AMAÇ: Bu çalýþmada topikal aleo veranýn (AV) sýçan modelinde deneysel olarak oluþturulan penil fraktur (PF) üzerindeki histopatolojik ve oksitatif etkileri deðerlendirildi.
GEREÇ VE YÖNTEM: Kýrk adet Wistar albino sýçan (220-250 g) kullanýldý. PF modeli deneysel olarak 15 numaralý lanset ile oluþturuldu. Sýçanlar rastgele ve eþit þekilde 5 gruba ayrýldý. Birinci grupta (C) herhangi bir kesi oluþturulmadý. Ýkinci grupta (P) insizyon oluþturuldu. Üçüncü grupta (PR) kesi hattý primer olarak kapatýldý. Dördüncü grupta (PA) 3 gün süreyle insizyon hattýna onarým yapmadan lokal olarak AV uygulandý. Son grupta (PAV) primer onarým bölgesine 3 gün süreyle AV uygulandý. Tüm gruplar histopatolojik ve biyokimyasal verilere göre birbirleriyle karþýlaþtýrýldý.
BULGULAR: PRA grubunda hiperemi-kanamanýn diðer gruplara göre baskýlandýðý görüldü (p<0.001). Enflamasyon sadece PR ve PRA grubunda görüldü (p<0.001). PA ve PRA gruplarýnda diðer gruplarla karþýlaþtýrýldýðýnda anlamlý fibrozis gözlendi (p<0.001). SOD ve GSH deðerleri PRA grubu lehine arttý (sýrasýyla p=0.009 ve p=0.035). TOS ve MDA deðerleri PA grubu lehine azaldý (sýrasýyla p=0.036 ve p=0.026). TNF-α en çok PRA gru-bunda, IL-1ß düzeyi ise en çok PRA grubunda azaldý ancak tüm bu deðiþiklikler istatistiksel anlamlýlýk kazanmadý (p>0.05).
SONUÇ: Topikal AV uygulamasýnýn doku inflamasyonunu ve oksidatif stresi azaltýðý ancak PF sonrasý fibrozis geliþimini arttýrdýðý görülmektedir.

BACKGROUND: This study assessed the histopathological and oxidative effects of topical Aloe Vera (AV) on penile fractures (PF) formed experimentally in a rat model.
METHODS: Forty Wistar albino rats (220-250 g) were used. The PF model was created experimentally with a number 15 lancet. Then, the rats were randomly and equally divided into five groups. In the first group (C), no incision was formed. In the second group (P), an incision was formed. In the third group (PR), the incision line was closed primarily. In the fourth group (PA), AV was locally applied onto the incision without suturing for three days. In the last group (PRA), AV was applied to the primary repair region for three days. All groups were compared to each other according to histopathological and biochemical data.
RESULTS: Hyperemia-bleeding was observed to be suppressed in the PRA group compared to the other groups (p<0.001). Inflammation was observed only in Groups PR and PRA (p<0.001). Significant fibrosis was observed in the PA and PRA groups compared to the other groups (p<0.001). Superoxide Dismutase (SOD) and Glutathione (GSH) values increased in favor of Group PRA (p=0.009 and p=0.035, respectively). Total Oxidative Status (TOS) and Malondialdehyde (MDA) values decreased in favor of Group PA (p=0.036 and p=0.026, respectively). Tumor Necrosis Factor-alpha (TNF-α) and Interleukin-1 beta (IL-1ß) levels decreased mostly in the PRA group, but these changes did not reach statistical significance (p>0.05).
CONCLUSION: Topical AV application reduces tissue inflammation and oxidative stress but appears to increase the development of fibrosis after PF.

AMAÇ: Nadir görülen ince baðýrsak tümörlerinin taný ve tedavisini klinik olgularla sunmak.
GEREÇ VE YÖNTEM: 2000-2023 yýllarý arasýnda tedavi edilen hastalar çalýþmaya dahil edildi. Hastalarýn klinik kayýtlarý retrospektif olarak analiz edildi.
BULGULAR: Çalýþmaya 34 hasta dahil edildi: Çalýþmaya 34 hasta dahil edildi. Bu hastalarýn 26'sý (%75.5) erkek ve 8'i (%23.5) kadýndý. Hastalarýn ortalama yaþý 62.1 idi. En sýk görülen semptom ve bulgular karýn aðrýsý (%76.4), þiþkinlik (%38,2), bulantý ve kusma (%17.6) idi. Taný yöntemleri olarak bilgisayarlý tomografi (BT) (%82.3), üst gastrointestinal çift balon enteroskopi (%35.2), kapsül endoskopi (%5.8) kullanýldý. Olgularýn 13'ünde adenokarsinom, 12'sinde GÝST ve 2'sinde NET saptandý.
SONUÇ: Ýnce baðýrsak tümörleri sýklýkla karýn aðrýsý, þiþkinlik ve bulantý-kusma ile baþvurur. BT ve endoskopik iþlemler taný için ilk tercihtir. Ýnce baðýrsak kanserleri klinik olarak silik bulgular ve yetersiz endoskopik görüntüleme nedeniyle geç teþhis edilmektedir. Belirli risk altýndaki ve semptomatik hasta gruplarýnda hedefe yönelik tarama stratejileri uygulanabilir. Taný konulan hastalarda erken cerrahi müdahale önemli avantajlar saðlamaktadýr.

BACKGROUND: This study presents the diagnosis and treatment of rare small bowel tumors through clinical cases.
METHODS: Patients treated between 2000 and 2023 were included in the study. The clinical records of the patients were analyzed retrospectively.
RESULTS: A total of 34 patients were included in the study. Of these patients, 26 (75.5%) were male and eight (23.5%) were female. The mean age of the patients was 62.1 years. The most common symptoms and signs were abdominal pain (76.4%), bloating (38.2%), and nausea and vomiting (17.6%). Diagnostic methods included computed tomography (CT) (82.3%), upper gastrointestinal double balloon enteroscopy (35.2%), and capsule endoscopy (5.8%). Diagnoses included adenocarcinoma in 13 cases, gastrointestinal stromal tumors (GISTs) in 12 cases, and neuroendocrine tumors (NETs) in two cases.
CONCLUSION: Small bowel tumors frequently present with abdominal pain, bloating, and nausea and vomiting. CT and endoscopic procedures are the primary diagnostic tools. Small bowel cancers are often diagnosed late due to subtle clinical findings and the limitations of endoscopic imaging. Targeted screening strategies may be beneficial for certain at-risk and symptomatic patient groups. Early surgical intervention offers significant advantages for diagnosed patients.

AMAÇ: Travmatik kafa yaralanmalarý, ölümlü adli olaylarda önemli nedenlerden biridir. Bu çalýþmada fatal travmatik kafa yaralanmalý olgularýn özeliklerinin incelenmesi amaçlanmaktadýr.
GEREÇ VE YÖNTEM: Bu çalýþmada ölümcül travmatik kafa yaralanmasý bulunan ve ölü muayene ve/veya otopsi yapýlan 311 adli olgu retrospektif olarak incelendi. Olgular cinsiyet, yaþ grubu, olay orijini, olay nedeni, kafatasý kýrýðý varlýðý, varsa kýrýlan kemik çeþidi, lokalizasyonu ve kýrýk þekli, intrakranial lezyon varlýðý, varsa lezyon çeþidi ve ölüm nedeni deðiþkenleri açýsýndan deðerlendirildi.
BULGULAR: Olgularýn 242’si (%77.8) erkek, 69'u (%22.2) kadýndý. Olaylarýn 235'i (%75.6) kaza orijinliydi ve 117 olgu (%37.6) araç içi trafik kazasý nedenliydi. 221 olguda (%71.1) intrakranial lezyon ve kafatasý kýrýðý birlikteydi. En sýk olarak, 171 olguda kafa tabaný kýrýðý ve 153 olguda temporal kemik kýrýðý izlendi. Eriþkin yaþ grubunda daha düþük (%69.7), ileri yaþ grubunda ise daha yüksek oranda (92.6%) intrakranial kanama meydana geldiði saptandý.
SONUÇ: Çalýþmamýzda maðduru olunan olay nedeni, meydana gelen kýrýk çeþidi, kafa tabaný kýrýðý meydana gelmesi ve çoklu kafatasý kýrýðýnýn meydana gelmesi gibi durumlarýn fatalite ihtimalini arttýrdýðý saptandý. Kafatasý kýrýklarýnýn meydana gelmesi, kafa içi basýncýný azaltmakta ve böylece kafa içi lezyonlarýn görülme sýklýðýný azalmaktadýr. Karayolu trafiði güvenlik politikalarýnýn geliþtirilmesi ve trafik kurallarýnýn/düzenlemelerinin etkili bir þekilde uygulanmasý ile ölümlerin insidansý azalacaktýr.

BACKGROUND: Traumatic head injuries (THIs) are one of the major causes of death in forensic cases. The aim of this study was to investigate the characteristics of patients with fatal THIs.
METHODS: In this study, a total of 311 patients with fatal THIs, who underwent postmortem examinations and/or autopsies, were retrospectively analyzed. Cases were evaluated based on sex, age group, incident origin, cause of the incident, presence of skull fracture, type of fractured bone (if any), fracture localization and pattern, presence and type of intracranial lesion (if any), and cause of death.
RESULTS: Out of the patients, 242 (77.8%) were male and 69 (22.2%) were female. Accidents accounted for 235 (75.6%) of the incidents, with in-vehicle traffic accidents causing 117 (37.6%). In 221 cases (71.1%), intracranial lesions and skull fractures were observed together. The most common fractures were base fractures (171 cases) and temporal bone fractures (153 cases). The rate of intracranial hemorrhage was lower in the adult age group (69.7%) compared to the older age group (92.6%).
CONCLUSION: The results obtained in this study indicate that the cause of the incident, type of fracture, presence of skull base fracture, and multiple skull fractures increase the likelihood of fatalities. The occurrence of skull fractures reduces intracranial pressure, thereby decreasing the incidence of intracranial lesions. The development and effective enforcement of road traffic safety policies and regulations will reduce the incidence of fatalities.

AMAÇ: 6 Þubat 2023 Kahramanmaraþ depremi ülkemizde ciddi bir yýkým yaratmýþtýr. 50 binden fazla kiþi hayatýný kaybetmiþ, binlere kiþi yaralanmýþ ve saðlýk kuruluþlarý hasar almýþtýr. Depremzedeler tedavi için baþka illerdeki hastanelere transfer edilmiþtir. Bu çalýþma ile 3. basamak hastanemize nakledilen yaralýlarda uygulanan anestezi yaklaþýmýný deðerlendirmeyi amaçladýk.
GEREÇ VE YÖNTEM: 6-20 Þubat 2023 tarihleri arasýnda opere edilen hastalarýn verileri retrospektif olarak incelenmiþtir. Çalýþmaya acil travma cerrahisi geçiren, 10 yaþ ve üzerindeki depremzede hastalar dahil edilmiþtir. Hastalarýn hastaneye kabul tarihi, demografik bilgileri, ameliyat türü, ameliyat bölgesi, anestezi tekniði, periferik blok tercihi, laboratuvar deðerleri, diyaliz ve yoðun bakým ihtiyaçlarý, saðkalýmlarý kaydedilmiþtir. Verilerin analizi için IBM® SPSS® 26.0 programý kullanýlmýþtýr.
BULGULAR: Çalýþmaya 375 vaka dahil edilmiþtir. 323 hasta ekstremite, 35 hasta vertebra yaralanmasý nedeniyle opere edilmiþtir. Ekstremite yaralanmalarýnýn %61.6’sý alt ekstremite, %17.1’i üst ekstremitedir. 147 hastaya debridman, 49 hastaya fasiyotomi ve 33 hastaya ampütasyon uygulanmýþtýr. Hastalarýn 352’sine genel anestezi, 19’una spinal anestezi ve 4’üne sedoanaljezi uygulanmýþtýr. 33 hastaya periferik sinir bloðu yapýlmýþtýr. 105 hastaya diyaliz tedavisi uygulanmýþtýr. 26 hasta tedavi sürecinde kaybedilmiþtir. Ýntraoperatif hasta kaybý olmamýþtýr.
SONUÇ: Depremzedelerde en sýk ekstremite yaralanmalarýnýn görülmesi rejyonal anesteziye eðilimi arttýrmaktadýr. Temel anestezi becerilerine Plan A bloklarýnýn eklenmesi ile afet durumlarýnda rejyonal anestezi tercihi artabilir. Ayrýca yaralýlarýn ileri merkezlere transferi ile morbiditenin azalacaðý düþünülebilir.

BACKGROUND: The February 6, 2023, Kahramanmaraþ earthquake caused significant destruction across our country. More than 50,000 people lost their lives, thousands were injured, and health facilities were damaged. Victims were transferred to hospitals in other provinces for treatment. This study evaluates the anesthesia approach applied to the injured who were transferred to our tertiary hospital.
METHODS: We retrospectively reviewed the data of patients who underwent surgery between February 6 and February 20, 2023. The study included earthquake victims who underwent emergency trauma surgery, aged 10 years and above. We recorded the date of admission to the hospital, demographic information, type of surgery, surgical site, anesthesia technique, preference for peripheral block, laboratory values, dialysis and intensive care needs, and survival rates. Data analysis was performed using the IBM® Statistical Package for the Social Sciences (SPSS®) Version 26.0.
RESULTS: A total of 375 cases were included in the study. Of these, 323 patients underwent surgery for extremity injuries, and 35 for vertebral injuries. Among the extremity injuries, 61.6% were to the lower extremities, and 17.1% to the upper extremities. Debridement was performed on 147 patients, fasciotomy on 49 patients, and amputation on 33 patients. General anesthesia was applied to 352 patients, spinal anesthesia to 19 patients, and sedoanalgesia to four patients. Peripheral nerve block was performed on 33 patients. Dialysis treatment was administered to 105 patients. Twenty-six patients were lost during the treatment process. There were no intraoperative patient deaths.
CONCLUSION: The predominance of extremity injuries among earthquake victims increases the inclination towards regional anesthesia. Incorporating Plan A blocks into basic anesthesia skills could enhance the preference for regional anesthesia in disaster situations. Furthermore, transferring the injured to advanced centers may reduce morbidity.

AMAÇ: Crush Sendromu, büyük ölçekli katastrofik depremlerden sonra morbidite ve mortalitenin en önemli nedenlerinden biridir. Ezilme Sendromu ile ilgili randomize kontrollü bir çalýþma bulunmadýðýndan, bu konudaki bilgiler uzmanlarýn deneyimleriyle sýnýrlýdýr. Bu çalýþmanýn temel amacý, 06 Þubat 2023 tarihinde meydana gelen Pazarcýk ve Elbistan depremleri sonrasýnda depremzedelerin epidemiyolojik, demografik özelliklerini, klinik sonuçlarýný ve mortalite faktörlerini analiz etmektir
GEREÇ VE YÖNTEM: Bu kesitsel ve gözlemsel retrospektif çalýþmada, 6 Þubat - 30 Nisan 2023 tarihleri arasýnda merkezimize baþvuran 610 depremzede deðerlendirildi. Bu hastalar arasýnda Crush Sendromu olan 128 hasta çalýþmaya dahil edildi. Hastalara ait bilgiler, hastaneye yatýþlarý sýrasýnda hastane kayýtlarýndan ve sevk edildiklerinde ulusal kayýtlardan elde edildi. Birincil sonucumuz mortalite için risk faktörlerini belirlemekti. Demografik ve laboratuvar verileri akut böbrek hasarý evrelerine göre karþýlaþtýrýldý; mortaliteyi etkileyen faktörler regresyon analizi ile belirlendi.
BULGULAR: 128 Crush Sendromu hastasýnýn (100 yetiþkin, 28 çocuk) 64'ü kadýndý. AKI oraný %32.8 idi. AKI hastalarý arasýnda hemodiyaliz gereksinimi sýklýðý %69 ve mortalite oraný %14.2 idi. Ölüm oraný Crush Sendromu olanlarda %4.6 iken, Crush Sendromu olmayan depremzedelerde %3.9 (19/482) idi. (p: 0.705) Çarpýcý bir þekilde, Crush sendromlu hastalarda mortaliteyi önemli ölçüde etkileyen sadece baþvuru sýrasýndaki düþük sistolik kan basýncýdýr. (HR: 1.088, p: 0.021 %95 C.I.)
SONUÇ: Çalýþmamýz, baþvuru sýrasýndaki düþük sistolik kan basýncýnýn Crush Sendromlu hastalarda artmýþ mortalite için önemli bir risk faktörü olduðunu vurgulamýþtýr. Bu sonuç, enkaz altýnda kan basýncýnýn ölçülmesi ve düþük sistolik kan basýncý olan hastalara daha agresif sývý tedavisi verilmesi konusunda literatüre katký saðlayabilir

BACKGROUND: Crush Syndrome is a major cause of morbidity and mortality following large-scale catastrophic earthquakes. Since there are no randomized controlled studies on Crush Syndrome, knowledge on this subject is limited to expert experience. The primary objective is to analyze the epidemiological and demographic characteristics, clinical outcomes, and mortality factors of earthquake victims after the Pazarcik and Elbistan earthquakes on February 6, 2023.
METHODS: This cross-sectional and observational retrospective study evaluated 610 earthquake victims who presented to our center between February 6 and April 30, 2023. Among these patients, 128 with Crush Syndrome were included in the study. Patient information was gathered from hospital records during their stay and from national registries upon referral. The primary outcome was to identify risk factors for mortality. Demographic and laboratory data were analyzed by acute kidney injury (AKI) stages; mortality-affecting factors were identified through regression analysis.
RESULTS: Of the 128 Crush Syndrome patients (100 adults, 28 children), 64 were female. The AKI rate was 32.8%. Among patients with AKI, the frequency of hemodialysis requirement was 69%, and the mortality rate was 14.2%. The overall mortality rate for patients with Crush Syndrome was 4.6%, compared to 3.9% (19/482) in earthquake victims without Crush Syndrome (p=0.705). Notably, low systolic blood pressure at admission was the only factor significantly affecting mortality in Crush Syndrome patients (Hazard Ratio [HR]: 1.088, p=0.021, 95% Confidence Interval [CI]).
CONCLUSION: Our study highlights low systolic blood pressure upon admission as a significant risk factor for increased mortality in Crush Syndrome patients. This finding may contribute to the literature by emphasizing the importance of monitoring blood pressure under rubble and administering more aggressive fluid therapy to patients with low systolic blood pressure.

AMAÇ: Depremler, genellikle þiddetli yaralanmalara ve travmatik durumlara neden olabilen doðal afetlerdir. Bu yaralanmalar arasýnda ezilme yaralanmalarý, kýrýklar, doku hasarý ve kan dolaþýmý problemleri bulunabilir. Hiperbarik oksijen tedavisi (HBOT), bu tür þiddetli yaralanmalara maruz kalan bireylerde son zamanlarda sýklýkla kullanýlan bir tedavi yöntemi haline gelmiþtir. HBOT, hastaya yüksek basýnç altýnda saf oksijen verilmesini içeren bir tedavi þeklidir. Bu tedavi, hücresel oksijenlenmeyi artýrarak doku iyileþmesini teþvik etmeyi amaçlar. Deprem sonrasý þiddetli yaralanmalarda, özellikle ezilme yaralanmalarýnda, doku iyileþmesini hýzlandýrma, iltihap azaltma ve enfeksiyon kontrolü gibi faktörlerde olumlu etkileri olabileceði düþünülmektedir. 06.02.2023'teki Kahramanmaraþ depreminin ardýndan þiddetli yaralanmalara maruz kalan 35 hastanýn hiperbarik oksijen tedavisi sonuçlarýný inceleyerek, tedavinin klinik etkilerini, iyileþme sürecini ve potansiyel avantajlarýný retrospektif olarak deðerlendirmek ve acil durum müdahale stratejilerini geliþtirmeye katký saðlamayý amaçlamaktadýr.
GEREÇ VE YÖNTEM: Bu çalýþma etik kurul onayý alýndýktan sonra gerçekleþtirilmiþtir. Çalýþmada, depremzede olarak baþvurusu alýnan ve depreme baðlý þiddetli yaralanmasý nedeniyle Hiperbarik Oksijen Tedavi Ünitesinde tedavi gören Mess Skoru 7-14 arasýnda olan hastalarýn verileri, geçmiþ kayýtlardan elde edilmiþ ve geriye dönük olarak incelenmiþtir. Demografik bilgiler, hasta verilerinin genel daðýlýmý, ortalama deðerleri, Hiperbarik Oksijen Tedavisi (HBOT) seans sayýlarý ve fonksiyonel sonuçlar, kayýt altýna alýnmýþtýr.
BULGULAR: Hiperbarik Oksijen tedavisine alýnan 35 hastanýn cinsiyet daðýlýmýnda %31.4'ü erkek, %68.6'sý kadýndý. Yaþ daðýlýmýna göre, hastalarýn %45.7'si 18 yaþ ve altýnda, %54.3'ü ise 19 yaþ ve üstündeydi. Hastalarýn yaþ ortalamasý 25 olup, yaþ daðýlýmý, minimum 1 ve maksimum 85 arasýnda deðiþmekteydi. Tedavi edilen hastalarda en sýk yaralanmalar alt ekstremitelerde gözlemlendi, özellikle sol alt ve sað alt ekstremite etkilendi. Hiperbarik Oksijen tedavisi sonrasýnda, hastalarýn çoðunda his geri kazanýmý (%54.3) ve fonksiyonel geri kazaným (%51.4) elde edildi. HBOT öncesi ve sonrasý amputasyon oranlarý incelendiðinde, HBOT öncesi minör amputasyon oraný %14.3, majör amputasyon oraný %11.4 iken, HBOT sonrasý minör amputasyon oraný %20.0 ve majör amputasyon oraný %11.4 olarak belirlendi.
SONUÇ: Bu çalýþma, depremde þiddetli yaralanmalarý olan hastalarda Hiperbarik Oksijen Tedavisi'nin (HBOT) olasý etkilerini deðerlendirdi ve elde edilen bulgular, HBOT'un bu özel hasta grubunda his geri kazanýmý, fonksiyonel iyileþme, minör amputasyon oranlarý ve enkaz altýnda geçirilen süre gibi kritik faktörler üzerinde olumlu etkiler saðlayabileceðini göstermiþtir.

BACKGROUND: Earthquakes are natural disasters that can often cause severe injuries and traumatic situations. These injuries can include crush injuries, fractures, tissue damage, and blood circulation problems. Hyperbaric oxygen therapy (HBOT) has recently become a frequently used treatment modality for individuals suffering from severe injuries. HBOT is a form of treatment that involves administering pure oxygen to the patient under high pressure. This treatment aims to promote tissue healing by increasing cellular oxygenation. It is thought to have a positive effect on factors such as accelerating tissue healing, reducing inflammation, and controlling infection in severe post-earthquake injuries, particularly crush injuries. This study aimed to retrospectively evaluate the clinical effects, contributions to the healing process, and potential advantages of HBOT in 35 patients with severe injuries after the Kahramanmaraþ earthquake that occurred on 06.02.2023 and to contribute to the development of emergency intervention strategies.
METHODS: This study was carried out after ethics committee approval. In the study, the data of patients with a MESS Score between 7-14 who were admitted as earthquake victims and treated in the HBOT Unit due to severe earthquake-related injuries were obtained from records and retrospectively analyzed. Demographic information, general distribution of patient data, mean values, number of HBOT sessions, and functional outcomes were recorded.
RESULTS: The gender distribution of the 35 patients who received HBOT was 31.4% male and 68.6% female. 45.7% of patients were aged 18 years or younger, and 54.3% were aged 19 years or older. The most common injuries in the treated patients were observed in the lower extremities. After HBOT, sensory recovery (54.3%) and functional recovery (51.4%) were achieved in the majority of patients. The minor amputation rate was 20.0% and the major amputation rate was 11.4% after HBOT.
CONCLUSION: This study evaluated the possible effects of HBOT on patients with severe earthquake injuries in Türkiye, and the results showed that HBOT may have a beneficial effect on critical factors such as sensory recovery, functional recovery, and amputation rates in this particular group of patients, and that this benefit may be more pronounced in those who started treatment early.

AMAÇ: Acil cerrahi önceliklendirmesinde hasta prognozunun tahmin edilebilmesi için çatýþma bölgelerindeki kitlesel travma hastalarýnda prognostik tahmin skorlama sistemlerini deðerlendiren çalýþmalara ihtiyaç vardýr. Bu çalýþmada Suriye’nin kuzeyinde kitlesel travma nedeniyle baþvuran hastalarda Revised Trauma Score (RTS), Injury Severity Score (ISS) ve Trauma and Injury Severity Score (TRISS) skalalarýnýn deðerlendirilmesi amaçlandý.
GEREÇ VE YÖNTEM: Bu çalýþmada, Suriye’nin kuzeyindeki hastanelerin acil servislerine kitlesel travma nedeniyle baþvuran hastalarýn retrospektif olarak deðerlendirilmesi yapýldý. 2021 yýlýnýn ilk yarýsýnda bu baþvurularda RTS, ISS ve TRISS puanlama sistemlerinin tanýsal etkinliði deðerlendirildi.
BULGULAR: Kitlesel travmalarýnýn en sýk nedenleri bomba patlamasý (%67.3), ateþli silah yaralanmalarý (%28.8) ve diðer nedenlerdi (%3.9). Odds oraný (OR) analiz edildiðinde, RTS ve TRISS skorundaki bir birimlik artýþýn hayatta kalma ihtimalini 6.133 ve 1.057 kat arttýrdýðý, ancak ISS'deki her bir birimlik artýþýn, hastanýn hayatta kalma olasýlýðýný 0.856 birim azalttýðý tespit edildi. RTS, TRISS ve ISS deðerleri incelendiðinde ROC eðrisi altýnda kalan alanýn istatistiksel olarak anlamlý olduðu (p<0.001) ve hepsinin sýrasýyla %99.0, %94.8 ve % 91.9 duyarlýlýklarla; %87.8, %90.5 ve 88.6 özgüllükle; 0.958, 0.975 ve 0.958 AUC deðerleri ile mortalite açýsýndan taný deðeri taþýdýðý görüldü.
SONUÇ: Kapasite aþýmlarýnda TRISS baþta olmak üzere travma skorlama sistemlerinin kullanýlmasý kitlesel travma hastalarýnýn önceliklendirilmesinde faydalý olabilir.

BACKGROUND: There is a need for studies evaluating prognostic scoring systems in mass trauma patients in conflict regions to predict patient prognosis for emergency surgical prioritization. In this study, we aimed to evaluate scoring systems such as the Revised Trauma Score (RTS), Injury Severity Score (ISS), and Trauma and Injury Severity Score (TRISS) in trauma patients admitted due to mass trauma in Northern Syria.
METHODS: This study was a retrospective evaluation of patients admitted due to mass trauma to the emergency departments of hospitals in Northern Syria. The diagnostic efficiency of RTS, ISS, and TRISS scoring systems was evaluated in these admissions in the first half of 2021.
RESULTS: The most common causes of mass trauma were bomb blast (67.3%), gunshot (28.8%), and 14 (3.9%) patients admitted with other causes. When the odds ratio (OR) was analyzed, a one-unit increase in the RTS score increased the odds of survival by a factor of 6.133, and a one-unit increase in the TRISS score increased the odds of survival by a factor of 1.057. Differently, it was found that each 1-unit increase in ISS decreased the patient's probability of survival by 0.856 units. When RTS, TRISS, and ISS scores were analyzed, the area under the ROC curve was statistically significant for all of them (p<0.001) and all of them had a diagnostic value for mortality with sensitivities of 99.0%, 94.8%, and 91.9%; specificities of 87.8%, 90.5%, and 88.6; AUC of 0.958, 0.975, and 0.958, respectively.
CONCLUSION: The use of trauma scoring systems, especially TRISS, may be useful for prioritizing patients in mass casualty settings in the presence of overcapacity.

AMAÇ: Üst ekstremite akut kompartman sendromu, cerrahi acil bir durumdur ve ekstremite fonksiyonlarýnýn korunmasý için hýzlý taný konulmasý ve fasiyotomilein derhal gerçekleþtirilmesi hayati öneme sahiptir. Bu retrospektif çalýþmanýn amacý, travmayý takiben 6 saat içinde fasiyotomi yapýlan ve daha geç zamanda yapýlan hastalarýn komplikasyon oranlarýný karþýlaþtýrmaktýr.
GEREÇ VE YÖNTEM: 2016-2022 yýllarý arasýnda üst ekstremite AKS'nin cerrahi tedavisi için fasiyotomi yapýlan hastalarýn týbbi kayýtlarý, yaþ, cinsiyet, dominant el, yaralanma mekanizmasý, yaralanma seviyesi, etkilenen kompartmanlar, iliþkili yaralanmalar, fasiyotomiye kadar geçen süre ve komplikasyonlar açýsýndan retrospektif olarak analiz edildi. Hastalar, fasiyotomi zamanlamasýna göre iki gruba ayrýldý.
BULGULAR: Üst ekstremite AKS için toplam 32 hastaya fasiyotomi yapýldý. Fasiyotomi yapýlan hastalarýn yaþ ortalamasý 6 saatten daha kýsa sürede fasyotomi yapýlan grupta (grup 1; 10 erkek, 7 kadýn) 31.1 ve 6 saatten daha fazla süre sonra fasiyotomi yapýlan hastalarda (grup 2; 13 erkek, 2 kadýn) 34.8 idi. En yaygýn etiyoloji ezilme yaralanmasýydý. Grup 1 (1/17) ve grup 2 (10/15) arasýnda komplikasyon oranlarý açýsýndan anlamlý fark vardý (p<0.001). Grup 2'de hastanede kalýþ süresi, grup 1'e göre istatistiksel olarak anlamlý þekilde daha yüksek bulundu (p=0.005).
SONUÇ: Üst ekstremite AKS için fasiyotomilerin, ilk travmadan sonraki 6 saat içinde yapýlmasý gerekmektedir. Bu þekilde komplikasyon oranlarý azaltýlabilir.

BACKGROUND: Acute compartment syndrome of the upper extremity is a surgical emergency, and timely diagnosis with immediate fasciotomies is essential for the preservation of function. This retrospective study aimed to compare the complication rates of patients who underwent fasciotomy before and after 6 hours following the initial trauma.
METHODS: The medical records of the patients who underwent fasciotomy for surgical treatment of ACS of the upper extremity between 2016 and 2022 were retrospectively analyzed for age, gender, dominant hand, mechanism of injury, injury level, affected compartments, associated injuries, time elapsed till fasciotomy, and complications. The patients were divided into two groups according to the timing of fasciotomy.
RESULTS: A total of 32 patients underwent fasciotomies for upper extremity ACS. The mean age of patients who underwent fasciotomy ≤ 6 hours (group 1; 10 males, 7 females) and patients who underwent fasciotomy > 6 hours (group 2; 13 males, 2 females) was 31.1 and 34.8, respectively. The most common etiology was crushing injury. There was a significant difference in complication rates between group 1 (1/17) and group 2 (10/15) (p<0.001). The length of hospitalization stay in group 2 was statistically higher than in group 1 (p=0.005).
CONCLUSION: Fasciotomies for ACS of the upper extremity should be performed in less than 6 hours following the initial trauma to prevent complications.

AMAÇ: Bu çalýþmanýn amacý, tamamen implante edilebilir venöz eriþim portu (TÝVAP) implantasyonu yapýlan hastalarýn demografik bilgilerini sunmak, erken ve geç komplikasyon oranlarýný araþtýrmak ve iþlemin ultrasonografi (US) kýlavuzluðunda yapýlmasýnýn faydalarýný deðerlendirmektir.
GEREÇ VE YÖNTEM: Mayýs 2018 ile Aralýk 2023 tarihleri arasýnda 537 TIVAP implantasyon prosedürünün sonuçlarý retrospektif olarak analiz edildi. Çalýþmada cerrahlarýn her iki ponksiyon yöntemi (anatomik iþaretler ve ultrason kýlavuzluðu) için deneyimlerine iliþkin veriler sunulmuþtur.
BULGULAR: Hastalarýn ortalama yaþý 53.1±11.9 yýldý ve 261'i (%48.6) kadýndý. Sað subklavyen ven tercih edilen giriþ yeriydi. On dört hastada erken komplikasyon ve 11 hastada geç komplikasyon geliþti. Arteriyel ponksiyon en sýk görülen erken komplikasyon iken, kateterle iliþkili enfeksiyon en sýk görülen geç komplikasyondu. Hastalarýn yaþý, cinsiyeti ve vücut kitle indeksi komplikasyon geliþimi için baðýmsýz risk faktörleri deðildi. Erken komplikasyonlar ponksiyon giriþim sayýsý arttýkça daha fazla görüldü (p=0.034) ve ultrason kýlavuzluðu kullanýldýðýnda anlamlý olarak daha az görüldü (p=0.011).
SONUÇ: Komplikasyon geliþme riski hastanýn yaþý veya cinsiyetinden etkilenmemiþtir. Ayrýca, vücut kitle indeksinin komplikasyon geliþen hastalar için baðýmsýz bir risk faktörü olmadýðý gösterilmiþtir. Çalýþmadan, ultrason kýlavuzluðunda implantasyon ile özellikle erken dönem komplikasyonlarýn azaltýlabileceði sonucu çýkarýlabilir.

BACKGROUND: The aim of this study was to present demographic information of patients undergoing totally implantable venous access port (TIVAP) implantation and to investigate the rates of early and late complications, assessing the benefits of performing the procedure underUS guidance.
METHODS: From May 2018 to December 2023, the outcomes of a total of 537 TIVAP implantation procedures were analyzed retrospectively. Data of the surgeons' experiences for both puncture methods (anatomical landmarks and ultrasound guidance) are presented in the study.
RESULTS: The average age of the patients was 53.1±11.9 years, and 261 (48.6%) were female. The right subclavian vein was the preferred insertion site. Fourteen patients developed early complications and 11 developed late complications. Arterial puncture was the most common early complication, while catheter-related infection was the most common late complication. The age, sex, and body mass index of the patients were not independent risk factors for developing complications. Early complications increased as the number of puncture attempts did (p=0.034) and developed significantly less when ultrasound guidance was used during insertion (p=0.011).
CONCLUSION: The risk of developing complications was not affected by patient’s age or sex. In addition, body mass index was not shown to be an independent risk factor for patients developing complications. It may be concluded from the study that early complications in particular can be reduced with ultrasound-guided implantation.

AMAÇ: Hýzlý ve etkili yemek piþirmek için yaygýn olarak kullanýlan düdüklü tencerelerin, uygun olmayan kullanýmdan kaynaklanan potansiyel tehlikeleri literatür yeterince vurgulamamýþtýr. Bu çalýþma, düdüklü tencere yanýklarý nedeniyle tedavi arayan 32 hastayý kapsayarak, düdüklü tencerelerin yanlýþ kullanýmýndan kaynaklanan ciddi risklere vurgu yapmayý amaçlamaktadýr.
GEREÇ VE YÖNTEM: Baðcýlar Eðitim ve Araþtýrma Hastanesi Yanýk Merkezi'ne 2017 ile 2020 yýllarý arasýnda düdüklü tencere yanýðý ile baþvuran hastalardan retrospektif veriler toplandý. Veriler, hasta özellikleri, yanma nedenleri, yerleri, ciddiyetleri, tedavileri ve klinik sonuçlarý içermektedir.
BULGULAR: Çalýþma, 32 hastayý (29 kadýn/3 erkek) içermekte olup, ortalama yaþlarý 42.3 (8-83) idi. Hastalar, yanýk bölgelerine göre kategorize edildi ve iliþkili yaralanmalar, özellikle oküler (%34.3) ve kulak yaralanmalarýný (%6.25) içermekteydi. Ortalama hastanede kalýþ süresi 10.5 gün [2-37] idi. Ürünle ilgili sorunlardan kaynaklanan 5 düdüklü tencere patlamasý yaþanýrken, 26 patlama kullanýcý hatalarýndan kaynaklandý (%15.6 / %81.2). Hastalar arasýnda mortalite gözlenmedi.
SONUÇ: Düdüklü tencereler, hýzlý yemek piþirmeyi kolaylaþtýrýrken, bu çalýþma ürün veya kullaným hatalarýndan kaynaklanan ciddi riskleri vurgulamaktadýr. Bu çalýþma, daha etkili kullaným talimatlarýna ve düdüklü tencerelerle ilgili farkýndalýðýn artýrýlmasýna ihtiyacý vurgulamaktadýr. Güvenli düdüklü tencere kullanýmýna odaklanan eðitim programlarýnýn, ciddi yaralanmalarýn insidansýný önemli ölçüde azaltabileceðini öngörmekteyiz.

BACKGROUND: Despite the widespread use of pressure cookers for quick and efficient cooking, literature has insufficiently highlighted the potential dangers resulting from inappropriate handling. This study aims to provide a comprehensive overview of 32 patients who presented with pressure cooker burns, emphasizing the serious risks associated with their misuse.
METHODS: Retrospective data were collected from patients admitted to Baðcýlar Training and Research Hospital Burn Center between 2017 and 2020 with pressure cooker burns in Türkiye. Data encompassed patient characteristics, burn causes, locations, severities, treatments, and clinical outcomes.
RESULTS: The study included 32 patients (29 female/3 male) with a mean age of 42.3 (8-83). Patients were categorized based on burn areas, revealing associated injuries such as ocular (34.3%) and ear injuries (6.25%). The average hospital stay was 10.5 days [2-37]. While five pressure cookers exploded due to product-related issues, 26 explosions resulted from user errors (15.6%/81.2%). Importantly, no mortality was observed among the patients.
CONCLUSION: While pressure cookers facilitate rapid food preparation, this study underscores the severe risks arising from product or usage errors. This study emphasizes the need for more effective usage instructions and increased awareness about pressure cookers to prevent burn risks. We anticipate that educational programs focused on safe pressure cooker use could significantly reduce the incidence of serious injuries.

A. baumannii enfeksiyonlarý sýklýkla hastane ile iliþkilidir, erken taný ve tedavý yapýlmadýðý zaman mortaliteye neden olabileceði belirtilmektedir. A. baumannii enfeksiyonlarý tipik olarak ameliyat veya travma sonrasýnda ortaya çýkar. Hastamýzda düþme sonrasý ve ameliyat sonrasý lateral ventrikülit ve lomber apse ile birlikte komplike A. baumannii menenjiti geliþti. Hasta, intratekal olarak uygulanan kolistin ve polimiksin B'den oluþan 21 günlük bir rejimle tedavi edildi. Bu tedavi periyodunun ardýndan hastanýn durumu iyileþti ve sonuçta baþarýlý bir iyileþme ve ardýndan taburculuk saðlandý. Bu vaka raporu, normalde kan-beyin bariyerini geçme potansiyeli sýnýrlý olan antibiyotiklerin intratekal uygulanmasýnýn, çoklu ilaca dirençli nozokomiyal menenjitte saðkalým sonuçlarýnýn iyileþmesine yol açma yeteneðini vurgulamaya hizmet etmektedir.

A. baumannii, which is said to be associated with nosocomial infections is considered a significant mortality risk if not adequately addressed. A. baumannii infections typically occur in the aftermath of surgery or trauma. Our patient developed complicated A. baumannii meningitis with lateral ventriculitis and a lumbar abscess post surgery after suffering from a fall. The patient was treated with a 21-day regimen of intrathecally administered colistin and polymyxin B. Following this therapeutic period, the patient's condition improved, ultimately leading to successful recovery and subsequent discharge. This case report serves to highlight the ability of intrathecal administration of antibiotics, that normally have limited potential of crossing the blood-brain-barrier, to lead to improved survival outcomes in multi-drug resistant nosocomial meningitis.

Ýnternal herniasyon son derece nadir görülen bir intestinal obstrüksiyon sebebidir. Paraduodenal herniler, barsaðýn anormal rotasyonu sonucunda oluþmaktadýr. Tekrarlayýcý karýn aðrýlarýndan akut barsak týkanýklýklarýna kadar deðiþebilen semptomlar oluþturmaktadýr. Zamanýnda taný konulup tedavi edilmezse barsakta iskemi ile sonuçlanabilmektedir. Bu yazýda, akut karýn bulgularýyla gelen 47 yaþýnda erkek hastanýn taný ve tedavi süreci retrospektif olarak deðerlendirilerek literatür eþliðinde sunulmasý amaçlanmýþtýr. Karýn eksplorasyonunda ince barsaklarýn tamamýna yakýn kýsmýnýn sað paraduodenal bölgeden posteriora doðru herniye olduðu görüldü. Ýnce barsak anslarý intraperitoneal alana redükte edilerek herni kesesinin giriþi primer olarak tamir edildi. Redüksiyon sonrasý iskemik kýsým rezeke edilerek anastomoz yapýlan hasta onuncu günde sorunsuz taburcu edildi.
Paraduodenal herni, karýn aðrýsý ve intestinal obstrüksiyon bulgularý olan hastalarda akýlda tutulmasý gereken bir durumdur. Geliþebilecek komplikasyonlarý önleyebilmek için erken taný hayati öneme sahiptir.

Internal herniation is an extremely rare cause of intestinal obstruction. Paraduodenal hernias result from abnormal rotation of the bowel. Symptoms that may range from recurrent abdominal pain to acute obstruction may occur. If it is not diagnosed and treated in time, the disease may result in intestinal ischemia. This article aimed to present the diagnosis and treatment process of a 47-year-old male presenting with acute abdomen symptoms by evaluating retrospectively with the accompaniment of literature. During the abdominal exploration of the patient, nearly all of the intestines were observed to be herniated from the right paraduodenal region to the posterior area. The opening of the hernial sac was repaired primarily by reducing the intestinal bowel loops into the intraperitoneal region. The patient undergoing anastomosis by performing resection of the ischemic part after reduction of herniated bowel loops was discharged uneventfully on the post-operative 10th day. Paraduodenal hernia is a condition that should be considered in patients with abdominal pain and intestinal obstruction symptoms. Early diagnosis is of vital importance to prevent the complications which can develop.