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Markel M, Lacher M, Hall NJ, Martynov I, Siles Hinojosa A, de Augustin Asensio JC, Fortmann C, Hukkinen M, Mutanen A, Ford K, Glenisson M, Bonnard A, Dimitrios G, Zavras N, Malowiecka M, Patkowski D, Zambaiti E, Pelizzo G, Salo M, Wester T, Hoel AT, Bjornland K, Arni D, Wildhaber BE, Karagöz A, Topuzlu Tekant G, Barroso C, Correia-Pinto J, Gorter R, van Heurn E, Reusens H, Steyaert H, Dagilyte R, Strumila A, Arneitz C, Till H, Dotlaci V, Rygl M, Jukic M, Pogorelic Z, Enache T, Balanescu L, Cascio S, Zani A, Pio L. Training in minimally invasive surgery: experience of paediatric surgery trainees in Europe. Br J Surg 2023; 110:1397-1399. [PMID: 37527435 DOI: 10.1093/bjs/znad245] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 07/10/2023] [Accepted: 07/14/2023] [Indexed: 08/03/2023]
Affiliation(s)
- Moritz Markel
- Department of Paediatric Surgery, University of Leipzig, Leipzig, Germany
| | - Martin Lacher
- Department of Paediatric Surgery, University of Leipzig, Leipzig, Germany
| | - Nigel J Hall
- University Surgery Unit, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Illya Martynov
- Department of Paediatric Surgery, University of Leipzig, Leipzig, Germany
| | | | | | - Caroline Fortmann
- Department of Paediatric Surgery, Hannover Medical School, Hannover, Germany
| | - Maria Hukkinen
- Department of Paediatric Surgery, University of Helsinki, Helsinki, Finland
| | - Annika Mutanen
- Department of Paediatric Surgery, University of Helsinki, Helsinki, Finland
| | - Kathryne Ford
- Pediatric Surgery Unit, Oxford Children's Hospital and University of Oxford, Oxford, UK
| | - Mathilde Glenisson
- Department of Paediatric Surgery and Urology, Necke-Enfants Malades Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Arnaud Bonnard
- Department of Paediatric Surgery and Urology, Robert Debré Hospital, Assistance Publique-Hôpitaux de Paris, Paris Cité University, Paris, France
| | - Godosis Dimitrios
- Paediatric Surgery Department, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Nikolaos Zavras
- Department of Paediatric Surgery, 'Attikon' University General Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Maria Malowiecka
- Pediatric Surgery Unit, Medical Centre of Postgraduate Education, Warsaw, Poland
| | - Dariusz Patkowski
- Paediatric Surgery and Urology Department, Wroclaw University of Medicine, Wroclaw, Poland
| | - Elisa Zambaiti
- Paediatric Surgery Department, Regina Margherita Hospital, Turin, Italy
| | - Gloria Pelizzo
- Paediatric Surgery Department, 'V. Buzzi' Children's Hospital and University of Milan, Milan, Italy
| | - Martin Salo
- Department of Paediatric Surgery, Skåne University Hospital, Lund, Sweden
| | - Tomas Wester
- Department of Paediatric Surgery, Karolinska University Hospital, Stockholm, Sweden
| | - Anders T Hoel
- Department of Paediatric Surgery, Oslo University Hospital and University of Oslo, Oslo, Norway
| | - Kristin Bjornland
- Department of Paediatric Surgery, Oslo University Hospital and University of Oslo, Oslo, Norway
| | - Delphine Arni
- University Centre of Paediatric Surgery of Western Switzerland, Division of Child and Adolescent Surgery, Department of Paediatrics, Gynaecology, and Obstetrics, University of Geneva, Geneva University Hospitals, Geneva, Switzerland
| | - Barbara E Wildhaber
- University Centre of Paediatric Surgery of Western Switzerland, Division of Child and Adolescent Surgery, Department of Paediatrics, Gynaecology, and Obstetrics, University of Geneva, Geneva University Hospitals, Geneva, Switzerland
| | - Ayse Karagöz
- Division of Paediatric Urology, Department of Paediatric Surgery, Istanbul University Cerrahpasa Faculty of Medicine, Istanbul, Turkey
| | - Gonca Topuzlu Tekant
- Division of Paediatric Urology, Department of Paediatric Surgery, Istanbul University Cerrahpasa Faculty of Medicine, Istanbul, Turkey
| | - Catarina Barroso
- Department of Paediatric Surgery, Hospital de Braga, Braga, Portugal
| | | | - Ramon Gorter
- Paediatric Surgical Centre of Amsterdam, Emma Children's Hospital and VU University Medical Centre, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Ernst van Heurn
- Paediatric Surgical Centre of Amsterdam, Emma Children's Hospital and VU University Medical Centre, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Helena Reusens
- Department of Paediatric Surgery, Université Libre de Bruxelles (ULB), Queen Fabiola Children's Hospital, Brussels, Belgium
| | - Henri Steyaert
- Department of Paediatric Surgery, Université Libre de Bruxelles (ULB), Queen Fabiola Children's Hospital, Brussels, Belgium
| | - Ruta Dagilyte
- Pediatric Surgery Unit, Children's Hospital, Affiliate of Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
| | - Arunas Strumila
- Pediatric Surgery Unit, Children's Hospital, Affiliate of Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
| | - Christoph Arneitz
- Department of Paediatric and Adolescent Surgery, Medical University of Graz, Graz, Austria
| | - Holger Till
- Department of Paediatric and Adolescent Surgery, Medical University of Graz, Graz, Austria
| | - Vojtech Dotlaci
- Department of Paediatric Surgery, Charles University and Motol University Hospital, Prague, Czech Republic
| | - Michal Rygl
- Department of Paediatric Surgery, Charles University and Motol University Hospital, Prague, Czech Republic
| | - Miro Jukic
- Department of Paediatric Surgery, University Hospital of Split, Split, Croatia
- Department of Surgery, University of Split, School of Medicine, Split, Croatia
| | - Zenon Pogorelic
- Department of Paediatric Surgery, University Hospital of Split, Split, Croatia
- Department of Surgery, University of Split, School of Medicine, Split, Croatia
| | - Tudor Enache
- Department of Paediatric Surgery, Grigore Alexandrescu Clinical Emergency Hospital for Children, Bucharest, Romania
| | - Laura Balanescu
- Department of Paediatric Surgery, Grigore Alexandrescu Clinical Emergency Hospital for Children, Bucharest, Romania
- Department of Paediatric Surgery and Orthopaedics, 'Carol Davila' University of Medicine and Pharmacy, Bucharest, Romania
| | - Salvatore Cascio
- Department of Paediatric Surgery and Paediatric Urology, Children's Health Ireland at Temple Street and University College Dublin, Dublin, Ireland
| | - Augusto Zani
- Division of General and Thoracic Surgery, Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Luca Pio
- Department of Paediatric Surgery and Urology, Robert Debré Hospital, Assistance Publique-Hôpitaux de Paris, Paris Cité University, Paris, France
- Department of Surgery, St Jude Children's Research Hospital, Memphis, Tennessee, USA
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Uygun Kızmaz Y, Külahçıoğlu Ş, Doğan Kaya S, Gürcü ME, Karagöz A, Kırali MK. Epidemiology and risk factors of infections among patients with extracorporeal membrane oxygenation in a tertiary heart center. Eur Rev Med Pharmacol Sci 2023; 27:7235-7244. [PMID: 37606132 DOI: 10.26355/eurrev_202308_33295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 08/23/2023]
Abstract
OBJECTIVE Extracorporeal membrane oxygenation (ECMO) is an important treatment strategy for severe acute respiratory and/or cardiac failure. Despite advancements in device technology and intensive care, mortality rates, and complications remain high. Patients undergoing ECMO are at an increased risk of infection due to factors such as immunosuppression, the presence of cannulas, and variable antibiotic pharmacokinetics. Unfortunately, an acquired infection in these patients can lead to increased morbidity, longer hospital stays, and even mortality. The purpose of this study was to examine the prevalence, profiles, and sites of ECMO-related infections, as well as underlying risk factors associated with these infections. PATIENTS AND METHODS We retrospectively analyzed clinical data from 73 patients who received veno-arterial (VA) and/or venovenous (VV) ECMO support due to severe but potentially reversible cardiac and/or pulmonary failure lasting ≥24 hours. We involved patients with no suspicion of pre-existing infection before ECMO insertion from January 2015 to February 2023, classifying them into either infected or non-infected based on available evidence. The estimated probability for infection according to ECMO-day was established. Significance was set at p<0.05. The primary interesting outcome is the infection probability. RESULTS Mean age was 52.2±14.8 years in all groups, and 55 (75.3%) were male. Median hospital stay was 6 (2-16) days and duration of ICU was 5 (2-10) days in all groups. The duration of ICU stay was significantly higher in the infected group compared to the non-infected group [10 days (5-15) vs. 3 days (2-7)], p<0.001, respectively. 66 patients (90.4%) received VA ECMO and 18 of them (94.7%) were infected. In all groups, the ECMO wean ratio was 28.8%. Death before 48 hours occurred in 28 patients (38.4%). 26% of patients under ECMO support consisted of the infected group and had 68 episodes per 1,000 ECMO days. Of these, the most frequent infection site was lower respiratory tract infection (47.3%). The most common pathogen among these was K. pneumonia. 39.7% of patients received no antibiotics. The probability of infection was 19% for 1.5 (mean-1SD) ECMO days, approximately 41% for 4 ECMO days, and 52% for (mean+1SD) 6.5 ECMO days. CONCLUSIONS Nosocomial infections, which are commonly observed during ECMO procedures, are considered a significant concern. The respiratory system is frequently affected by such infections. Even though the use of antibiotics for prophylaxis remains debatable, it is predicted that there will be an inclination towards the regular application of prophylactic measures and the development of standardized protocols based on solid evidence obtained from prospective research studies in the future.
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Affiliation(s)
- Y Uygun Kızmaz
- Department of Infectious Diseases and Clinical Microbiology, Kosuyolu High Specialization Training and Research Hospital, Istanbul, Turkey.
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Hazirolan G, Koçak N, Karagöz A. Sequence-based identification, genotyping and virulence factors of Trichosporon asahii strains isolated from urine samples of hospitalized patients (2011-2016). J Mycol Med 2018; 28:452-456. [PMID: 29983233 DOI: 10.1016/j.mycmed.2018.06.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Revised: 06/11/2018] [Accepted: 06/19/2018] [Indexed: 02/03/2023]
Abstract
INTRODUCTION Trichosporon asahii is the most common species that causes trichosporonosis. MATERIALS AND METHODS In the present study, a collection of 68T. asahii strains recovered from hospitalized patients urine samples between 2011 and 2016 was examined. T. asahii strains were identified by sequencing the intergenic spacer 1 region (IGS1) and genotyped. In addition, proteinase, phospholipase, esterase, haemolytic activity, and biofilm formation of a total of T. asahii strains were investigated. RESULTS The predominant genotype was 1 (79.3%) and followed by 5 (8%), 3 (6.9%), 6 (3.4%), 4 (1.1%), 9 (1.1%). In none of the 68 strains, proteinase and phospholipase activities could be detected, while all were found to be esterase positive. Biofilm production and hemolytic activity were detected in 23.5 and 97% respectively. DISCUSSION Our results indicated that six genotypes were (1, 5, 3, 6, 4, 9) present among T. asahii strains and no property was found to associate with a genotype, in terms of virulence factors.
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Affiliation(s)
- G Hazirolan
- Hacettepe University Faculty of Medicine, Department of Medical Microbiology, Hacettepe Üniversitesi Tıp Fakültesi, Tıbbi Mikrobiyoloji ABD, Sıhhiye, 06100 Ankara, Turkey.
| | - N Koçak
- Selçuk Üniversity Medicine Faculty, Department of Medical Genetics, Selçuk Üniversitesi Tıp Fakültesi Tıbbi Genetik ABD Selçuklu/Konya, Ankara, Turkey
| | - A Karagöz
- Public Health Agency of Turkey, National Molecular Microbiology Reference Centers Laboratory, Türkiye Halk Sağlığı Kurumu, Moleküler Mikrobiyoloji Referans Laboratuvarları, Adnan Saygun Cad. No: 55 Sıhhiye, Ankara, Turkey
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Onat A, Çoban N, Can G, Yüksel M, Karagöz A, Yüksel H, Ademoğlu E, Erginel-Ünaltuna N. Low "quotient" Lp(a) concentration mediates autoimmune activation and independently predicts cardiometabolic risk. Exp Clin Endocrinol Diabetes 2014; 123:11-8. [PMID: 25314652 DOI: 10.1055/s-0034-1385922] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
OBJECTIVE We determined whether U-shaped relationships exist between serum lipoprotein[Lp](a) and cardiometabolic risk. METHODS In population-based nondiabetic and diabetic middle-aged adults (n=1 428 and 241, respectively) who had been genotyped for the LPA rs10455872 A>G polymorphism, we adjusted the Lp(a) concentration for the effects of genotype and other covariates. Via sex-specific equations we estimated expected Lp(a) concentration in each participant, and the quotient between observed to expected Lp(a) values was determined. Lp(a) and Lp(a) quotient tertiles served to identify non-linear associations with outcomes. RESULTS Incident 81 cases of diabetes and 128 of coronary heart disease (CHD) developed at 5.1 years' follow-up. Lp(a) concentration was linearly associated with the LPA genotype, gender, total cholesterol, (inversely) fasting insulin, which together with age formed the variables to derive the equations. In logistic regression for incident diabetes, the low Lp(a) quotient tertile was a predictor (RR 1.95 [95%CI 1.10; 3.47]) alike the low Lp(a) tertile, additively to major confounders. Cox regression models comprising sex, age, LPA genotype, smoking status, systolic pressure and serum HDL-cholesterol disclosed that, compared with the mid-tertile, both low (HR 1.77) and high Lp(a) quotient tertiles significantly predicted incident CHD, especially in women. CONCLUSION Elevated cardiometabolic risk is conferred by apparently reduced circulating Lp(a) assays supporting the notion that "low" serum Lp(a), mediating autoimmune activation, is a major determinant of cardiometabolic risk.
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Affiliation(s)
- A Onat
- Department of Cardiology, Istanbul University, Istanbul
| | - N Çoban
- Department of Genetics, Institute for Experimental Medical Research, Istanbul University, Istanbul
| | - G Can
- Department of Public Health, Cerrahpaşa Medical Faculty, Istanbul University, Istanbul
| | - M Yüksel
- Department of Cardiology, Dicle University, Diyarbakir, Turkey
| | - A Karagöz
- Department of Medicine, Giresun Educ. Hospital, Giresun, Turkey
| | - H Yüksel
- Department of Cardiology, Istanbul University, Istanbul
| | - E Ademoğlu
- Department of Biochemistry, Medical Faculty, Istanbul University, Istanbul
| | - N Erginel-Ünaltuna
- Department of Genetics, Institute for Experimental Medical Research, Istanbul University, Istanbul
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Karagöz A, Bezgin T, Kutlutürk I, Külahçıoğlu S, Tanboğa IH, Güler A, Karabay CY, Oduncu V, Aksoy H, Kırma C. Subclinical left ventricular systolic dysfunction in diabetic patients and its association with retinopathy: A 2D speckle tracking echocardiography study. Herz 2014; 40 Suppl 3:240-6. [PMID: 25205476 DOI: 10.1007/s00059-014-4138-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2014] [Revised: 07/02/2014] [Accepted: 07/10/2014] [Indexed: 11/28/2022]
Abstract
AIM It is important to diagnose diabetic cardiomyopathy in the early stages to prevent development of evident heart failure in the future. The primary objective of this study was to evaluate the presence of subclinical left ventricular (LV) dysfunction with two-dimensional (2D) speckle tracking echocardiography (STE) and the secondary objective was to compare retinopathy-positive and -negative diabetic patients. PATIENTS AND METHODS A total of 82 patients with type II diabetes mellitus (DM) and 90 gender-matched healthy controls were included. Retinopathy was present in 55 patients in the study group. All study participants underwent conventional 2D echocardiography and STE. RESULTS All diabetic patients had preserved LV ejection fraction (LV-EF ≥ 50). Compared with the control group, diabetic patients had a larger left atrium (47.3 ± 19.9 mm vs. 36.9 ± 17.8 mm, p < 0.001) and a higher E/Em ratio (12.0 ± 2.9 vs. 10.5 ± 3.7, p = 0.004). The LV-EF, LV end diastolic and end systolic volumes, E/A ratios, deceleration times, and tissue Doppler parameters were compared between groups. The study group was observed to have statistically significant lower four-chamber (4C; 17.7 ± 3.0 % vs. 19.3 ± 3.5 %, p = 0.002), three-chamber (3C; 17.5 ± 3.0 % vs. 19.2 ± 3.4 %, p = 0.001), and two-chamber (2C; 18.5 ± 3.5 % vs. 20.1 ± 2.4 %, p = 0.001) peak longitudinal strain values compared with the control group. Moreover, LV global strain values were found to be significantly lower in the DM group than in the control group (17.9 ± 2.7 % vs. 21.1 ± 3.2 %, p < 0.001). By contrast, basal rotation (4.9 ± 3.3° vs.2.8 ± 4.5°, p = 0.001), apical rotation (15.3 ± 6.7° vs. 12.1 ± 5.3°, p = 0.001) and LV twist (20.2 ± 7.2° vs. 16.9 ± 6.5°, p = 0.002) in the DM group were significantly increased compared with those of controls. CONCLUSION The STE procedure can be a useful novel technique in the determination of subclinical LV dysfunction in diabetic patients. Diabetic patients have lower longitudinal myocardial mechanics, and circumferential and rotational mechanics are impaired. There was no significant association between diabetic retinopathy and LV function.
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Affiliation(s)
- A Karagöz
- Cardiology Clinic, Kartal Koşuyolu Heart Research Hospital, Denizer Cad. Cevizli Kartal, 34846, Istanbul, Turkey
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