to spontaneous bacterial peritonitis. Unless it is treated, the mortality rate as a result of spontaneous bacterial peritonitis is 50%, and serious complications may arise. Materials and Methods: Medical records from 29 patients on the deceased-donor transplant waiting list and receiving treatment at the Baskent University Hospital Gastroenterology Clinic for cirrhotic ascites infection between 1996 and 2013 were analyzed. Demographic information, para centesis findings, clinical follow-up, and treatment results were reviewed and collected from patient medical records, with data recorded to the research form. Results: In our patient group, 72.4% were men and the average age was 46.6 years. Most of our patients were at advanced stage, with 55.2% having a Child-Pugh score of C and an average Model for End-Stage Liver Disease score of 17 +/- 4.1. We found that 34.5% of the patients received prophylactic treatment for spontaneous bacterial peritonitis, 72.4% received a proton pump inhibitor, and 82.8% had treatment with intravenous albumin support at the time of diagnosis. Albumin treatment showed no effect on mortality. Mortality rate among patients with Child-Pugh score of C was 81.3%. Conclusions: Existence of chronic renal failure, liver graft surgery, and hepatocellular cancer did not seem to have a significant effect on patient mortality. The albumin treatment protocol showed no significant difference despite common belief among physicians.
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    Prognostic factors associated with cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy in recurrent ovarian cancer
    (2020) Ayhan, Ali; Akilli, Huseyin; 33020918; AAX-3230-2020; AAJ-5802-2021
    Objective To identify factors affecting survival for women undergoing cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy (HIPEC). Methods A retrospective study at Baskent University School of Medicine, Ankara, Turkey. Data were evaluated for 71 women with recurrent ovarian cancer who underwent cytoreductive surgery with R0 resection plus HIPEC between 2016 and 2019. Potential factors affecting survival (platinum sensitivity, bevacizumab administration before HIPEC, albumin and CA125 levels, presence of ascites, age, number of chemotherapy lines, and time interval between last chemotherapy and HIPEC) were evaluated. Complications of HIPEC were documented. Results The median age was 58 years, and the median follow-up was 12 months. In univariate analyses, platinum sensitivity, albumin level, and time since last chemotherapy cycle affected overall survival. In multivariate Cox regression analysis, use of bevacizumab before HIPEC (hazard ratio [HR], 6.7; 95% confidence interval [CI], 1.39-32.3; P=0.018) and presence of ascites (HR, 5.3; 95% CI, 1.65-17.5; P=0.005) were independent negative prognostic factors. Seven (8.9%) women experienced grade III-IV complications. Conclusion In recurrent ovarian cancer, HIPEC is a promising treatment with mild-to-moderate toxicity. However, the presence of ascites and progression under bevacizumab treatment before HIPEC seem to be negative prognostic factors; these findings will be important for patient selection.
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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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    Effect of pigtail catheter application on obstetric outcomes in in vitro fertilization/intracytoplasmic sperm injection pregnancies following hyperstimulation syndrome
    (2017) Aytac, Pinar Caglar; Kalayci, Hakan; Yetkinel, Selcuk; Alkas, Didem; Simsek, Seda Yuksel; Haydardedeoglu, Bulent; Kilicdag, Esra Bulgan; 28913144
    Objective: To evaluate the effects of percutaneous pigtail catheter drainage on the outcomes of intracytoplasmic sperm injection (ICSI) pregnancies following moderate or severe ovarian hyperstimulation syndrome (OHSS). Materials and Methods: This retrospective study included 189 patients hospitalized for OHSS following ICSI treatment in a tertiary in vitro fertilization unit between 2006 and 2014. Pigtail catheters were applied in 63 patients; the other 126 patients did not need that treatment. The obstetric reports of 173 patients could be accessed and were examined to investigate the pregnancy outcomes of those with and without catheters. Results: No complications such as infection or vascular or intra-abdominal organ trauma were observed related to the pigtail application. There were no differences in abortus, preterm labor, gestational diabetes mellitus, and preeclampsia ratio between the pigtail and control groups (p>0.05). The rate of readmission to hospital for OHSS was lower in the pigtail group than in the control group although not statistically significant (p=0.08). Conclusion: Pigtail application is a safe and effective method for draining ascites in patients with OHSS after ICSI treatment. The use of pigtail catheters had no adverse effects on the perinatal outcomes of patients hospitalized with OHSS who became pregnant after ICSI treatment. In addition, the percutaneous drainage of ascites via a pigtail catheter helped prevent the readmission of patients with moderate or severe OHSS.