The long outcome in patients with carotico-subclavian bypass surgery for subclavian steal syndrome

OBJECTIVE: In our study we aimed to evaluate long term outcome of carotico-subclavian bypass surgery in patients with subclavian steal syndrome. MATERIALS and METHODS: We evaluated the patients who underwent caroticosubclavian bypass surgery between the years 1999 and 2011 in our clinic. Total number of patients was 6 (5 female and 1 male). The mean age of the patients was 60.8±2.1 (48- 78). The patients presented with claducatio of upper extremities, headache, dizziness, and differences in arterial pressure between two arms. RESULTS: There were no complications after the carotico-subclavian bypass surgery. The differences in arterial pressure between the two arms disappeared together with the symptoms after the surgery. CONCLUSION: Carotico-subclavian bypass surgery is a procedure with low mortality and morbidity rates and good long term outcomes in patients with subclavian steal syndrome

Primary Spinal Glioblastoma Multiforme: A Case Report and Review of The Literature

WOS: 000343369600017Introduction: Primary spinal glioblastoma multiforme is a very rare disease with high morbidity and mortality rates. No definite treatment algorhythm can be constituted, but multimodal treatment regimens have been administered. Aim of the treatment is to excise the mass nearly completely, and then application of radiotherapy and chemotherapy in a short period. Methods: Publications were identified by browsing search engines such as PubMed and MEDLINE for English-language articles since 1989 using a list of keywords; as well as identifying references from review articles. The following keywords were used for searching databases: primary, spinal, glioblastoma multiforme. Results: Intramedullary mass was detected at the levels of C2-T8 in the spinal magnetic resonance imaging (MRI) examination performed in our 4-year old male patient, who applied to us with complaints of weakness in lower extremities and gaita-urine incontinence. Sepsis was developed in postoperative period of the patient, whose mass was gross-totally resected by using microsurgery method. After the patient was started to have radiotherapy, he was extubated with improvements in the clinical state and neurological picture. He has been followed up at the hospital in the three-month monitorization after the treatment. Literature data suggested that all three therapy modalities can be used for sGBM, sequentially or concurrently, it has a poor survival, most of the patients die due to disease and the duration of symptoms are very short. Conclusion: Because the disease is very rare, prospective studies cannot be performed in this patient population

Primer Spinal Glioblastoma Multiforme: Bir Vaka Sunumu ve Literatür Derlemesi

Giriş: Primer spinal glioblastoma multiforme yüksek morbidite ve mortalite hızına sahip çok nadir görülen bir hastalıktır. Kesin bir tedavi algoritması yoktur ancak multimodal tedavi rejimleri uygulanmaktadır. Tedavinin amacı kitlenin tama yakın çıkarılması, sonrasında radyoterapi ve kemoterapinin kısa sürede uygulanmasıdır. Metod: 1989'dan itibaren İngilizce yazılmış makaleler, anahtar kelimelerin kullanılması ve derleme makalelerinden referansların ayrıştırılması yoluyla PubMed ve MEDLINE gibi arama motorları taranarak ayrıştırılmıştır. Kullanılan anahtar kelimeler primer, spinal ve glioblastoma multiformedir. Sonuçlar: Alt ekstremitede güçsüzlük ve gayta-üriner inkontinans ile başvuran 4 yaşındaki bir erkek hastada spinal manyetik rezonans görüntülemede (MRI)C2-T8 seviyesinde intramedüller kitle saptandı. Mikrocerrahi metodla kitlesi tama yakın çıkarılan hastada postoperatif dönemde sepsis gelişti. Radyoterapi başlanmasından kısa bir süre sonra klinik durumunda ve nörolojik tablosunda düzelme olan hasta ekstübe edildi. Tedavi sonrası hastanede 3 ay daha izlenmiştir. Literatür bulguları sGBM tedavisinde sekansiyel veya eş zamanlı olarak her üç modalitenin de kullanılabileceğini, kötü prognoza sahip olduğunu, hastaların çoğunluğunun hastalığa bağlı olarak öldüğünü ve semptomların süresinin çok kısa olduğunu göstermektedir. Tartışma: Hastalık nadir görüldüğü için, bu grup hasta popülasyonunda prospektif çalışmalar yapılamamaktadır.Introduction: Primary spinal glioblastoma multiforme is a very rare disease with high morbidity and mortality rates. No definite treatment algorhythm can be constituted, but multimodal treatment regimens have been administered. Aim of the treatment is to excise the mass nearly completely, and then application of radiotherapy and chemotherapy in a short period. Methods: Publications were identified by browsing search engines such as PubMed and MEDLINE for English-language articles since 1989 using a list of keywords; as well as identifying references from review articles. The following keywords were used for searching databases: primary, spinal, glioblastoma multiforme. Results: Intramedullary mass was detected at the levels of C2-T8 in the spinal magnetic resonance imaging (MRI) examination performed in our 4-year old male patient, who applied to us with complaints of weakness in lower extremities and gaita-urine incontinence. Sepsis was developed in postoperative period of the patient, whose mass was gross-totally resected by using microsurgery method. After the patient was started to have radiotherapy, he was extubated with improvements in the clinical state and neurological picture. He has been followed up at the hospital in the three-month monitorization after the treatment. Literature data suggested that all three therapy modalities can be used for sGBM, sequentially or concurrently, it has a poor survival, most of the patients die due to disease and the duration of symptoms are very short. Conclusion: Because the disease is very rare, prospective studies cannot be performed in this patient population

Evaluation of the Patient Comfort of Hemodialysis Access with Visual Analogue Scale

Amaç: Bu çalışmada kateter aracılığıyla hemodiyalize alınan hastalarda kateter uygulanma yerinin hasta memnuniyeti ve günlük yaşamı üzerine olan etkisini araştırdık. Gereç ve Yöntemler: Bu prospektif çalışmaya Ocak 2005-Eylül 2006 tarihleri arasında kliniğimizde hemodiyaliz amaçlı geçici ve kalıcı kateter takılan 171 hasta (104'ü erkek, 67'si kadın, yaş ortalaması 56,3±14,8) alındı. Hastaların hemodiyaliz kateterinden memnuniyeti ağrı, kateter kaynaklı hareketin engellenmesi, tuvalet ihtiyacını giderebilme, duş alma ile ilgili sıkıntı, uyku kalitesi ve estetik rahatsızlık düzeyleri Vizüel Analog Skala (0-10 cm) ile değerlendirildi. Bulgular: Kliniğimizde çoğunlukla sağ internal juguler vene geçici hemodiyaliz kateteri takılması tercih edilmiştir. En fazla şikayet sağ internal juguler vene kateter takılan hastalardan gelmiştir. Anatomik lokalizasyona göre en yüksek görsel analog ölçek skorları, sağ internal juguler ven kateterizasyonu yapılan hastalarda bulunmuştur. Bu hastalarda en fazla rahatsızlığın duş sırasında olduğu görülmüştür (ortalama görsel analog ölçek skoru 8.4 cm). Şikayet türüne göre görsel analog ölçek skorları değerlendirildiğinde ağrı ve duş sırasında rahatsızlık en fazla şikayetçi olunan rahatsızlıklar olmuştur (sırasıyla p=0.000 ve p=0.003). Tüm anatomik kateter lokalizasyonlarında en yüksek görsel analog ölçek skorları duş sırasında rahatsızlıkta olduğu görülmüştür. Sonuç: Subklavian yolla hemodiyaliz kateteri takılması, tromboz vb komplikasyonları nedeniyle daha az sıklıkla tercih edilmesine rağmen çalışmamızda hasta memnuniyeti ve konforunun bu teknikte daha fazla olduğu gözlenmiştir. Tromboz riskini azaltacak, hasta memnuniyeti ve konforunu arttıracak yeni yöntemler ve materyaller üzerinde çalışmalar yapılması gerektiğini düşünmekteyiz.Aim: In this study, we investigated the effects of catheter application sites on patients' quality of life and comfort. Material and Methods: Between June 2005 - September 2006, 171 patients (104 male, 67 female, mean age 56,3 ±14,8) who had hemodialysis access through a catheter (temporary or tunneled) were investigated prospectively in our clinic. Patients' quality of life was evaluated with Visual Analogue Scale (0 - 10 cm) including scales about catheter related pain, mobility impairment, esthetic anxiety, discomfort in urination, sleeping and bathing. Results: Right internal jugular vein is the most preferred catheter site in our clinic. And it is the most common catheter site that patients have complaints. Also this is supported with the highest Visual Analogue Scale scores about this anatomical site. According to the Visual Analogue Scale scores, pain and discomfort during shower are the most common complaints. And discomfort at shower is the most common complaint with all of the catheter sites and has the highest Visual Analogue Scale scores. Conclusions: Subclavian vein hemodialysis access may not be the first choice because of the high rates of related complications like vein thrombosis, but we observed that it is the most comfortable and pleasing method for chronic hemodialysis patients in our study. We think that more research should be conducted about the methods and instruments to prevent the catheter complications and improve patient comfort

In vitro effects of amiodarone on coronary artery bypass grafts

Background: This study aims to investigate the effects of amiodarone on the most commonly used grafts, internal thoracic artery (ITA), saphenous vein (SV), and radial artery (RA) in organ bath. Methods: Twenty patients (16 males, 4 females; mean ages 58.4 +/- 9.9 years; range 38 to 80 years) who underwent isolated coronary artery bypass graft (CABG) surgery between May 2008 and October 2008 were included in this study. Internal thoracic artery, saphenous vein, and radial artery grafts were harvested. Specimens were taken to laboratory in +4 degrees C Krebs solution. Specimens were suspended in 10 ml organ bath containing Krebs solution. Results: Amiodarone caused relaxation in all grafts (ITA, RA, SV) between 10(-9)-10(-3,5) M concentration in a dose dependent manner (p<0.01). Maximum relaxation rates (mean) induced by amiodarone were 78.9%, 74.9% and 66.5% for ITA, RA and SV, respectively. Conclusion: Although we did not evaluate the endothelium-independent relaxation response in this study, higher rates of relaxation response were observed with ITA grafts comparing to other grafts, and these results were compatible with literature. According to the results of this study, amiodarone-class III antiarrhythmic agent- caused vasodilation in all three grafts in vitro. Vasodilator effect of amiodarone on grafts may help to increase patency rates

Early outcomes of coroner arter bypass greft performed before 40 years old

Amaç: Ülkemizde ve Dünya’da genç yaş grubu hastalardaki artışa paralel olarak koroner arter bypass greft (CABG) cerrahisi sıklığı artmaktadır. Bu retrospektif çalışmada, kliniğimizde 40 yaş ve altında kardiyopulmoner bypass (CPB) ile izole CABG uygulanan olgulardaki erken dönem sonuçların değerlendirilmesi amaçlandı. Gereç ve Yöntem: Nisan.2004- Ocak 2012 tarihleri arasında CPB ile 40 yaş ve altında CABG operasyonu gerçekleştirilen 106 hasta çalışmaya dahil edildi. Hastaların demografik verileri, perioperatif ve postoperatif parametreleri değerlendirildi. Bulgular: Demografik veriler incelendiğinde olguların %59.4’ünde sigara kullanımı, %30.2’sinde diabetes mellitus, %25.5’inde obezite, %66’sında hiperlipidemi saptandı. Hastaların %5.7’sinde sol ana koroner arter hastalığı, %8.5’inde tek damar, %37.7’sinde iki damar ve %53.8’inde üç damar hastalığı mevcut idi. Operasyon verileri değerlendirildiğinde kross klemp süresi 37 dk, CPB süresi 66.8 dk ve ortalama greft sayısı 2.5 saptandı. Mortalite gözlenmedi. Yedi olguda atriyal fibrilasyon, 3 hastada safen ven grefti alınan bacakta yüzeyel doku enfeksiyonu gelişmişti. Sonuç: Bu çalışma ile 40 yaş ve altı CABG uygulananlar olgularda sigara ve diabetes mellitus önemli bir risk faktörü olarak tespit edilmiştir.Objective: Recently, Coronary artery bypass grefting (CABG) surgery frequency has increased paralel to the increase of young patients in our country and the world. In this retrospective study, our aim was to evaluate early outcomes of patients &amp;#8804;40 years old underwent isolated CABG with cardiopulmoner bypass (CPB). Material and Method: Our study has included 106 patients &amp;#8804;40 years old who underwent CABG with CPB between April 2004 to January 2012. Demographic data, perioperative and postoperative parameters were evaluated. Results: Demographic data were examined such as smoking cigarette rate of 59.4%, diabetes mellitus 30.2%, obesity 25.5%, hyperlipidemia 66%. The patients had left main coronary artery, single-vessel, two-vessel and three-vessel disease, 5.7%, 8.5%, 37.7%, 53.8%, respectively. Intraoperative parameters were as follows: mean cross clamp time 37 min, cardiopulmoner bypass time 66.8 min, mean graft number was 2.5. No mortality was seen. Seven cases had atrial fibrillation, and 3 patients had superfical infection at the sapheneous vein harvesting site. Conclusion: Smoking cigarette and diabetes mellitus are common important risk factors in patients underwent CABG &amp;#8804;4O years old

Risk factors for chronic venous insufficiency in nurses in Türkiye-NueVo TR

Aim: Chronic venous insufficiency (CVI) is a condition that results from obstruction, valve insufficiency, dysfunction of calf muscle pump, or their combinations. This study analyzed the risk factors and demographic characteristics of CVI in nurses in Türkiye. Additionally, it seeks to identify the total number of patients treated at medical centers in 2022 and assess the prevalence of CVI. Material and Methods: This multicenter, descriptive, and cross-sectional study was conducted with the participation of nurses working in 18 centers. Nurses completed a questionnaire that included their demographic information and venous insufficiency risk factors, and the Venous Insufficiency Epidemiological and Economic Study-Quality of Life Questionnaire. Researchers also completed the Standard CEAP Form Section C. The cases were divided into 2 groups: CVI (-) group (n=776, 43.5%) and CVI (+) group (n=1010, 56.5%). Results: A total of 1786 nurses participated in this study. Older age (>30-39 years), female gender, ≥2 pregnancies, ≥2 childbirths, years in the profession (>5-15 years), family history, and night cramps were identified as risk factors for CVI (p0.05). Hypertension, diabetes, and a history of deep vein thrombosis were the most common coexisting diseases. With a one-unit increase in age, risk of CVI increased 1.1-fold, family history of VV increased CVI risk 1.9-fold and presence of nocturnal night cramps increased risk of CVI 2.6-fold. The prevalence of CVI in 2022 was found to be 22.66% in this study. Conclusion: Older age, female gender, ≥2 pregnancies, ≥2 childbirths, years in the profession, family history, and night cramps are identified as risk factors for CVI in nurses. Common comorbid diseases include hypertension, diabetes, and a history of DVT. Pregnancy, particularly with multiple occurrences, stands out as a critical period for CVI. Reported symptoms in CVI (+) nurses include leg pain, swelling, heaviness, restless legs, and throbbing. Nurses demonstrate a higher incidence of CVI compared to other professions, highlighting an occupational risk. These findings stress the importance of preventive measures for nurses