Browsing by Author "Ece, B."

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Are Preoperative CT Findings Useful in Predicting the Duration of Laparoscopic Appendectomy in Pediatric Patients? A Single Center Study
(2024) Taskent, I.; Ece, B.; Narsat, M.A.
Preoperative computed tomography (CT) imaging plays a vital role in accurately diagnosing acute appendicitis and assessing the severity of the condition, as well as the complexity of the surgical procedure. CT imaging provides detailed information on the anatomical and pathological aspects of appendicitis, allowing surgeons to anticipate technical challenges and select the most appropriate surgical approach. This retrospective study aimed to investigate the correlation between preoperative CT findings and the duration of laparoscopic appendectomy (LA) in pediatric patients. This retrospective study included 104 pediatric patients diagnosed with acute appendicitis via contrast-enhanced CT who subsequently underwent laparoscopic appendectomy (LA) between November 2021 and February 2024. CT images were meticulously reviewed by two experienced radiologists blinded to the clinical and surgical outcomes. The severity of appendicitis was evaluated using a five-point scale based on the presence of periappendiceal fat, fluid, extraluminal air, and abscesses. The average operation time was 51.1 ± 21.6 min. Correlation analysis revealed significant positive associations between operation time and neutrophil count ( = 0.014), C-reactive protein levels ( = 0.002), symptom-to-operation time ( = 0.004), and appendix diameter ( = 0.017). The total CT score also showed a significant correlation with operation time ( < 0.001). Multiple regression analysis demonstrated that a symptom duration of more than 2 days ( = 0.047), time from CT to surgery ( = 0.039), and the presence of a periappendiceal abscess ( = 0.005) were independent predictors of prolonged operation time. In the perforated appendicitis group, the presence of a periappendiceal abscess on CT was significantly associated with prolonged operation time ( = 0.020). In the non-perforated group, the presence of periappendiceal fluid was significantly related to longer operation times ( = 0.026). In our study, preoperative CT findings, particularly the presence of a periappendiceal abscess, were significantly associated with prolonged operation times in pediatric patients undergoing laparoscopic appendectomy. Elevated CRP levels, the time between CT imaging and surgery, and a symptom duration of more than 2 days were also found to significantly impact the procedure's duration.
Are Preoperative CT Findings Useful in Predicting the Duration of Laparoscopic Appendectomy in Pediatric Patients? A Single Center Study
(Multidisciplinary Digital Publishing Institute (MDPI), 2024) Taskent, I.; Ece, B.; Narsat, M.A.
Background/Objectives: Preoperative computed tomography (CT) imaging plays a vital role in accurately diagnosing acute appendicitis and assessing the severity of the condition, as well as the complexity of the surgical procedure. CT imaging provides detailed information on the anatomical and pathological aspects of appendicitis, allowing surgeons to anticipate technical challenges and select the most appropriate surgical approach. This retrospective study aimed to investigate the correlation between preoperative CT findings and the duration of laparoscopic appendectomy (LA) in pediatric patients. Methods: This retrospective study included 104 pediatric patients diagnosed with acute appendicitis via contrast-enhanced CT who subsequently underwent laparoscopic appendectomy (LA) between November 2021 and February 2024. CT images were meticulously reviewed by two experienced radiologists blinded to the clinical and surgical outcomes. The severity of appendicitis was evaluated using a five-point scale based on the presence of periappendiceal fat, fluid, extraluminal air, and abscesses. Results: The average operation time was 51.1 ± 21.6 min. Correlation analysis revealed significant positive associations between operation time and neutrophil count (p = 0.014), C-reactive protein levels (p = 0.002), symptom-to-operation time (p = 0.004), and appendix diameter (p = 0.017). The total CT score also showed a significant correlation with operation time (p < 0.001). Multiple regression analysis demonstrated that a symptom duration of more than 2 days (p = 0.047), time from CT to surgery (p = 0.039), and the presence of a periappendiceal abscess (p = 0.005) were independent predictors of prolonged operation time. In the perforated appendicitis group, the presence of a periappendiceal abscess on CT was significantly associated with prolonged operation time (p = 0.020). In the non-perforated group, the presence of periappendiceal fluid was significantly related to longer operation times (p = 0.026). Conclusions: In our study, preoperative CT findings, particularly the presence of a periappendiceal abscess, were significantly associated with prolonged operation times in pediatric patients undergoing laparoscopic appendectomy. Elevated CRP levels, the time between CT imaging and surgery, and a symptom duration of more than 2 days were also found to significantly impact the procedure’s duration.
Assessment of Psoas Muscle Index in Middle-Aged Type 2 Diabetes Patients: Impact of Insulin Therapy on Sarcopenia
(2024) Taskent, I.; Ece, B.; Aydin, S.
Objective: Sarcopenia, characterized by progressive skeletal muscle loss, poses significant health risks, including physical impairment and mortality. The relationship between sarcopenia and insulin resistance suggests insulin therapy's potential in preserving muscle mass, particularly in Type 2 diabetes mellitus (T2DM) patients. This study aims to evaluate the Psoas Muscle Index (PMI) via computed tomography (CT) in middle-aged T2DM patients on insulin therapy versus oral antidiabetic drugs (OAD) and controls. Methods: This retrospective study included 107 middle-aged T2DM patients undergoing non-contrast CT scans and 58 age-matched controls. CT images were analyzed to calculate PMI. Statistical analysis included Chi-square tests, independent samples t-tests, Mann-Whitney U tests, and correlation analyses. Results: Insulin-treated patients exhibited higher PMI than OAD users (p < 0.001), while OAD users had lower PMI than controls (p < 0.001). No significant difference was found between insulin-treated patients and controls (p = 0.616). Negative correlations were observed between T2DM duration/age and PMI across all groups, with a positive correlation between T2DM duration and BMI observed in the OAD group. Conclusions: Insulin therapy in T2DM patients, regardless of age or disease duration, positively impacts muscle mass, highlighting its potential in preserving muscular health and advocating for tailored treatment strategies in T2DM management.
Assessment of Psoas Muscle Index in Middle-Aged Type 2 Diabetes Patients: Impact of Insulin Therapy on Sarcopenia
(Multidisciplinary Digital Publishing Institute (MDPI), 2024) Taskent, I.; Ece, B.; Aydin, S.
Objective: Sarcopenia, characterized by progressive skeletal muscle loss, poses significant health risks, including physical impairment and mortality. The relationship between sarcopenia and insulin resistance suggests insulin therapy’s potential in preserving muscle mass, particularly in Type 2 diabetes mellitus (T2DM) patients. This study aims to evaluate the Psoas Muscle Index (PMI) via computed tomography (CT) in middle-aged T2DM patients on insulin therapy versus oral antidiabetic drugs (OAD) and controls. Methods: This retrospective study included 107 middle-aged T2DM patients undergoing non-contrast CT scans and 58 age-matched controls. CT images were analyzed to calculate PMI. Statistical analysis included Chi-square tests, independent samples t-tests, Mann–Whitney U tests, and correlation analyses. Results: Insulin-treated patients exhibited higher PMI than OAD users (p < 0.001), while OAD users had lower PMI than controls (p < 0.001). No significant difference was found between insulin-treated patients and controls (p = 0.616). Negative correlations were observed between T2DM duration/age and PMI across all groups, with a positive correlation between T2DM duration and BMI observed in the OAD group. Conclusions: Insulin therapy in T2DM patients, regardless of age or disease duration, positively impacts muscle mass, highlighting its potential in preserving muscular health and advocating for tailored treatment strategies in T2DM management.
Assessment of Psoas Muscle Index in Middle-Aged Type 2 Diabetes Patients: Impact of Insulin Therapy on Sarcopenia
(2024.01.01) Taskent, I.; Ece, B.; Aydin, S.
Objective: Sarcopenia, characterized by progressive skeletal muscle loss, poses significant health risks, including physical impairment and mortality. The relationship between sarcopenia and insulin resistance suggests insulin therapy's potential in preserving muscle mass, particularly in Type 2 diabetes mellitus (T2DM) patients. This study aims to evaluate the Psoas Muscle Index (PMI) via computed tomography (CT) in middle-aged T2DM patients on insulin therapy versus oral antidiabetic drugs (OAD) and controls. Methods: This retrospective study included 107 middle-aged T2DM patients undergoing non-contrast CT scans and 58 age-matched controls. CT images were analyzed to calculate PMI. Statistical analysis included Chi-square tests, independent samples t-tests, Mann-Whitney U tests, and correlation analyses. Results: Insulin-treated patients exhibited higher PMI than OAD users (p < 0.001), while OAD users had lower PMI than controls (p < 0.001). No significant difference was found between insulin-treated patients and controls (p = 0.616). Negative correlations were observed between T2DM duration/age and PMI across all groups, with a positive correlation between T2DM duration and BMI observed in the OAD group. Conclusions: Insulin therapy in T2DM patients, regardless of age or disease duration, positively impacts muscle mass, highlighting its potential in preserving muscular health and advocating for tailored treatment strategies in T2DM management.
Criminal Responsibility Assessment of Frontotemporal Demantia: A Case Presentation
(2024.01.01) Kiliç, S.; Aktas, M.; Inaltekin, A.; Ece, B.
Frontotemporal dementia (FTD) is one of the most prevalent forms of early-onset dementia cases and a kind of primary degenerative dementia. Assessment of criminal responsibility is one of the most important issues for forensic psychiatry due to the help of justice. A 55-year-old male who allegedly committed an offense of threat and libel to a doctor was referred to the psychiatric clinic at our hospital by the prosecution office for the evaluation of his criminal responsibility. Seventeen years ago, he suffered severe head trauma. After this trauma, his mental and behavioral problems began to develop. It was realized that his ability to think abstractly, reasoning, and reality testing are impaired. Brain magnetic resonance imaging revealed atrophy characterized by sulcal widening and brain parencymal volume loss, which are more prominent in the bilateral frontal and temporal lobes. Additionally, disinhibited behaviors in his medical history such as verbal violence and suddenly leaving the house were noticed. A diagnosis of frontotemporal dementia was made. We understood the onset of symptoms of our case began when he was 40-year-old from the medical records. With this aspect, our case has a remarkably young age of initiation of symptoms. The purpose of this case report is to draw physicians' attention to the medical symptoms and medicolegal consequences of a patient with early-onset FTD.
Evaluation of the Effect of Topical Prostaglandin Analog Treatment on Orbital Structures in Open-Angle Glaucoma with Computed Tomography
(2024) Ece, B.Ş.D.; Yozgat, Z.; Bayramlı, H.; Ece, B.; Aydin, S.
This study aims to evaluate the computed tomography (CT) scans of glaucoma patients using prostaglandin analogs (PGA) in one eye, investigate findings associated with prostaglandin-associated periorbitopathy (PAP), and compare these findings with those of the contralateral eyes. : Patients with open-angle glaucoma who had CT images of the orbital region taken for another reason at least one month after starting PGA treatment in one eye were included in the study. Enophthalmos measurements from thin-slice CT images, along with 3D volume measurements of orbital fat tissue, periorbital muscles, and the optic nerve, were performed. Ophthalmological examination findings and treatment information were collected. The values were compared with those of the contralateral eyes of the same patients not using PGA. Intraclass correlation coefficients (ICCs) were computed to evaluate measurement repeatability. : Forty patients were included in the study. Among them, 29 (72.5%) used latanoprost, 9 (22.5%) used bimatoprost, and 2 (5%) used travoprost. The mean enophthalmos values on the treated side (15.5 ± 2.0 mm) were lower than on the untreated side (16.1 ± 1.4 mm), but this difference was not statistically significant ( = 0.07). In 29 patients (72.5%), enophthalmos measurements were smaller on the treated side, with 7 patients (17.5%) showing a difference of 2 mm or more. No significant correlation was found between the duration of PGA use and enophthalmos measurements ( = 0.768 r = -0.048). Additionally, no significant differences were found in orbital fat volume, total extraocular muscle volume, and optic nerve volume ( > 0.05). ICC values demonstrated excellent reliability (ICC > 0.75) for all measurements. : We did not find significant differences in enophthalmos measurements, orbital fat volume, total muscle volume, and optic nerve volume between the PGA-treated and untreated eyes.
Exploring PGE2 and LXA4 Levels in Migraine Patients: The Potential of LXA4-Based Therapies
(2024.01.01) Kocaturk, I.; Gulten, S.; Ece, B.; Guven, F.M.K.
Neurogenic inflammation plays a significant role in the pathogenesis of migraines. This study aimed to investigate the serum levels of prostaglandin E2 (PGE2), lipoxin A4 (LXA4), and other inflammatory biomarkers (C-reactive protein, fibrinogen) in migraine patients. In total, 53 migraine patients and 53 healthy controls were evaluated. Blood serum samples were collected during both attack and interictal periods and compared with the control group. In both the attack and interictal periods, PGE2 and LXA4 values were significantly lower in migraine patients compared to the control group (p < 0.001). Additionally, PGE2 values during the attack period were significantly higher than those during the interictal period (p = 0.016). Patients experiencing migraine attacks lasting >= 12 h had significantly lower serum PGE2 and LXA4 levels compared to those with attacks lasting < 12 h (p = 0.028 and p = 0.009, respectively). In ROC analysis, cut-off values of 332.7 pg/mL for PGE2 and 27.2 ng/mL for LXA4 were determined with 70-80% sensitivity and specificity. In conclusion, PGE2 and LXA4 levels are significantly lower in migraine patients during both interictal and attack periods. Additionally, the levels of LXA4 and PGE2 decrease more with the prolongation of migraine attack duration. Our findings provide a basis for future treatment planning.
Exploring PGE2 and LXA4 Levels in Migraine Patients: The Potential of LXA4-Based Therapies
(2024) Kocaturk, I.; Gulten, S.; Ece, B.; Kukul Guven, F.M.
Neurogenic inflammation plays a significant role in the pathogenesis of migraines. This study aimed to investigate the serum levels of prostaglandin E2 (PGE2), lipoxin A4 (LXA4), and other inflammatory biomarkers (C-reactive protein, fibrinogen) in migraine patients. In total, 53 migraine patients and 53 healthy controls were evaluated. Blood serum samples were collected during both attack and interictal periods and compared with the control group. In both the attack and interictal periods, PGE2 and LXA4 values were significantly lower in migraine patients compared to the control group ( < 0.001). Additionally, PGE2 values during the attack period were significantly higher than those during the interictal period ( = 0.016). Patients experiencing migraine attacks lasting ≥ 12 h had significantly lower serum PGE2 and LXA4 levels compared to those with attacks lasting < 12 h ( = 0.028 and = 0.009, respectively). In ROC analysis, cut-off values of 332.7 pg/mL for PGE2 and 27.2 ng/mL for LXA4 were determined with 70-80% sensitivity and specificity. In conclusion, PGE2 and LXA4 levels are significantly lower in migraine patients during both interictal and attack periods. Additionally, the levels of LXA4 and PGE2 decrease more with the prolongation of migraine attack duration. Our findings provide a basis for future treatment planning.