Anesthetic management in endovascular treatment of aortic pathologies

Objective: In this study we aimed to compare the anesthesia methods we used in the endovascular treatment of thoracic and abdominal aorta pathologies and to discuss accompanied by literature. Methods: Our study was carried out be retrospectively assessing a total of 20 patients on whom we had administered endovascular treatment for aortic aneurism and aortic dissection. The demographic features of the patients, their American Anesthesia Association (ASA) scores, laboratory findings, accompanying diseases, whether they smoke, their ejection fraction and the place and type of aortic pathology was recorded. Also the surgical procedure, anesthesia method, the amounts of crystalloids, colloids and blood products used during the surgery, the anesthesia and surgery durations, complications and interventions, duration of stays in intensive care and the hospital in general and the mortality rates were recorded. All cases were provided with standard anesthesia monitoring. Results: A total of 20 (M=15, F=5) cases were included in our study. 16 of our cases were in ASA 3 risk group and 4 were in ASA 4 risk group. While patients who had been administered with thoracic endovascular aortic repair (TEVAR) were all given general anesthesia, seven patients who had been administered with abdominal endovascular aortic repair (EVAR) were given regional and 6 were given general anesthesia and one case was only given sedoanalgesia. While 8 of the patients administered with EVAR had hypertension all of the patients administered with TEVAR had hypertension. No significant differences were found in blood and blood product transfusions, preoperative and postoperative hemoglobin, hematocrit, urea and creatinine values between two groups. Conclusion: In EVAR and TEVAR applications general anesthesia, regional anesthesia, sedoanalgesia accompanied by local anesthesia can be successfully administered depending on the patient’s status and the location of the procedure

Our experience on brachial plexus blockade in upper extremity surgery

Objective: Peripheral nerve blocks are usually used either alone or along with general anesthesia for postoperative analgesia. We also aimed to present the results and experiences.Materials and methods: This retrospective study was conducted to scan the files of patients who underwent orthopedic upper extremity surgery with peripheral nerve block between September 2009 and October 2010. After ethics committee approval was obtained, 114 patients who were ASA physical status I-III, aged 18-70, performed upper extremity surgery in the Orthopedics and Traumatology Clinic were included to study. Patients’ demographic data, clinical diagnoses, premedication status, peripheral block type, local anesthetic dose, stimuplex needle types, hemodynamic parameters at the during surgery, the first postoperative analgesic requirements, complications and patient satisfaction were recorded.Results: Demographic data were similar to each other. Brachial plexus block was commonly performed for the forearm surgery. Infraclavicular block was performed the most frequently to patients. As the classical methods in the supine position were preferred in 98.2% of patients, Stimuplex A needle (B. Braun, Melsungen AG, Germany) have been used for blockage in 80.7% of patients. Also, in 54.4% of patients, 30 ml of local anesthetic solution composed of bupivacaine + prilocaine was used for blockade. Blocks applied to patients had provided adequate anesthesia.Conclusion: Since the brachial plexus blockade guided peripheral nerve stimulator for upper extremity surgery provide adequate depth of anesthesia and analgesia, it may be a good alternative to general anesthesia because of unwanted side effect

Clinical Approach to Ocular Cicatricial Pemphigoid

Objectives:To evaluate the demographic data, ocular and systemic findings, clinical management, and outcomes of patients with ocular cicatricial pemphigoid (OCP).Materials and Methods:The medical records of 11 patients diagnosed as having OCP in the ophthalmology department of Ege University between 2008 and 2021 were evaluated retrospectively.Results:The patients’ mean follow-up time was 14±5.76 months. All eyes (100%) had conjunctival involvement and 18 (81.81%) had corneal involvement. According to the Tauber staging system, 7 (31.81%), 8 (36.36%), and 7 (31.81%) of the eyes were stage 2, 3, and 4, respectively. The diagnosis was confirmed in 6 (66.66%) of 9 patients who underwent biopsy. Amniotic membrane transplantation was performed in 7 eyes, entropion surgery in 2 eyes, and electrocauterization for trichiasis in 5 eyes. Systemic involvement was observed in 45.45% (5/11) of patients, most commonly oral mucosal involvement (18.18%). Review of medical records showed that alkylating agents, steroids, and dapsone were used in patients treated before 2020. Mycophenolate mofetil was preferred to be used in combination with corticosteroids. Although treatment responses before mycophenolate mofetil usage could not be evaluated well because of loss to follow-up, 4 (66.66%) of 6 patients who received steroid treatment combined with mycophenolate mofetil showed partial or complete clinical remission. No serious side effects and drug withdrawal were observed.Conclusion:OCP is a sight-threatening autoimmune disease that affects older adults. Although positive biopsy results are valuable for diagnosis, negative results do not exclude the diagnosis. The main treatment is systemic immunosuppressives. Disease activity can be suppressed, especially with early initiation of drug therapy. These patients require a multidisciplinary approach. Especially in the presence of isolated ocular findings, ophthalmologists should be able to make the decision to start immunosuppressive treatment, and systemic treatment should not be delayed

Geology of Datça (Muğla) and its near surroundings area.

TEZ8083Tez (Yüksek Lisans) -- Çukurova Üniversitesi, Adana, 2010.Kaynakça (s. 83-88) var.x, 91 s. : rnk. res., hrt. ; 29 cm.Bu çalışma, Muğla iline bağlı Datça ilçesi ve yakın dolayının dahil olduğu, Marmaris O19 a3-d2 ve kısmen Marmaris O19 a4-d1 paftalarının içerisinde kalan alanda gerçekleştirilmiştir. Yaklaşık 108 km2'lik bu alanda bölgenin yapısal konumu ve Likya Napları'nın bölgedeki tektonostratigrafik yerleşimi açıklanmaya çalışılmıştır. Çalışma alanındaki litostratigrafi birimleri, arasında önemli zaman boşluğu olan paleotektonik ve neotektonik birimlerden oluşmaktadır. Çalışma alanında tektonostratigrafik yerleşime göre 7 adet litostratigrafi birimi haritalanmıştır. Bu birimler sırasıyla; alt tektonik dilimi oluşturan Apsiyen-Albiyen yaşlı Marmaris peridotiti, orta tektonik dilimi oluşturan Toarsiyen-Üst Kretase yaşlı Göçgediği formasyonu, üst tektonik dilimi oluşturan Orta Triyas-Liyas yaşlı Kayaköy dolomiti, Üst Jura-Alt Maestrihtiyen yaşlı Orhaniye formasyonu ve Üst Senoniyen yaşlı Karaböğürtlen formasyonudur. Bu paleotektonik birimlerin üzerine açısal uyumsuzlukla Üst Piyasensiyen yaşlı Yıldırımlı formasyonu gelmektedir. Neotektonik birimlerin en genç çökelimi ise, açısal uyumsuzlukla Yıldırımlı formasyonu üzerinde yer alan Kuvaterner yaşlı volkanikler, yamaç molozları, plaj çökelleri ve alüvyondur. Çalışma alanının tektonik konumu kapsamında bölgede 9 adet fay haritalanmıştır. Yapılan arazi çalışmaları sonucunda elde edilen bulgularla, bölgenin 1/25.000 ölçekli detay jeoloji haritası, genelleştirilmiş tektonostratigrafik kesiti ve jeoloji enine kesitleri hazırlanmıştır.This study has been carried out in the topographic maps of Marmaris O19 a3-d2 and partially in the Marmaris O19 a4-d1 where include Datça village and its near surroundings in Muğla. Structural position of the investigated area that covers an area of approximately 108 square km have been studied and also tectonostratigraphical setting of Lycian nappes seen in the area are tried to be explained. Lithostratigraphical units of the area are mainly made up of palaeotectonic and neo-tectonic units that have subsequent (long) time gap each other. 7 lithostratigraphical units have been differentiated and mapped according to the settlement of the tectono-stratigraphical units of the study area. These units from bottom to the top as follow; Aptian-Albian age Marmaris peridotits (lower tectonic slice); Toarcian-Late Creatceous age Göçgediği formation (middle tectonic slice); and middle Triassic-Liassic age Kayaköy dolomites, late Jurassic-Lower Maastrichtian age Orhaniye formation and late Senonian age Karaböğürtlen formation (upper tectonic slice). Terrestrial and marine facies of Yıldırımlı formation is of late Piacenzian age rests on the present palaeotectonic units with angular unconformity. The youngest sediments of neo-tectonic units are Quaternary age volcanics, slope deposits, beachs sediments and alluviums that rest on the Yıldırımlı formation with angular unconformity. 9 differently oriented normal and dextral strike slip faults have been observed and mapped within the investigated area. 1/25.000 scale detailed geological maps of the study area, generalized tectono-stratigraphical section and three geological cross sections have been prepared with the data obtained from the field studies.Bu çalışma Ç.Ü. Bilimsel Araştırma Projeleri Birimi tarafından desteklenmiştir. Proje No: MMF2009YL57

OTLUKİLİSE (GÜRÜN-SİVAS) DEMİR YATAĞININ KÖKENİNE BİR YAKLAŞIM

Bu çalışmada Sivas ili, Gürün ilçesi civarında yer alan Otlukilise demir yatağının maden jeolojisi ele alınmakta ve kökensel yorumu tartışılmaktadır. Platform tipi kireçtaşları ile temsil edilen Jura-Alt Kretase yaşlı Yüceyurt formasyonu üzerinde açılan havzanın ilk çökelleri havza yamaçlarında depolanan Üst Kretase yaşlı Yanıktepe formasyonuna özgü rudistli kireçtaşları ile şeyl, marn, kumtaşı ardalanmasından oluşmaktadır. Bu birimler üzerinde, havzanın giderek derinleşmesine bağlı olarak çökelmiş olan Paleosen yaşlı Akdere formasyonuna özgü sedimenter birimler gözlenmektedir. Bu formasyonun üzerine Orta Eosen yaşlı Başören formasyonu uyumsuz olarak gelmektedir. En üstte ise tüm bu birimleri uyumsuz olarak örten Miyosen ve Pliyo - Kuvaterner yaşlı Gövdelidağ ve Gürün formasyonlarına özgü sedimenter kayaçlar ile volkanitlerin oluşturduğu istif yer almaktadır. Otlukilise demir oluşumlarının kökeni, Yanıktepe ve Akdere formasyonları içinde yer yer gözlenen volkanik ara katkılarla ilişkili düşünülen volkanosedimenter oluşumlu siderit cevherlerinin ikincil süreçler ile zenginleştiği dize bütününde irdelenmiştir. Demirce zengin masif cevher örneklerinde yapılan çalışmalar, karbonatların çökeldiği bir ortama yayılan denizaltı volkanitlerinin dolaylı - dolaysız biçimde serpantinitlerden yıkadığı veya çözdüğü demir ve yandaş elementlerinin ortama hidrotermal - eksalatif girişlerine eşlik eden, yine hidrotermal oluşumlu yoğun silis gelişleri ile karakterize olunan silikat fazının ve aynı denizaltı volkanitlerinin deniz suyu ile reaksiyonu sonucu oluşan sülfid fazının birlikte katılımcı olduğu bir sedimentasyon havzasına özgü cevherleşme geçmişini şekillendirmektedir. Demirce fakir konglomeratik - breşik cevher örneklerinde gözlenen, özellikle kuvars ile siderit, kil ve/veya killi siderit seviyeleri arasında izlenen ve belirli matematiksel kurallar ile ifade edilebilen "ardışıklı birliktelik" deformasyon öncesindeki sedimerter ilişkiye işaret etmekte olup, kil ve kuvarsça zengin içice girmiş cevherli bir horizonun oluşum sırası ve/veya hemen sonrasındaki havza tabanı hareketleri ile yer yer masif, yer yer de parçalanmış cevher biçiminde şekillenebileceği ortaya konulabilmektedir. Böylece Otlukilise demir yatağı, Lahn - Dill tipi sinsedimenter - volkanojen ve eksalatif - sedimenter yataklara Türkiye'deki Deveci demir yatağı benzeri bir diğer örneği temsil etmektedir

Endovascular stent-graft treatment of giant celiac artery pseudoaneurysm

BACKGROUND: Visceral artery aneurysms (VAAs) comprise an uncommon but life-threatening vascular disease. When rupture is the first clinical presentation, mortality rate reaches 70%. Increased use of cross-sectional imaging has led to a greater rate of diagnosis (40-80%) of asymptomatic VAAs. In the past, surgery was the treatment of choice for VAAs carrying high risk of mortality and morbidity. CASE REPORT: A 22-year-old man, who had undergone gastric, pancreatic and aortic surgery 2.5 years earlier, presented with progressive abdominal pain. Multidetector computed tomography scan revealed an 8-cm celiac pseudoaneurysm. We report a giant celiac pseudoaneurysm treated with stent-graft implantation. CONCLUSIONS: Endovascular treatment of VAA is a safe and effective method alternative to surgery

Zinc Phosphide Poisoning

Zinc phosphide has been used widely as a rodenticide. Upon ingestion, it gets converted to phosphine gas in the body, which is subsequently absorbed into the bloodstream through the stomach and the intestines and gets captured by the liver and the lungs. Phosphine gas produces various metabolic and nonmetabolic toxic effects. Clinical symptoms are circulatory collapse, hypotension, shock symptoms, myocarditis, pericarditis, acute pulmonary edema, and congestive heart failure. In this case presentation, we aim to present the intensive care process and treatment resistance of a patient who ingested zinc phosphide for suicide purposes

A rare cause of ischemic stroke: Intravasculer B cell lymphoma

Intravascular B cell lymphoma is rare and an agressive form of large B cell lymphoma which can affect central nervous system. Because of its varied clinical symptoms and the absence of lymphadenopathy, it is generally diagnosed postmortem. Cerebral infarction due to occlusion of arteries can be seen as a rare clinical form of central nervous system involvement. Large artery atherosclerosis, cardiyoembolism and small artery occlusion are the important causes of ischemic stroke but no any cause is detected in %15-40 of all cases. In this report, with the discussion of a case with ischemia like encephalopathy and multiple cerebral ischemic lesions at different stages in cranial MRI which was diagnosed by the help of brain biopsy as a intravascular B cell lymphoma, it is aimed to take attention intravascular lymphoma as a rare cause of ischemic stroke

Elektrik yanıklarında mortaliteye etki eden faktörler

WOS: 000403589400009PubMed ID: 28530776BACKGROUND: The aim of this study was to determine the factors affecting mortality rate among patients with an electrical burn. METHODS: A total of 115 patients admitted to the emergency department and hospitalized in the Burn Treatment Center or Intensive Care Unit (ICU) due to the electrical burn, were included in the study. RESULTS: A total of 115 patients (4 female and 111 male) with a mean age of 32.88 +/- 12.87 years were included in the study. The mean hospitalization period was 25.03 coproduct 20.50 days, and the mean total body surface area burned (% TBSA) was 22.83 +/- 15.54%. Among those patients, 9 (8.5%) expired, and the remaining 106 were discharged after treatment. In a logistic regression analysis, TBSA > 20% (p= 0.02, OR: 11.7, CI: 1.38-99.16); ICU requirement (p= 0.005, OR: 1.28, CI: 1.08-1.58); erythrocyte transfusion requirement (p= 0.02, OR: 12.48, CI: 1.44-107.83); fresh frozen plasma (FFP) requirement (p= 0.03, OR: 10.23, CI: 1.18-88.17); albumin requirement (p= 0.02, OR: 12.60, CI: 1.44-109.85); admission serum albumin level %20 (p=0.02, odds ratio (OR): 11.7, confidence interval (CI): 1.38–99.16), YB gerekenler (p=0.005, OR: 1.28, CI: 1.08–1.58); eritrosit transferi gerekenler (p=0.02, OR: 12.48, CI: 1.44–107.83); Taze donmuş plazma (TDP) gereksinimi olanlar (p=0.03, OR 10.23, CI: 1.18–88.17); albümin gereksinimi olanlar (p=0.02, OR: 12.60, CI: 1.44–109.85); kabulde serum albümin seviyesi <3.5 mg/dL (p=0.04, OR: 7.25, CI: 0.82–63.64); kabul hemoglobin seviyesi <12 mg/dL (p=0.01, OR: 8.29, CI: 1.57–43.61) hastalarda mortaliteyi belirleyen risk faktörleri olarak belirledik. TARTIŞMA: Klinik uygulamada, elektrik yanığı olan hastalarda bu faktörlerin analiz edilmesi mortalite oranını belirlemede yararlı olabilir. Elektrik yanığı olan hastalarda mortalite risk faktörlerini ve uzun dönem morbiditeleri belirlemek için daha geniş çalışmalara gereksinimi vardır