The Pediatric Tracheostomy Practice During COVID-19 Pandemic at a PICU

Introduction:To evaluate pediatric tracheostomies performed at a tertiary care pediatric intensive care unit (PICU) before and after the Coronavirus disease-2019 (COVID-19) pandemic.Methods:A total of 57 pediatric tracheostomy patients performed at a tertiary care PICU were included. Prognostic scores including pediatric risk of mortality 2, pediatric index of mortality 2 and pediatric logistic organ dysfunction scores, the family education process and time to home discharge were evaluated according to time of tracheostomy (pre-pandemic vs. after pandemic) and responsible surgeon (pediatric surgeon vs. otolaryngologist). MedCalc® Statistical Software version 19.7.2 (MedCalc Software Ltd, Ostend, Belgium; https: //www.medcalc.org; 2021) was used for statistical analysis.Results:A non-significant tendency for higher rate of pediatric surgery-based tracheostomies was noted after the pandemic (76.0 vs. 24.0%, p=0.134). No significant difference was noted between tracheostomies performed before vs. after the COVID-19 pandemic and those performed by otolaryngologists vs. pediatric surgeons in terms of prognostic scores and time to home discharge.Conclusion:Our findings emphasize the maintenance of high quality patient care for pediatric tracheostomy patients in accordance with standardized tracheostomy protocols and policies during the pandemic period with no significant difference between tracheostomies performed before and after the COVID-19 pandemic and those performed by pediatric surgeons vs. otolaryngologists in terms of prognostic scores and time to home discharge

Fuzel alkollerinden asetat esterleri üreten reaksiyonlu distilasyon prosesinin incelenmesi ve kontrolu

Tez (Doktora)-- İTÜ Fen Bil. Enst., 1996.DoktoraPh.D

İntraperitoneal ve retroperitoneal yaklaşımla endoskopik nefroüreterektomi ve üst kutup nefroüreterektomi deneyimimiz

Aim: Examining the effectiveness of nephroureterectomy and upper pole nephroureterectomy via endoscopy. Material and Methods: The results of 12 patients who underwent retroperitoneoscopic and laparoscopic nephroureterectomy and upper pole nephroureterectomy in the last two years were presented. Results: Eight nephroureterectomies (2 retroperitonoscopic and 6 peritoneoscopic) were performed. Male to female ratio was 3/5, and average age was 9,6 (1-13 years). Minimum two and maximum five ports were used. Cholesistectomy in one, and ovarial cycst aspiration in another patient were applied during the same procedure with laparoscopic nephrectomies. Two open ureteroneocystostomies were added in two patients. Upper pole heminephrectomy was performed in four girls with an average age of 6.1 (8 months-13 years). One of these cases had a unilateral triplex collecting system. Two of the heminephrectomies were retroperitoneoscopic and two were laparoscopic. There was no difference between the durations of surgery and hospitalization of these small groups. Conclusion: Neither laparoscopic nor retroperitoneoscopic nephrectomy is superior to other regarding operating time and hospital stay. However, laparoscopic route was preferred more frequently because of its simplicity for the surgeon, and its large exposure allowing extra interventions for adjacent intraperitoneal pathologies.Amaç: Endoskopik yolla uygulanan nefroüreterektomi ve üst kutup nefroüreterektomi işlemlerinin etkinliğinin irdelenmesi. Gereç ve Yöntem: Kliniğimizde son iki yılda, retroperitoneoskopik ve laparoskopik yolla nefroüreterektomi ve üst kutup nefroüreterektomi uygulanan 12 hastanın sonuçları sunulmuştur. Bulgular: İkisi retroperitoneoskopik 6 tanesi laparoskopik olmak üzere toplam 8 hastaya nefrektomi uygulandı. Olguların beşi kız üçü oğlan, yaş ortalaması 9,6 (1-13 yaş arası)' dır. Kullanılan port sayısı 2 ila 5'dir. Laparoskopik nefroüreterektomi yapılan olguların birinde aynı seansta kolesistektomi, bir diğerinde ise over kistine aspirasyon uygulanmıştır. İki olguda da açık üreteroneosistostomi girişimi eklenmiştir. Yaş ortalaması 6,1 (8 ay - 13 yaş arası) ve hepsi kız olan dört hastaya da üst kutup heminefrektomisi uygulanmıştır. Bu olguların bir tanesinde tripleks sistem bulunmakta idi. Heminefrektomilerin ikisi laparoskopik, ikisi retroperitoneoskopik uygulanmıştır. Uygulamaların cerrahi işlem süresi ve hastanede yatış süreleri arasında belirgin bir fark saptanmamıştır. Sonuç: Nefrektomi ve heminefrektomi girişimleri için retroperitoneal veya laparoskopik yaklaşımların birbirlerine belirgin üstünlükleri saptanmamasına karşın, ek patolojilere girişim yapma gereksinimi olduğu durumlarda ve uygulama kolaylığı açısından laparoskopik girişimler daha fazla tercih edilmiştir

Coronary arterial revascularization in an adult with congenitally corrected transposition of great arteries and dextrocardia

Objectives: Congenitally corrected transposition of great arteries with dextrocardia is an extremely rare lesion in adulthood. This group of patients does not live long enough for atherosclerotic coronary artery disease processes, because of existing comorbid anomalies. Methods: We report a 47-year-old man with isolated congenitally corrected transposition of great arteries, dextrocardia, and athersclerotic coronary artery disease. The patient underwent coronary artery revascularization with cardiopulmonary bypass. The free left internal mammary artery (LIMA) was grafted to the tiny left anterior descending artery (LAD), and the reversed saphenous vein Y graft was anastomosed to the posterior descending and posterolateral branches of the morphologic right coronary artery. Results: The patient recovered uneventfully. He is alive and well 24 months after the surgery. Conclusions: To our knowledge, the present case is the first congenitally corrected transposition of great arteries with dextrocardia treated with grafted coronary artery bypass. Early and full revascularization is very important for the systemic right ventricle exposed to a systemic workload. The vessel pathologies and technical details of this unusual case are discussed in this paper

Atypical intradural spinal tuberculosis: report of three cases

Objective: To report three cases of intradural spinal tuberculosis ( TB) by calling attention to atypical forms of spinal TB