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    Analysis of patients with suspected diagnosis of spontaneous bacterial peritonitis in the emergency department
    (2019) Salt, Omer; Sayhan, Mustafa Burak
    Aim: In this study, we aimed to determine the epidemiological characteristics, microbiological and laboratory parameters of the patients diagnosed with spontaneous bacterial peritonitis (SBP) in the tertiary emergency department and to determine the inhospital mortality rates. Material and Methods: A total of 294 patients who met these criteria and whose data were fully accessible from the hospital information management system included in the study. Demographic data such as age, gender, cirrhosis etiology, laboratory results and in-hospital mortality were recorded on the study form previously prepared. Child-Pugh and model for end stage liver disease (MELD) scores were calculated according to the formulas. Results: The mean age of the patients was 49 ± 17 years (mean ± SD) and 212 (72.1%) were male. When the patients were examined in terms of the etiology of cirrhosis; the most common cause was viral hepatitis with 53.4% (n: 157), followed by alcoholic hepatitis with 28.4% (n: 83). In terms of Child-Pugh grades, 45.2% (n: 132) of the patients were Child-Pugh grade C. In acid fluid analysis; there were 57 (19.3%) patients in SBP group, 45 (15.3%) patients in the culture negative neutrocytic ascites group and 192 (65.4%) patients in monomicrobial bacterascites group. Conclusion: Since the first admission address of these patients are mostly ED, especially emergency physicians should always keep this diagnosis in mind for such patients.
  • Küçük Resim Yok
    Öğe
    Comparison of Sirolimus and Colchicine Treatment on the Development of Peritoneal Fibrozis in Rats Having Peritoneal Dialysis
    (Galenos Publ House, 2015) Sagiroglu, Tamer; Sayhan, Mustafa Burak; Yagci, Mehmet A.; Yalta, Tulin; Sagiroglu, Gonul; Copuroglu, Elif; Oguz, Serhat
    Background: Continuous ambulatory peritoneal dialysis is a successful treatment modality for patients with end-stage renal disease. Peritoneal fibrosis (PF) is the most critical complication of long-term peritoneal dialysis (PD). Aims: In our study, we aimed to compare the effects of colchicine and sirolimus on PF induced by hypertonic peritoneal dialysis solutions in rats. Study Design: Animal experiment. Methods: Twenty-four rats were randomly divided into three groups. The control group received an intraperitoneal injection (ip) of saline. The sirolimus group received the PD solution, plus 1.0 mg/kg/day Rapamune (R). The colchicine group received the PD solution ip plus 1.0 mg/kg/day of colchicine. Blood samples were taken to measure the serum levels of VEGF, TGF-beta, and TNF-alpha. Peritoneal tissue samples were taken for histopathological evaluation. Results: TGF-beta and TNF-alpha values in the sirolimus group were found to be statistically significantly lower than in the control and colchicine groups, but the differences between the control and colchicine groups were not statistically significant. No statistically significant differences were found between the groups regarding the VEGF values. Vascular neogenesis and peritoneal thickness were compared; the values in the sirolimus group were statistically reduced compared to the values in the control group. Mild fibrosis developed in 75% of all animals in the sirolimus group; there was no moderate or severe fibrosis observed. Fibrosis developed to varying degrees in 100% of the animals in the control and colchicine groups. Conclusion: The present study demonstrates that sirolimus might be beneficial for preventing or delaying the progression of PF and neoangiogenesis. These alterations in the peritoneal membrane may be connected with reduced TNF-alpha and TGF-beta levels. the control and colchicine groups, but the differences between the control and colchicine groups were not statistically significant. No statistically significant differences were found between the groups regarding the VEGF values. Vascular neogenesis and peritoneal thickness were compared; the values in the sirolimus group were statistically reduced compared to the values in the control group. Mild fibrosis developed in 75% of all animals in the sirolimus group; there was no moderate or severe fibrosis observed. Fibrosis developed to varying degrees in 100% of the animals in the control and colchicine groups. Conclusion: The present study demonstrates that sirolimus might be beneficial for preventing or delaying the progression of PF and neoangiogenesis. These alterations in the peritoneal membrane may be connected with reduced TNF-alpha and TGF-beta levels.