AMAÇ: Akut pankreatitte geliþen inflamasyona sekonder immün yanýt, pankreatitin klinik seyrinde önemli rol oynamaktadýr. Bu çalýþmanýn amacý pankreatit þiddetine göre çeþitli sitokin ve kemokinlerdeki deðiþiklikleri birlikte ortaya koymaktýr.
GEREÇ VE YÖNTEM: Yirmi bir adet Wistar diþi albino sýçan üç eþit gruba ayrýldý. Kontrol grubuna herhangi bir müdahale yapýlmadý. Hafif ve þiddetli pankreatit gruplarýna sýrasýyla 50 µg/kg ve 80 µg/kg dozlarýnda beþ saat boyunca saatte bir kez intraperitoneal cerulein uygulandý. Pankreatit geliþip geliþmediði ve varsa þiddet düzeyi sakrifikasyon sonrasý histolojik deðerlendirme ile doðrulandý. Tüm sýçanlardan kan örnekleri alýndý ve IL-10, IFN-y, CXCL-1, MCP-1, TNF-a, GM-CSF, IL-18, IL-12p70, IL-1β, IL-17A, IL-33, IL-1α, IL-6 düzeylerine bakýldý. Ayrýca pankreas dokularýnýn Schoenberg inflamasyon skorlarý da deðerlendirildi.
BULGULAR: Histopatolojik incelemeye göre çalýþma gruplarýnýn tüm vakalarýnda akut pankreatit modeli baþarýyla saðlandý. Pankreatitli sýçanlarda CXCL-1, MCP-1 ve IL-6 parametrelerinin istatistiksel olarak anlamlý derecede yüksek olduðu, þiddetli pankreatitli sýçanlarda ise CXCL-1, MCP-1 ve IL-6 parametrelerinin istatistiksel olarak anlamlý derecede yüksek olduðu belirlendi. Korelasyon analizinde MCP-1 ve IL-6 pankreatit þiddeti ile orta düzeyde korelasyon göstermektedir.
SONUÇ: CXCL-1, MCP-1 ve IL-6, pankreatit geliþimi ve seyrinin nasýl olacaðýný göstermede anlamlý görülmüþtür. Bu sitokinlerin üretim ve etki yolaklarý akut pankreatitin medikal tedavisi için potansiyel hedefler olarak deðerlendirilebilir.

BACKGROUND: The immune response secondary to inflammation that develops in acute pancreatitis plays an important role in the clinical course of the disease. This study aims to evaluate the changes in various cytokines and chemokines according to the severity of pancreatitis.
METHODS: Twenty-one female Wistar albino rats were divided into three equal groups. The control group received no intervention. Intraperitoneal cerulein was administered to the other groups once per hour for five hours at doses of 50 µg/kg and 80 µg/kg for the mild and severe pancreatitis groups, respectively. The development of pancreatitis and its severity level were confirmed by histological evaluation after euthanization. Blood samples were taken from all rats to measure levels of Interleukin-10 (IL-10), Interferon gamma (IFN-γ), C-X-C Motif Chemokine Ligand 1 (CXCL-1), Monocyte Chemoattractant Protein-1 (MCP-1), Tumor Necrosis Factor alpha (TNF-α), Granulocyte-Macrophage Colony-Stimulating Factor (GM-CSF), IL-18, IL-12p70, IL-1β, IL-17A, IL-33, IL-1α, and IL-6. Additionally, the Schoenberg inflammation scores of pancreatic tissues were evaluated.
RESULTS: The acute pancreatitis model was successfully induced in all cases within the study groups, according to histopathological examination. It was found that the levels of CXCL-1, MCP-1, and IL-6 were statistically significantly higher in rats with pancreatitis, with these parameters being elevated in the group with severe pancreatitis. In correlation analyses, MCP-1 and IL-6 showed a moderate correlation with the severity of pancreatitis.
CONCLUSION: CXCL-1, MCP-1, and IL-6 exhibit predictive characteristics for the occurrence and clinical course of pancreatitis. Our results highlight the production and working pathways of these cytokines as potential targets for therapeutic intervention.

AMAÇ: Bu çalýþmada; batýn cerrahilerinin giderek daha fazla sayýda yapýlmasýyla sýklýkla karþýlaþýlan ve ciddi mortalite ile morbidite sebebi olan intraabdominal adezyonlarýn azaltýlabilmesi için; adezyon modeli oluþturulmuþ ratlarda, %5 borik asit solüsyonu uygulamasýnýn batýn içi adezyon geliþimine etkisini araþtýrmak amaçlanmýþtýr. Borik asidin daha önce kanýtlanmýþ olan antiinflamatuvar, antioksidan ve antifibrotik etkileri ile intraabdominal adezyon geliþimini azaltacaðý düþünülmüþtür.
GEREÇ VE YÖNTEM: Çalýþma her biri 16 adet rat içeren 2 grupta (adezyon modeli oluþturulmuþ kontrol grubu ve %5’lik borik asit solüsyonu uygulanmýþ deney grubu) yapýldý. Operasyon sonrasý 14. günde ratlar sakrifiye edilip tekrar eksplore edildi ve geliþen adezyonlar makroskopik ve mikroskopik olarak deðerlendirildi. Makroskopik ve mikroskobik skorlamalar sonucunda elde edilen veriler IBM SPSS Statistics 24 programýnda Mann-Whitney U testi ile deðerlendirildi. Ýstatistiksel anlamlýlýk düzeyi “p<0.05” olarak belirlendi.
BULGULAR: Ýstatistiksel veriler incelendiðinde borik asit uygulanan grupta adezyon geliþiminde makroskopik ve mikroskopik olarak anlamlý bir azalma olduðu görüldü (p<0.05).
SONUÇ: Bu çalýþmanýn sonucunda; deneysel adezyon modelinde intraabdominal %5’ lik borik asit solüsyonu uygulamasýnýn, postoperatif intraabdominal adezyonlarý azaltmada anlamlý etkiye sahip olabileceði gösterilmiþtir. Bu etkinin borik asidin antiinflamatuvar, antioksidan ve antifibrotik etkilerinden kaynaklandýðý öngörülmektedir. Bu çalýþma, borik asidin intraabdominal adezyonlarý azaltma mekanizmasýnýn ve ideal dozun araþtýrýlmasý için öncü olacaktýr.

BACKGROUND: The continuous advancement in medical and surgical techniques has led to a rise in the frequency of abdominal operations, subsequently increasing the incidence of intra-abdominal adhesions. Over 90% of laparotomies result in postoperative intra-abdominal adhesions. This study investigates the effect of a 5% boric acid solution on the development of intra-abdominal adhesions in rats, using an adhesion model.
METHODS: This study was conducted with two groups: a control group, in which the adhesion model was applied without any treatment, and a boric acid group, which was treated with a 5% boric acid solution. Each group comprised 16 rats. On the 14th postoperative day, the rats were sacrificed, re-explored, and the developed adhesions were evaluated both macroscopically and microscopically. The data from macroscopic and microscopic scoring were analyzed using the Mann-Whitney U test in the IBM Statistical Package for the Social Sciences (SPSS) Statistics 24 program. A p-value of less than 0.05 was considered statistically significant. This research was supported by the Manisa Celal Bayar University Scientific Research Projects Commission.
RESULTS: A statistically significant difference was observed between the boric acid-treated group and the control group, with the boric acid group showing a significant decrease in adhesion development both macroscopically and microscopically (p<0.05).
CONCLUSION: In the future, boron could play a significant role in reducing and preventing intra-abdominal adhesions after surgery. This investigation could pave the way for further research into the mechanism by which boric acid prevents the development of intra-abdominal adhesions. Moreover, it is imperative to explore the potential side effects of intra-abdominal boron application at the optimum concentration of the solution.

AMAÇ: Eriþkinlerde akut kolesistit tanýsýnda C-reaktif protein, prokalsitonin, tam kan sayýmý parametreleri, delta nötrofil indeksi, iskemik modifiye albümin, presepsin, oksidatif stres göstergeleri gibi inflamasyon, oksidatif stres ve iskemi ile iliþkili belirteçlerin patolojideki yerini belirlemektir.
GEREÇ VE YÖNTEM: Çalýþmaya acil serviste akut kolesistit tanýsý alan hastalar ve saðlýklý kontrol grubu dahil edildi. Çalýþmaya alýnan hastalara rutin kan sayýmý ve biyokimya tetkikleri yapýldý. Ýskemik modifiye albümin, presepsin ve oksidatif stres göstergelerini ölçmek için kan serumu kullanýldý.
BULGULAR: Lökosit sayýsý, nötrofil/lenfosit oraný, trombosit/lenfosit oraný, delta nötrofil indeksi, C-reaktif protein, prokalsitonin, iskemik modifiye albümin, iskemik modifiye albümin/albümin oraný, presepsin ve oksidatif stres göstergeleri deðerleri akut kolesistit tanýlý hastalar da kontrol grubu ile karþýlaþtýrýldýðýnda anlamlý olarak yüksek saptandý.
SONUÇ: Nötrofil/lenfosit oraný, delta nötrofil indeksi, iskemik modifiye albümin, iskemik modifiye albümin/albümin oraný ve presepsin deðerlerinin yüksek duyarlýlýk, özgüllük ve düþük negatiflik olasýlýðý oranlarý nedeniyle akut kolesistit tanýsýnda yeni belirteçler olarak kullanýlabileceðine inanýyoruz.

BACKGROUND: The purpose of this study is to determine the significance of markers such as C-reactive protein, procalcitonin, complete blood count parameters, delta neutrophil index, ischemia-modified albumin, presepsin, and oxidative stress indicators, which are associated with inflammation, oxidative stress, and ischemia in the pathology and diagnosis of acute cholecystitis in adults.
METHODS: Patients diagnosed with acute cholecystitis in the emergency department and healthy individuals in the control group were included in the study. Routine blood count and biochemistry analyses were performed on the participants. Blood serum was used to measure ischemia-modified albumin, presepsin, and oxidative stress indicators.
RESULTS: White blood cell count, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, delta neutrophil index, C-reactive protein, procalcitonin, ischemia-modified albumin, ischemia-modified albumin to albumin ratio, presepsin, and oxidative stress indicators were significantly higher in patients with cholecystitis compared to the control group. Measurements of white blood cell count, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and delta neutrophil index can be included as part of the complete blood count. The complete blood count parameters are readily available and do not incur additional costs to the healthcare system.
CONCLUSION: The authors believe that the neutrophil-to-lymphocyte ratio, delta neutrophil index, ischemia-modified albumin, ischemia-modified albumin to albumin ratio, and presepsin values can be used as new markers in the diagnosis of acute cholecystitis due to their high sensitivity, specificity, and low negative likelihood ratio.

AMAÇ: Bu çalýþmanýn amacý, Acil Servis (AS) ortamýnda Akut Ayak Bileði Burkulmasý (AABB) olan hastalarda Kinezyotape (KT) uygulamasýnýn destekleyici tedavi olarak etkinliðini deðerlendirmektir.
GEREÇ VE YÖNTEM: Üçüncü basamak bir AS'te prospektif yarý-rasgele kontrollü bir çalýþma yapýlmýþtýr. Ýzole stabil Grade 1 ve Grade 2 AABB tanýsý konmuþ eriþkin hastalar dahil edildi. Hastalar, iki gruba ayrýldý: KT grubu, geleneksel tedaviye ek olarak KT uygulanan grup; kontrol grubu ise sadece geleneksel tedavi alan grup. Aðrý þiddeti, analjezik kullanýmý ve hasta memnuniyeti deðerlendirildi.
BULGULAR: Her iki grup arasýnda baþlangýçta ve 30. dakikada benzer aðrý düzeyleri bildirilirken, kontrol grubu 60. dakikada anlamlý ölçüde daha düþük aðrý düzeyleri bildirdi (sýrasýyla p=.575, p=.437 ve p=.042). KT grubu, analjezik ilaç tüketiminde azalma ve daha yüksek hasta memnuniyet düzeyleri sergiledi (sýrasýyla p<.001 ve p=.003). Lojistik regresyon analizi, 60. dakikada aðrý þiddetindeki farkýn anlamýný yitirdiðini, ancak analjezik kullanýmý ve hasta memnuniyetinin anlamlý olduðunu ortaya koydu (sýrasýyla p=.631, p=.003 ve p=.026).
SONUÇ: KT uygulamasý, destekleyici bir tedavi olarak, AS'teki AABB hastalarýnda analjezik ihtiyacýný azaltabilir ve hasta memnuniyetini artýrabilir. Uygulamanýn etkinliðini doðrulamak ve standart AABB tedavi protokollerindeki yerini belirlemek için daha fazla araþtýrmaya ihtiyaç vardýr.

BACKGROUND: The objective of this study was to assess the efficacy of Kinesio Tape (KT) application as a complementary treatment for patients with acute ankle sprain (AAS) in an Emergency Department (ED) setting.
METHODS: A prospective, quasi-randomized controlled trial was conducted in a tertiary care ED. Adult patients diagnosed with isolated, stable Grade 1 and Grade 2 AAS were included. Patients were divided into two groups: the KT group, where KT was applied in addition to conventional treatment, and the control group, receiving only conventional treatment. Pain intensity, analgesic usage, and patient satisfaction were assessed.
RESULTS: While pain levels were similar between both groups at baseline and the 30th minute, the control group reported significantly lower pain levels at the 60th minute (p=0.575, p=0.437, and p=0.042, respectively). The KT group exhibited reduced analgesic drug consumption and higher patient satisfaction levels (p<0.001 and p=0.003, respectively). Logistic regression analysis revealed that the difference in pain intensity at the 60th minute lost significance, while analgesic usage and patient satisfaction remained significant (p=0.631, p=0.003, and p=0.026, respectively).
CONCLUSION: KT application, as a complementary treatment, may reduce the need for analgesics and enhance patient satisfaction in patients with AAS in the ED. Further research is needed to refine its application and confirm its effectiveness in standard AAS treatment protocols.

BACKGROUND: In our earthquake-prone country, it is crucial to gather data from regional hospitals following earthquakes. This information is essential for preparing for future disasters and enhancing healthcare services for those affected by earthquakes. This study aimed to evaluate the Pediatric Trauma Score (PTS) and the Shock Index, Pediatric Age-Adjusted (SIPA), in children affected by earthquakes, to provide clinicians with insights into the severity of trauma and hemodynamic stability.
METHODS: The study included patients admitted to our hospital's pediatric emergency service within the three weeks following the earthquake. We evaluated their age, sex, admission vital signs, mechanical ventilation requirements, development of crush syndrome, length of hospital stay, PTS, and SIPA.
RESULTS: Our study included 176 children (89 females and 87 males) with trauma. Fifty-eight (32.95%) children had crush syndrome, and 87 (49.43%) were hospitalized. The median PTS was 10 (ranging from -3 to 12), and the median SIPA was 1.00 (ranging from 0.57 to 2.10). We observed a negative correlation between the time spent under debris and PTS (r=-0.228, p=0.002) and a positive correlation with the SIPA score (r=0.268, p<0.001). The time spent under debris (p<0.001) and SIPA score (p<0.001) were significantly higher in hospitalized children. PTS was significantly lower in hospitalized children than in others. A PTS cutoff point of 7.5, and a SIPA cutoff point of 1.05, predicted hospitalization in all children. Time spent under debris and SIPA were significantly higher in children with crush syndrome than in others (p<0.001). PTS at a cutoff point of 8.5 and SIPA at a cutoff point of 1.05 predicted crush syndrome in all children.
CONCLUSION: PTS and SIPA are important practical scoring systems that can be used to predict the severity of trauma, hospitalization, crush syndrome, and the clinical course in pediatric patients admitted to the hospital due to earthquake trauma.

BACKGROUND: In our earthquake-prone country, it is crucial to gather data from regional hospitals following earthquakes. This information is essential for preparing for future disasters and enhancing healthcare services for those affected by earthquakes. This study aimed to evaluate the Pediatric Trauma Score (PTS) and the Shock Index, Pediatric Age-Adjusted (SIPA), in children affected by earthquakes, to provide clinicians with insights into the severity of trauma and hemodynamic stability.
METHODS: The study included patients admitted to our hospital's pediatric emergency service within the three weeks following the earthquake. We evaluated their age, sex, admission vital signs, mechanical ventilation requirements, development of crush syndrome, length of hospital stay, PTS, and SIPA.
RESULTS: Our study included 176 children (89 females and 87 males) with trauma. Fifty-eight (32.95%) children had crush syndrome, and 87 (49.43%) were hospitalized. The median PTS was 10 (ranging from -3 to 12), and the median SIPA was 1.00 (ranging from 0.57 to 2.10). We observed a negative correlation between the time spent under debris and PTS (r=-0.228, p=0.002) and a positive correlation with the SIPA score (r=0.268, p<0.001). The time spent under debris (p<0.001) and SIPA score (p<0.001) were significantly higher in hospitalized children. PTS was significantly lower in hospitalized children than in others. A PTS cutoff point of 7.5, and a SIPA cutoff point of 1.05, predicted hospitalization in all children. Time spent under debris and SIPA were significantly higher in children with crush syndrome than in others (p<0.001). PTS at a cutoff point of 8.5 and SIPA at a cutoff point of 1.05 predicted crush syndrome in all children.
CONCLUSION: PTS and SIPA are important practical scoring systems that can be used to predict the severity of trauma, hospitalization, crush syndrome, and the clinical course in pediatric patients admitted to the hospital due to earthquake trauma.

AMAÇ: Künt karýn travmasýna baðlý pankreas yaralanmalarý eþlik eden yaralanmalarla birlikte yüksek mortalite oranýna sahiptir. Bu çalýþmanýn amacý, pankreas travmalý hastalarda retropankreatik yað dokusu büyüklüðü ile pankreas ve komþu organ yaralanmalarýnýn þiddeti arasýndaki iliþkiyi araþtýrmaktýr.
GEREÇ VE YÖNTEM: Künt karýn travmasý olan 34 hastanýn (25 erkek, 9 kadýn, 13-69 yaþ) ve 34 kontrolün (28 erkek, 6 kadýn, 15-66 yaþ) bilgisayarlý tomografi görüntüleri (BT) retrospektif olarak tarandý. Pankreas gövdesinin arka tarafýnda yer alan retropankreatik yað dokusunun alaný tüm hastalar için aksiyel düzlemde ölçüldü. Pankreas yaralanmasýnýn derecesi yaralanma yeri, retropankreatik yað dokusu alaný ve diðer organ yaralanma dereceleri açýsýndan deðerlendirildi.
BULGULAR: Pankreas yaralanmasý 16 hastada (%23.5) baþ kesiminde, dört hastada (%5.9) gövde kesiminde, 14 hastada (%20.6) kuyruk kesimi yerleþimliydi. Retropankreatik yað alaný pankreas travmalý hastalarda, kontrollere göre anlamlý derecede düþük bulundu (<0.0001). Retropankreatik yað alanýnýn vertebral korpus alanýnýn oraný, pankreas yaralanmasý olan ve olmayan hastalar arasýnda anlamlý farklýlýk gösterdi (p=0.014). SONUÇ: Retropankreatik yað dokusu pankreas gövdesinin künt karýn travmasýndan daha az etkilenmesini saðlar ve retropankreatik yað dokusu miktarýndaki artýþ daha düþük pankreas hasarý oranlarý ile iliþkilidir.

BACKGROUND: Pancreatic injuries from blunt abdominal trauma have a high mortality rate, often accompanied by injuries to adjacent organs. This study aims to investigate the relationship between the size of retropancreatic adipose tissue and the severity of pancreatic and adjacent organ injuries in patients with pancreatic trauma.
METHODS: We retrospectively screened computed tomography (CT) images of 34 patients (25 males, nine females, aged 13-69 years) and 34 controls (28 males, six females, aged 15-66 years) who suffered blunt abdominal trauma. The area of adipose tissue located posterior to the pancreatic body was measured in the axial plane for all subjects. The severity of pancreatic injury was assessed in terms of the injury site, the retropancreatic adipose tissue area, and the degree of other organ injuries.
RESULTS: Pancreatic injuries were located in the head for 16 patients (23.5%), in the body for four patients (5.9%), and in the tail for 14 patients (20.6%). The retropancreatic fat area was found to be significantly smaller in patients with pancreatic trauma compared to controls (p<0.0001). Furthermore, the ratio of the retropancreatic fat area to the vertebral corpus area differed significantly between patients with and without pancreatic injuries (p=0.014).
CONCLUSION: Retropancreatic adipose tissue protects the pancreatic body from the impacts of blunt abdominal trauma. An increased amount of retropancreatic adipose tissue is associated with a reduced rate of pancreatic injury.

AMAÇ: Acil servis (AS) baþvurularýnda ayak bileði yaralanmalarý önemli bir yer tutmaktadýr. Etkin bir taný ve tedavi süreci, hastalarýn hýzla iyileþmesi ve acil servislerdeki týkanýklýðýn azaltýlmasý için hayati öneme sahiptir. Bu çalýþmanýn amacý, acil servise baþvuran geriatrik hastalarda Ottawa ayak bileði kurallarýnýn (OAR) yeterliliðini ve etkinliðini deðerlendirmektir.
GEREÇ VE YÖNTEM: Þubat 2022-Kasým 2022 tarihleri arasýnda, izole ayak bileði yaralanmasý þikayetiyle acil servise baþvuran 65 yaþ ve üzeri 160 hasta (118 kadýn, 42 erkek) çalýþmaya dahil edilmiþtir. OAR'nin sensitivitesi, spesifitesi, pozitif prediktif deðeri ve negatif prediktif deðeri hesaplandý.
BULGULAR: Çalýþmada, hastalarýn %37.5'inde fraktür tespit edilmiþtir. OAR'nin sensitivitesi %98.33, spesifitesi %86, negatif prediktif deðeri %98.85 ve pozitif prediktif deðeri %80.82 olarak bulunmuþtur.
SONUÇ: Çalýþma, OAR'nin geriatrik popülasyonda yüksek sensitiviteye sahip olduðunu, ancak spesifite ve pozitif prediktif deðer açýsýndan bazý sýnýrlýlýklar gösterdiðini ortaya koymaktadýr. Bu sonuçlar, geriatrik popülasyonda ayak bileði yaralanmalarýnýn deðerlendirilmesinde OAR'nin kullanýmýnýn etkinliðini desteklemekte, ancak ayný zamanda yanlýþ pozitif sonuçlar açýsýndan dikkatli kullanýlmasý gerektiðini göstermektedir.

BACKGROUND: Ankle injuries are a common reason for visits to the emergency department (ED). An effective diagnosis and treatment process is crucial for the swift recovery of patients and for alleviating congestion in EDs. This study aims to evaluate the adequacy and effectiveness of the Ottawa Ankle Rules (OAR) in geriatric patients presenting to the emergency department (ED).
METHODS: Between February 2022 and November 2022, 160 patients aged 65 and older (118 women, 42 men) who presented to the ED with isolated ankle injuries were included in the study. We calculated the sensitivity, specificity, positive predictive value, and negative predictive value of the OAR.
RESULTS: The study found fractures in 37.5% of patients. The sensitivity of the OAR was 98.33%, the specificity was 86%, the negative predictive value was 98.85%, and the positive predictive value was 80.82%.
CONCLUSION: This study demonstrates that the OAR is highly sensitive in the geriatric population but shows some limitations in terms of specificity and positive predictive value. These results support the effectiveness of using the OAR in evaluating ankle injuries in the geriatric population but also highlight the need for cautious application due to the potential for false-positive outcomes.

AMAÇ: Künt karýn travmalarý tüm travma vakalarýnýn önemli bir bölümünü oluþturur ve sýklýkla karaciðer yaralanmalarý ile iliþkilidir. Yüksek dereceli künt karaciðer yaralanmalarý ise günümüzde dahi hayatý tehdit eden klinik tablolara sebebiyet verebilmektedir. Bu nedenle daha yakýn takip ve tedavi gerekecek kritik hastalarýn tanýnmasý önem arz etmektedir. Bu minvalde mortaliteyi arttýran faktörlerin tespiti için bu hastalardaki deneyimimizi paylaþmayý amaçladýk.
GEREÇ VE YÖNTEM: 2008 ve 2023 yýllarý arasýnda acil kliniðinde künt travma sonrasý grade 3 ve üzeri karaciðer yaralanmasý tanýsý almýþ 38 hasta çalýþmaya dahil edildi. Vefat eden 11 hasta 1. gruba alýnýrken, sað kalan 27 hasta 2. gruba dahil edildi. Gruplar yaralanma mekanizmasý, görüntüleme sonuçlarý, glasgow koma skorlarý, travma þiddeti skorlarý, baþvuru esnasýndaki baz açýðý, laktat ve pH deðerleri yönünden karþýlaþtýrýldý. Anlamlý fark olan parametrelerde eþik deðeri bulmak için ROC analizi kullanýldý.
BULGULAR: Karaciðer yaralanma derecesi ve ek abdominal organ yaralanma oranlarý 1. grupta anlamlý daha yüksekti (p<0.05). Ekstraabdominal organ yaralanmasý yönünden gruplar arasýnda fark yoktu (p>0.05). Eritrosit suspansiyonu ihtiyacý 1. grupta anlamlý daha yüksekti (p<0.05). Ortalama laktat ve baz açýðý deðerleri 1. grupta anlamlý daha yüksekti (p<0.05). Lökosit deðerleri 1. grupta anlamlý daha düþük bulundu (p<0.05).
SONUÇ: Baz açýðý, hemoglobin, laktat, travma þiddeti skoru, karaciðer yaralanma derecesi, eþlik eden abdominal yaralanmalar ve eritrosit suspansiyon ihtiyacý artmýþ mortalite ile iliþkili bulunmuþtur. Yukarýda belirtilen parametreler ile alakalý net eþik deðerlerinin belirlenebilmesi için daha fazla veriye ve yayýna ihtiyaç vardýr.

BACKGROUND: Blunt abdominal trauma constitutes a significant portion of trauma cases and is often associated with liver injury. Given that high-grade liver injuries remain life-threatening, identifying patients who will likely require more vigilant attention and care is crucial. This study aims to determine the parameters that increase mortality in patients with high-grade liver trauma.
METHODS: This study enrolled 38 patients with Grade III or higher liver injuries, treated by the general surgery department between 2008 and 2023. Eleven patients who died were categorized into Group 1, and 27 survivors were placed in Group 2. We evaluated their respective mechanisms of injury, imaging results, Glasgow Coma Scale scores, Base Excess, Lactate levels, pH, and Injury Severity Score findings. Receiver Operating Characteristics (ROC) analysis was performed for parameters with significant differences, and certain cutoff values were determined.
RESULTS: The grade of liver injury and additional abdominal organ injuries were significantly higher in Group 1 (p<0.05). The difference in extra-abdominal injury sites was statistically insignificant between the groups (p>0.05). Erythrocyte suspension requirements were significantly higher in Group 1 (p<0.05). Average lactate and base deficit values were also significantly higher in Group 1 (p<0.05), while leukocyte counts were significantly lower in Group 1 (p<0.05).
CONCLUSION: Base deficit, hemoglobin (Hb), lactate levels, injury severity, liver injury grade, accompanying abdominal injuries at admission, and erythrocyte suspension demands were found to be associated with increased mortality rates. Certain cutoff values for the aforementioned parameters could be established. However, further data are required to confirm these findings.

AMAÇ: Kutlamalarda silahlarýn havaya ateþlenmesi, kamu güvenliði için önemli riskler oluþturan bir gelenektir. Yorgun mermi yaralanmasý olarak isimlendirilen bu olay sonrasý düþen bu mermiler yüksek hýzlara ulaþabilir ve bir kiþiye, hayvana veya eþyaya çarpmasý durumunda ciddi yaralanma veya ölüme neden olma potansiyeline sahip olabilir.
GEREÇ VE YÖNTEM: Bu çalýþmanýn amacý, 2014-2023 yýllarý arasýndaki 10 yýllýk dönemde Türkiye'nin iki farklý kentindeki 3 farklý hastaneye baþvuran kutlama amaçlý silah ateþine baðlý yaralanmalarýn (CGRI) retrospektif olarak tespit edilmesi ve sonuçlarýnýn araþtýrýlmasýdýr.
BULGULAR: Trabzon Kanuni Eðitim ve Araþtýrma Hastanesi, Karadeniz Teknik Üniversitesi Týp Fakültesi Farabi Hastanesi ve Yeditepe Üniversitesi Kozyataðý Hastanesi'nden elde edilen veriler, 48 yorgun mermi yaralanmasý vakasýný ortaya koydu; bu yaralýlarýn %64.6'sýný erkekler oluþturdu. 0-17 yaþ arasý çocuklar en çok etkilenen grup, baþ-boyun-yüz bölgesi en sýk yaralanan bölge iken, vakalarýn çoðunluðunun kýrsal alanlarda gerçekleþtiði belirlendi. Sekiz vaka (%16.7) ölümle sonuçlandý. Silahlarýn ateþlenme nedenleri vakalarýn %43.8'inde belirlenemedi.
SONUÇ: Sosyolojik olarak, bazý toplumlarda silah sahipliði prestij anlamýna gelir ve genellikle düðünlerde kutlamalara yönelik silah kullanýmýný tetikler. Ancak bu gelenek, dünya çapýnda trajedilere yol açabilmektedir. Ruhsatsýz silah kullanýmýný önlemek için daha sýký düzenlemeler ve yasal altyapýlara ihtiyaç vardýr. Kutlamalarda ateþlenen silahlarýn toplum olarak normal görülmesine karþý etkili bir mücadele için iþbirlikçi çabalar hayati öneme sahiptir. Gelecekte yapýlabilecek prospektif çalýþmalar, CGRI insidansýný kapsamlý bir þekilde deðerlendirebilir ve kamu saðlýðýný korumak için önleyici stratejilerin belirlenmesinde rol alabililir.

BACKGROUND: Firing guns into the air during celebrations is a tradition that poses significant risks to public safety. These falling bullets, often referred to as tired bullets, can attain high velocities during their descent and have the potential to cause serious injury or death to people and animals, or significant damage to property upon impact.
METHODS: This study aimed to retrospectively detect and analyze incidents of celebratory gunfire-related injuries (CGRI) that were admitted to three different hospitals in two cities in Turkey over a 10-year period from 2014 to 2023.
RESULTS: Data collected from Trabzon Kanuni Training and Research Hospital, Karadeniz Technical University Faculty of Medicine Farabi Hospital, and Yeditepe University Kozyataðý Hospital revealed 48 cases of injuries attributed to celebratory gunfire. Of these cases, 64.6% involved male victims. Children aged 0-17 years were the most affected demographic, with the head, neck, and face being the most frequently injured areas. The majority of incidents occurred in rural areas. Eight cases (16.7%) resulted in fatalities. The reasons for gunfire in 43.8% of the cases could not be determined.
CONCLUSION: Sociologically, gun ownership is often associated with prestige and can trigger the use of firearms in celebrations, such as weddings, in some societies. However, this tradition can result in tragic consequences worldwide. Stricter regulations and legal frameworks are necessary to prevent the use of unlicensed weapons. Collaborative efforts are crucial for effectively addressing the societal normalization of celebratory gunfire. Future prospective studies can comprehensively evaluate the incidence of CGRI and identify effective preventive strategies to safeguard public health.

AMAÇ: Acil kolorektal rezeksiyonlar genel cerrahi pratiðinde önemli yer tutmakta ve sol kolon yerleþimli patolojiler azýmsanmayacak ölçüde görülmektedir. Çalýþmamýzda, benign etiyolojili izole sol kolon cerrahisi sonuçlarýný klinikopatolojik ve biyokimyasal veriler üzerinden deðerlendirmeyi amaçladýk.
GEREÇ VE YÖNTEM: Üçüncü basamak bir hastane genel cerrahi kliniðinde, Ocak 2017-Ocak 2022 tarihleri arasýnda malignite acilleri haricinde sol kolon cerrahisi yapýlan hastalarýn, demografik, klinik ve laboratuvar verileri retrospektif olarak taranarak istatistiksel analizi yapýldý.
BULGULAR: Çalýþmaya dahil edilen 48 hastanýn yaþ ortalamasý 56.9±16.4 yýl idi. En sýk acil cerrahi endikasyonu komplike akut divertikülit idi (n=19, %39.6). En sýk yapýlan cerrahi teknik hartmann prosedürüydü (n=30, %62.5). Postoperatif morbidite ve mortalite (30 gün içinde) oranýmýz sýrasýyla %27.1 ve %8.3 idi. Ýleri yaþ (ortalama 65.4±15.8’e karþýn 53.8±15.7, p=0.028), preoperatif vazopressör ajan kullanýmý, daha düþük trombosit düzeyleri, hipoalbuminemi (<3 mg/dl) ve azotemi (üre>20 mg/dl) artmýþ postoperarif morbiditeyle iliþkiliydi. Komorbidite, American Society of Anesthesiologists (ASA) skoru, cerrahi teknik ve diðer klinik veriler ile postoperatif sonuçlar arasýnda istatistiksel anlamlýlýk bulunamadý.
SONUÇ: Sol kolon patolojileri nedeniyle yapýlan acil kolorektal cerrahide; yaþlý, böbrek fonksiyon anormalliði olan ve vazopressör kullanýmý gerektiren hipotansif hastalarýn perioperatif süreçte kapsamlý deðerlendirilmeleri gerekmektedir.

BACKGROUND: Emergency colorectal resections hold a significant position in general surgical practice, and pathologies of the left colon are relatively common. This study was conducted to assess the outcomes of isolated left colon surgeries with benign etiologies, drawing on clinicopathological and biochemical data.
METHODS: We carried out a retrospective review and statistical analysis of demographic, clinical, and laboratory data of patients who underwent left colon surgery at the general surgery clinic of a tertiary care hospital, excluding those with malignancy-related emergencies, from January 2017 to January 2022.
RESULTS: The average age of the 48 patients in the study was 56.9±16.4 years. Complicated acute diverticulitis was the most frequent indication for emergency surgery (n=19, 39.6%). The Hartmann procedure was the surgical technique most often employed (n=30, 62.5%). The rates of postoperative morbidity and mortality within 30 days were 27.1% and 8.3%, respectively. Increased postoperative morbidity was linked to advanced age (mean 65.4±15.8 vs. 53.8±15.7, p=0.028), the preoperative administration of vasopressors, lower platelet counts, hypoalbuminemia (<3 mg/dl), and azotemia (blood urea nitrogen >20 mg/dl). There was no statistically significant correlation between comorbidities, American Society of Anesthesiologists (ASA) scores, surgical methods, or other clinical data and postoperative outcomes.
CONCLUSION: For emergency colorectal surgery pertaining to left colon pathologies, it is critical to conduct a comprehensive evaluation in the perioperative period, especially for elderly and hypotensive patients with renal function abnormalities and for those requiring vasopressors.

BACKGROUND: This descriptive analysis examines the victims of the February 6, 2023, earthquakes in Kahramanmaraþ and Elbistan, Türkiye. It aims to detail the injury profiles related to neuro-musculoskeletal trauma, assess the rehabilitation needs of patients, and propose a comprehensive rehabilitation approach.
METHODS: The study included patients injured in the Kahramanmaraþ-centered earthquake on February 6, 2023, who were transported to our hospital based on their rehabilitation needs. Data from patients treated at our hospital were recorded retrospectively. This included demographic information, accompanying pathologies, laboratory findings, rehabilitation programs, and treatments received during their hospital stay. Statistical analyses were conducted to examine the data.
RESULTS: A total of 141 patients with musculoskeletal injuries were admitted due to injuries sustained from the earthquake. The mean age of the participants was 39.76 years, with a slight female predominance (56.7%). The majority of patients sustained injuries while trapped under debris (90.1%), with an average duration of 10 hours under rubble. Fractures were the most common form of injury (53.2%), predominantly affecting the lower extremities. Peripheral nerve injuries were present in 41.1% of patients, and amputations were observed in 30.5%. Complications included compartment syndrome (46.1%), crush syndrome (36.2%), and various infections. Pain was prevalent among patients, with somatic pain being the most reported type. Individualized rehabilitation programs were implemented, incorporating physical therapy, wound care, pain management, and psychosocial support.
CONCLUSION: This study highlights the critical rehabilitation needs of earthquake survivors and emphasizes the importance of early and comprehensive rehabilitation interventions. Multidisciplinary rehabilitation programs were crucial in addressing medical issues, functional limitations, and psychological challenges faced by the survivors. The findings contribute to a deeper understanding of earthquake-related injuries and underscore the significance of well-coordinated rehabilitation strategies in disaster responses.

BACKGROUND: This descriptive analysis examines the victims of the February 6, 2023, earthquakes in Kahramanmaraþ and Elbistan, Türkiye. It aims to detail the injury profiles related to neuro-musculoskeletal trauma, assess the rehabilitation needs of patients, and propose a comprehensive rehabilitation approach.
METHODS: The study included patients injured in the Kahramanmaraþ-centered earthquake on February 6, 2023, who were transported to our hospital based on their rehabilitation needs. Data from patients treated at our hospital were recorded retrospectively. This included demographic information, accompanying pathologies, laboratory findings, rehabilitation programs, and treatments received during their hospital stay. Statistical analyses were conducted to examine the data.
RESULTS: A total of 141 patients with musculoskeletal injuries were admitted due to injuries sustained from the earthquake. The mean age of the participants was 39.76 years, with a slight female predominance (56.7%). The majority of patients sustained injuries while trapped under debris (90.1%), with an average duration of 10 hours under rubble. Fractures were the most common form of injury (53.2%), predominantly affecting the lower extremities. Peripheral nerve injuries were present in 41.1% of patients, and amputations were observed in 30.5%. Complications included compartment syndrome (46.1%), crush syndrome (36.2%), and various infections. Pain was prevalent among patients, with somatic pain being the most reported type. Individualized rehabilitation programs were implemented, incorporating physical therapy, wound care, pain management, and psychosocial support.
CONCLUSION: This study highlights the critical rehabilitation needs of earthquake survivors and emphasizes the importance of early and comprehensive rehabilitation interventions. Multidisciplinary rehabilitation programs were crucial in addressing medical issues, functional limitations, and psychological challenges faced by the survivors. The findings contribute to a deeper understanding of earthquake-related injuries and underscore the significance of well-coordinated rehabilitation strategies in disaster responses.

Geniþ kolon rezeksiyonlarý sonrasýnda kolorektal anastomoz yapmak mümkün olmayabilir. Bu nedenle, sað kolon transpozisyonu ile yapýlan Deloyers prosedürü tanýmlanmýþtýr. 2010-2023 yýllarý arasýnda yapýlan Deloyers prosedürlerini inceleyerek, prosedürün hangi durumlarda uygulandýðýný ve erken ile geç dönem sonuçlarýný tartýþmayý amaçladýk. Ateþli silah yaralanmasý sonucu sigmoid kolon, inen kolon, transvers kolon ve mezenterde büyük organ ve doku kaybý yaþayan 22 yaþýndaki bir kadýn hastada, hasar kontrol cerrahisini takiben restoratif cerrahide Deloyers prosedürü uygulandý. Çekum ve sað kolonun mobilizasyonu sonrasýnda, ileokolik arter pedikülü üzerinde kraniokaudal yönde rotasyon yapýldý, ardýndan appendektomi gerçekleþtirildi. Kolorektal anastomoz ise sirküler stapler ile oluþturuldu. Postoperatif takiplerde herhangi bir komplikasyon geliþmedi. Postoperatif 14. günde hasta taburcu edilen hastanýn barsak hareketleri 2.5 mg difenoksilat hidroklorür ve 0.025 mg atropin sülfat tedavisi ile günde 4 kezdi. 6 aylýk izlemde, medikal tedaviye ihtiyaç duymaksýzýn barsak hareketleri günde 2'ye düþtü. Geniþ sol kolektomileri takiben hastalarýn fonksiyonel sonuçlarýný düþünerek, düþük morbiditesi olan Deloyers prosedürü güvenle uygulanabilir.

Following extended colon resections, it may not always be possible to perform colorectal anastomosis. The Deloyers procedure, which involves the transposition of the right colon, has been identified as a viable solution. This report aims to discuss the circumstances under which the Deloyers procedure was performed, as well as to evaluate the early and late postoperative outcomes, by reviewing cases conducted between 2010 and 2023. In a 22-year-old female patient who suffered major organ and tissue loss (with injuries to the sigmoid colon, descending colon, transverse colon, and mesentery) due to a firearm injury, the Deloyers procedure was applied during restorative surgery following initial damage control surgery. The procedure involved mobilizing the cecum and right colon, performing a cranio-caudal rotation over the ileocolic artery pedicle, followed by an appendectomy, and creating a colorectal anastomosis using circular staplers. There were no complications during the postoperative follow-ups. By the 14th postoperative day, the patient was discharged and experienced bowel movements four times a day, managed with 2.5 mg of diphenoxylate hydrochloride and 0.025 mg of atropine sulfate. At the 6-month follow-up, the frequency of bowel movements had decreased to twice daily without the need for medical treatment. Given the functional outcomes in patients after extended left colectomies, the Deloyers procedure, with its low associated morbidity, stands out as a viable option.