Anestezi Polikliniğine Ameliyat İçin Başvuran Hastalardaki Tiroid Bozukluklarının Spektrumu vePrevalansı

Amaç: Gelişebilecek komplikasyonlar nedeniyle tiroid disfonksiyonu olan hastaların anestezi yaklaşımı ve ameliyatı önemlidir. Çalışmada tiroid bozukluk prevalansını, tiroid fonksiyon testlerinin peroperatif dönemde anestezi bakımından öneminin belirlenmesini ve rutin olarak çalışılmasının gerekliliğini değerlendirmeyi amaçladık. Yöntemler: 2011-2013 yılları arasında ameliyat için başvuran 10.600 hasta taranarak kayıt edildi. Aşikâr hipotiroidi serbest tiroksin (sT4) 0,7 ng dL-1 ve tiroid stimulant hormon (TSH) 4 mIU mL-1 olarak, subklinik hipotiroidi ise serbest hormon düzeyleri normal iken TSH4 mIU mL-1 olarak tanımlandı. Aşikar hipertiroidi sT41,7 ng dL-1 ve TSH0,1 mIU mL-1 olarak, subklinik hipertiroidi ise serbest hormon düzeyleri normalken TSH0,1 mIU mL-1 olarak tanımlandı. Verilerin analizi SPSS (Statistical Package for Social Sciences) 17,0 istatistik paket programı kullanılarak yapıldı. Gruplar arasında fark olup olmadığını karşılaştırmak için Independent Samples t testi (bağımsız gruplarda t testi) ve One-Way ANOVA (Varyans Analizi) Testi kullanıldı. Bulgular: Araştırmaya katılanların; %8,5'inde hipotiroidi, %2,5'inde hipertiroidi olduğu, %3,5'ine tedavi uygulandığı ve %2,5'inin ertelendiği bulundu. Kadın hastaların hipotiroidi olma oranlarının istatistiksel olarak erkeklerden daha yüksek olduğu fakat hipertiroidi bakımından fark olmadığı saptandı. Sonuç: Bölgesel faktörlerden dolayı tiroid fonksiyon testlerinin (TFT) çalışılmasının önemli olduğu düşüncesindeyiz. Fakat maliyetler göz önünde bulundurulduğunda, yaş arttıkça tiroid disfonksiyon riskinin artması nedeniyle, muayane bulguları normal olan genç hastalar için TFT'nin rutin olarak çalışılmasının mutlak gereksinim olmadığı kanısına vardık.Objective: An anaesthetic approach and surgery are important treatment strategies in patients with thyroid dysfunction due to potential complications. We investigated the prevalence of thyroid disorders, the significance of thyroid function tests (TFTs) with respect to anaesthesia in the preoperative period and the need for routine examinations. Methods: A total of 10,600 patients who were admitted to the anaesthesiology outpatient clinic for surgery were retrospectively screened and enrolled between 2011 and 2013. Evident hypothyroidism was defined as free tetra-iodothyronine (fT4) 4 mIU mL-1, and subclinical hypothyroidism was defined as TSH >4 mIU mL-1 with normal free hormone levels. Evident hyperthyroidism was defined as fT4 >1.7 ng dL-1 and TSH <0.1 mIU mL-1, and subclinical hyperthyroidism was defined as TSH <0.1 mIU mL-1 with normal free hormone levels. Statistical analysis was conducted using the Statistical Package for the Social Sciences (SPSS) version 17.0. Independent samples t-test and one-way analysis of variance were used to compare the difference between groups. Results: Of the participants, 8.5% were found to have hypothyroidism, 2.5% had hyperthyroidism, 3.5% received treatment and 2.5% had their treatment postponed. The likelihood of hypothyroidism was greater among females, and no difference was found between genders with respect to hyperthyroidism. Conclusion: We believe that TFTs are important because of regional factors. However, given the high cost of TFTs and because thyroid dysfunction risk increases with age, we concluded that routine TFTs in young patients with normal physical examination findings are not mandatory

Spectrum and prevalence of thyroid disorders in patients admitted to the anaesthesiology outpatient clinic for surgery

WOS: 000370844000005PubMed: 27366505Objective: An anaesthetic approach and surgery are important treatment strategies in patients with thyroid dysfunction due to potential complications. We investigated the prevalence of thyroid disorders, the significance of thyroid function tests (TFTs) with respect to anaesthesia in the preoperative period and the need for routine examinations. Methods: A total of 10,600 patients who were admitted to the anaesthesiology outpatient clinic for surgery were retrospectively screened and enrolled between 2011 and 2013. Evident hypothyroidism was defined as free tetra-iodothyronine (fT4) 4 mIU mL(-1), and subclinical hypothyroidism was defined as TSH > 4 mIU mL(-1) with normal free hormone levels. Evident hyperthyroidism was defined as fT4 > 1.7 ng dL(-1) and TSH < 0.1 mIU mL(-1), and subclinical hyperthyroidism was defined as TSH < 0.1 mIU mL(-1) with normal free hormone levels. Statistical analysis was conducted using the Statistical Package for the Social Sciences (SPSS) version 17.0. Independent samples t-test and one-way analysis of variance were used to compare the difference between groups. Results: Of the participants, 8.5% were found to have hypothyroidism, 2.5% had hyperthyroidism, 3.5% received treatment and 2.5% had their treatment postponed. The likelihood of hypothyroidism was greater among females, and no difference was found between genders with respect to hyperthyroidism. Conclusion: We believe that TFTs are important because of regional factors. However, given the high cost of TFTs and because thyroid dysfunction risk increases with age, we concluded that routine TFTs in young patients with normal physical examination findings are not mandatory

Overseas Experience and Requests in Intensive Care Doctors

Objective: To evaluate the overseas experiences of our intensive care unit doctors and to determine out the reasons for our doctors who couldnot go and what support they wanted. Materials and Methods: The created questionnaire was delivered to the doctors via the internet. The survey consisted of three main parts. They were asked in the first part, sociodemographic characteristics; in the second part, how long they went abroad, how they choose the center, from whom they received support; in the third part, the reasons why our physicians who donot have been abroad experienced could not go, on which subject/center they want to gain professional experience, and how to get support in this regard. Results: 31.4% of the 156 participants had professional abroad experience. 55% of those who went stated that they found the center with their own efforts, and very few (13 people, 26%) stated that they received support from the education/administrative unit of the institution they worked during the admission. In academically titled physicians, the level of foreign language and the importance given to education abroad were quite high. It was determined that the frequency of reading articles was correlated only with the duration of the profession. The most common reasons for physicians who couldnot get a chance to go was not being able to find a clinic/scholarship program to go to/not being informed (63.5%) and high accommodation/living fees (48.4%). Conclusion: Professional overseas experience has a high contribution to our physicians and our health system. The biggest obstacle for our physicians who cannot attend is not being able to find a center/clinic to go to. We think that the institutions/associations to which they are affiliated can support this issue

Vaccination status of COVID-19 patients followed up in the ICU in a country with heterologous vaccination policy: A multicenter national study in Turkey

Objective: Vaccination against severe acute respiratory syndrome coronavirus-2 (SARS-2) prevents the development of serious diseases has been shown in many studies. However, the effect of vaccination on outcomes in COVID-19 patients requiring intensive care is not clear. Methods: This is a retrospective multicenter study conducted in 17 intensive care unit (ICU) in Turkey between January 1, 2021, and December 31, 2021. Patients aged 18 years and older who were diagnosed with COVID-19 and followed in ICU were included in the study. Patients who have never been vaccinated and patients who have been vaccinated with a single dose were considered unvaccinated. Logistic regression models were fit for the two outcomes (28-day mortality and in-hospital mortality). Results: A total of 2968 patients were included final analysis. The most of patients followed in the ICU during the study period were unvaccinated (58.5%). Vaccinated patients were older, had higher Charlson comorbidity index (CCI), and had higher APACHE-2 scores than unvaccinated patients. Risk for 28-day mortality and in-hospital mortality was similar in across the year both vaccinated and unvaccinated patients. However, risk for in-hospital mortality and 28-day mortality was higher in the unvaccinated patients in quarter 4 adjusted for gender and CCI (OR: 1.45, 95% CI: 1.06–1.99 and OR: 1.42, 95% CI: 1.03–1.96, respectively) compared to the vaccinated group. Conclusion: Despite effective vaccination, fully vaccinated patients may be admitted to ICU because of disease severity. Unvaccinated patients were younger and had fewer comorbid conditions. Unvaccinated patients have an increased risk of 28-day mortality when adjusted for gender and CCI