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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 Acil serviste Akdeniz benekli ateşi(Aves, 2015) Dikme, Özgür; Topaçoğlu, Hakan; Dikme, Özlem; Faculty Member; Koç University HospitalIntroduction: Mediterranean spotted fever (MSF) is one of the tick-borne rickettsial infections caused by Rickettsia conorii. In this case, we describe a patient who was admitted to the Emergency Department (ED) with persistent fever caused by MSF. Case Report: A 36-year-old male patient was admitted to the ED with persistent fever. Six days ago, antibacterial therapy had been started by his family practitioner; however, his fever continued. Upon admission on the seventh day of fever, the patient appeared ill. He had complaints such as malaise, myalgias, and nausea/vomiting. His fever was 38.6 degrees C, and other vital signs were normal. On physical examination, a single, crusted, ulcerated papule with a red halo resembling a cigarette burn was observed on the left leg. According to the diagnostic criteria for MSF, his score was 33, and he was admitted to the infectious disease department. Antibodies against Rickettsia were positive with the immunofluorescence assay. Fever after continuing for 24 hours reduced when a dose of 200 mg/daily doxycycline treatment was started. Conclusion: The aim of this presentation is to point out that MSF should be considered in the ED for the differential diagnosis of patient with a history of tick bite, persistent fever, maculopapular rash, headache, myalgia, arthralgia, and particularly with black eschar/tache noire.Publication 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 predictive value of procalcitonin in the prognosis of patients with acute coronary syndrome(Galenos Yayınevi, 2019) Coşkun, Abuzer; Eren, Şevki Hakan; Aktaş, Can; Faculty Member; School of Medicine; 24297Aim: the study aimed to investigate the prognostic value of serum procalcitonin (PCT) levels in patients with acute coronary syndrome (ACS). Materials and Methods: two hundred patients with ACS who applied to the emergency department due to chest pain and were hospitalized into the cardiology clinic of our hospital between January 2014 and December 2016 were included in this cross-sectional cohort study. The patients were divided into four groups based on their diagnosis. The first group was inferior myocardial infarction (MI), the second group was anterior MI, the third group was non-ST-elevation MI (NSTEMI), and the fourth group was high-risk unstable angina (UA). These groups were compared according to PCT, age, gender, left ventricular ejection fraction, cardiac troponin (cTn) I, three-vessel disease (TVD), and mortality rate. Results: there were statistically significant differences between ACS groups concerning PCT values. PCT level was significantly higher in inferior MI than in anterior MI, NSTEMI, and UA groups. There were statistically significant differences between cTn positivity checked at 0th, 6th, and 12th hours and ischemic heart failure after MI as well as between mortality and TVD. TVD and mortality were found to be significantly higher in the inferior MI group than the other subgroups. Ischemic heart failure was found to be statistically higher in anterior subgroup than the other subgroups. Conclusion: increased PCT level may be a marker that can be used in indicating ACS and its prognosis.Publication Open Access Bisikletten düşme sonrası izole künt submandibular gland yaralanması(Aves, 2015) Erten, Abdulkerim; Aktaş, Can; Ekinci, Salih; Demirtaş, Yoldaş; Faculty Member; Koç University Hospital; 24297; N/A; N/AIntroduction: Injury to deep neck structures should be considered during emergency room (ER) admissions in patients with a chief complaint of swelling in the neck, particularly when there is a history of trauma to the neck. Life-threatening conditions should be assessed, diagnosis should be made using appropriate imaging modalities, and treatment should be planned accordingly. Case Report: A 30-year-old male presented to the ER with the chief complaint of a swollen neck 2 h after he fell off a bicycle. Based on the ultrasound and computed tomography analysis, he was diagnosed with isolated submandibular injury. Conclusion: Isolated submandibular injury following a blunt trauma is a rare condition. Obtaining appropriate imaging modalities is helpful in confirming the diagnosis. Patients with blunt trauma should also be carefully assessed for other, nonapparent injuries.