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Epidemiology and risk factors for mortality in critically ill patients with pancreatic infection

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Journal of Intensive Medicine 2024年第1期4卷 81-93页

作者： Marie Dejonckheere Massimo Antonelli Kostoula Arvaniti Koen Blot Ben CreaghBrown Dylan Wde Lange Jan De Waele Mieke Deschepper Yalim Dikmen George Dimopoulos Christian Eckmann Guy Francois Massimo Girardis Despoina Koulenti Sonia Labeau Jeffrey Lipman Fernando Lipovestky Emilio Maseda Philippe Montravers Adam Mikstacki JoseArtur Paiva Cecilia Pereyra Jordi Rello JeanFrancois Timsit Dirk Vogelaers Stijn Blot the Abdominal Sepsis Study(AbSeS)group on behalf of the Trials Group of the European Society of Intensive Care Medicine department of Internal Medicine and Pediatrics Faculty of Medicine and Health SciencesGhent UniversityGhentBelgium department of Anesthesiology Intensive Care and Emergency MedicineFondazione Policlinico Universitario A.Gemelli IRCCSRomeItaly UniversitàCattolica del Sacro Cuore RomeItaly Intensive Care Unit Papageorgiou University Affiliated HospitalThessaloníkiGreece department of Epidemiology and Public Health SciensanoIxellesBelgium Surrey Perioperative Anaesthetic Critical Care Collaborative Research Group(SPACeR) Royal Surrey County HospitalGuildfordUK department of Clinical and Experimental Medicine University of SurreyGuildfordUK department of Intensive Care Medicine University Medical Center UtrechtUniversity UtrechtUtrechtthe Netherlands department of Intensive Care Medicine Ghent University HospitalGhentBelgium Data Science Institute Ghent University HospitalGhentBelgium department of Anesthesiology and Reanimation Cerrahpasa School of MedicineIstanbul University-CerrahpasaIstanbulTurkey rd department of Critical Care “EVGENIDIO”HospitalNational and Kapodistrian University of AthensAthensGreece department of General Visceral and Thoracic SurgeryKlinikum Hannoversch-MuendenGoettingen UniversityGöttingenGermany Division of Scientific Affairs-Research European Society of Intensive Care MedicineBrusselsBelgium Anesthesia and Intensive Care department University Hospital of ModenaModenaItaly UQ Centre for Clinical Research Faculty of MedicineThe University of QueenslandBrisbaneQLDAustralia nd Critical Care department Attikon University HospitalAthensGreece department of Nursing Faculty of EducationHealth and Social WorkUniversity College GhentGhentBelgium Jamieson Trauma Institute The University of QueenslandBrisbaneQLDAustralia Nimes university Hospital University of MontpellierNimesFrance Critical Care department Hospital of the Interamerican Open University(UAI)Buenos AiresArgentina Surgical Critical Care Department of AnesthesiaHospital Universitario

Background:The AbSeS-classification defines specific phenotypes of patients with intra-abdominal infection based on the(1)setting of infection onset(community-acquired,early onset,or late-onset hospital-acquired),(2)presence or absence of either localized or diffuse peritonitis,and(3)severity of disease expression(infection,sepsis,or septic shock).This classification system demonstrated reliable risk stratification in intensive care unit(ICU)patients with intra-abdominal *** study aimed to describe the epidemiology of ICU patients with pancreatic infection and assess the relationship between the components of the AbSeS-classification and ***:This was a secondary analysis of an international observational study(“AbSeS”)investigating ICU patients with intra-abdominal *** patients with pancreatic infection were included in this analysis(n=165).Mortality was defined as ICU mortality within 28 days of observation for patients discharged earlier from the *** with mortality were assessed using logistic regression analysis and reported as odds ratio(OR)and 95%confidence interval(CI).Results:The overall mortality was 35.2%(n=58).The independent risk factors for mortality included older age(OR=1.03,95%CI:1.0 to 1.1 P=0.023),localized peritonitis(OR=4.4,95%CI:1.4 to 13.9 P=0.011),and persistent signs of inflammation at day 7(OR=9.5,95%CI:3.8 to 23.9,P<0.001)or after the implementation of additional source control interventions within the first week(OR=4.0,95%CI:1.3 to 12.2,P=0.013).Gramnegative bacteria were most frequently isolated(n=58,49.2%)without clinically relevant differences in microbial etiology between survivors and ***:In pancreatic infection,a challenging source/damage control and ongoing pancreatic inflammation appear to be the strongest contributors to an unfavorable short-term *** this limited series,essentials of the AbSeS-classification,such as the setting of infection onset,diffuse

关键词： Pancreatic infection Intensive care unit Mortality Intra-abdominal infection Sepsis

N2 disease in non-small cell lung cancer patients,diagnosis and evaluation:a Turkish chest surgeon s perspective

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中国肺癌杂志 2008年第5期11卷 622-626页

作者： Alper TOKER department of thoracic surgery istanbul Medical School istanbul university

Mediastinal or N2 disease is the most important factor in selecting the optimal treatment strategy in patients without distant metastasis.A direct surgical resection has not generally been accepted as a treatment modality in whom mediastinal nodal involvement is *** with lung cancer can be diagnosed as clinical N2 disease based on CT and PET-CT characteristics of the mediastinum and the clinical *** diagnostic modalities used in the detection of N2 disease are:mediastinoscopy,endoesophageal ultrasound guided biopsy(EUS),transbronchial needle aspiration(TBNA),endobronchial ultrasound guided biopsy(EBUS),video-assisted thoracoscopic surgery(VATS),and mediastinotomy/extended *** this article,the author discusses about invasive and noninvasive techniques on the evaluation of mediastinal disease and presents his experience on this topic.

关键词： Mediastinum Neoplasm staging Lung neoplasms

Glasgow coma scale and APACHE-II scores affect the liver transplantation outcomes in patients with acute liver failure

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Hepatobiliary & Pancreatic Diseases International 2013年第6期12卷 589-593页

作者： Necdet Guler Omer Unalp Ayse Guler Onur Yaprak Murat Dayangac Murat Sozbilen Murat Akyildiz Yaman Tokat Organ Transplantation Center Sisli Florence Nightingale Hospital Organ Transplantation Center Sisli Florence Nightingale Hospital Departments of General Surgery Organ Transplantation Center Sisli Florence Nightingale Hospital Neurology Ege university Medical School IzmirTurkey department of Gastroenterology Istanbul Bilim UniversityMedical School

BACKGROUND:The timing and selection of patients for liver transplantation in acute liver failure are great *** study aimed to investigate the effect of Glasgow coma scale(GCS)and APACHE-II scores on liver transplantation outcomes in patients with acute liver ***:A total of 25 patients with acute liver failure were retrospectively analyzed according to age,etiology,time to transplantation,coma scores,complications and ***:Eighteen patients received transplants from live donors and 7 had cadaveric whole liver *** mean duration of follow-up after liver transplantation was 39.86±40.23 *** patients died within the perioperative period and the 1-,3-,5-year survival rates of the patients were72%,72%and 60%,*** parameters evaluated for the perioperative deaths versus alive were as follows:the mean age of the patients was 33.71 vs 28 years,MELD score was 40 vs32.66,GCS was 5.57 vs 10.16,APACHE-II score was 23 vs 18.11,serum sodium level was 138.57 vs 138.44 mmol/L,mean waiting time before the operation was 12 vs 5.16 *** GCS,high APACHE-II score and longer waiting time before the operation(P<0.01)were found as statistically significant factors for perioperative ***:Lower GCS and higher APACHE-II scores are related to poor outcomes in patients with acute liver failure after liver transplantation.

关键词： liver transplantation acute liver failure APACHE-II waiting time Glasgow coma scale

Hashimoto Thyroiditis:Simple Diagnosis with 2D-Shear Wave Elastography

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International Journal of Clinical Medicine 2020年第2期11卷 23-31页

作者： Düzgün Yildirim Deniz Esin Tekcan Sanli Deniz Alis Mutlu Sahin Alev Bakir Ahmet Erdem Kilavuz department of Medical Imaging Vocational School of Health SciencesAcibadem UniversityIstanbulTurkey department of Radiology Acibadem Kozyatagi HospitalIstanbulTurkey department of Radiology Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Research and Training HospitalIstanbulTurkey department of General surgery Diskapi Yildirim Beyazit Education and Research HospitalAnkaraTurkey Biostatistics and Medical Informatics department Halic UniversityIstanbulTurkey department of Otorhinolaryngology Acibadem UniversityIstanbulTurkey

Background: Hashimoto thyroiditis diagnosis is primarily established on clinical and laboratory findings;however, some hashimoto thyroiditis cases are euthyroid and seronegative. Moreover, these patients might also have normal conventional ultrasound findings. Aims: In our study, we aimed to distinguish the typical background characteristics of hashimoto thyroiditis using virtual touch tissue imaging quantification maps obtained with acoustic radiation force impulse imaging. Methods: Our study consisted of 28 hashimoto thyroiditis patients without characteristics of ultrasound findings and 28 healthy subjects. The thyroid parenchymal tissue mechanical properties were analyzed with the virtual touch tissue imaging quantification after ultrasound examination, and then related colored maps were obtained. Shear wave velocities were recorded (m/s) from the homogenous area where hardest and softest points were closest to each other on virtual touch tissue imaging quantification maps. The difference between the minimum and maximum shear wave velocities for each case (Δv) was calculated and recorded. Results: Assessment of virtual touch tissue imaging quantification maps revealed a significant difference between hashimoto thyroiditis and control groups in terms of maximum SWV’s, but no significant difference was observed between the minimum shear wave velocities (p Δv values were taken into account. In summary, the effects of chronic autoimmune thyroiditis can be distinguished by simply using Δv on virtual touch tissue imaging quantification maps. When the cut-off value of Δv was accepted 0.42, the diagnosis of hashimoto thyroiditis could be made with 88% accuracy. Conclusion: We suggest that shear wave velocities measurement on virtual touch tissue imaging quantification maps is a promising method in equivocal hashimoto thyroiditis cases, in which the diagnosis of hashimoto thyroiditis is unachievable with clinical, laboratory and conventional ultra

关键词： ARFI Hashimoto Thyroiditis SWE SWV VTIQ

Injuries Requiring surgery in Folk Dancers： A Retrospective Cohort Study of 9 Years

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Journal of Sports Science 2018年第2期6卷 108-117页

作者： Neslihan Aksu Vefa Atansay Taner Aksu Safiye Koculu Sukriye Damla Kara Isik Karalok department of Orthopedics and Traumatology Faculty of Medicine Istanbul Bilim University Abide i Hurriyet Cad No 164 Sisli 34381 Istanbul Turkey department of Orthopedics and Traumatology Medical Faculty Bahcesehir University Medical Park Hospital Fevzipasa mah Dolap cad. Fatih Istanbul Turkey department of Clinic Microbiology and Enfectious Desease Faculty of Medicine Istanbul Bilim University Abide i Hurriyet Cad No 164 Sisli 34381 Istanbul Turkey department of Neurology University of South Florida FL 33606 USA Radiology department Faculty of Medicine istanbul Bilim University Abide i Hurriyet Cad No 164 Sisli 34381 Istanbul Turkey

Background： In this study, we examined professional folk dancer injuries which required surgery and if there are any associated factors like age, gender, dexterity, dance style and to evaluate the return to their full capacity. Materials and Methods： Seventy five members of the Fire of Anatolia dance group （mean age： 26.8 ± 5.2; 18-38 years） performers were evaluated. The dancers suffered 14 orthopedic injuries requiring surgery （3 meniscus tears, 2 anterior cruciate ligament tears one of which is with posterolateral corner tear, 1 posterior cruciate ligament tear, 1 patellar dislocation, 1 scaphoid fracture, 1 extensor tendon cut in hand, 1 infrapatellar bursitis, 2 Hoffa’s fat pad syndromes, 2 symptomatic medial plicaes） during a nine-year period. Follow-up time was 51 ± 41.9 （29.5-92） months. Results： Following surgeries, the dancers could restart rehearsals in 12.7 ± 9 （range： 4 to 36） weeks and perform live on the stage in 16.2 ± 12.2 （range： 5 to 52） weeks on average. Conclusion： Males were 8.64 times more likely to suffer an injury requiring surgery compared to the females （p = 0.003） and twelve （85.7%） of these injuries were lower extremity injuries and were all located in the knee in Anatolian folk dancers.

关键词： Dancer injuries folk dancers knee injuries arthroscopy return to dance knee surgery.

Current adjuvant treatment modalities for gastric cancer:From history to the future

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World Journal of Gastrointestinal Oncology 2016年第5期8卷 439-449页

作者： Leyla Kilic Cetin Ordu Ibrahim Yildiz Fatma Sen Serkan Keskin Rumeysa Ciftci Kezban Nur Pilanci department of Medical Oncology Acibadem University Hospital department of Medical Oncology Istanbul Bilim University department of Medical Oncology Institute of OncologyIstanbul University department of Medical Oncology Haseki Training and Research Hospital

The discrepancy between the surgical technique and the type of adjuvant chemotherapy used in clinical trials and patient outcomes in terms of overall survival rates has led to the generation of different adjuvant treatment protocols in distinct parts of the *** adjuvant treatment recommendation is generally chemoradiotherapy in the United States,perioperative chemotherapy in the United Kingdom and parts of Europe,and chemotherapy in *** options mainly rely on the United States Intergroup-0116,United Kingdom British Medical Research Council Adjuvant Gastric Infusional Chemotherapy,and the Asian Adjuvant Chemotherapy Trial of S-1 for Gastric Cancer and Capecitabine and Oxaliplatin Adjuvant Study in Stomach Cancer ***,the benefits were evident for only certain patients,which were not very homogeneous regarding the type of surgery,chemotherapy regimens,and stage of *** the dissimilarities in survival are attributable to surgical technique or intrinsic biological differences is a subject of *** of the extent of surgery,multimodal therapy may offer modest survival advantage at least for diseases with lymph node ***,in the era of individualized treatment for most of the other cancer types,identification of special subgroups comprising those who will derive more or no benefit from adjuvant therapy merits further *** aim of this review is to reveal the historical evolution and future reflections of adjuvant treatment modalities for resected gastric cancer patients.

关键词： Adjuvant chemoradiotherapy Biomarker Gastric cancer Lymph nodes

Laparoscopic management of totally intra-thoracic stomach with chronic volvulus

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World Journal of Gastroenterology 2013年第35期19卷 5848-5854页

作者： Toygar Toydemir Gkhan Cipe Oguzhan Karatepe Mehmet Ali Yerdel department of General surgery Istanbul Surgery Hospital department of General surgery Medical School of Bezmialem Vak f University

AIM:To evaluate the outcomes of patients who underwent laparoscopic repair of intra-thoracic gastric volvulus(IGV)and to assess the preoperative ***:A retrospective review of a prospectively collected database of patient medical records identified14 patients who underwent a laparoscopic repair of *** procedure included reduction of the stomach into the abdomen,total sac excision,reinforced hiatoplasty with mesh and construction of a partial *** perioperative data,operative details and complications were *** patients had at least 6 mo of ***:There were 4 male and 10 female *** mean age and the mean body mass index were 66years and 28.7 kg/m2,*** patients presented with epigastric discomfort and early *** was no mortality,and none of the cases were converted to an open *** mean operative time was235 min,and the mean length of hospitalization was 2 *** were no intraoperative *** minor complications occurred in 3 patients including pleuraleffusion,subcutaneous emphysema,dysphagia and delayed gastric *** minor complications resolved spontaneously without any *** the mean follow-up of 29 mo,one patient had a radiological wrap herniation without *** remains symptom free with daily ***:The laparoscopic management of IGV is a safe but technically demanding *** best outcomes can be achieved in centers with extensive experience in minimally invasive esophageal surgery.

关键词： Laparoscopic procedure Hiatal hernia Stomach Volvulus Mesh repair

Post-discharge mortality in the first wave of COVID-19 in Turkey

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Asian Pacific Journal of Tropical Medicine 2022年第11期15卷 479-484页

作者： Fusun Fakili Pelin Duru Cetinkaya Oya Baydar Serap Argun Baris Nurdan Kokturk Seval Kul Oguz Karcioglu Pinar Aysert Yildiz Ilim Irmak Yonca Sekibag Emel Azak Sait Mulamahmutoglu Caglar Cuhadaroglu Bugra Kerget Burcu Baran Ketencioglu Hasan Selcuk Ozger Gulcihan Ozkan Zeynep Ture Merve Ercelik Tansu Ulukavak Ciftci Ozlem Alici Esra Nurlu Temel Ozlem Ataoglu Neslihan Kose Muge Meltem Tor Gulsah Gunluoglu Sedat Altin Onder Ozturk Pinar Yildiz Gulhan Ilknur Basyigit Hasim Boyaci I Kivilcim Oguzulgen Sermin Borekci Bilun Gemicioglu Ismail Hanta Hacer Kuzu Okur Gulseren Sagcan Metin Akgun Ali Fuat Kalyoncu Oya Itil Hasan Bayram department of Pulmonary Medicine Faculty of MedicineGaziantep UniversityGaziantepTurkey department of Pulmonary Medicine University of Health SciencesAdana City Training and Research HospitalFaculty of MedicineCukurova UniversityAdanaTurkey department of Pulmonary Medicine Faculty of MedicineCukurova UniversityAdanaTurkey department of Pulmonary Medicine Faculty of MedicineKocaeli UniversityKocaeliTurkey department of Pulmonary Medicine Faculty of MedicineGazi UniversityAnkaraTurkey department of Biostatistics Faculty of MedicineGaziantep UniversityGaziantepTurkey department of Pulmonary Medicine Halil Sivgin Cubuk State HospitalAnkaraTurkey department of Infectious Disease Faculty of MedicineGazi UniversityAnkaraTurkey department of Pulmonary Medicine Faculty of MedicineHacettepe UniversityAnkaraTurkey department of Pulmonary Medicine Cerrahpasa Faculty of MedicineIstanbul University−CerrahpasaIstanbulTurkey department of Infectious Disease and Clinical Microbiology Faculty of MedicineKocaeli UniversityKocaeliTurkey department of Pulmonary Medicine Altunizade Acibadem HospitalIstanbulTurkey department of Pulmonary Medicine Faculty of MedicineAtaturk UniversityErzurumTurkey department of Pulmonary Medicine Faculty of MedicineErciyes UniversityKayseriTurkey department of Pulmonary Medicine Maslak Acibadem HospitalIstanbulTurkey department of Infectious Disease and Clinical Microbiology Faculty of MedicineErciyes UniversityKayseriTurkey department of Pulmonary Medicine Faculty of MedicineDuzce UniversityDuzceTurkey department of Infectious Disease Faculty of MedicineTurkiye Gazetesi Private HospitalIstanbulTurkey department of Infectious Diseases and Clinical Microbiology Faculty of MedicineSuleyman Demirel UniversityIspartaTurkey department of Pulmonary Medicine Bilecik Training and Research HospitalBilecikTurkey department of Pulmonary Medicine Faculty of MedicineZonguldak Bulent Ecevit UniversityZonguldakTurkey department of Pulmonary Medicine Universi

Objective:To determine post-discharge mortality and associated factors of the first-wave multicenter Turkish thoracic Society(TTD)-TURCOVID ***:In this retrospective cohort study,we analyzed the data of 18 of 26 centers included in the first TTD-TURCOVID study,and 1112 cases diagnosed with COVID-19 between 11 March and 31 July 2020 participated in the *** causes of death after COVID-19 discharge were ***:The mean age of the patients was(51.07±16.93)years,with 57.6%male *** the cohort group,89.1%of COVID-19 treatment locations were hospital wards,3.6%were intensive care units(ICUs),and 7.2%were community *** the longterm follow-up,the in-hospital mortality rate was 3.6%(95%CI 2.6-4.8),the post-discharge mortality rate was 2.8%(95%CI 1.9-3.9),and the total mortality was 6.3%(95%CI 5.0-7.8).After discharge,63.3%of mortality overall occurred during the first six *** rates in post-discharge follow-ups were 12.7%(95%CI 8.0-30.6)in cancer patients,10.8%(95%CI 6.3-22.9)in chronic obstructive pulmonary disease patients,11.1%(95%CI 4.4-22.7)in heart failure patients,7.8(95%CI 3.8-14.3)in atherosclerotic heart disease patients,and 2.3%(95%CI 0.8-5.6)in diabetes mellitus *** smokers/ex-smokers,the all-mortality rates were higher than in ***:This multicenter study showed that patients over 65 years of age,males,former/active smoker,ICU stay,lung,heart disease,and malignancy should be followed up for at least the first six months after discharge due to COVID-19.

关键词： COVID-19 Post-discharge Mortality Comorbidity

胸腺瘤微创切除术的基本原则和标准术语的定义

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中国肺癌杂志 2014年第2期17卷 90-94页

作者：付浩中国胸腺瘤协作组全体成员 Alper Toker Joshua Sonett Marcin Zielinski Federico Rea Victor Tomulescu Frank C.Detterbeck 北京大学肿瘤医院 department of thoracic surgery Istanbul University School of Medicine department of General thoracic surgery Colombia University department of thoracic surgery Pulmonary Hospital department of thoracic surgery University of Padova General surgery and Liver Transplantation University of Medicine and Pharmacy department of thoracic surgery Yale School of Medicine

根治性手术切除是胸腺瘤的主要治疗手段，手术目的在于完整切除肿瘤及胸腺组织，并且进行彻底的探查排除可能存在的非连续但可切除的病灶。通常主张胸骨劈开的整块切除，R0切除是公认的关乎远期疗效的重要因素。近年随着胸腔镜技术的不... 详细信息

根治性手术切除是胸腺瘤的主要治疗手段，手术目的在于完整切除肿瘤及胸腺组织，并且进行彻底的探查排除可能存在的非连续但可切除的病灶。通常主张胸骨劈开的整块切除，R0切除是公认的关乎远期疗效的重要因素。近年随着胸腔镜技术的不断进步，微创手术在胸腺瘤手术中的应用受到了极大地关注，但存在许多值得注意的问题，如何保护膈神经？膈神经切除后是否需要行膈肌折叠术？如何在腔镜下判断是否有上腔静脉和肺静脉的浸润？在微创手术时若切缘很近是否更容易发生胸膜播散？如果一次面对的问题太多，很有可能让微创手术的适用范围又回到从前。如果术后出现不良的结果就更难继续去探索微创技术和如何避免这些问题。多数学者仍对微创手术的结果持谨慎态度，如何确保这些结果与标准开放性手术相当是值得重视的问题。尽管微创手术缩短了住院时间并减轻了患者的疼痛，但与开放手术相比微创手术的肿瘤学优势还没能很好地被报道[1]。只有时间能告诉我们这些微创技术和目前的标准治疗是否相当。虽然有经验的术者采用微创手术可以切除邻近的累及器官，然而在快速拓展微创手术之前必须首先通过直接案例小心评估微创手术的预后结果。普遍认为应避免微创手术切除膈神经和大血管。由于胸腺恶性肿瘤的低发病率特点和微创手术的稀少性特点亟需有共同标准的国际合作。为此国际胸腺肿瘤协作组织（International Thymic Malignancy Interest Group, ITMIG）先由有胸腺瘤微创切除术经验的医生组成初步工作组，在回顾了目前文献中针对胸腺瘤微创切除术的定义、术语和策略后提出了初步建议，由拓展工作组进一步完善后由ITMIG工作组中的更多不同背景的专家进行讨论，最终由ITMIG的成员一致通过。内容涉及胸腺瘤微创手术策略、手术方法的基本概念、基本原则和必须遵守的特定标准等定义。以便在前瞻性的数据库采用连续和系统的方式收集数据来更恰当地评估微创手术。使不同中心之间使用这项技术应用共同的语言，便于中心之间的合作和数据资源共享。

关键词：微创手术标准术语胸腺瘤切除术根治性手术切除胸腔镜技术国际合作胸腺组织