To determine the outcomes of partial splenic embolization (PSE) for massive splenomegaly due to idiopathic portal hypertension (IPH). In this prospective study, we evaluated the characteristics and prognosis of consecutive patients with IPH who underwent PSE for all indications at a single medical center between June 2009 and January 2015. The inclusion criteria were: presence of hypersplenism, massive splenomegaly, and resultant pancytopenia. The exclusion criteria were: presence of other diseases causing portal hypertension. During the post-PSE period, the patients were hospitalized. All patients underwent abdominal computed tomography imaging 4 wk post-PSE to determine total splenic and non-infarcted splenic volumes. A total of 11 patients, with median age of 33.27 ± 4.8 years, were included in the study. Mean spleen size was 22.9 cm (21-28 cm), and severe hypersplenism was diagnosed in all patients before PSE. Post-PSE, leukocyte and platelet counts increased significantly, reaching peak levels in the second week with gradual decreases thereafter. Liver function tests did not exhibit significant changes during post-intervention follow-up. All patients developed post-embolization syndrome, and one patient experienced serious complications; all complications were successfully treated with conservative therapy and no death occurred. Our findings showed that PSE has a lower complication rate than previously-reported surgical complication rates, which supports this intervention as a viable alternative for high-risk operable patients with severe hypersplenism.

Synthesis and characterization of (E)-4-((5-bromo-2-(λ¹-oxidanyl)benzylidene)amino)-N-(5-methyl-1,3,4-thiadiazol-2-yl)benzenesulfonamide (1), its substituted phthalonitrile derivative (2) and its tetra substituted zinc(II) phthalocyanine complex (3) were performed. Compounds 1, 2 and 3 were characterized by methods such as elemental analyses, FT-IR, ¹H-NMR, ¹³C-NMR (except for 3) and MALDI-TOF mass spectra. The photophysical and photochemical properties of this substituted zinc(II) phthalocyanine complex aimed to be used as a photosensitizer were investigated in DMSO solution for determination of their photosensitizing abilities in photocatalytic applications such as photodynamic therapy. The influence of the substituent as a bioactive compound on the phthalocyanine skeleton on spectroscopic, photophysical and photochemical properties were also determined and compared with unsubstituted zinc(II) phthalocyanine and some zinc(II) phthalocyanines containing different substituents previously studied. According to photophysical and photochemical investigations, 3 has potential as a photosensitizer for photodynamic therapy.

Background: The initial treatment for fecal incontinence (FI) includes supportive treatment and medical treatment. If the initial treatment fails, biofeedback therapy (BFT) is recommended. However, there are limited and conflicting results in the literature supporting the beneficial effect of BFT for FI. The aim of the study is to analyze the efficacy of BFT in 126 patients who have FI due to several causes. Methods: The data of 126 patients (88 females (69.8%) and 38 males (30.2%)) were collected retrospectively. Colonoscopy, anorectal manometry (ARM), and 3D-Endoanal ultrasonography (EAUS) were performed for all patients before applying BFT. In addition, all patients received toilet training instruction and training in Kegel and other pelvic floor strengthening exercises from an experienced nurse, before BFT. Results: The median age of participants was 54 years (range 18-75 years). While 80 patients (63.5%) had clinical and manometric benefit from BFT, 46 patients (36.5%) did not respond to BFT. According to the EAUS and ARM findings, BFT was beneficial in patients who had partial external sphincter failure, and was unsuccessful in patients who had both internal and external sphincter failure, both internal and external sphincter tears, and external sphincter tear rates of more than 25%. After BFT, significant increases in squeeze pressures were observed, with this increase being higher in the positive-response group. Conclusion: The results suggest that BFT is effective in the treatment of FI for specific patient populations.

İş Sağlığı ve Güvenliği (İSG), çeşitli endüstri ve faaliyetlere özgü olarak tıp, psikoloji, eğitim, toksikoloji, ergonomi, fizik, kimya, ekonomi, hukuk, teknoloji gibi bilimsel alanlarla ilgili konulara temas eden geniş kapsamlı ve çok disiplinli bir kavramdır. İSG, bu çok çeşitli alanlarla ilgili ve ilişkili olmasının yanı sıra, bazı temel ilkelere sahiptir. Bu ilkelerden en önemlisi, her çalışanın İSG haklarına sahip olması ve bu hakların güvence altına alınması gerekliliğidir. Diğer önemli ilke ise işyerinde sağlık ve güvenliğin tesisi için çalışanın, işverenin ve devletin birtakım sorumlulukları ve yükümlülüklerinin olmasıdır. Hak ve sorumlulukların tam olarak yerine getirilmesi için öncelikle bu konuda bilgi sahibi olmak, dolayısıyla eğitim ve öğretim almak gerekmektedir. Bu araştırma çalışmasında, çalışanların İSG eğitimi konusundaki bilinç düzeylerini belirlemek amacıyla betimsel bir alan çalışması yapılmıştır. Çalışmada nicel araştırma tekniklerinden kaynak tarama ve anket yöntemleri kullanılmıştır. Anket, Çanakkale Onsekiz Mart Üniversitesi’nin farklı birimlerinde görev yapan akademik ve idari personel ile yüz yüze görüşülerek gerçekleştirilmiştir. Katılımcıların anket formlarına verdikleri cevaplar Cronbach Alpha testi kullanılarak güven analizine tabi tutulmuştur. Çalışma sonucunda, çalışanların farklı demografik (cinsiyet, bölüm, medeni durum, unvan gibi) özelliklerine göre İSG konusundaki bilgi düzeyleri ve farkındalıkları tablolar halinde gösterilmiştir.

Background: The aim of the study was to share the effectiveness of pneumatic dilation in geriatric achalasia patients. Methods: Achalasia patients over the age of 65 and those under the age of 65 as the control group who received pneumatic dilation as the first-line treatment were evaluated in the study. Results: The average age of geriatric patients was 72.5 ± 55.92 years (65-90), with 50.3% of them being male. Follow-up was conducted for a mean of 64.52 ± 38.73 months. While pneumatic dilation was successful in 98.6% (141/143) of geriatric patients, it was also successful in 94% (141/150) of non-geriatric patients. Remission after single balloon dilatation was observed in 81.8% of geriatric patients, while it was observed in only 52.7% of non-geriatric patients (P = .000). When comparing remission after single dilatation and multiple dilatations, it was observed that geriatric patients who achieved remission after multiple balloon dilatation had higher lower esophageal sphincter pressure and Eckardt scores at the diagnosis and higher lower esophageal sphincter pressure and esophageal body resting pressures after the first balloon dilatation. Conclusions: The proportion of elders in the world population is increasing daily and this disease has been known to disproportionately afflict this group. Although surgical treatments, in particular per-oral endoscopic myotomy, have recently gained popularity as therapies for achalasia, pneumatic dilation remains the most commonly used in geriatric patients. Cite this article as: Tenlik İ, Öztürk Ö, Özin Y, et al. Pneumatic dilation in geriatric achalasia patients. Turk J Gastroenterol. 2023;34(4):332-338.