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Permanent URI for this collectionhttps://hdl.handle.net/20.500.14288/6
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Publication Open Access Comparison of analgesic consumption of hemophilic and non-hemophilic patients in knee arthroplasty(Turkish Assoc Trauma Emergency Surgery, 2022) Canbolat, Nur; Dinc, Tugce; Koltka, Kemalettin; Zulfikar, Bulent; Koc, Basak; Buget, Mehmet I.; N/A; Kılıçoğlu, Önder; Faculty Member; School of Medicine; N/ABACKGROUND: Hemophilia is a rare hereditary bleeding disorder that develops as a result of factor VIII or IX deficiency. Long-term complications of hemophilia such as arthropathy, synovitis, and arthritis can lead to the development of recurrent chronic pain. Pain is therefore a critical aspect of hemophilia. The gold standard treatment for end-stage hemophilic knee arthropathy is total knee arthroplasty (TKA). The hypothesis of this study was that after knee replacement surgeries that cause severe post-operative pain, hemophilia patients with chronic analgesic consumption may experience higher levels of pain than non-hemophilic patients, and use more opioid and non-opioid drugs. METHODS: This retrospective study included 82 patients who were hemophilic and non-hemophilic TKA patients operated under general anesthesia. Seventy-three patients were evaluated and divided into two groups according to the diagnosis of hemophilia: 36 patients were investigated in the hemophilic group and 37 patients in the non-hemophilic group. RESULTS: Post-operative tramadol consumption (p=0.002) and pethidine consumption (p=0.003) were significantly higher in the group hemophilia. The length of stay in the hospital was also significantly longer in the hemophilic group (p=0.0001). CONCLUSION: In the light of these informations, we think that acute post-operative pain management of hemophilia patients should be planned as personalized, multimodal preventive, and pre-emptive analgesia.Publication Open Access Environment, global climate change, and cardiopulmonary health(American Thoracic Society (ATS), 2017) Bauer, Alison K.; Abdalati, Waleed; Carlsten, Christopher; Pinkerton, Kent E.; Thurston, George D.; Balmes, John R.; Takaro, Tim K.; N/A; Bayram, Hasan; Faculty Member; School of Medicine; 4890Publication Open Access Nosocomial infections and associated risk factors in geriatric patients in the intensive care unit(Aves, 2016) İnci, Ayşe; Karabay, Ayşegül; Demiraran, Yavuz; N/A; Erus, Suat; Faculty Member; School of MedicineAim: The elderly population increases worldwide. The purpose of this study was to evaluate nosocomial infections (NI) detected in geriatric patients and to determine the risk factors leading to their development. Materials and Methods: Patients monitored in our hospital's Intensive Care Unit (ICU) were evaluated daily by intensive care and infectious disease specialists, including surveillance by our Infection Control Committee. We included the patients aged >= 65 years who were monitored in the adult ICU between January and December 2014, using the methods of retrospective file screening and computer record review. Patients were classified into two groups: patients with and without NI. Results: In total, 222 (38.07%) patients were >= 65 years old. 44 NI events were detected in 27 patients. Groups were compared with respect to age; sex; presence of mechanic ventilation (MV), central venous catheterization (CVC), cerebrovascular disease, chronic obstructive disease, diabetes mellitus; and mortality. The presence of MV, CVC, and mortality were seen to be significantly higher in patients with NI compared with those without. The most common NIs found were sepsis and pneumonia. The most common infectious agent was Acinetobacter. Conclusion: NIs observed in hospital ICUs are common, but largely preventable, conditions. A systematic approach and well-disciplined empiric therapy are very important. Our study revealed that the mortality rate is high in elderly patients who develop NI, and NI is more commonly seen in patients who undergo invasive interventions. We believe that using invasive interventions as little as possible in this group may improve their treatment success and outcome.Publication Open Access The diagnostic value of irisin in patients with acute abdominal pain: a preliminary study(Kare Yayıncılık, 2018) Yeniocak, Selman; Karcıoğlu, Özgür; Kalkan, Asım; Saraç, Fatma; Keklikkıran, Zehra Zeynep; Gümüş, Alper; Koldaş, Macit; Korkut, Semih; N/A; Karadana, Gökçe Akgül; Doctor; School of MedicineBackground: the aim of this study was to investigate the prognostic value of irisin by examining the serum level of this smooth muscle protein in patients presenting at the emergency department (ED) with acute abdominal pain. Methods: this research was performed as a single-center, prospective, cross-sectional study. In all, 213 adult patients presenting at the ED with acute abdominal pain and 140 healthy controls were enrolled. The serum irisin level was correlated with the leukocyte, C-reactive protein, amylase, and creatine kinase values. The irisin level was compared between groups of those who were admitted or discharged, and those who received surgical or medical treatment. Results: the mean irisin level of the 213 patients and the 140 controls was 6.81 +/- 3.17 mcg/mL vs. 5.69 +/- 2.08 mcg/mL. The mean irisin value of the hospitalized patients (7.98 +/- 3.1 1 mcg/mL) was significantly higher than that of the discharged patient group (6.38 +/- 3.09 mcg/mL) and the controls (control vs. discharged: p=0.202; control vs. hospitalized: p<0.001; discharged vs. hospitalized: p=0.001). When compared with that of the control group, the irisin level was significantly higher in patients with gall bladder diseases, urolithiasis, and acute appendicitis (p=0.001, p=0.007, p=0.007). Conclusion: the serum irisin level in patients with abdominal pain may serve as a guide in diagnostic decision-making and determining the prognosis for cases of acute abdominal pain involving luminal obstruction in tubular intra-abdominal organs.Publication Open Access Serum cortisol level as a useful predictor of surgical disease in patients with acute abdominal pain(Pharmamed Mado Doo, 2019) Dikme, Özgür; N/A; Dikme, Özlem; Faculty Member; School of MedicineIntroduction: the immediate aim should be to identify potentially resuscitative acute abdominal pain that requires prompt investigation or early surgical intervention. We aimed to evaluate whether serum cortisol levels differentiate surgical and non-surgical disease in patients with acute abdominal pain. Materials and methods: in this prospective cross-sectional study, the primary end-point was defined as differences in serum cortisol levels between surgically and non-surgically treated patients with non-traumatic acute abdominal pain. The secondary end-point was to compare the cortisol levels with defined complete blood count (CRC) parameters in those groups. Results: one hundred eleven patients with acute abdominal pain were included in the study. Three most frequent diagnoses were nonspecific abdominal pain, acute appendicitis and dyspeptic complaints. Thirty patients were hospitalized and 22 of them were operated. The median cortisol level was 23.13 mu g/dl in surgically treated patients and 13.94 mu g/dl in non-surgically treated patients (p<0.001). The area under the ROC curve using cortisol to detect surgical disease was 0.750 (95% CI, 0.659-0.827) and the accuracy of cortisol to detect surgical disease was not inferior to defined CRC parameters. A cortisol value of 17.98 mu g/dl had a sensitivity of 67.4% and a specificity of 77.3% for surgical disease. Conclusion: operated patients had higher serum cortisol levels. High serum cortisol levels may indicate surgical disease at the early stage on admission in ED patients with acute abdominal pain and may be used as a marker in the prediction of acute surgical abdomen.