COMPARISON OF ANALGESIC EFFECTS OF SINGLE DOSE AND DIVIDED DOSES INTRAARTICULAR BUPIVACAINE, FENTANYL AND PREDNISOLONE ADMINISTRATION IN ARTHROSCOPIC KNEE SURGERY

Objective: We aimed to compare the perioperative hemodynamic and postoperative analgesic effects of i.a. administration of single dose and in two separate doses of bupivacaine+fentanyl+prednisolone combination through a catheter for supplying an effective postoperative analgesia after arthroscopic knee surgery and to help early mobilization

Intraocular Pressure Changes Following Phacoemulsification

WOS: 000314145000003Objective: To analyze the effect of phacoemulsification on intraocular pressure (IOP) and to evaluate the management for high postoperative IOP. Material and Methods: Data of 812 eyes of 584 consecutive patients (330 males and 254 females) who underwent Uneventful phacoemulsification in Department of Ophthalmology, Baskent University Adana Research Center were investigated retrospectively. The ages ranged between 26 and 89 years (65.5 +/- 9.8 years). Intraocular pressure values of preoperative and postoperative first day, first week and first month visits were recorded. Intraocular pressures over 22 mm Hg were considered as high IOP. Either anterior chamber decompression or antiglaucomatous medication was used to decrease the postoperative rise in IOP. Changes in TOP were analyzed using ANOVA. Results: The mean preoperative TOP was 15.6 +/- 4.3 mmHg, which increased to 19.7 +/- 9.0 mmHg on the 1st day (p<0.001). The IOP decreased significantly to 12.7 +/- 4.5 mmHg at 1st week, and 12.8 +/- 3.7 mmHg at 1st month (p<0.001, both). In 249 (30.7%) eyes, high IOP was detected on the first day. In 114 (45.8%) of these eyes, TOP was reduced by anterior chamber decompression while in 73 (29.3%) eyes glaucoma medication was prescribed. At first month 13 (1.6%) eyes had high IOP. Conclusion: Although, a rise in IOP remains a problem in the postoperative first day; both anterior chamber decompression and glaucoma medication seem to be effective and safe to overcome this condition. In short term, uneventful phacoemulsification and intraocular lens implantation results in a decrease in IOP

Polypharmacy in the Elderly: A Multicenter Study

Objective: The aim of this study was to evaluate the polypharmacy issue and its correlations with socio-economic variables in Turkish elderly patients

Polypharmacy in the Elderly: A Multicenter Study

WOS: 000270438400009PubMed ID: 19716065Objective: The aim of this study was to evaluate the polypharmacy issue and its correlations with socio-economic variables in Turkish elderly patients. Design: Cross-sectional Setting: Outpatient clinics of the medical schools, departments of physical medicine and rehabilitation from 12 provinces. Participants: A total of 1430 elderly in different geographical regions of Turkey during January 2007 to January 2008 were included. Measurements: Patients were interviewed using a questionnaire that included demographic characteristics, current medical diagnosis, and pharmaceuticals that are used by elderly. Demographical parameters were gender, age, marital status, number of children, level of education, province, and status of retirement. Results: The mean number of drugs was found to be higher in the females. There was a significant difference among age groups, marital status groups, and the number of children categories. The distribution of the number of drugs among education levels did not differ significantly, whereas the distribution of the number of drugs between the status of retirement and presence of chronic disease differed significantly. Conclusions: Polypharmacy is correlated with various factors including age, sex, marital status, number of children, status of retirement, and presence of chronic medical conditions but not educational status in our study group. (J Am Med Dir Assoc 2009; 10: 486-490

Evaluation and follow-up of patients diagnosed with hypophysitis: a cohort study

Objective Primary hypophysitis might be challenging to diagnose, and there is a lack of evidence regarding optimal treatment strategies due to rarity of the disease. We aim to investigate the clinical features and compare the outcomes of different management strategies of primary hypophysitis in a large group of patients recruited on a nationwide basis.Design A retrospective observational study.Methods The demographic, clinical, and radiologic features and follow-up data were collected in study protocol templates and analyzed.Results One hundred and thirteen patients (78.8% female, median age: 36 years) were included. Lymphocytic (46.7%) and granulomatous hypophysitis (35.6%) were the prevailing subtypes out of 45 patients diagnosed after pathologic investigations. Headache (75.8%) was the most common symptom, and central hypogonadism (49.5%) was the most common hormone insufficiency. Of the patients, 52.2% were clinically observed without interventions, 18.6% were started on glucocorticoid therapy, and 29.2% underwent surgery at presentation. Headache, suprasellar extension, and chiasmal compression were more common among glucocorticoid-treated patients than who were observed. Cox regression analysis revealed higher hormonal and radiologic improvement rates in the glucocorticoid-treated group than observation group (hazard ratio, 4.60; 95% CI, 1.62-12.84 and HR, 3.1; 95% CI, 1.40-6.68, respectively). The main indication for surgery was the inability to exclude a pituitary adenoma in the presence of compression symptoms, with a recurrence rate of 9%.Conclusion The rate of spontaneous improvement might justify observation in mild cases. Glucocorticoids proved superior to observation in terms of hormonal and radiologic improvements. Surgery may not be curative and might be considered in indeterminate, treatment-resistant, or severe cases

Subacute THYROiditis Related to SARS-CoV-2 VAccine and Covid-19 (THYROVAC Study): A Multicenter Nationwide Study.

Context The aims of the study are to compare characteristics of subacute thyroiditis (SAT) related to different etiologies, and to identify predictors of recurrence of SAT and incident hypothyroidism. Methods This nationwide, multicenter, retrospective cohort study included 53 endocrinology centers in Turkey. The study participants were divided into either COVID-19-related SAT (Cov-SAT), SARS-CoV-2 vaccine-related SAT (Vac-SAT), or control SAT (Cont-SAT) groups. Results Of the 811 patients, 258 (31.8%) were included in the Vac-SAT group, 98 (12.1%) in the Cov-SAT group, and 455 (56.1%) in the Cont-SAT group. No difference was found between the groups with regard to laboratory and imaging findings. SAT etiology was not an independent predictor of recurrence or hypothyroidism. In the entire cohort, steroid therapy requirement and younger age were statistically significant predictors for SAT recurrence. C-reactive protein measured during SAT onset, female sex, absence of antithyroid peroxidase (TPO) positivity, and absence of steroid therapy were statistically significant predictors of incident (early) hypothyroidism, irrespective of SAT etiology. On the other hand, probable predictors of established hypothyroidism differed from that of incident hypothyroidism. Conclusion Since there is no difference in terms of follow-up parameters and outcomes, COVID-19- and SARS-CoV-2 vaccine-related SAT can be treated and followed up like classic SATs. Recurrence was determined by younger age and steroid therapy requirement. Steroid therapy independently predicts incident hypothyroidism that may sometimes be transient in overall SAT and is also associated with a lower risk of established hypothyroidism