Antibiotic Prophylaxis in Second Trimester Amniocentesis: Is it Necessary?
Kadir Bakay², Davut Güven¹, Fatih Aytekin², Hasan Ulubasoglu¹, Özgür Dizili¹
1 Department of Faculty of Medicine, 19 Mayıs University, Samsun, 2 Obstetrics and Gynecology Clinics, Başkent University, Alanya Hospital, Antalya, Turkey
Aim: Amniocentesis is an invasive diagnostic procedure performed under ultrasonographic guidance. With this procedure amniotic fluid is sampled from the pregnant uterus by a needle puncture through the overlying skin into the uterus and amniotic cavity. In the present prospective randomized multicentered case controlled study we aim to compare the efficacy of antibiotic prophylaxis in preventing fetal loss during amniocentesis in 564 pregnancies. Material and Method: 564 singleton pregnancies between 16 and 18 weeks’ gestation admitted to our prenatal unit for amniocentesis between June 2011-July 2012 were included. Ampicillin (1g) was administered to 300 patients (that were odd numbered) upon admittance while the remaining 264 (that were even numbered) did not receive any prophylaxis. Results: The rate of fetal loss between patients who received ampicillin (0.33%) and who did not (0.37%) was similar (p:0.87). Discussion: As maternal mortality and morbidity after amniocentesis is very low (less than 1/1000) antibiotic prophylaxis is usually not recommended. Gramellini et al. reported that antibiotic prophylaxis actually made no difference in post procedural abortion rates and our results were in line with these. However multi-center studies with larger groups are warranted.
Amniocentesis; Antibiotic; Prophylaxis; Fetal Loss; Perinatology
Dilated Cardiomyopathi Mimicking Massive Pleural Effusion in an Infant
Naime Tokur1 , Şevki Mustafa Demiröz2 , Burcu Cantay3
1 Pediatry Clinic, Kahramanmaraş Necip Fazıl City Hospital, 2 Thoracic Surgery Clinic, Faculty of Medicine, Kahramanmaraş Sütçü İmam University, 3 Pediatry Clinic, Faculty of Medicine, Kahramanmaraş Sütçü İmam University, Kahramanmaraş, Turkey
While pneumonia incidence decreases, pneumonic complications such pleural effusion and empyema are increasing in whole World. In the presence of pleural fluid, diagnostic thoracentesis is used to evaluate the composition of the pleural fluid. Doing thoracentesis in an uncertain diagnose of pleural effusion my lead to life-threatening complications [1,2]. A 6-month infant was diagnosed for right side pneumonia and treated for respiratory failure in pediatric intensive care unit was consulted with thoracic surgery for a massive pleural fluid view on chest x-ray (Figure 1A). Thorax ultrasonography done before the toracentesis revealed no pleural fluid or consolidation but cardiomegaly and pressured lung parenchyma in left hemithorax. So no thoracentesis was done. Echocardiography revealed “middle to severe mitral valve insufficiency, triquspit insufficiency with dilated cardiomyopathy and congestive heart failure”. In a five days of follow up under mechanic ventilation and with medical treatment of pneumonia and heart failure, the chest x-ray view and clinical scene dramatically improved (Figure 1B,C,D). Thoracentesis is an invasive diagnostic procedure which is used frequently. In a misdiagnosis of pleural fluid accumulation clinicians should not be too hasty about doing a thoracentesis. For patients clinically not stable enough for performing a computed tomography, thorax ultrasound is an effective imaging modality to guide the clinician [3,4,5].
1. Muzumdar H, Arens R. Pleural fluid. Pediatr Rev. 2007 Dec;28(12):462-4. 2. Rocha G.Pleural effusions in the neonate. Curr Opin Pulm Med. 2007 Jul;13(4):305-11. 3. Lichtenstein DA.Ultrasound examination of the lungs in the intensive care unit. Pediatr Crit Care Med. 2009 Nov;10(6):693-8. 4. Singhi SC, Mathew JL, Kumar RM, Jindal A, Jhondale SN, Benkatti G.Clinical pearls in pediatric cardiology. Indian J Pediatr. 2011 Oct;78(10):1273-80 5. Loizzi M, De Palma A, Pagliarulo V, Loizzi D, Sollitto F. Pulmonary infections of surgical interest in childhood. Thorac Surg Clin. 2012 Aug;22(3):387-401.
How to Cite: Naime Tokur, Sevki Demiroz, Burcu Cantay . Dilated Cardiomyopathi Mimicking Massive Pleural Effusion in an Infant. Eu Clin Anal Med 2014; DOI:10.4328/ECAM.25
Being Update and Cited
Orhan Yücel1 , M Seda Balaban2
1 Department of Thoracic Surgery, Gulhane Military Medical Academy, 2 Department of Hematology, Hacettepe University Medical Faculty Adult Hospital, Ankara, Turkey
Derman Medical Publishing is continuing to make forward steps in medicine in a principled manner. There are two international journals in the scope of Derman Medical Publishing; Journal of Clinical and Analytical Medicine and Eurasian Clinical and Analytical Medicine. By today there are over 14.000followers of our journals as readers, authors, peer-reviewers, specialists and physicians. Nearly 2500 articles have been sent to our secretary in 2013.Online publishing of articles firstly has been pleasure for our users. Accepted articles were published online approximately in ten days. All the articles sent to our journal were edited carefully and with devotion. During edition period of articles, we were all accessible. We replied e-mails of authors and peer-reviwers in a very short time in order to make the edition process faster. We thank to firstly authors than peer-reviewers and scientific committee members for all the activities of Derman Medical Publishing. Traditional ‘The Best Article of The Year Award’ of Derman Medical Publishing has gone to its winners this year too.The articles were evaluated according to their citation rates and how much they are update, downloaded and read by readers, found interesting by readers. Winners of the award were announced to our readers online and by e-mail. Derman Medical Publishing gave ‘The Best Article of The Year Award’ to 21 articles in last five years[1-21].
1. Tuzun A, Degertekin B, Yesilova Z, Naharcı I, Eken A, Aydin A. et al. Plasma MDA Levels, GSH-Px Activities and Nitrite/Nitrate Levels in Patients with Familial Mediterranean Fever. JClinAnalMed2010;1(1):1-5. 2. Pilegaard HK. ThoracoscopicSympathectomy. J Clin Anal Med 2010;1(3):65 -7. 3. Light RL. Management of Parapneumonic Effusions. J Clin Anal Med 2010;1(2):48-51. 4. Kunak ZI, Akgul EO, Yaren H, Cayci T, Kurt YG, Aydin Iet al.Measurement of TS-131, a New MonopyridiniumOxime, by High Performance Liquid Chromatography in Rat Plasma Samples. J Clin Anal Med 2011;2(2):19-21. 5. Haecker FM. The vacuum bell for treatment of pectusexcavatum:an effective tool for conservative therapy. J Clin Anal Med 2011;2(1):1-4. 6. Ozpolat B, Cavusoglu T, Yilmaz S, Buyukkocak U, Gunaydin S. Clinical and Laboratory Evaluation of Anti-Microbial Efficacy of Photocatalysts. J Clin Anal Med 2011;2(2):32- 5. 7. Atilgan D, Yasar A, Erdemir F, Parlaktas BS, Uluocak N, Firat F. Comparison of the Efficacy of Four Different Alpha Blockers in the Treatment of Benign Prostatic Hyperplasia. J Clin Anal Med 2011;2(2):27-31. 8. Tekeoglu I, Hiz O, Ozbay B, Toprak M, Avcu S. Pulmonary Involvement in Rheumatic Diseases: HRCT Findings. J Clin Anal Med 2011;2(2):36-9. 9. Yazkan R, Ozsoy IE, Ergene G, Avcilar M. Single Stage Transthoracic Approach to the Right Lung and Liver Dome Hydatid Cysts. J Clin Anal Med 2011;2(3):7-10. 10. Sever C, Kulahci Y, Duman H. Prediction of Mortality and Causes of Death in a Burn Centre: A Retrospective Clinical Study. J Clin Anal Med 2011;2(3):24-6. 11. Bilgic S, Ege T, Ersen O, Koca K, Oguz O, Sehirlioglu A. Posterior Fixation of Lumbar Burst Fractures. Comparison of Short Segment and Long Segment Pedicle Fixation. J Clin Anal Med 2011;2(2):15-8. 12. Ayan M, Sogut E, Tas U, Erdemir F, Karaman S, Arici S, Esen M. Compare the Analgesic Effectiveness of Diclofenac and Paracetamol in Patients with Renal Colic. J Clin Anal Med 2013;4(1): 16-8. 13. Karamustafaoglu YA, Yanik F, Yoruk Y. IntrathoracicDesmoplasticFibroblastoma: A Rare Localization. J Clin Anal Med 2013;4(1): 56-7. 14. Tastepe AI, Yazıcı U, Bicakcioglu PY, Gulhan E, Agackiran Y. Simultaneous Pulmonary and TransdiaphragmaticSurrenal Resection in Non-small Celled Lung Cancer. J Clin Anal Med 2013;4(2): 140-2. 15. Arslan Z, Arslan G, Guler G. The Interaction of Clopidogrel and Proton Pump Inhibitors. J Clin Anal Med 2013;4(2): 158-60. 16. Tanrıkulu AC, Abakay A, Abakay O, Sezgi C, Sen HS, Onder OF et al. Clinical Characteristics of Patients with Mesothelioma: A University Hospital of 2011 Data. J Clin Anal Med 2013;4(3): 186-8. 17. Soydan H, Malkoc E, Dursun F, Okcelik S, Ates F, Adayener C et al. Radical Prostatectomy and Active Surveillance in Prostate Cancer; The Evaluation of Erectile Function and Depression. J Clin Anal Med 2013;4(3): 189-92. 18. Durukan AB, Gurbuz HA, Salman N, Durukan E, Serter FT, Tavlasoglu M. et al. Evaluation of HbA1c Levels and Postoperative Atrial Fibrillation in Diabetic Patients. J Clin Anal Med 2013;4(3): 204-8. 19. Hoscan Y, Eldem HO, Muderrisoglu H. Use of Ivabradine in a Patient Having Pacemaker and Inappropriate Sinus Tachycardia. J Clin Anal Med 2013;4(3): 228-9. 20. Sariyildiz L, Akdag T. A New Predictor AMH (anti-müllerian hormone) to Determining Ovarian Reserve and Menoposual Aging in the Women. J Clin Anal Med 2013;4(3): 241-4. 21. Ozdemir M, Bakan N, Sahin OT, Kurtcelebi N, Erbesler ZA, Tunca ST. The Comparison of Sevoflurane-Remifentanyl and Propofol-Remifentanyl in Robotic Prostatectomies. J Clin Anal Med 2013;4(4): 313-7.
Corresponding Author: M.Seda Balaban, Department of Hematology, Hacettepe University Medical Faculty Adult Hospital, Ankara, Turkey. GSM: +905301176399 E-Mail: email@example.com
How to Cite: Orhan Yucel, Muruvvet Balaban. Being update and cited. Eu Clin Anal Med. 2014; DOI: 10.4328/ECAM.28
Letter to Editor
Analysis of 54 Patients Who Underwent Thoracoscopic Sympathectomy
Fatih Hikmet Candaş
Thoracic Surgery Clinic, GATA Haydarpasa Training Hospital, Istanbul, Turkey
To the editor:
I curiously read the manuscript entitled ‘’Analysis of 54 Patients Who Underwent Thoracoscopic Sympathectomy ’’ which was written by Cubuk S et al.  and published in the January 2013 issue of your periodical. Firstly, I want to thank to Cubuk at al. for conveying their experiences. Additionally I want to point a few issues out in order to take more advantage of the author’s existing experiences and knowledge. Compansatory hyperhidrosis (CH) is a common but rarely disturbing complication which can be seen in different rates after thoracoscopic sympathectomy . As it mentioned in the manuscript, it depends on the level and the length of sympathectomy. Furthermore it can also be seen in different rates according to the sympathectomy technique used [3,4]. In their series, the authors performed en-block resection for 36 of 54 patients and couter ablation for 18 of 54 patients. I want to ask if they mentioned any significant differences in CH rates between these two techniques. Recurrence was seen in two patients, who underwent a second surgical operation. One patient experienced decreased heart rate and due to this complication he underwent two-staged operation. In the literature, it is emphasized that recurrences are more frequent in couter ablation but it can also be associated with collateral transmissions [3,5]. Moreover long resections are more related to heart complications. I think it would be better if the authors specify the recurrences according to which technique they used, what they performed in the second operation and in which group heart rate decreased. The authors reported that they reached 50 of 54 patients with telephone and the communication for the other four patients is missing. Statistical analysis was performed out of 50 patients and reported success rate was %100; on the other hand, I think CH rates were analyzed probably out of 54 patients and the reported rate was %46.3 (n:25). I think a correction is needed about this statistical analysis. I would like to thank to Cubuk et al. for their meritorious report. Yours sincerely.
1. Cubuk S, Yücel O, Karataş O, et al. Analysis of 54 Patients Who Underwent Thoracoscopic Sympathectomy. J Ann Eu Med 2013;1(1): 1-3. 2. Miller DL, Bryant AS, Force SD, Miller JI Jr. Effect of sympathectomy level on the incidence of compensatory hyperhidrosis after sympathectomy for palmar hyperhidrosis. J Thorac Cardiovasc Surg. 2009;138(3):581-5. 3. Kopelman D, Hashmonai M. The Correlation Between the Method of Sympathetic Ablation for Palmar Hyperhidrosis and the Occurrence of Compensatory Hyperhidrosis: A Review. World J Surg 2008;32:2343–56. 4. Rantanen T, Telaranta T. Long-term results of endoscopic symphathetic block using the Lin-Telaranta classification. Surg Endosc. 2013;27(10):3860-4. 5. Findikcioglu A, Kilic D, Hatipoglu A. Is Clipping Superior to Cauterization in the Treatment of Palmar Hyperhidrosis? Thorac Cardiovasc Surg. 2013 Jul 9.
Corresponding Author: Fatih Hikmet Candaş, GATA Haydarpaşa Eğitim Hastanesi, Göğüs Cerrahisi Servisi, İstanbul, Türkiye. GSM: +905053295326 E-Mail: firstname.lastname@example.org
How to CiteFatih Hikmet Candas. Analysis of 54 Patients Who Underwent Thoracoscopic Sympathectomy. Eu Clin Anal Med. 2014; DOI: 10.4328/ECAM.24