Medical Science and Discovery

Comprehensive Analysis of Ovarian Serous Borderline Tumors: Lymph Node Involvement and Implants - A Case Report

Ahmet Midi, Beste Hazneci, Yılmaz Güzel, Ayşe Nimet Karadayı — Tue, 30 Apr 2024 00:00:00 +0300

Objective: Ovarian serous borderline tumors (SBTs) are a distinct subtype of ovarian tumors that exhibit characteristics intermediate between benign tumors and invasive ovarian cancers. These tumors may display cellular changes suggestive of malignancy but do not meet all the criteria for full malignancy.

Case: This article presents the case of a 55-year-old female who presented to the clinic with complaints of pain and swelling in the lower abdominal quadrant. Upon examination, multiloculated mass lesions were found in the bilateral adnexa, and the patient was diagnosed with Borderline (low malignant potential) serous tumor. The patient underwent total abdominal hysterectomy, bilateral salpingo-oophorectomy, partial omentectomy, and peritoneal implant excision. Additionally, pelvic lymph node resection was performed, and abdominal lavage fluid was collected. The tissue sections were examined under a light microscope, revealing epithelial-lined papillae with a complex structure resembling the columnar fallopian tube epithelium, showing hierarchical branching. The patient was diagnosed with Borderline (low malignant potential) serous tumor, omental implants, and lymph node involvement.

Conclusion: The presence of lymph node involvement and implants in ovarian SBT necessitates thorough surgical exploration and may impact the choice of therapies. Therefore, early detection and accurate staging are crucial in determining prognosis and treatment strategy.

Intestinal intramural hematoma: A rare complication of Anticoagulation Therapy

Kağan Gökçe, Demet Doğan, Merve Yazıcı — Tue, 30 Apr 2024 00:00:00 +0300

Objective: Anticoagulant therapy is commonly used in the treatment of cardiac and thromboembolic diseases, with bleeding being the most common side effect, which increases in likelihood with prolonged usage. Intestinal intramural hematoma, although rare, is a potential complication of anticoagulant therapy.

Case: Herein, we present the case of a 49-year-old male patient who presented to our outpatient general surgery clinic with complaints of nausea, vomiting, and abdominal pain. Upon examination, electrocardiography (ECG) revealed sinus rhythm without any ischemic changes, and echocardiography findings were within normal limits. The patient reported the use of warfarin, and his International Normalized Ratio (INR) was found to be 14.7 (normal range: 0.8-1.1). A 10 mg (1 ampoule) intravenous (IV) infusion of vitamin K was administered, and the warfarin dosage was adjusted accordingly. Subsequent follow-up assessments showed normalization of the INR levels.

Conclusion: Intestinal intramural hematoma is an exceedingly rare condition that necessitates prompt diagnosis and intervention, as delayed recognition can lead to life-threatening complications. Clinicians should maintain a high index of suspicion for intestinal obstruction secondary to anticoagulant therapy in patients presenting to the emergency department with symptoms such as abdominal pain, nausea, and vomiting.

A case of spontaneous spinal epidural hematoma with stroke symptoms

İrem Yıldırım, Niyazi Uysal, Gönül Akdağ — Tue, 30 Apr 2024 00:00:00 +0300

Objective: Spontaneous spinal epidural hematoma (SSEH) can present with symptoms resembling stroke, potentially leading to misdiagnosis and inappropriate treatment. In this case report, we aim to present a patient with SSEH whose clinical findings mimicked those of ischemic stroke.

Case Presentation: A 78-year-old woman presented to the emergency department with sudden weakness in her left arm and leg. Motor examination revealed a strength value of 3-4/5 in the left upper and lower extremities. Brain computed tomography (CT) and brain diffusion magnetic resonance imaging (MRI) showed no acute neurological pathology. However, cervical MRI revealed heterogeneous signal areas in the extradural region posterior to the C3-C5 level. Further evaluation with cervical spinal CT identified an epidural hematoma. The patient was referred to neurosurgery, and surgical intervention was planned. Following surgery, the patient's motor strength was assessed as 2-3/5 in the upper and lower extremities.

Conclusions: SSEH can occur in patients with multiple risk factors, although significant risk factors were not identified in our case. Paraparesis and tetraparesis are more commonly observed presentations of SSEH than hemiparesis. In our case, hemiparesis was an initial finding that resembled stroke symptoms. SSEH most frequently occurs at the C6 and T12 vertebral levels, making the location of our patient's lesion between the C3-C5 vertebrae even rarer. In summary, SSEH may rarely present with symptoms mimicking stroke, emphasizing the importance of accurate diagnosis to avoid mismanagement.

An Evaluation of Antibiotic Prescribing Practices Among Dentists in Turkey for the Management of Periodontal and Peri-Implant Diseases

Gözde Erimli, Duygu Kılıç — Mon, 01 Apr 2024 00:00:00 +0300

Objective: The utilization of antibiotics alongside surgical and nonsurgical mechanical interventions for the management of periodontal and peri-implant diseases lacks standardization. Hence, this study aims to investigate the antibiotic prescribing practices among dentists in Turkey to elucidate the rationale and timing behind systemic antibiotic usage in the treatment of these ailments.

Materials and Methods: Between May 2021 and October 2022, 312 dentists across Turkey were invited to participate in a cross-sectional survey. A chi-squared test was used to compare categorical variables according to groups. G-power analysis was used to determine the sample size before the study.

Results: The frequency of antibiotic prescriptions during the initial management of periodontitis, peri-implant mucositis, and gingivitis was observed to be lower compared to other procedures. As treatments progressed from nonsurgical to surgical interventions, there was a concurrent rise in the frequency of antibiotic prescriptions. Amoxicillin + clavulanic acid emerged as the most frequently prescribed antibiotic, with the primary reasons for prescription being the mitigation of infection risk and adherence to established literature guidelines.

Conclusions: A discernible upward trend in antibiotic prescription is evident as treatment transitions from nonsurgical to more complex surgical modalities. The findings of our survey offer valuable insights for dentists in selecting appropriate antibiotics for the management of periodontal and peri-implant diseases.

Evaluation the COVID-19 related posts of the Official Facebook Page of the World Health Organization

Zeynep Özün Erinç, Özden Gökdemir, İsmail Çifçi, Olgu Aygün, Umut Gök Balcı — Wed, 24 Apr 2024 00:00:00 +0300

Objective: This study aims to analyze the COVID-19-related posts on the official Facebook page of the World Health Organization (WHO). Specifically, we aim to evaluate the engagement metrics such as views, comments, shares, and reactions received by categorized posts. Additionally, we seek to identify the topics that generate the highest levels of engagement in terms of comments and sharing reactions.

Material and Methods: This retrospective observational research project was designed to evaluate COVID-19-related posts on the official WHO Facebook Page between March 15, 2020, and March 15 2021. The data was analyzed using IBM SPSS Statistics 25.0.

Result: 2021 COVID-19-related posts on the Official Facebook Page of the WHO (n=877) were examined. 23.7% of the shares were about protective equipment, 22.2% were about the pandemic, 12.6% were about personal protective equipment, 11.5% were about social distancing, and 10.3% were media briefings. It was observed that they were about COVID-19??, 9.9% were about syndemic, 6.5% were about vaccine, 1.9% were about medicine, 0.9% were about mutation. An examination of posts related to drugs, vaccines, and media briefings revealed that the most prevalent response was 'like'. Statistical analysis indicated that the number of 'like' reactions was significantly higher for vaccine-related posts compared to non-vaccine related posts. Conversely, the number of angry reactions was lower for vaccine-related posts than for non-vaccine related posts.

Conclusion: This study provides valuable insights into the engagement patterns of COVID-19-related posts on the official Facebook page of the World Health Organization (WHO). Our analysis highlights the prevalence of topics such as protective equipment, the pandemic, personal protective equipment, social distancing, and media briefings among the examined posts. Notably, vaccine-related posts garnered a significantly higher number of 'like' reactions compared to non-vaccine related posts, underscoring the importance of vaccine-related communication efforts. These findings emphasize the significance of accurate and informative content dissemination by authoritative institutions like the WHO during global health crises such as the COVID-19 pandemic.

The relationship between secondary traumatic stress level and perceived caring behaviors among nursing students

Şerife Kelle Dikbaş, Şenay Uzun — Mon, 29 Apr 2024 00:00:00 +0300

Objective: Secondary traumatic stress in nursing students has adverse effects on students' care behaviors and students' professional and personal lives. The aim of this study: To examine the relationship between secondary traumatic stress levels and perceived caring behaviors of nursing students.

Material and Methods: The study was designed as a descriptive and cross-sectional study. The study was conducted with 147 students studying in the nursing department of a foundation university in Istanbul. 60% of the population was reached. The data of the study were collected by using the "Sociodemographic and Occupational Characteristics Information Form", "Caring Behaviors Scale" and "Secondary Traumatic Stress Scale" through Google Form sent online to the participants. Descriptive data were analyzed using mean, median, minimum, maximum, frequency and standard deviation.

Results: The study was conducted with a total of 147 nursing students, 83.0% (n=122) female and 17.0% (n=25) male. The total score of the STS scale of the nursing students participating in the study was 32.1 ± 12.6, and the mean score of the CBS was 5.57 ± 0.52. It was found that there was a significant difference between the mean score of secondary traumatic stress in terms of "willingly choosing the department they studied", "being affected by the trauma that patients were exposed to during the clinical practice period", and "thinking that you need psychological support due to an event that affected you during clinical practice" (p<0.05). It was found that there was a significant difference between the Care Behaviors Scale sub-dimension scores in terms of "Gender", "Finding oneself successful in clinical practice during the student period" (p<0.05).

Conclusion: According to the results of this study, while secondary traumatic stress was low in nursing students, the perception of caring behaviors was found to be high. There was no relationship between secondary traumatic stress and the perception of caring behaviors in nursing students.

Outcomes of corticosteroid treatment in critically ill COVID-19 patients

Mon, 29 Apr 2024 00:00:00 +0300

Objective: This study aims to examine the impact of low-dose and high-dose corticosteroids on the clinical outcomes and mortality of critically ill patients with COVID-19 in intensive care units.

Material and Methods: This study was conducted on 197 confirmed COVID-19 patients who received corticosteroid therapy in the intensive care unit (ICU) between June 1st and December 31st, 2020. Patients were divided into two groups for low- and high-dose corticosteroid therapy. Both groups were compared according to demographic features, comorbid conditions, laboratory parameters, as well as the ordinal scale for clinical improvement (OSCI), hospital mortality, and length of stay in the intensive care unit.

Results: A total of 140 patients received low-dose corticosteroids, while 57 patients received high-dose corticosteroid therapy. Our findings revealed a significantly higher median length of stay in the ICU and mortality in the group that received high-dose corticosteroid therapy. We observed a significant reduction in ferritin and D-dimer levels in the group receiving high-dose corticosteroid therapy (p < 0.003, p < 0.012, respectively). Furthermore, OSCIs on admission, day 5, and day 10 after corticosteroid therapy were higher in the group receiving high-dose corticosteroids.

Conclusion: The results of this study indicate that high-dose corticosteroid therapy in critically ill patients with COVID-19 is associated with high mortality rates and prolonged intensive care stays.