The Incidence of Methemoglobinemia Due to Prilocaine Use in Circumcision

Objective:Local anesthesia with prilocaine is widely used in circumcision procedures. However, the incidence of methemoglobinemia due to prilocaine use during these procedures remains unknown. Therefore, this retrospective study was planned to determine the possibility of development of prilocaine-associated methemoglobinemia during circumcision.Materials and Methods:Medical records of 2.431 patients who were circumcised between 2008 and 2015 in University of Health Sciences, İzmir Dr. Suat Seren Chest Diseases and Surgery Training and Research Hospital, Turkiye, were evaluated. Prior to all circumcision procedures, 1.5 mg/kg of local anesthetic was subcutaneously administered to the penis root at 4-5 points from a 20 mL vial containing 400 mg (20 mg/mL) of prilocaine (2%).Results:Of the 2.431 patients included in the study, two (0.008%) developed methemoglobinemia requiring treatment. According to the medical records, five patients (0.021%) developed mild bruising on the hands, feet and sides of the lips.Conclusion:Prilocaine is more frequently encountered as a cause of acquired methemoglobinemia in newborns and children compared to adults. Determining the causative factor for methemoglobinemia and undertaking early and effective application of methylene blue or ascorbic acid can be life-saving

Intravesical Migration of Intrauterine Device: A Report of Cases of Total and Partial Migration

Intrauterine devices (IUD) are the commonly used long-acting, reversible and effective method of contraception. Migration of IUD into the bladder via uterine perforation is a very rare complication. In this paper, we aimed to present two different cases with different migration steps. In the first case, IUD was petrified and completely migrated into the bladder wall; in the second case, IUD was hanged on to the bladder wall

Comparison of Efficacy and Complications of Holmium Laser and Pneumatic Lithotripters Used in the Ureterorenoscopic Treatment of Proximal Ureter Stones, a Multi-Center Study of Society of Urological Surgery Aegean Study Group

Objective:The aim of this study is to compare the efficacy and complications of holmium laser and pneumatic lithotripsy used in the ureterorenoscopic treatment of proximal ureteral stones.Materials and Methods:Data of 638 patients, who underwent ureterorenoscopy (URS) due to proximal ureteral stones in different centers, were obtained from patient files. The patients were divided into two groups according to the type of lithotripter used: group 1; laser lithotripter (n=324; 50.8%) and group 2; pneumatic lithotripter (n=314; 49.2%). URS was considered successful upon determination stone-free status with the imaging methods after treatment. The effectiveness and the complications of holmium:yttrium-aluminum-garnet laser and pneumatic lithotripsy were compared.Results:The total success rate of URS was 82.6% and the complication rate was 8.1%. The mean age of patients was similar between the groups; however, the body mass index values, stone surface area and stone Hounsfield unit were significantly higher in group 1. Although the mean operative time, complication rate and the mean length of hospital stay were similar between the groups; the URS success and postoperative ureteral J stent use rates were significantly higher in group 1 and the push-back rate was significantly higher in group 2.Conclusion:If laser lithotripsy is available in a clinic, we believe that it is better to use it as the first option in the treatment of proximal ureter stones. However, considering that it is not easy to access laser lithotripters due to their high cost in Turkey, pneumatic lithotripters may be an effective and inexpensive alternative that can also be safely used in these cases

Effect of the Anesthetic Method on the Outcomes of Ureteroscopy for Proximal Ureteral Stones: A Multi-center Study of the Society of Urological Surgery Aegean Study Group

Objective:To analyze the effect of the anesthesia method (spinal and general) on the outcome of ureteroscopy (URS) in patients treated for proximal ureteral stones.Materials and Methods:Patients, who underwent URS for proximal ureteral stones at various urology clinics in Turkiye, were included in the study. The patients were divided into two groups according to the anesthesia method performed; the procedure was performed under spinal anesthesia (SA) in group 1 and general anesthesia (GA) in group 2. Patients’ demographic, perioperative data and complication rates were compared between the two groups in a retrospective manner.Results:There were 309 and 329 patients in groups 1 and 2, respectively. The mean stone area and Hounsfield unit in GA group were higher (p0.05). The rate of success of URS, which is accepted as complete stone-free status, was higher in the SA group (p=0.041).Conclusion:URS, which is used in the treatment of proximal ureteral stones, has a high success rate, independent of the anesthesia method used. It is important to keep in mind the patient’s comorbidities prior to selecting the anesthesia method and that the stone area and the Hounsfield unit are the important factors affecting the outcomes

The efficacy of cinacalcet in the treatment of hyperparathyroidism in Turkish hemodialysis patient population

WOS: 000393291900012OBJECTIVE: Cinacalcet reduces parathyroid hormone levels by increasing the sensitivity of the parathyroid gland to calcium. in this study, we firstly aimed to evaluate the efficacy of cinacalcet in Turkish hemodialysis patients. MATERIAL and METHODS: 4483 hemodialysis patients were screened and 469 patients who had used cinacalcet were included in the study. the patients were divided into 4 groups according to drug usage durations (Group 1: 3 months, Group 2: 6 months, Group 3: 9 months and Group 4: 12 months). the patients' Parathormone, Ca, P and CaxP levels at the 3rd, 6th, 9th and 12th months were compared to the start of treatment and previous months. RESULTS: the levels of Parathormone, Ca, P and CaxP significantly decreased compared to their initial levels in all groups (from 1412 pg/ml to 1222 pg/mL for Parathormone, p< 0,001) in the 3rd month. However, this reduction was not continued in the subsequent months (Parathormone: 1381 pg/ml for the 12th month). CONCLUSION: Cinacalcet may not provide adequate benefit in control of hyperparathyroidism in Turkish hemodialysis patient population

Bazı ıslatılmış sebze tohumlarının ekim tekniği üzerine bir araştırma

Bu tezin, veri tabanı üzerinden yayınlanma izni bulunmamaktadır. Yayınlanma izni olmayan tezlerin basılı kopyalarına Üniversite kütüphaneniz aracılığıyla (TÜBESS üzerinden) erişebilirsiniz.IX ABSTRACT Fluid drilling as an alternative to conventional drilling provides high emergence and early-rising.. On the other hand there are some difficulties associated with fluid drilling. Those difficulties are mainly related to the preparation of gel and seed mixture and some economical problems. To avoid these problems, a drilling technique that uses the seeds soaked in water and provides high field and simultaneous emergence just like fluid drilling was developed. In this study, the seeder developed was a hydro-pneumatic one in order to meet the requirements mentioned above. Some experiments were carried out in the laboratory to determine the appropriateness of the seeder. For the experiments, a sticky belt that allows the simulation of field conditions was used in the laboratory. During the experiments, vacuum and blowing pressures, seed- water concentration, working speed and the frequency of seed release, and the inclination effects were determined. The results obtained from the study indicated that at 60 mbar vacuum and 40 mbar blowing pressures for pepper and 60 mbar vacuum and blowing pressures are the suitable pressure levels. At 34% emergence level and 9 cm seed spacing, the concentration of 1750 ml water and 200 gr. seed and 1.0 m/s working speed and no inclination were found to be optimum conditions for a successful drilling.VIII ABSTRACT Klasik kuru tohum ekim yöntemine alternatif olarak geliştirilen jelle ekim yönteminde, erkencilik ve yüksek tarla filiz çıkış derecesi sağlanabilmektedir. Fakat, jel ve tohum-jel karışımı hazırlanmasında uygulama zorluğu ve ekonomik yönden birtakım sakıncalar olabilir. Bundan kaçınmak ve jelle ekimde olduğu gibi tohumlardan, erken, yüksek tarla filiz çıkış dereceli ve bunlarla birlikte eş zamanlı bir çıkış sağlanması için, su aldırılarak suda şişirilmiş ve böylece çimlenmeye ümitlenmiş tohum ekim yöntemi geliştirilmiştir. Bu çalışmada yukarıda belirtilen amaçlara uygun ekim yapabilecek bir hidro- pnomatik ekici düzen geliştirilmiştir. Islatılmış biber ve domates tohumlarıyla laboratuarda, yapışkan bant üzerine ekim denemeleri yapılmıştır. Denemelerde emme ve üfleme basıncı değerleri, su-tohum konsantrasyon oram, ilerleme hızı, dane atım frekansı, eğimden etkilenme derecesi, ve sıra üzeri tohum dağılım düzgünlüğü değerleri belirlenmeye çalışılmıştır. Denemeler sonucunda; geliştirilen hidro-pnomatik ekici düzenin; biber tohumlarında 60 mbar emme ~ 40 mbar üfleme, domates tohumlarında 60 mbar emme ~ 60 mbar üfleme basıncında, %34 T.F.Ç.D. ve 150 cm sura arası mesafe için Z=9 cm sıra üzeri ekim mesafesi, 1750 ml su ~ 200 g. tohum konsantrasyon oranı, düzde (%0 eğim derecesi) ve 1.0 m/s. ilerleme hızında başarılı bulunmuştu

How Much Do Chronic Diseases Affect Absenteeism?

Bu çalışmanın amacı kronik hastalıkların ve sosyo-demografik faktörlerin işe devamsızlık üzerindeki etkilerini belirlemektir. Kronik hastalığa ait verilerin ve sosyo-demografik değişkenlerin devamsızlığı etkileme derecesini tespit etmek için üç model kurulmuştur. Modellerin analizinde Binary Logit Regresyon analizi kullanılmıştır. Analizde kullanılan değişkenler 2016 yılına ait “TÜİK Sağlık Araştırması” mikro veri setinden elde edilmiştir. Kişide kroner kalp hastalığının varlığı, inme-felç hastalığı, bel ve boyun bölgesi problemleri, alerji ve böbrek hastalığının işe devamsızlığı arttırdığı belirlenmiştir. Araştırma sonuçlarına göre kronik hastalıkların ve sosyo-demografik değişkenlerin hastalık devamsızlığında etkili olduğu belirlenmiştir.The aim of this study is to determine the effects of chronic diseases and socio-demographic factors on sickness absenteeism.Three models are to established to determine the degree of influence of chronic disease and socio-demographic variableson absenteeism. Binary Logit Regression analysis is used for the analysis of the models. Micro data set of “Turkish StatisticalInstitute” Health Survey in 2016 is used. Coronary chronic heart disease, stroke, back diseases, neck diseases, allergy, liverfailure, kidney disease and depression were determined positively affecting absenteeism. According to the results of thestudy, chronic diseases and socio-demographic variables are found to be effective in sickness absenteeism

KRONİK HASTALIKLARIN VE ÇEŞİTLİ DEMOGRAFİK FAKTÖRLERİN HASTALIĞA BAĞLI DEVAMSIZLIĞA ETKİSİ

Bu çalışmanın amacı, kronik hastalıkların ve çeşitli demografik faktörlerin hastalığa bağlı işe gidilemeyen gün sayısını (işteki devamsızlığı) etkileme derecesini tespit etmektir. 2016 “TÜİK Sağlık Araştırması” verileri ile üç model kurgulanmıştır. On üç kronik hastalığa ait verilerin ve sosyo demografik faktörlerin işe gidilemeyen gün sayısını etkileme derecesini tespit etmek için Kantil Regresyon analizi gerçekleştirilmiştir. Kroner kalp hastalığının, inme, karaciğer yetmezliği ve depresyonun araştırma kapsamında kurulan her üç modelde devamsızlığı etkileyen kronik hastalık grupları arasında olduğu belirlenmiştir. Bunun yanında ağrının hayatı engelleme durumu arttıkça devamsızlık süresinin arttığına yönelik ilişki tespit edilmiştir. Eğitim düzeylerinin orta kantil düzeylerinde devamsızlığı azaltıcı etkisi bulunmakta iken, gelir düzeylerindeki ve yaştaki artış orta ve üst kantillerde devamsızlığı arttırdığı görülmektedir. Yürüme değişkenin ise orta düzey kantilde devamsızlığı azaltıcı etkisi bulunduğu anlaşılmaktadır. Çalışma şeklinin yarı zamanlı olmasının da devamsızlığı azalttığı belirlenmiştir (p<0,05). Çalışma sonuçlarına göre, kronik hastalıkların doğrudan maliyetler yanında hastalığa bağlı iş günü kayıplarıyla da dolaylı maliyetleri arttırdığı tespit edilmiştir. Karar vericiler özellikle işe bağlı devamsızlığı azaltmak için kroner kalp hastalığı, inme, depresyon ve karaciğer yetmezliği hastalıklarını önleme çalışmalarına öncelik vermelidir. Ağrı yönetimi her sağlık kurumunda planlanmalıdır. Son olarak yürüyüşün hastalığa bağlı devamsızlığı azalttığı desteklenmelidir. Hareketli yaşam tarzını destekleyen sağlığı geliştirme programlarına politika yapıcılar tarafından kaynak aktarılmalıdır.The aim of this study is to determine the effects of chronic diseases and socio-demographic factors on the number of non-working days (absenteeism). In the analysis, micro data set of “Turkish Statistical Institute” Health Survey in 2016 is used and three models were established. Quantile Regression analysis method was used to determine the data on thirteen chronic diseases and socio-demographic factors affecting the number of non-working days. It was determined that coronary heart disease, stroke, liver failure and depression were among the chronic disease groups affecting absenteeism in all three models established within the scope of the research. In addition, the relationship between the middle and upper quantile levels was determined to increase the duration of absenteeism as the hindering life of pain increases. While education levels have the effect of decreasing absenteeism in the middle quantile levels, the increase in income levels and age seems to increase absenteeism in the middle and upper quantiles. It is understood that the walking variable has the effect of reducing absenteeism in the mid-level quantile. It is seen that the part-time working style has a negative and significant effect on absenteeism (p<0,05). According to the results of the study, it has been determined that chronic diseases increase the indirect costs with the work-related non-working days due to the disease as well as direct costs. Decision makers should prioritize efforts to prevent coronary heart disease, stroke, depression and liver failure, especially to reduce sickness absenteeism. Pain management should be planned in every health institution. Finally, walking should be supported since it reduces disease-related absenteeism. Resources should be transferred to health promotion programs that support a mobile lifestyle by policy makers

Intravesical Migration of Intrauterine Device: A Report of Cases of Total and Partial Migration

Intrauterine devices (IUD) are the commonly used long-acting, reversible and effective method of contraception. Migration of IUD into the bladder via uterine perforation is a very rare complication. In this paper, we aimed to present two different cases with different migration steps. In the first case, IUD was petrified and completely migrated into the bladder wall; in the second case, IUD was hanged on to the bladder wall