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Entübasyon & Kollaps İlişkisi: Kritik Hastada Güvenli Entübasyon İpuçları
Pub Date : 2023-07-11 DOI: 10.38175/phnx.1292091
Serdar Özdemir
Trakeal entübasyon, kritik hastalarda en sık uygulanan prosedürler arasındadır. Trakeal entübasyonun majör komplikasyon riskini arttıran farklı değişkenler tanımlanmıştır. Kritik hastada yapılan trakeal entübasyonların entübasyon ilişkili kardiyak arrest ve entübasyon ilişkili hipotansiyon bildirilen majör komplikasyonlardır. Mevcut literatür ışığında endotrakeal entübasyon öncesi hipotansiyon entübasyon ilişkili vasküler kollaps için en önemli risk faktörüdür. Bolus sıvı veya inotrop uygulamasını önermek için yeterli literatür henüz yoktur ve mevcut çalışmaların çok fazla kısıtlılığı mevcuttur. Klinisyenler ve araştırmacılar bu alanda daha fazla araştırma yapmak için cesaretlendirilmelidirler.
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引用次数: 0
Akut Miyokard Infarktüslü Hastalarda Hemogram, Biyokimya, İnflamatuar Belirteçler ve Elektrolit Düzeylerinin Değerlendirilmesi
Pub Date : 2023-05-26 DOI: 10.38175/phnx.1297449
Muhammed Semih Gedi̇k, Kemal Göçer
Aim: Hemogram, biochemistry, serum electrolyte, and inflammatory marker levels are altered in patients with acute myocardial infarction. When diagnosing and monitoring patients with acute myocardial infarction using cardiac-specific biomarkers, the levels of these markers should also be under control. We looked into the diagnostic and therapeutic value of hemogram, biochemistry, inflammatory markers, and electrolyte levels in acute myocardial infarction patients. Material Method: It is a descriptive epidemiological study. Within the scope of the study, all patients aged 18 years and over and diagnosed with acute myocardial infarction in the Emergency Department and Cardiology Department of Kahramanmaraş Sütçü İmam University Faculty of Medicine Hospital between 01.01.2020 - 31.07.2022 were included retrospectively. Hemogram, biochemistry, serum electrolyte and inflammatory marker levels were investigated in acute myocardial infarction patients. Results: Leukocyte, neutrophil, procalcitonin and C-reactive protein values were significantly higher in patients with acute myocardial infarction. Although platelet/lymphocyte ratios were high, no significance was found. In patients with acute myocardial infarction, glucose values measured at the time of stress were found to be high (hyperglycaemia). When we analysed the serum lactate levels of patients with acute myocardial infarction, it was found to be significantly higher. Conclusion: In patients with acute myocardial infarction, hemogram, biochemistry, serum electrolyte and inflammatory marker levels are altered. The levels of these markers should also be controlled during the diagnosis and follow-up of acute myocardial infarction patients with cardiac specific biomarkers. We believe that hemogram, biochemistry, inflammatory markers and electrolyte levels may contribute to the prediction of early serious complications in patients with acute myocardial infarction.
目的:急性心肌梗死患者的血象、生化、血清电解质和炎症标志物水平发生改变。在使用心脏特异性生物标志物诊断和监测急性心肌梗死患者时,也应控制这些标志物的水平。我们探讨了血象、生化、炎症标志物和电解质水平对急性心肌梗死的诊断和治疗价值。材料方法:采用描述性流行病学研究。在研究范围内,回顾性纳入了2020年1月1日至2022年7月31日期间在kahramanmaraki Sütçü İmam大学医学院医院急诊科和心内科诊断为急性心肌梗死的所有18岁及以上患者。对急性心肌梗死患者进行血象、生化、血清电解质及炎症标志物的检测。结果:急性心肌梗死患者白细胞、中性粒细胞、降钙素原和c反应蛋白水平明显升高。虽然血小板/淋巴细胞比值较高,但未发现显著性差异。在急性心肌梗死患者中,应激时测量的血糖值较高(高血糖)。当我们分析急性心肌梗死患者的血清乳酸水平时,发现它明显更高。结论:急性心肌梗死患者血象、生化、血清电解质及炎症标志物均发生改变。在诊断和随访具有心脏特异性生物标志物的急性心肌梗死患者时,也应控制这些标志物的水平。我们认为血象、生物化学、炎症标志物和电解质水平可能有助于预测急性心肌梗死患者的早期严重并发症。
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引用次数: 0
Acil Servise Başvuran Yaşlı Hastalarda Deliryum İçin Risk Faktörlerinin Belirlenmesi
Pub Date : 2023-05-25 DOI: 10.38175/phnx.1290770
Esra KABADAYI SAHIN, Serkan Şahi̇n
Objective: Delirium is reported as a common clinical state among elderly patients seeking care in the emergency departments (ED). However, it is commonly underdiagnosed in the ED. This study aimed to evaluate delirium prevalence and determine the risk factors for developing delirium in elderly patients in ED. Material and Methods: 238 patients over the age of 65 who applied to the ED were included. The patient group was screened for delirium by the emergency specialist using the 'Confusion assessment method (CAM)'. The patients were then evaluated for delirium by a psychiatrist according to DSM-5 criteria. Demographic data, vital signs, and laboratory findings of the patients were recorded. Results: Delirium is detected in 10.9% of the patients by using CAM and in 11.8% of the patients according to DSM-5 criteria. There was not any statistically significant difference between the groups with and without delirium in terms of age, gender, comorbid diseases, presence of dementia, and presence of polypharmacy. A positive correlation between mean arterial blood pressure (MABP) (r=0.373, p
目的:谵妄是在急诊科(ED)就诊的老年患者中常见的临床状态。然而,在急诊科中,谵妄通常被低估。本研究旨在评估谵妄的患病率,并确定老年急诊科患者发生谵妄的危险因素。材料和方法:纳入238例65岁以上的急诊科患者。患者组由急诊专家使用“混乱评估法(CAM)”筛选谵妄。然后由精神科医生根据DSM-5标准评估患者是否患有谵妄。记录患者的人口统计资料、生命体征和实验室检查结果。结果:采用CAM诊断谵妄的比例为10.9%,采用DSM-5诊断标准诊断谵妄的比例为11.8%。有无谵妄的两组在年龄、性别、合并症、痴呆的存在和多药的存在方面没有统计学上的显著差异。与平均动脉血压(MABP)呈正相关(r=0.373, p
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引用次数: 0
Protez eklem enfeksiyonlarında Mycobacterium tuberculosis'in yeri 结核分枝杆菌在假体关节感染中的作用
Pub Date : 2023-05-15 DOI: 10.38175/phnx.1251925
Mehmet KURT, Sevil ALKAN, Taylan ÖNDER, Esra GÜRBÜZ
Protez eklem enfeksiyonları tedavi maliyeti, morbidite ve hatta bazen mortaliteye sebep olan yönetimi zor enfeksiyonlardır. Bu enfeksiyonlarda etkenler sıklıkla gram pozitif bakteriler olsa da altta yatan immunsüpresyon gibi risk faktörleri olan kişilerde bazen çok farklı etkenler de tespit edilebilmektedir. Mycobacterium tuberculosis protez eklem enfeksiyonlarında nadir saptanan etkenlerden biridir. Bu enfeksiyon ortopedistlerin bu olguları yönetmesinde zorlukla sonuçlanabilir. Bu derleme çalışmasında, M. tuberculosis’a bağlı TB protez eklem enfeksiyonlarının tanı, tedavi ve sonuçlarını tanımlamak amacıyla bir literatür taraması gerçekleştirdik.
人工关节感染很难处理,会造成治疗费用、发病率,有时甚至会导致死亡。虽然这些感染的致病菌通常是革兰氏阳性菌,但有时在有潜在免疫抑制等危险因素的患者身上也能检测到非常不同的病原体。结核分枝杆菌是假体关节感染的罕见病原体之一。这种感染可能导致骨科医生在处理这些病例时遇到困难。在本综述研究中,我们对结核分枝杆菌引起的结核性假体关节感染的诊断、治疗和结果进行了文献综述。
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引用次数: 0
Helicobacter pylori enfeksiyonunun hematolojik belirtileri 幽门螺旋杆菌感染的血液学表现
Pub Date : 2023-05-11 DOI: 10.38175/phnx.1255049
Can ÖZLÜ, Sevil ALKAN, Tuba ERÜRKER ÖZTÜRK
Helicobacter pylori dünya çapında görülen bir bakteriyal enfeksiyona yol açar. Helicobacter pylori asemptomatik enfeksiyondan, peptik ülser, gastrit, gastrointestinal maligniteye kadar birçok hastalığa yol açar. Son yıllarda bu enfeksiyonun gastrointestinal tutulumlarının dışında birçok hastlalık etiyolojisinde de rol oynadığı bildirilmiştir. Hematolojik tutulumlar da bu tutulumlardandır. Bu derleme çalışmasında Helicobacter pylori enfeksiyonunun hematolojik belirtilerini literatür eşliğinde gözden geçirmeyi amaçladık.
幽门螺旋杆菌是一种全球性细菌感染。幽门螺杆菌可导致多种疾病,从无症状感染到消化性溃疡、胃炎和胃肠道恶性肿瘤。近年来,有报道称幽门螺杆菌感染在胃肠道受累以外的许多疾病的病因中也发挥了作用。血液病就是其中之一。在这项回顾性研究中,我们旨在根据文献回顾幽门螺杆菌感染的血液学表现。
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引用次数: 0
Dilemma of Lung Infection Associated with Acute Heart Failure 肺部感染与急性心力衰竭的困境
Pub Date : 2023-05-11 DOI: 10.38175/phnx.1247747
S. Özdemir, A. Özkan
Derginizin 2022 yılı ikinci sayısında yayınlanan Akça ve arkadaşları tarafından hazırlanan “Pandeminin Dilemması: İlaç Yan Etkisi mi? Ya COVID-19'sa?” isimli yazıyı büyük bir ilgi ile okuduk. Yazarlara ve editöriyel kurula klinik sorunu tartışan bu ilgi çekici yazıdan dolayı teşekkür ederiz (1). Biz de bu yazımızda pnömoni ve özellikle SARS-CoV-2 pnömonisi ile ayırt etmede klinisyenleri zorlayan bir diğer antite olan akut kalp yetmezliğine değinmek isteriz.
Akça 等人撰写的文章发表在贵刊 2022 年第二期上,题为 "大流行病的困境:药物副作用?我们感谢作者和编委会撰写了这篇讨论临床问题的有趣文章(1)。在本文中,我们想提及急性心力衰竭,这是临床医生在区分肺炎,尤其是 SARS-CoV-2 肺炎时面临的另一个难题。
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引用次数: 0
Carbon Monoxide Poisoning Associated Hyperlactatemia 一氧化碳中毒引起的高乳酸血症
Pub Date : 2023-03-28 DOI: 10.38175/phnx.1267524
A. Özkan, Burak Demirci
We read with great interest the article titled “TThe Role of SII and SIRI Values in Predicting the Severity of CO Poisoning in the Emergency Department” prepared by Acar and Ertekin, published in the first issue of 2023 of your journal. We thank the authors and the editorial board for the article discussing the relationship between the severity of CO poisoning and combined hematological indices such as systemic immune inflammation index, systemic inflammatory response index and systemic inflammation total index, which have been defined in the last decade in the literature in carbon monoxide (CO) poisoning. However, we would like to point out a few points that will contribute to the discussion of the article on the pathogenesis of hyperlactatemia and the hemodynamic impact in CO poisoning, which the authors used to describe severe poisoning.
我们非常感兴趣地阅读了由Acar和Ertekin撰写的题为《SII和SIRI值在预测急诊科CO中毒严重程度中的作用》的文章,该文章发表在您的期刊2023年第1期。我们感谢作者和编委会讨论一氧化碳中毒严重程度与近十年来在一氧化碳中毒文献中定义的全身免疫炎症指数、全身炎症反应指数和全身炎症总指数等综合血液学指标之间的关系。然而,我们想指出几点,这将有助于讨论高乳酸血症的发病机制和一氧化碳中毒的血流动力学影响,作者用一氧化碳中毒来描述严重中毒。
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引用次数: 0
COVID-19 Pandemisi Öncesi ve Döneminde Yoğun Bakım Ünitesinde Takip Edilen Hastaların Kan Kültürü İzolatlarının Tür Dağılımı ve Antibiyotik Duyarlılıklarının Değerlendirilmesi: Retrospektif, Tek Merkez Analizi
Pub Date : 2023-03-20 DOI: 10.38175/phnx.1222179
Kadir Arslan, A. Şahin
Introduction: This study aims to identify the microorganism species isolated from blood cultures of patients hospitalized in the ICU of a tertiary center before and during the COVID-19 pandemic and to investigate their antibiotic susceptibility. Material and Methods: Patients hospitalized in the ICU two years before and after the COVID-19 pandemic between March 15, 2019, and March 15, 2021, were divided into two groups, and their blood cultures were evaluated retrospectively. Isolated microorganisms and their antibiotic susceptibility were analyzed. Results: A total of 1282 patients' blood cultures were analyzed, and demographic data were similar between groups. Blood culture growth was detected in 39.6% (n=202) of the patients in the pre-pandemic period and 41% (n=317) in the pandemic period. Gram-positive bacteria were isolated in 71.3%, gram-negative bacteria in 21.6%, and Candida spp. in 7.1% of the population. Klebsiella spp. was significantly higher, and Enterococcus spp. was significantly lower in blood cultures during the pandemic. In the COVID-19 period, although not significant, a decrease in antibiotic susceptibility was detected for Staphylococcus aureus, Klebsiella spp., E.coli, Enterobacter spp. and Pseudomonas spp. There was a statistically significant decrease in susceptibility to teicoplanin and linezolid in coagulase-negative staphylococci (CNS). During the pandemic, 57.6% (n=172) of the patients were positive for COVID-19. In COVID-19-positive patients, while Candida spp. was significantly higher, no decrease in antifungal susceptibility was detected. Conclusion: During the pandemic, antibiotic susceptibility to gram-positive and gram-negative microorganisms decreased. Although there was a significant increase in Candida spp. rates in COVID-19-positive patients, there was no decrease in their antifungal susceptibility.
前言:本研究旨在鉴定2019冠状病毒病大流行前和期间某三级中心ICU住院患者血培养分离的微生物种类,并调查其抗生素敏感性。材料与方法:将2019年3月15日至2021年3月15日COVID-19大流行前后两年在ICU住院的患者分为两组,回顾性评价其血培养。对分离的微生物及其药敏进行了分析。结果:共分析1282例患者血培养,组间人口学数据相似。39.6% (n=202)的患者在大流行前检测到血培养物生长,41% (n=317)的患者在大流行期间检测到血培养物生长。革兰氏阳性菌占71.3%,革兰氏阴性菌占21.6%,念珠菌占7.1%。在大流行期间,克雷伯氏菌在血培养中显著升高,肠球菌在血培养中显著降低。在COVID-19期间,金黄色葡萄球菌、克雷伯氏菌、大肠杆菌、肠杆菌和假单胞菌对抗生素的敏感性虽无显著下降,但对凝固酶阴性葡萄球菌(CNS)对替柯planin和利奈唑胺的敏感性下降有统计学意义。在大流行期间,57.6% (n=172)的患者呈COVID-19阳性。在covid -19阳性患者中,虽然念珠菌含量明显升高,但抗真菌敏感性未见下降。结论:在大流行期间,革兰氏阳性和革兰氏阴性微生物的抗生素敏感性下降。虽然在covid -19阳性患者中念珠菌感染率显著升高,但其抗真菌敏感性并未下降。
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引用次数: 0
Prognostic Value of SCUBE-1 in Ischemic Stroke SCUBE-1在缺血性脑卒中中的预后价值
Pub Date : 2023-03-09 DOI: 10.38175/phnx.1251231
I. Altunok
SCUBE-1 is a newly identified cell surface protein identified during early embryogenesis. SCUBE-1 is known to be involved in the angiogenesis mechanism. SCUBE-1 was first detected in human umbilical vein endothelial cells, so it was said that it originates and is secreted from the vascular endothelium. It is also found in organs and tissues with high vascularization such as kidney, brain, lung, spleen and liver
SCUBE-1是在胚胎早期发现的一种新发现的细胞表面蛋白。已知SCUBE-1参与血管生成机制。SCUBE-1最早在人脐静脉内皮细胞中检测到,因此认为它起源于血管内皮并由血管内皮分泌。它也存在于肾、脑、肺、脾和肝等血管化程度高的器官和组织中
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引用次数: 0
Kardiyopulmoner Resüsitasyon Eğitimine Etki Eden Faktörler: Sakarya Örneği
Pub Date : 2023-02-23 DOI: 10.38175/phnx.1228219
Nuray Aslan, Necip Gökhan Guner, Yeşim Durgun, Ensar Durmuş, Yusuf Yurumez
Amaç: Bu çalışmada, hekim dışı sağlık çalışanlarına yönelik olarak yapılan Kardiyopulmoner Resüsitasyon (KPR) eğitimindeki başarı durumuna etki eden faktörlerin araştırılması amaçlanmıştır. Gereç ve Yöntemler: Bu çalışma Sakarya İl Sağlık Müdürlüğü Acil Sağlık Hizmetleri Şubesi koordinatörlüğü ve sorumluluğunda Eylül 2021 tarihinde düzenlenen, KPR eğitimine katılan 285 hemşire ve ebe tarafından eğitim sırasında doldurulan ön test ve son test formlarının değerlendirilmesi ile gerçekleştirildi. Elde edilen veriler IBM SPSS 21 programı ile analiz edildi. Bulgular: Katılımcıların yaş ortalaması 25,06±3,45 yıl ve %85’i kadındı. Eğitime katılanların (n=285) son test başarı puanlarının 74,84±20,11 olduğu tespit edildi. Bu sonucun ön test başarı puanından (38,35±17,15) istatistiksel olarak anlamlı derecede yüksek olduğu saptandı (p
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引用次数: 0
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Phoenix Medical Journal
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