30 research outputs found

    The Height Gain in Scoliotic Deformity Correction: Assessed by New Predictive Formula

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    Height gain after scoliosis correction is of a special interest for the patient and family. Ylikoski was the first to suggest a formula predicting height loss in untreated scoliotic patients. Stokes has recently suggested a new formula by using Cobb angle to determine height loss in idiopathic curves. We hypothesized that new additional variables to Cobb angle such as apical vertebral translation (AVT), number of instrumented segments (N), and disc heights may increase the accuracy of predicted height gain. According to our findings simple expression for height gain by simplified version of the formula is: SPΔH = 0.0059X1θ1 + 2.3(1 − (θ2/θ1))N, where θ1 is preoperative Cobb angle, X1 is preoperative AVT, θ2 is postoperative Cobb angle, and N is the number of instrumented vertebra. The purpose of this study is to analyze a new mathematical formula to predict height gain after scoliotic deformity correction

    Neonatal exchange transfusion: experience of a state hospital in ankara during a four year period

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    Bu çalısmada yenidogan döneminde hiperbilirubinemi nedeniyle kan degisimi (KD) uygulanan hastalarda etiyoloji, komplikasyon ve tedavinin yakın dönem sonuçlarının belirlenmesi amaçlanmıstır. Ocak 1998 ve Aralık 2001 tarihleri arasında S.B. Ankara Egitim ve Arastırma Hastanesi Pediatri 1 ve 2 Kliniklerinde hiperbilirubinemi nedeniyle takip edilen hastalar retrospektif olarak degerlendirildi. Dört yıllık sürede 1152 hastanın hiperbilirubinemi nedeniyle izlendigi ve bunlardan 79'unda 91 kan degisimi uygulandıgı belirlendi. Ortalama basvuru yası 4,1 ± 2,7 gündü. Olguların %36,7'sinde (n=29)ABO uygunsuzlugu , %6,3'ünde (n=5) Rh uygunsuzlugu mevcuttu ve %1,2'sinde hem ABO hem de Rh uygunsuzlugu mevcuttu. Kan degisimi öncesi ve sonrası bilirubin, kalsiyum,hemoglobin düzeyi ve trombosit sayıları arasında anlamlı fark bulunmaktadır. (p< 0,05) Kan degisimi uygulanan 45 hastada (%56,9) komplikasyon belirlenmistir. Komplikasyon olarak kardiyopulmoner arrest %1,2 (n=1); sepsis %2,5 (n=2); trombositopeni %25,3 (n=20); anemi %37,9 (n=30) ve hiperkalsemi %36,7 (n=29) olguda saptanmıstır. :Kan degisimi yenidoganın ciddi hiperbilirubinemisinin etkili tedavisinde halen altın standart olma özelligini korumaktadır.ABO uygunsuzlugunun daha hafif hastalık olusturdugu bilinmektedir, ancak serimizde % 36,7 hastada ABO uygunsuzlugu olan hastalara KD uygulandıgı saptandı. Bu çalısmada KD gerektiren en önemli nedeninABO uygunsuzlugu oldugu belirlendi. Fototerapiye ragmen geç getirilen veya çok yüksek total bilirubin düzeyi ile basvuran hastalarda KD komplikasyon riski kern ikterus gelisme riskinden düsük oldugu sürece KD geciktirilmemelidir. Günümüzde KD pratigi giderek azaldıgından komplikasyonları en aza indirmek için deneyimli merkezlerde uygulanmalıdır. Antenatal dönemde tüm gebeler ve eslerinde kan grupları, Rh ve ABO uygunsuzlugu riski önceden belirlenmeli ve dogumun saglık personeli gözetiminde gerçeklesmesi saglanmalıdır.We aimed to determine the etiology, complications and treatment outcome of patients who underwent exchange transfusion (ET) for neonatal hyperbilirubinemia in our hospital. This retrospective study was performed at Ankara State Hospital between January 1998 and December 2001. Among 1152 patients admitted for hyperbilirubinemia 91 exchange transfusions which were performed on 79 (6.86%) neonates were evaluated. Mean age at admission was 4.1 2.7 days.ABOincompatibility was detected in 29 (36.7 %) cases andRh incompatibility in 5 (6.3%) cases and one case had bothABO and Rh incompatibility. Hemoglobin (Hb), calcium, bilirubin and platelet count before and after ET showed statistically significant difference(p<0.05). Exchange transfusion complications occurred in 45 neonates (56.9%). These were: anaemia n=30 (37.9%); hypercalcemia n=29 (36.7%); thrombocytopenia n=20 (25.3%) sepsis n=2 (2.5%); cardiopulmonary arrest n=1 (1.2%) ET is still the gold standard for treatment of severe neonatal hyperbilirubinemia. In our seriesABO incompatibility was found to be the most common cause of neonatal jaundice. The morbidity caused by ET is high; therefore it should be performed in clinics which were responding to these complications of ET. When the risks of hyperbilirubinemia overweigh ET complications, ET must not be delayed. All pregnancies must be investigated forABOincompatibility during the prenatal period and labour must take place in a medical centre

    Girişimsel tedavi uygulanan baş ağrılarında pupil çapının değerlendirilmesi

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    MakaleWOS:000940895500004PubMed ID: 36625194Objectives: Pain is a subjective experience. Besides, sensory, affective and behavioral responses, and autonomic response are part of pain response to noxious stimuli. Evaluation of pupil diameter by pupillometry has been used as an alternative method for pain assessment. In algologic procedures like interventional headache management have not been addressed in the literature. Herein, we investigated changes in pupil diameter during interventional headache management as an objective method for pain assessment. Methods: Demographic data of the patients were collected before the bilateral major occipital nerve blockage (MONB) pro-cedure. Numeric rating score (NRS) and pupil diameter measurements by pupillometer were recorded before MONB. Standard MONB procedure was applied to all patients. Pain assessment and pupillary diameter measurements were obtained after nerve blockage. Results: Twenty-eight patients were included in this study. Mean age was 41.03 +/- 12.63 years. There is no difference between the hemodynamic parameters before and after the procedure. Post-procedure NRS and pupil diameter values were signifi-cantly lower than pre-procedure values. There was a positive correlation between changes in NRS scores and changes in the right and left pupil diameters. Conclusion: There was a significant correlation between NRS score and pupil diameter in patients who underwent MONB. Monitoring of pupil diameter can be used for pain assessment during headache treatment. Evaluation of pupil diameter is a new approach in pain palliation. Future research is needed to study the effect of other parameters, that is, gender, age, origin of pain, acute, and chronic pain on pupil diameter and to evaluate its application in different algological procedures.Amaç: Ağrı, öznel bir deneyimdir. Duyusal, duygusal ve davranışsal tepkilerin yanı sıra otonomik tepki, ağrılı uyaranlara verilen tepkinin bir parçasıdır. Pupil çapının pupillometre ile değerlendirilmesi, ağrı değerlendirmesi için alternatif bir yöntem olarak kullanıldı. Bu çalışmada, girişimsel baş ağrısı yönetimi sırasında ağrı değerlendirmesi için pupil çapındaki değişiklikler araştırıldı. Gereç ve Yöntem: Bilateral majör oksipital sinir blokajı (MONB) işlemi öncesi hastaların demografik verileri toplandı. Numerik derecelendirme puanı (NRS) ve pupillometre ile göz bebeği çapı ölçümleri, MONB’den önce kaydedildi. Tüm hastalara standart MONB prosedürü uygulandı. Sinir blokajı sonrası ağrı değerlendirmesi ve pupil çapı ölçümleri alındı. Bulgular: Çalışmaya 28 hasta dahil edildi. Hastaların yaş ortalaması 41,03 +/- 12,63 yıl idi. İşlem öncesi ve sonrası hemodinamik parametreler arasında fark yoktu. İşlem sonrası NRS ve göz bebeği çapı değerleri işlem öncesi değerlerden önemli ölçüde düşüktü. NRS puanlarındaki değişiklikler ile sağ ve sol göz bebeği çaplarındaki değişiklikler arasında pozitif bir ilişki vardı. Sonuç: MONB uygulanan hastalarda NRS skoru ile göz bebeği çapı arasında anlamlı bir ilişki vardı. Baş ağrısı tedavisi sırasında ağrı değerlendirmesi için göz bebeği çapının izlenmesi kullanılabilir. Pupil çapının değerlendirilmesi ağrı palyasyonunda yeni bir yaklaşımdır. Cinsiyet, yaş, ağrının kaynağı, akut ve kronik ağrı gibi diğer parametrelerin göz bebeği çapı üzerindeki etkisini incelemek ve farklı algolojik prosedürlerde uygulanmasını değerlendirmek için gelecekteki araştırmalara ihtiyaç vardır

    Evaluation of Dynamic Postural Balance in Pediatric Familial Mediterranean Fever Patients

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    Aim:Familial Mediterranean Fever (FMF) is an autoinflammatory and chronic disorder. Colchicine has been prescribed to treat FMF since 1972. Balance is a complex function of the neuromuscular system. The aim of this study is to determine 1) if there is a connection between FMF and dynamic balance, 2) if colchicine use affects balance, and 3) if the disease severity score is related to a disruption in balance.Materials and Methods:The study examined 50 pediatric patients with FMF and 130 healthy age- and sex-matched children as control subjects. Dynamic postural stability was measured using the Biodex Stability System (BSS).Results:The stability indices were significantly higher in the FMF group than in the controls. There was no relationship between the FMF disease severity score and the three stability indices, while the colchicine dose was related to all three stability indices.Conclusion:By detecting any change in balance status early using a simple, safe, objective measurement of balance via the BSS in FMF patients, neuromyopathy could be identified earlier and unwanted outcomes prevented

    The effect of post-wildfire management practices on vegetation recovery: Insights from the Sapadere fire, Antalya, Türkiye

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    Post-wildfire management actions mainly targeting the removal of salvage logs and burned trees is a common but controversial practice. Although it aims to regain some of the natural and economic value of a forest, it also requires disturbing burned areas, which may have some negative consequences affecting, for instance, the carbon cycle, soil erosion, and vegetation cover. Observations from different geographic settings contribute to this scientific debate, and yet, the spatiotemporal evolution of the post-fire road network developed as part of fire management practices and its influence on vegetation recovery has been rarely examined. Specifically, we still lack observations from Türkiye, though wildfires are a common event. This research examined the evolution of the vegetation cover in relation to post-fire road constructions and the resultant debris materials in areas affected by the 2017 Sapadere fire in Antalya, Türkiye. We used multi-sensor, multi-temporal optical satellite data and monitored the variation in both vegetation cover and road network from the pre-to post-fire periods between 2014 and 2021. Our results showed that fire management practices almost doubled the road network in the post-fire period, from 487 km to 900 km. Overall, 7% of the burned area was affected by these practices. As a result, vegetation cover in those areas shows only ∼50% recovery, whereas undisturbed areas exhibit ∼100% recovery 5 years after the event. Notably, such spatiotemporal analysis carried out for different burned areas would provide a better insight into the most suitable post-fire management practices. Our findings, in particular, show that the current practices need to be revisited as they cause a delay in vegetation recovery

    Juvenile idiopathic scoliosis treated with posterior arthrodesis and segmental pedicle screw instrumentation before the age of 9 years: a 5-year follow-up

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    <p>Abstract</p> <p>Study design</p> <p>Retrospective study.</p> <p>Objective</p> <p>To evaluate the radiological results of fusion with segmental pedicle screw fixation in juvenile idiopathic scoliosis with a minimum 5-year follow-up.</p> <p>Summary of background data</p> <p>Progression of spinal deformity after posterior instrumentation and fusion in immature patients has been reported by several authors. Segmental pedicle screw fixation has been shown to be effective in controlling both coronal and sagittal plane deformities. However, there is no long term study of fusion with segmental pedicle screw fixation in these group of patients.</p> <p>Methods</p> <p>Seven patients with juvenile idiopathic scoliosis treated by segmental pedicle screw fixation and fusion were analyzed. The average age of the patients was 7.4 years (range 5–9 years) at the time of the operation. All the patients were followed up 5 years or more (range 5–8 years) and were all Risser V at the most recent follow up. Three dimensional reconstruction of the radiographs was obtained and 3DStudio Max software was used for combining, evaluating and modifying the technical data derived from both 2d and 3d scan data.</p> <p>Results</p> <p>The preoperative thoracic curve of 56 ± 15° was corrected to 24 ± 17° (57% correction) at the latest follow-up. The lumbar curve of 43 ± 14° was corrected to 23 ± 6° (46% correction) at the latest follow-up. The preoperative thoracic kyphosis of 37 ± 13° and the lumbar lordosis of 33 ± 13° were changed to 27 ± 13° and 42 ± 21°, respectively at the latest follow-up. None of the patients showed coronal decompensation at the latest follow-up. Four patients had no evidence of crankshaft phenomenon. In two patients slight increase in Cobb angle at the instrumented segments with a significant increase in AVR suggesting crankshaft phenomenon was seen. One patient had a curve increase in both instrumented and non instrumented segments due to incorrect strategy.</p> <p>Conclusion</p> <p>In juvenile idiopathic curves of Risser 0 patients with open triradiate cartilages, routine combined anterior fusion to prevent crankshaft may not be warranted by posterior segmental pedicle screw instrumentation.</p

    Parents of pediatric patients anxiety level research in planned elective operation

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    Çalışmamızda operasyona girecek çocuk olguların ebeveynlerinde zaten var olmasını beklediğimiz anksiyetenin hangi faktörlerin etkisiyle arttığını saptamayı ve bu oluşan anksiyeteyi azaltmak için biz anestezistlerin neler yapabileceğimizi ortaya koymayı hedefledik Gereç ve Yöntem: Çalışma anestezi polikliniğinde elektif şartlarda genel anestezi altında cerrahi operasyon planlanan çocuk hastaların ebeveynlerinde uygulandı. 18-65 yaş arası 300 anne veya baba çalışmaya dahil edildi ve sosyodemografik özellikleri kaydedilip, Durumluk-Süreklilik Kaygı Ölçegi (STAI-I,STAİ-II), Amsterdam Preoperatif Anksiyete ve İnformasyon Skalası (APAİS) uygulandı. Bulgular: Çalışmaya dahil edilen 300 gönüllünün yaş ortalaması 33,26 ±7,09 yıl idi. Kadınlarda, gelir seviyesi düşük olanlarda, sosyal güvencesi olmayanlarda anksiyete seviyesi bulundu (p<0,05). Eğitim seviyesinin yüksek olmasının anksiyeteyi azalttığı görüldü ( p<0,05). Sonuç: Preoperatif anksiyeteyi artıran faktörler arasında düzeltilebilir nedenler bulunmaktadır. Bireysel ve toplumsal planlamalar ile perioperatif anksiyete azaltılabilir. Anahtar Kelimeler: Preoperatif anksiyete, ebeveyn anksiyetesi, Durumluk-Süreklilik Kaygı Ölçegi (STAI), Amsterdam Preoperatif Anksiyete ve İnformasyon Skalası (APAIS)In our study, we aimed to determine what the anxiety of the parents of the children who are going to the operation would increase with the influence of the factors, and to reveal what we can do anesthesiologists to reduce this anxiety. Material and Methods: The study was applied to the parents of children who go into elective surgery with general anesthesia, at the anesthesia outpatient clinic.300 mothers or fathers aged 18-65 years were included in the study and their socio-demographic characteristics were recorded and the State-Trait Anxiety Scale (STAI-I, STAI-II), Amsterdam Preoperative Anxiety and Information Scale (APAIS) were administered. Results: The average age of the 300 volunteers included in the study was 33.26 ± 7.09 years. Anxiety was high level in females, low-income parents and non-health insurance parents (p <0.05). It was observed that high education level decreased anxiety (p <0.05). Conclusions: Among the factors that increase preoperative anxiety are correctable causes. Individual and social planning can reduce perioperative anxiety. Key Words: Pre-operative Anxiety, Parental Anxiety, State-Trait Anxiety Inventory (STAI), Amsterdam Preoperative Anxiety and Information Scale (APAIS

    Demir Eksikliği Anemisi Bulunan Çocuklarda Demir Yerine Koyma Tedavisinin İştah Üzerine Etkisi

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    Amaç: Demir eksikliği anemisi (DEA) en sık ve önlenebilir mikrositik anemi sebebidir. Çocuk ve gebeler DEA’den en çok etkilenen hasta grubudur. DEA’nin önemli bulgularından biri iştahsızlıktır. Demir desteği yapılan demir eksikliği anemili çocuklarda iştahın düzelmesi ile ilgili sonuçlar ise çelişkilidir. Bu araştırmada demir tedavisi ile iştahın nasıl değiştiğinin belirlenmesi amaçlanmıştırGereç ve Yöntem: Ocak 2013-Mayıs 2014 tarihleri arasında Gaziosmanpaşa Üniversitesi Tıp Fakültesi Çocuk Sağlığı ve Hastalıkları Polikliniğine gelen 1-18 yaş arası demir eksikliği anemisi tanısı almış başka kronik hastalığı bulunmayan 106 çocuk çalışma grubuna dâhil edildi. Demir eksikliği anemisi olan çocuklarda tedavi öncesi ve sonrası yeme davranışları ÇYDA (Çocuklarda Yeme Davranışı Anketi) kullanarak belirlendi.Bulgular: Demir tedavisi öncesi grubun beslenme eğilimlerine bakıldığında en yüksek skorun; içme tutkusu, tokluk heveslisi ve gıdadan keyif alma davranışlarında; en düşük skorun ise duygusal aşırı yeme davranışında olduğu gözlenmekteydi. Demir tedavisi sonrasında; negatif iştah tutumlarından olan tokluk heveslisi ve yavaş yeme dışında tüm alt boyutlarda artan skor gözlenmekteyken en yüksek skor gıdadan keyif alma ve içme tutkusu grubunda gözlendi. Tedavi sonrası pozitif iştah tutumlarında cinsiyet farkı olmaksızın artan skorlar tespit edildi. Tartışma: Bu bulgular; demir eksikliği anemisinde demir replasman tedavisinin çocukların iştahında pozitif bir etki oluşturduğunu göstermektedir

    Measurement of hydroxyproline and nitric oxide, and comparison of sac fluid acidity in different inguinal pathologies

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    Purpose: To compare hydroxyproline and nitric oxide levels, and fluid acidity between sac tissues from inguinal hernia, hydrocele and undescended testis patients. Material and method: Thirty patients were in the inguinal hernia group, 11 patients in the hydrocele group and 5 patients in the undescended testis with inguinal hernia group. Intrasaccular fluid acidity, and nitric oxide and hydroxyproline levels in sac tissues were measured and analyzed statistically between groups. Results: Intrasaccular fluid could be obtained from 24 inguinal hernia and 6 hydrocele patients. Acidity level (pH) was 7.5 +/- 0.74 in the hernia group and 7.86 +/- 0.63 in the hydrocele group (p 0.05). Conclusion: Hydroxyproline and nitric oxide pathways do not seem to be responsible for the different characteristics of inguinal diseases. However, differences in the acidity of sac fluid may be evidence of the different mechanisms of hernia and hydrocele formation. (C) 2013 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.Scientific Research Projects Unit of Gaziosmanpasa University, Tokat, TurkeyGaziosmanpasa UniversityThis study is funded by the Scientific Research Projects Unit of Gaziosmanpasa University, Tokat, Turkey

    Noonan Syndrome and anesthesia management

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    Noonan sendromu (NS) otozomal dominant geçiş gösterebilen veya sporadik olarak ortaya çıkabilen, 1:1000-1:2000 insidanslıbir hastalıktır. Sendroma konjenital kardiyak anomaliler, böbrek malformasyonları ve lenfatik sistem patolojileri, puberte gecikmesi,işitme kaybı, kanama diyatezi ve orta derecede mental retardasyon da eşlik edebilir. Preoperatif değerlendirmenin çok önemliolduğu bu hastalarda, hem havayolu yönetimi açısından hem de hemodinamik ve metabolik açıdan gerekli önlemleri alabilmekiçin hastalığın seyri iyi sorgulanmalıdır. Bu olgu bildiriminde, kısa süreli bir müdahale olan dakriosistorinostomi (DSR) operasyonuiçin genel anestezi planlanan hastada laringeal maske (LMA) uygulamasını sunmak ve NS'nu tartışmak istedik.Noonan syndrome (NS) is a 1:1000-1:2000 incidence disease which can have the characteristics of an autosomal dominantinheritance or emerge as sporadic. This disease can also be accompanied with congenital cardiac abnormalities, kidneymalformations, hearing loss, bleeding diathesis and moderate mental retardation. The course of disease should be highlyinvestigated on the patients, whose preoperative evaluation is crucial. This is extremely important in order to take precautionsboth for airway management and for hemodynamical and metabolic reasons. In this case statement we aimed to discuss Noonansyndrome and present laryngeal mask (LMA) practice on a patient who is planned general anesthesia for dacryocystorhrnostomy(DSR) operation which is considered as a short-time intervention
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