Saygıdeğer okuyucular,Her şeyden önce size teşekkür etmek istiyorum, bilgi çağında, bilgiden yoksun, bilgiden uzak işini yapadurmak yerine, sağlık alanındaki inovasyon, teknoloji ve yapay zeka kulvarlarındaki merakınız ve hekimseniz hastanıza en doğru tanıyı koyup, en doğru tedaviyi vermek gayesi yada alan uzmanı iseniz de bu alanlarda gelişime inanarak okumayı seçtiğiniz, konfor alanınızı bozmayı kabul ettiğiniz için.Bu kitapta sağlığımızın geleceğinin büyük bir kısmını oluşturacak olan, sağlığın yapay zekasını size sunduk. Yapay zekanın sağlık alanındaki gelişmelerini, karar destek sistemlerini, büyük veriyi ve gelecek perspektifini en güncel bilgiler ışığında bu kitapta bulacaksınız.

Objective. Peptic ulcer disease (PUD) in children is an uncommon disorder. An estimated 1.3 percent to 20 percent of people die from perforated peptic ulcers (PPU), a PUD consequence. Using a database, we assess the prevalence and prognosis of PPU in patients. We also do radiological and laparoscopic operations for PPU in young patients. In pediatric patients, sufficient accumulation of knowledge about laparoscopic repair is at the level of case reports. This study aims to assess the results in pediatric cases operated for PUP by open or laparoscopic surgery and determine the role of computed tomography (CT) in diagnosing PUP. Methods. Data was collected from the Department of Pediatric Surgery, Sisli Hamidiye Etfal Training and Research Hospital, Turkey, from 2015 to 2020. Patients under 18 years of age who were operated on for PUP between 2015 and 2020 were divided into two groups. Group 1 involved those patients operated by laparoscopic surgery, whereas Group 2 involved those used by open surgery. Both groups were retrospectively evaluated in terms of demographic data, clinical findings, preoperative‐intraoperative findings and surgical methods (open or laparoscopic), duration of surgery, duration of nasogastric intubation, time of return to oral feeding, length of hospital stay, and postoperative complications. Results. 18 patients consisting of 15 boys and 3 girls were included in the study. Group 1 involved 10 patients, whereas Group 2 involved 8 patients. In Group 1, the symptom onset period was 1.6 ± 1.9 days, and in Group 2, it was 6.6 ± 6.1 days. In the erect abdominal radiographs (AXR) of 10 (58.8%) patients, the air was under the diaphragm. Six patients whose erect AXRs showed no attitude under the diaphragm but had abdominal pain and acute abdominal manifestation were given abdominal computed tomography (CT) scanning. In all patients with PUP, laparoscopic/open surgery involves primary suturing and repair by omentoplasty (Graham patch). The mean operative time was 87.0 ± 26.3 minutes in Group 1 and 122.5 ± 57.6 minutes in Group 2. The mean length of hospital stay was 3.9 ± 1.3 days in Group 1 and 5.8 ± 2.1 days in Group 2. Neither group developed any major surgical complications. Conclusions. Adolescents with a history of sudden onset and severe abdominal pain may present with peptic ulcer perforation even if there is no known diagnosis of peptic ulcer or predisposing factor. In cases suspected of PUP, it is vital to order and carefully examine erect AXR, which is an easy and inexpensive method. Computed tomography should be the first choice in patients without free air in ADBG but whose anamnesis and findings match peptic ulcer perforation.

Background: Although appendicitis is the most common emergency abdominal surgical pathology in the pediatric age group, there are a limited number of publications in the literature on how appendicitis has affected patients during the COVID-19 pandemic. Objectives: This study examined the effects of fear of being infected with COVID-19 and isolation measures on complications and morbidity in pediatric appendicitis cases. Methods: This study was performed in the Department of Pediatric Surgery, Faculty of Medicine, Health Sciences University, Şişli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey. Patients aged 18 years and younger who were operated on for appendicitis between 11 March 2019 and 11 May 2019 were classified as group 1, and patients aged 18 years and younger who were operated on for appendicitis between 11 March 2020 and 11 May 2020 (during the pandemic) were classified as group 2. Both groups were compared in terms of age, gender, symptoms, duration of symptoms, surgical method, duration of operation, length of hospital stay, and postoperative complications. Results: There were 85 patients in group 1 and 49 in group 2. The mean age was 11.5 ± 3.5 years in group 1 and 12.2 ± 3.0 years in group 2. While the mean hospital admission time for group 1 was 52.2 ± 38.5 hours, it was 50.2 ± 40.0 hours for group 2. The complicated appendicitis rates were 37% and 25% in group 1 and group 2, respectively. In group 1, 94.1% of the operations were completed laparoscopically, whereas, in group 2, this rate was 88.6%. The mean operation time was 64.0 ± 24.4 minutes in group 1 and 69.0 ± 33.0 minutes in group 2. The mean length of hospital stay was 2.9 ± 2.0 days in group 1 and 3.1 ± 3.40 days in group 2. The complication rate was 8.2% in group 1 and 11.4% in group 2. Conclusions: Despite the isolation measures and the risk of virus transmission, the psychosocial effects of the pandemic did not prevent real emergency cases with appendicitis from visiting hospitals.

Purpose: Despite extensive evidence supporting synoptic reporting in adult surgical oncology, the pediatric surgical oncology evidence base remains sparse, institution-dependent, and implementation-limited, resulting in a critical translational gap. This systematic review evaluates the implementation and effectiveness of synoptic operative reports (SR) in improving documentation completeness in pediatric oncology surgery compared with traditional narrative reports (NR). Methods: Prospective and retrospective studies evaluating operative report completeness in pediatric oncology surgery were identified through a comprehensive search of PubMed, Scopus, and Web of Science. Of 1926 screened records, 11 articles underwent full-text review, and 4 studies met inclusion criteria. Results: The four included studies analyzed 341 operative reports (217 NRs and 124 SRs). Documentation completeness was the primary outcome. Across all evaluated intraoperative elements, synoptic reports were associated with approximately tenfold higher odds of complete documentation compared with narrative reports (pooled OR for NR vs. SR, 0.10; 95% CI, 0.07–0.14; p < 0.001). Conclusions: Synoptic reporting consistently improves the completeness of pediatric oncologic operative documentation compared with narrative formats; however, adoption in pediatric surgical oncology remains limited. Multicenter and implementation-focused research is needed to assess scalability, integration within electronic medical record (EMR) systems, and the impact of synoptic reporting on communication and clinical decision-making.

Çocuklarda İnvaginasyon Meltem KABA Enürezis Nokturna Arzu CANMEMİŞ Pediatrik Taş Hastalığında Girişimsel Tedavi Yöntemleri Çiğdem ARSLAN ALICI Göğüs Duvarı Deformiteleri Emine Burcu ÇIĞŞAR KUZU Meckel Divertikülü Duygu GÜREL Pediatrik Populasyonda Akut Skrotuma Yaklaşım Eren YAŞA Wilms Tümörü Aydın ÜNAL

Intestinal neomucosa formation is a technique defined for the treatment of short bowel syndrome. This study evaluates the effect of glutamine and omega-3 fatty acids on the growth of intestinal neomucosa on the colonic serosal surface has been evaluated.Materials and methods: Thirty-two adult male Sprague-Dawley rats were randomly divided into 4 groups: sham, control, glutamine, and omega-3. Laparotomy was performed on all groups. For rats other than the sham group, a 1-cm full-thickness incision was made 4 cm proximal to the ileocecal valve, and colonic serosal surface was sutured as a serosal patch over these openings. By using the oral gavage technique, the glutamine group was ingested with 200 mg/kg/day of glutamine, and the omega-3 group was ingested with 100 mg/kg/day of omega-3 fatty acids. At the end of 14 days, the rats were euthanized, blood specimens were collected, and intestinal segments, including serosal patches, were excised.Results: Transforming growth factor-beta was significantly lower in the glutamine group compared to the control group. Similarly, fibroblast growth factor-2 was significantly lower in the glutamine group compared to the sham group. Intestinal neomucosa formation was observed in 100% of rats in the glutamine group. In the control and omega-3 groups, intestinal neomucosa formation was observed in 57.1% and 60% of rats, respectively. The inflammatory response, granulation tissue formation, and fibroblastic activity were more severe in the rats of the glutamine and omega-3 groups.Conclusion: The intestinal neomucosa formation is an experimental technique, and both glutamine and omega-3 fatty acids have the potential to positively affect inflammatory response, granulation tissue formation, and fibroblastic activity. Specifically, glutamine has a favorable effect on intestinal neomucosa formation.