Removing a pin from the urethra of a 14-year-old male patient: a case report

The diagnosis and treatment of foreign bodies in the urogenital system are difficult and it’s rare in children; It may also cause secondary injuries. In this article, we present a 14-year-old male patient who was admitted to the emergency outpatient clinic with complaints of difficulty in voiding and dysuria. He was diagnosed with a pin in the urethra and treated using an endoscopic method. He was hospitalised for foreign body removal after he admitted in his anamnesis about insertion a pin into his urethra the day before his complaints started. A pin was seen in the urethra on the urethrocystoscopy, and was successfully removed. Since foreign body in the urogenital system is rare in children, it is necessary to suspect, in order to make the diagnosis. In most cases, endoscopic intervention is sufficient. Psychiatric consultation should be requested for the patients, especially for pediatrics

A Pregnant Developed Cardiac Arrest Due To Anaphylaxis

We present a pregnant developed cardiac arrest due to a severe anaphylactic reaction to i.v. sulbactam-ampicillin, who had no history of allergy to penicillin and cephalosporin. Ampicillin is one of the most common drugs to elicit a rash, with an overall incidence of 3% to 8%. Five to ten percent of people on ampicillin develop eruptions between the 5th and 14th day following initiation of therapy. The incidence of immediate hypersensitivity reaction or anaphylactic reaction to cephalosporin antibiotics has been estimated at 0.02% and most of these patients have a history of allergy to penicillin and/or adverse reactions to cephalosporins. We present a case of immediate systemic reaction to sulbactam-ampicillin in a pregnant women whom exposed to intravenous sulbactam-ampicillin several times in past. The patient manifested a severe reaction which included anaphylactic shock, requiring orotracheal intubation and epinephrine. In this case, we emphasized the importance of early, fast, effective,and proper cardiac resusitation for anaphylaxis which may improve the prognosis

A study on analgesic effect of foenculum vulgara extracts in mice

Rezene bitkisi eterik yag ekstresinin analjezik etkisinin arastırıldıgı bu çalısmada 50 adet fare kullanıldı. Fareler bes gruba ayrıldı: I. gruba (kontrol) periton içi yolla (i.p.) 0.2 ml serum fizyolojik (SF), II. gruba (referans) oral yolla (p.o.) 100 mg/kg aspirin, III. gruba (referans) derialtı yolla (s.c.) 10 mg/kg morfin HCl, IV. gruba i.p. yolla 0.25 ml/kg rezene eterik yagı (REY) ve V. gruba i.p. 0.50 ml/kg REY uygulandı. Uygulama öncesinde ve uygulamadan sonraki 30., 90. ve 150. dakikalarda çalısma grupları tail-flick cihazı ile test edildi. Veriler varyans analiziyle degerlendirildi. Aspirin grubunun çalısmanın 150. dakikasında SF grubuna göre anlamlı seviyede analjezik etki gösterdigi, morfin HCl grubunun ise çalısmanın 30. ve 90. dakikalarında diger tüm çalısma gruplarına göre anlamlı derecede analjezik etki gösterdigi, fakat çalısmanın tüm evrelerinde REY’nın her iki dozunun da analjezik etkisinin bulunmadıgı saptanmıstır.In this study, 50 mice were used to investigate the analgesic effect of Foeniculum vulgare Miller (Fennel) etheric oil extracts. The experimental protocol were approved by the Animal Research Committee of University of Yuzuncu Yil. The animals divided into five groups: The animals in Group I (Control group) were given 0.2 ml of 0.9 % NaCl solution i.p. , Group II (referance) were dosed with 100 mg/kg aspirin p.o. , Group III (referance) were treated with 10 mg/kg morphine HCl s.c., the mice in Group IV and Group V were administered etheric oil extract of Foeniculum vulgare at doses of 0.25 ml/kg and 0.50 ml/kg i.p. respectively. Animals were tested using tail-flick instrument before treatments and at 30th, 90th and 150th minutes after treatments. Obtained all data were analyzed with One-way analysis of variance (ANOVA). At 150th minute, it was found that aspirin has analgesic effect significantly compared with control group. morphine HCl showed higher analgesic effect at 30th and 90th minutes than other groups. Foeniculum vulgare etheric oil extract at both of doses did not showed analgesic effect significantly

Reexpansion Pulmonary Edema

Reexpansion pulmonary edema is a rare but life threating complication which is occurring during the treatment of lung collapse secondary to pleural effusion, pneumothorax or atelectasis. We presented a 68 year-old case with hypertension, heart failure, cerebrovascular disease and diabetes mellitus who had developed reexpansion pulmonary edema three hours after the application of unilateral thoracentesis (Journal of the Turkish Society of Intensive Care 2011; 9: 26-9

Misplacements Of Central Venous Catheters: Internal Jugular Versus Subclavian Access In Critical Care Patients

Aim; In central venous catheterization (CVC), misplacement is not a rare complication since this is a blinded procedure. The aim of this study was to compare the misplacement risks of the access of internal jugular vein with that of subclavian vein catheterizations. Methods; The records of a total of 1092 patients in whom central venous catheters were placed between 2002 and 2006 in Anesthesiology Intensive Care Unit and the location of the tips was confirmed radiologically were retrospectively evaluated. Neck and infraclavicular region were cleaned by antiseptic solution after routine monitorization. CVC were easily inserted with Seldinger’s technique after blood aspiration through internal jugular vein or subclavian vein. Results; In adult patients, six internal jugular catheter misplacements were seen (0.80%); among them five were kinking and one was intrapleural location of the catheter tip. Six subclavian misplacements (2.02 %) were detected, five of them were located in contralateral subclavian vein, and one was located in ipsilateral internal jugular vein. In children, two subclavian misplacements were seen as crossing to contraleteral subclavian vein, and there were no internal jugular misplacement. There was no statistically difference for misplacement between the access sites (in adult p= 0.110, in children p=0.501). Conclusion; We have concluded that experience of operator should be taken into account for choice of catheterization site

Yoğun bakım ünitesinde ventilatör ilişkili pnömoniyi önlemede Glutamin destekli total parenteral beslenme

Amaç: Ventilatör ilişkili pnömoni (VAP), mortalite ve morbiditeyi artıran, hastanede kalış süresini uzatan ve hastane giderlerini artıran bir nazokomial pnömoni formudur. Glutamin intestinal mukozal yapıyı korur, immün fonksiyonları artırır ve total parenteral beslenme (TPN) uygulanan hastalarda zararlı değişiklikleri azaltır. Biz yoğun bakım ünitesinde (YBÜ) mekanik ventilatör desteği alan hastalarda VAP gelişiminin glutamin destekli TPN ile önlenebileceği hipotezini kurduk. Materyal ve Metodlar: Çalışmamızda etik kurul onayı ve bilgilendirilmiş onam alındıktan sonra YBÜ’nde mekanik ventilatör desteği alan 60 hasta takip edildi. Hastalar 3 gruba ayrıldı. İlk grup enteral beslenme (n=20) alırken, ikinci gruba TPN (n=20), üçüncü gruba ise glutamin destekli TPN (n=20) başlandı. C-reaktif protein (CRP), sedimentasyon hızı, vücut ısısı, pürülan sekresyon gelişip gelişmediği, sekresyon miktarında artış olup olmadığı, sekresyonların karakterinde değişiklik ve derin trakeal aspirasyon ihtiyacında artış olup olmadığı günlük muayeneler ve radyografi ile takip edildi. Bulgular: Gruplar arasında VAP gelişim açısından istatistiksel olarak anlamlı fark bulunmadı (p=0.622). Sonuç: Glutamin destekli TPN alan grupta daha az oranda VAP gelişmesine rağmen, gruplar arasındaki fark istatistiksel olarak anlamlı değildi. Glutamin destekli TPN, VAP gelişimini önlemede glutaminsiz TPN ve enteral beslenmeden üstün değildir.Objective: Ventilator-associated pneumonia (VAP) is a form of nosocomial pneumonia that increases patient morbidity and mortality, length of hospital stay, and healthcare costs. Glutamine preserves the intestinal mucosal structure, increases immune function, and reduces harmful changes in gut permeability in patients receiving total parenteral nutrition (TPN). We hypothesized that TPN supplemented by glutamine might prevent the development of VAP in patients on mechanical ventilator support in the intensive care unit (ICU). Material and Methods: With the approval of the ethics committee and informed consent from relatives, 60 patients who were followed in the ICU with mechanical ventilator support were included in our study. Patients were divided into three groups. The first group received enteral nutrition (n=20), and the second was prescribed TPN (n=20) while the third group was given glutamine-supplemented TPN (n=20). C-reactive protein (CRP), sedimentation rate, body temperature, development of purulent secretions, increase in the amount of secretions, changes in the characteristics of secretions and an increase in requirement of deep tracheal aspiration were monitored for seven days by daily examination and radiographs. Results: No statistically significant difference was found among groups in terms of development of VAP (p=0.622). Conclusion: Although VAP developed at a lower rate in the glutamine-supplemented TPN group, no statistically significant difference was found among any of the groups. Glutamine-supplemented TPN may have no superiority over unsupplemented enteral and TPN in preventing VAP

Glutamine Supplemented Parenteral Nutrition to Prevent Ventilator-Associated Pneumonia in the Intensive Care Unit

Objective: Ventilator-associated pneumonia (VAP) is a form of nosocomial pneumonia that increases patient morbidity and mortality, length of hospital stay, and healthcare costs. Glutamine preserves the intestinal mucosal structure, increases immune function, and reduces harmful changes in gut permeability in patients receiving total parenteral nutrition (TPN). We hypothesized that TPN supplemented by glutamine might prevent the development of VAP in patients on mechanical ventilator support in the intensive care unit (ICU). Material and Methods: With the approval of the ethics committee and informed consent from relatives, 60 patients who were followed in the ICU with mechanical ventilator support were included in our study. Patients were divided into three groups. The first group received enteral nutrition (n=20), and the second was prescribed TPN (n=20) while the third group was given glutamine-supplemented TPN (n=20). C-reactive protein (CRP), sedimentation rate, body temperature, development of purulent secretions, increase in the amount of secretions, changes in the characteristics of secretions and an increase in requirement of deep tracheal aspiration were monitored for seven days by daily examination and radiographs. Results: No statistically significant difference was found among groups in terms of development of VAP (p=0.622). Conclusion: Although VAP developed at a lower rate in the glutamine-supplemented TPN group, no statistically significant difference was found among any of the groups. Glutamine-supplemented TPN may have no superiority over unsupplemented enteral and TPN in preventing VAP

Evaluation of the effectiveness of vacuum-assisted closure in the treatment of Fournier gangrene

Background and objective: To evaluate the effectiveness of vacuum-assisted closure (VAC) in the treatment of Fournier gangrene (FG). Material and methods: Forty-eight male patients treated for Fournier gangrene were included in the study. The patients were divided into two groups (Group I: conventional dressing, Group II: VAC therapy). Characteristics of the patients, laboratory parameters, number of debridement procedures, daily number of dressings, visual analogue scale (VAS) during dressing, analgesic requirement, colostomy requirement, time from the first debridement to wound closure, wound closure method, length of hospital stay, and mortality rates were compared. Results: Group I comprised 33 patients and Group II comprised 15 patients. The number of dressings, VAS score and daily analgesic requirement were statistically significantly lower in Group II (p < 0.05) than in Group I. The number of debridement procedures, colostomy requirement, orchiectomy rate, time from first debridement to wound closure, length of hospital stay, wound closure method and mortality rate were similar between these two groups (p > 0.05). Conclusion: The clinical results of conventional dressing and VAC therapy were similar for treating FG. VAC therapy is an effective postoperative wound care method that offers less requirement for dressing changes, less pain, less analgesic requirement and more patient satisfaction compared to conventional dressing