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Öğe Causes of acute abdomen, preferred imaging methods, and prognoses in geriatric patients presenting to the emergency department with abdominal pain(Assoc Medica Brasileira, 2022) Ilgar, Mehtap; Akcicek, Mehmet; Ekmekyapar, MuhammedOBJECTIVE: Abdominal pain is one of the most common reasons for admission to the emergency department in the geriatric population. The aim of this study was to investigate the diseases frequently detected in elderly patients diagnosed with acute abdomen in the emergency department, the imaging methods used in the diagnostic processes of these diseases, and the prognosis of the patients. METHODS: In all, 175 patients who visited the emergency department due to abdominal pain and were hospitalized with a diagnosis of acute abdomen were evaluated. The patients were categorized into seven groups according to their diagnosis as biliary diseases, pancreatitis, appendicitis, gastrointestinal system perforation, ileus, mesenteric ischemia, and atypical causes. RESULTS: The mean age of the patients was 76.3 +/- 7.7 years (range 65-93), and 96 (54.9%) were women. The most common causes of acute abdomen were biliary diseases and pancreatitis. Ultrasonography (88.6%) was the most frequently preferred imaging method in the emergency department, and it was most frequently used for biliary diseases. Notably, 20 (11.4%) patients were treated in the intensive care unit, and 9 (5.1%) patients died. CONCLUSION: The most common causes of acute abdomen in the geriatric population were biliary diseases and pancreatitis, and ultrasonography imaging was the most common choice for the diagnosis of these diseases. In elderly patients with abdominal pain, rapid and accurate diagnosis and selection of the correct imaging method are extremely important.Öğe Diagnostic Benefits and Surgical Implications of Methods for Tumor Localization in Sigmoid and Rectum Tumors(Mdpi, 2024) Gul, Mehmet Onur; Akcicek, Mehmet; Iflazoglu, Nidal; Corbaci, Kadir; Emir, Cuma Ali; Guzel, Mehmet; Parsak, Cem Kaan(1) Background: In our study, we aimed to determine the accuracy rates of imaging methods for sigmoid, rectosigmoid colon, and rectum cancer. (2) Methods: Patients with tumors located in the rectosigmoid colon, sigmoid colon, and rectum who were operated on were included. Upon admission, we examined the patients' first diagnostic colonoscopies and their preoperative repeat control colonoscopies and computed tomography (CT) report. (3) Results: In this study, 23 patients (57.5%) were male. The overall accuracy rates were 80.0% (32/40) in colonoscopy, 65.0% (26/40) in preoperative CT, and 87.5% (35/40) in retro CT, and the differences among the examination methods were statistically significant (p = 0.049). The sensitivity levels decreased to 50.0% for colonoscopy and preoperative CT and 75.0% for retro CT in rectosigmoid colon tumors. In rectal tumors, the sensitivity levels were 75.0% in colonoscopy, 60.0% in preoperative CT, and 80.0% in retro CT. In two patients, the tumor location was given incorrectly, and postoperative pathological evaluations indicated T3N0 tumors; the initially planned treatment was thus changed to include radiotherapy in addition to chemotherapy in the postoperative period because the tumor was located in the middle rectum. (4) Conclusions: Accuracy in tumor localization in sigmoid, rectosigmoid, and rectum tumors still needs to be improved, which could be accomplished with prospective studies. CT evaluations for cancer localization in this patient group should be re-evaluated by a radiologist.Öğe Is acute appendicitis complicated or uncomplicated? Approaching the question via computed tomography(Sage Publications Ltd, 2023) Akcicek, Mehmet; Ilgar, Mehtap; Unlu, SerkanBackground The distinction between complicated and uncomplicated appendicitis is very important for the selection of the treatment method. Purpose To investigate the sensitivity and specificity of computed tomography (CT) in differentiating between complicated and uncomplicated appendicitis to demonstrate that false negativity in differentiating these cases can be reduced when CT findings are incorporated into the clinical evaluation of patients. Material and Methods All patients aged >= 18 years who underwent appendectomy at Malatya Training and Research Hospital in 2020 and 2021 were retrospectively screened. Of them, 283 patients were included in the study who had undergone CT before the operation. Patients with appendicitis were divided into two groups: complicated and uncomplicated, according to the results of their pathology tests. Demographic data, laboratory results, and CT images of the patients were evaluated. Results The patients with complicated appendicitis had a significantly higher mean age (P<0.001). The most common CT findings in patients with complicated appendicitis were moderate or severe peri-appendiceal fat stranding (PFS) and appendix wall enhancement defect (AWD). The findings with the highest sensitivity were PFS (77.9%) and AWD (69.4%). Although abscess, phlegmon, and peri-appendiceal air had the highest specificity (100%), these findings were the ones with the lowest sensitivity. According to the scoring system was developed for the differential diagnosis, CT had a sensitivity of 83.3% and a specificity of 79.2%. Conclusion Based on the sensitivity and specificity values measured for CT according to the findings of our study, the scoring system may be useful for the differential diagnosis of complicated appendicitis.Öğe Is anemia a risk factor in pneumonia progression in covid-19-infected patients?(Wolters Kluwer Medknow Publications, 2022) Akcicek, Mehmet; Ilgar, Mehtap; Unlu, SerkanBackground Determining the factors contributing to the development of severe coronavirus 2019 disease (COVID-19) disease is of great importance for health guidance. In this study, the authors aimed to investigate whether there is a relationship between anemia and progression of COVID-19 pneumonia. Patients and methods Records of 201 patients whose RT-PCR positivity for COVID-19 was confirmed between August 2020 and October 2020, when admissions and hospitalizations were at their peak, were retrospectively reviewed. The scoring system based on visual evaluation was used for evaluating the severity of the disease on each computed tomography (CT). To determine the progression status of pneumonia, the score difference was calculated by the difference between two CT scores. The patients were divided into two groups according to their hemoglobin levels as anemic and nonanemic patients. Results A significant difference was reported between the CT score difference groups in terms of mean age (P < 0.001). The mean age of the group that did not show progression was significantly lower than the other groups. Although the mean hemoglobin level of the group that did not show progression was higher than the other groups, no significant difference was reported between the groups (P=0.768). There was no significant difference between the CT score difference groups in terms of the presence or absence of anemia (P=0.791). Conclusion No significant relationship was found between hemoglobin levels, anemia, and pneumonia progression in COVID-19-infected patients.Öğe Relationship Between Viral Load and Laboratory Values and Radiological Findings in Patients with COVID-19(Galenos Publ House, 2022) Altintop Geckil, Aysegul; Benk, Isilay Gokce; Aydin, Sukru; Akcicek, MehmetIntroduction: This study investigates the relationship between the viral load calculated from oropharyngeal/nasopharyngeal swabs at diagnosis and the laboratory parameters and radiological findings in patients with Coronavirus disease-2019 (COVID-19). Materials and Methods: Sixty-seven patients who were positive for severe acute respiratory syndrome-coronavirus-2 via quantitative reverse transcription-polymerase chain reaction (qPCR) from their oropharyngeal/nasopharyngeal swabs and admitted to Malatya Turgut Ozal University Hospital were included in the study. Demographic data, laboratory parameters, and the severity of thorax computed tomography findings were recorded. The relationship between the viral load and these data was compared. Results: The mean age of the patients was 63.4 +/- 9.8 years, mean body mass index (BMI) was 28.6 +/- 5.4 kg/m(2), and mean cycle threshold (Ct) values were 21.4 +/- 5.2 cycles. No correlation was found between Ct value and gender, age, and BMI. There was a significant relationship between radiological severity and Ct value, age, and gender. There was a significant correlation between the Ct value and C-reactive protein, leukocyte, neutrophil, lymphocyte, neutrophil-lymphocyte ratio, ferritin, albumin, and calcium levels. In contrast, no significant correlation was found between hemoglobin, hematocrit, thrombocyte, urea, creatinine, total protein, gamma glutamyl transferase, alkaline phosphatase, sodium, potassium, D-dimer, procalcitonin levels, and Ct value. Conclusion: The viral load amount shown by PCR during the early period predicts the condition of the patient's lung in the advanced immunological phase. The Ct value can be an independent factor for evaluating the patient's radiological and biochemical status.
