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In this study, we aimed to evaluate the clinical characteristics and outcome of patients with hydatid cyst (HC) of the liver who were laparoscopically operated at our clinic and to define a new technique and technical details to present our experience in the field of laparoscopic treatment of hepatic hydatid cysts.Between January 2014 and October 2016, 18 patients with hydatid disease of the liver were considered for laparoscopic surgery in Dr. Lutfi Kirdar Education and Research Hospital, Department of General Surgery. All patients were evaluated based on history, physical examination, ultrasound (US), and computed tomography (CT) scan. All ultrasound examinations were classified according to Gharbi. All cases received laparoscopic surgical interventions. Demographic data, clinical presentation, cyst location, operative data, postoperative complications and follow-up results were recorded retrospectively.Eighteen patients underwent laparoscopic surgery for hydatid cysts of the liver. here were 14 female (78%) and 4 male (22%) patients with a mean age of 42.9 years (range, 19-57). The hydatid cysts were solitary in 11 patients, and multiple in 7 patients had 2 or more cysts (4 patients had 2 cysts, 3 patients had 3 cysts). Most of the cysts on USG were Gharbi type III (8 cysts), 4 of Type II, and 3 of Type I. The average operating time was 75 minutes (range 50 - 135 minutes). Conversion to open surgery was necessary in one patients due to cyst in difficult location.Laparoscopic management of hydatid cysts of the liver can be performed safely and successfully. This technique can be used in patients with unique, small sized, superficially located cysts, and also has the advantages of other abdominal laparoscopic operations.Hepatic hydatid cysts, Laparoscopic surgery.Studio finalizzato a valutare le caratteristiche cliniche e l’esito di pazienti con cisti idatidea del fegato che sono stati operati per via laparoscopica nella nostra clinica e di definire una nuova tecnica e dettagli tecnici per presentare la nostra esperienza nel campo della terapia laparoscopica epatica cisti idatidee. Tra gennaio 2014 e ottobre 2016, sono stati considerati per la chirurgia laparoscopica presso il Dott. Lutfi Kirdar, Ospedale per l’Istruzione e la Ricerca, Dipartimento di Chirurgia Generale 18 pazienti con malattia idatidea del fegato. Tutti i pazienti sono stati valutati sulla base di anamnesi, esame fisico, ecografia (US) e tomografia computerizzata (TC). Tutti gli esami ecografici sono stati classificati secondo Gharbi. Tutti i casi hanno ricevuto interventi chirurgici laparoscopici. I dati demografici, la presentazione clinica, la posizione della cisti, i dati operativi, le complicanze postoperatorie e i risultati del follow-up sono stati registrati retrospettivamente. 14 pazienti erano di sesso femminile (78%) e 4 maschile (22%) con un’età media di 42,9 anni (intervallo 19- 57). Le cisti idatidee erano solitarie in 11 pazienti, e in 7 pazienti multiple avevano 2 o più cisti (4 pazienti avevano 2 cisti, 3 pazienti avevano 3 cisti). La maggior parte delle cisti su USG erano di tipo Gharbi III (8 cisti), 4 di Tipo II e 3 di Tipo I. Il tempo medio di funzionamento era di 75 minuti (intervallo 50-135 minuti). La conversione alla chirurgia aperta si è resa necessaria in un paziente a causa della posizione difficile della cisti.. Posiamo concludere che la gestione laparoscopica delle cisti idatidee del fegato può essere eseguita in modo sicuro e con successo. Questa tecnica può essere utilizzata in pazienti con cisti uniche, di dimensioni ridotte e superficialmente localizzate e presenta anche i vantaggi di altre operazioni laparoscopiche addominali.

In this study, we aimed to evaluate outcomes of % 20 silver nitrate (SNS) application in perianal fistula patients.All patients who received 20 % SNS treatment for intersphincteric and transsphincteric fistulas between January 2017 and December 2017 were included in our study. Patients were invited for control examinations after one week. Patients with continued discharges after single dose of SNS kept receiving solution six more times with one month intervals. Stopping of discharges were considered as finalization of the study. Cases with discharges after 6 episodes of SNS were described as insufficient healing. The patients were grouped according to healing status (healing patients in Group 1, non-healing patients in Group 2) .Gender, age, follow-up times, date of the complaint start, number of SNS application, type of fistula and frequency of fistula discharge were recorded.A total of 49 patients were included in this study. Forty-four (% 89.8) of them were male. The mean age was 44.9. Twenty-eight patients (57.1%) had intersphincteric fistulas, while twenty-two patients (42.9%) had intersfinteric fistulas. Mean number of SNS application was 4.1 (1-6). Patients in Group 1 had mean number of SNS therapy as 3.42 (1-6), whereas cases in Group 2 this number was 5.5 (3-6). Patients were observed approximately for 8.84 months (6-12). We were able to reach sufficient healing in 13 (%26) cases via 2 times and 20 (%40) cases via 3-6 times application of SNS.We were able to reach complete healing rates as % 67 with SNS application in perianal fistula. This is a non-invasive procedure and could be applied in out patient clinics, with low costs. Less complication rates enhances attraction. Patients will not loose chance of surgical treatment. Therefore, we believe SNS may be used as first line treatment in perianal fistulas.Follow-up, Perianal fistula, Silver nitrate.Vengono valutati i risultati del trattamento in 49 pazienti affetti da fistole perianali con l’applicazione locale di una soluzione di nitrato d’argento al 20%. Lo studio riguarda sia fistole intersfinteriche che transfinteriche trattate tra gennaio 2017 e dicembre 2017, invitando i pazienti per gli esami di controllo dopo una settimana dall’inizio del trattamento. I pazienti con perduranti perdite continue dopo una singola dose singola di nitrato d’argento sono stati ripetutamente trattati con la soluzione altre sei volte ad intervalli di un mese. La scomparsa delle secrezioni è stata considerata come termine finalizzato dello studio. I casi che dopo sei applicazioni continuavano a presentare delle perdite sono stati considerati di insufficiente guarigione. I pazienti sono stati raggruppati in base allo stato di guarigione: Gruppo 1, pazienti guariti; Gruppo 2, pazienti non guariti. Sono stati registrati sesso, età, durata del follow-up, data di inizio della segnalazione di perdurante secrezione, numero di applicazioni del nitrato d’argento, tipo di fistola e frequenza delle perdite. Su 49 pazienti studiati, 44 erano uomini (89,8%); età media 44,9 anni. 28 casi (57,1%) si trattava di fistole intersfinteriche, mentre 22 pazienti (42,9%) avevano fistole intersfinteriche. Il numero medio di applicazione del nitrato d’argento è risultato di 4.1. I pazienti del Gruppo 1 hanno ricevuto in media 3,42 applicazioni (1-6), mentre casi nel Gruppo 2 il numero medio di applicazioni è stato 5,5. I pazienti sono stati controllati per circa 8,84 mesi (6-12). La guarigione è stata ottenuta in 13 casi (% 26) in due tempi e in altri 20 casi (% 40) con applicazioni del nitrato d’argento da 3 a 6 volte. Il tasso di guarigione completa con il trattamento con nitrato d’argento è stato ottenuto nel 67% dei casi. Si è trattato di una procedura non invasiva, applicabile in regime ambulatoriale a costi contenuti, e la situazione dell’incidenza di complicanze aumenta l’interesse del metodo. Inoltre i pazienti non perdono la possibilità di un trattamento chirurgico, e pertanto si ritiene che il nitrato d’argento possa essere usato come trattamento di prima linea nelle fistole perianali.

Aim To investigate the efficacy and safety of the single-step surgery in elderly patients with obstructive colorectal cancer. Methods All patients who underwent single-step surgery and primary anastomosis for obstructive colorectal cancer in the period between January 2012 December 2017 were evaluated in this study. The patients were divided into two groups: younger than 65 (Group Young) and older than 65 (Group Old). Demographic data, American Society of Anesthesiologists scores (ASA) scores, comorbidities, preoperative albumin levels, type of surgery, postoperative morbidity and mortality, pathological stages, and overall survival rates were investigated. Results A total of 89 patients were included: 49 (54%) were older than 65 (Group Old). In Group Old, the mean age was 75 (65-97), of which 28 (58.3%) were males. There were 41 patients younger than 65 (Group Young) with the mean age of 52.6 (41-64 years of age), of which 21 (51.2%) were males. There was no difference between groups according to albumin level. There was no statistical difference between two groups according to tumour localization, pathological stage and type of surgery, as well as according to surgical complications. The median overall survival rate was 11 months in both groups (0-66) (p=0.320). Conclusion Meticulous preparation of older patients (correction of anaemia, electrolyte levels and pH ) paves the road for successful surgeries, including single-step resection and primary anastomosis.

To analyze the presence of HBV DNA in blood donors admitted to blood banks with HBsAg negativity and isolated anti-HBc positivity.Sera samples of 2500 HBsAg negative donors were included in the study. HBsAg tests were assayed with VITROS analyzer. Anti-HBc total, anti-HBs, HBeAg, anti-HBe and anti-HBc IgM tests were manually studied with DIA PRO kit by employing ELISA method. HBV DNA test was evaluated with iQ5 Real Time PCR Detection System with real-time PCR method.A total number of 401 (16.4%) HBsAg negative blood donors had anti-HBc positivity. Forty-five of 401 (1.8%) anti-HBc positive samples were anti-HBs negative. These 45 persons were evaluated for anti-HBc positivity. Thirty-six of 45 anti-HBc positive persons had only anti-HBc positivity, and other nine patients had Anti-HBe antibody. HBV DNA was detected in three (6.6 %) of 45 isolated Anti-HBc positive persons as in one of nine persons and two of 36 persons.The persons who have only HBs Ag negativity may not be appropriate to become blood donors. Anti-HBc test should be done for HBsAg negative persons. They should not be accepted as blood donors if Anti-HBc is found positive.

To determine predictive fatality criteria based on clinical and laboratory findings on admission to hospital in patients diagnosed with pandemic influenza A (H1N1) virus infection.The study was conducted at the School of Medicine, Karadeniz Technical University, Trabzon, Turkey. Demographic, clinical, and laboratory data for hospitalized cases with a diagnosis of A (H1N1) virus infection between October 2009 and May 2010 were analyzed retrospectively. Patients were divided into 2 groups: fatal (group I) and non-fatal (group II). The 2 group's demographic, clinical, and laboratory data were compared on admission.Ten (20%) of the 50 patients included in the study died. The average age of group I was significantly higher than that of the group II. No significant difference was observed between the groups in terms of underlying chronic diseases and pregnancy. Fever, phlegm, shortness of breath, tachypnea, cyanosis were observed at significantly higher levels in group I compared to group II. Serum hemoglobin, glucose, albumin levels, arterial oxygen saturation were significantly lower in group I compared to group II; aspartate transaminase, alanine aminotransferase, C-reactive protein, procalcitonin, blood urea nitrogen levels, time between onset of symptoms and commencement of antiviral treatment were all significantly higher in group I.This study shows that in addition to demographic characteristics and clinical findings, prognosis of patients with A (H1N1) virus infection can be determined beforehand with various laboratory tests. But these parameters, which can guide the clinician in the prior identification of potentially fatal A (H1N1) cases will contribute to the provision of supporting treatment and, when necessary, intensive care services for such patients.

The aim of this study was to investigate the prevalence of hepatitis B virus (HBV) genotypes in Isparta, Southwest of Turkey, as well as the clinical features and transmission route for patients with HBV infections.Patients (n = 135) with HBV infection were included in the study. Epidemiological and clinical data were obtained. HBV genotypes were determined with a preS2 epitope ELISA kit.Although the HBV transmission route remained unidentified in 51.1% of the patients, blood contact was determined as the most common probable transmission route (38.5%). One hundred twenty-four (91.8%) of 135 samples, could be genotyped. One hundred fifteen (85.1%) were genotyped as type D/E, six (4.4%) were genotyped as type A, two (1.4%) were genotyped as type C, and one (0.7%) were genotyped as type F.Genotype D/E is determined as the predominant HBV genotype circulating in Isparta, Southwest of Turkey. No relationship between genotypes and disease severity and transmission route has been detected.

This case-control study was carried out to investigate whether eosinophilia is a common finding in parasitic diseases and to determine the prevalence of the parasitic diseases in definitive groups. Toxocariasis and fasciolosis were investigated in patients with eosinophilia, patients with non-eosinophilia, and healthy controls. All cases were analyzed for antibodies against Toxocara canis and Fasciola hepatica by modified enzyme-linked immunosorbent assay (ELISA) employing, as antigen, excretory/secretory products of Toxocara and Fasciola (ES-ELISA). Seropositivity was determined in 39 (29.1%) and 12 (8.9%) toxocariasis and fasciolosis patients with eosinophilia respectively. The seropositivity was found in 26 (19.4%) and 5 (3.7%) toxocariasis and fasciolosis patients without eosinophilia respectively. The seropositivity was found in 13 (15.5%) and 1 (1.2%) toxocariasis and fasciolosis patients in the control group. The total seropositivity in both toxocariasis and fasciolosis in the eosinophilic group (8.5%) increased significantly compared to patients without eosinophilia (23.1%) and healthy controls (6.6%) (chi2:6.343, p0.05 and chi2:10.293, p0.01). Eosinophilia correlated with antibodies against Toxocara and E. hepatica. The results suggest that serological methods can be used for diagnosis of parasitic infections in tissue. Thus, the actual prevalence of tissue parasites can be revealed particularly in developing and emerging countries.