Pentoz monofosfat yolu aracılığı ile glukoz-6-fosfat dehidrogenaz (G6PD) enzimi eritrositleri ve hemoglobin moleküllerini oksidatif strese karşı korur. Dünyadaki en sık enzim eksikliği olarak görülen G6PD enzim eksikliğinde; akut hemolitik anemi, yenidoğan sarılığı, favizm ve kalıtsal sferositik olmayan hemolitik anemi gibi klinik durumlar görülür. Akut koroner sendrom esnasında genel klinik duruma bağlı oluşan oksidatif ajanlar ve koroner anjiyografi öncesi ve sırasında uygulanan medikasyonlar hemolitik ve trombotik krize neden olabilirler. Bu yazıda G6PD eksikliği bulunan 64 yaşındaki kadın hastaya akut koroner sendrom tanısı ile perkütan koroner girişim (PKG) sırasında ve takibinde gelişen yaygın koroner tromboz vakasını sunduk.
{"title":"DIFFUSE THROMBOSIS DURING PERCUTANEOUS CORONARY INTERVENTION IN A PATIENT WITH GLUCOSE 6 PHOSPHATE DEHYDROGENASE ENZYME DEFICIENCY","authors":"M. Demir, Ö. Akkuş, Gökay Taylan","doi":"10.48176/esmj.2023.122","DOIUrl":"https://doi.org/10.48176/esmj.2023.122","url":null,"abstract":"Pentoz monofosfat yolu aracılığı ile glukoz-6-fosfat dehidrogenaz (G6PD) enzimi eritrositleri ve hemoglobin moleküllerini oksidatif strese karşı korur. Dünyadaki en sık enzim eksikliği olarak görülen G6PD enzim eksikliğinde; akut hemolitik anemi, yenidoğan sarılığı, favizm ve kalıtsal sferositik olmayan hemolitik anemi gibi klinik durumlar görülür. \u0000Akut koroner sendrom esnasında genel klinik duruma bağlı oluşan oksidatif ajanlar ve koroner anjiyografi öncesi ve sırasında uygulanan medikasyonlar hemolitik ve trombotik krize neden olabilirler. Bu yazıda G6PD eksikliği bulunan 64 yaşındaki kadın hastaya akut koroner sendrom tanısı ile perkütan koroner girişim (PKG) sırasında ve takibinde gelişen yaygın koroner tromboz vakasını sunduk.\u0000","PeriodicalId":348820,"journal":{"name":"Eskisehir Medical Journal, Eskisehir City Hospital","volume":"111 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117230645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Z. Kaya, B. Ç. Bi̇lgi̇n, Sevi̇lay Süreyya Ermi̇ş, Tayfun Bi̇lgi̇ç, Yaşar Bi̇ldi̇ri̇ci̇, Berri̇n YALINBAŞ KAYA
Giriş: Yanık cilt hasarı dışında pek çok organı etkileyebilen, kompleks mediatör sistemlerinin aktive olması ile patofizyolojik değişikliklere neden olan bir durumdur. Çalışmada yanık yoğun bakımında takip edilen hastalarda yanık türüne göre aspartat aminotransferaz, alanin aminotransferaz ve kreatinin fosfokinaz enzim düzeylerinin seyri ve doku hasarının düzeyini belirlemek amaçlanmıştır. Yöntemler: Eskişehir Şehir Hastanesi Yanık Merkezi Yanık Yoğun Bakımı’nda Temmuz 2019-0cak 2022 tarihleri arasında yanık sonrası 24 saat içinde yoğun bakıma yatışı yapılan 18 yaş üzeri hastaların yaş ve cinsiyet gibi demografik verilerine ek olarak yanık tipleri kayıt edildi. Kronik hastalık öyküsü, mükerrer yatışı bulunan ve hastane yatış süresi 5 günün altında olan hastalar kapsam dışı tutuldu. Hastaların yatışlarının bir, üç ve beşinci gününde aspartat aminotransferaz, alanin aminotransferaz ve kreatinin fosfokinaz düzeyleri değerlendirildi. Bulgular: Çalışma kapsamına alınan 131 hastanın 95’i (%72.52) erkek cinsiyette olup, ortanca yaş 35 (18-92) yıl olarak saptandı. Yanık tipine göre; elektrik akımına maruziyet ile yanık 20, alev yanığı 38, haşlanma yanığı 43, temas yanığı 12, kimyasal yanık 4, alev-inhalasyon yanığı 14 olarak saptandı. Yalnızca elektrik akımı yanıkları ve alev-inhalasyon yanık hastalarında yatış anında ve takipte aspartat aminotransferaz, alanin aminotransferaz ve kreatinin fosfokinaz düzeyleri yüksekti (p<0,05). Sonuç: Bu çalışmada elektrik yanıklarında ve alev-inhalasyon tipi yanıklarda doku hasarı, karaciğer ve iskelet kası hipoksisi gibi pek çok karmaşık mekanizmalarla aspartat aminotransferaz, alanin aminotransferaz ve kreatinin fosfokinaz düzeylerinin arttığı söylenebilir. Her yanık türünün kendine özgü hasarı, takibi ve tedavisi vardır. Bu çalışma ile yanık tipine göre doku hasarı değerlendirilerek yanık türüne göre takip ve uygulanacak tedavilere katkı sağlayacağına inanıyoruz.
{"title":"YANIK YOĞUN BAKIMDA TAKİP EDİLEN HASTALARIN YANIK TÜRÜNE GÖRE AST, ALT VE CPK DÜZEYLERİ VE TEDAVİ SÜRECİNDEKİ SEYRİ","authors":"Z. Kaya, B. Ç. Bi̇lgi̇n, Sevi̇lay Süreyya Ermi̇ş, Tayfun Bi̇lgi̇ç, Yaşar Bi̇ldi̇ri̇ci̇, Berri̇n YALINBAŞ KAYA","doi":"10.48176/esmj.2023.120","DOIUrl":"https://doi.org/10.48176/esmj.2023.120","url":null,"abstract":"Giriş: Yanık cilt hasarı dışında pek çok organı etkileyebilen, kompleks mediatör sistemlerinin aktive olması ile patofizyolojik değişikliklere neden olan bir durumdur. Çalışmada yanık yoğun bakımında takip edilen hastalarda yanık türüne göre aspartat aminotransferaz, alanin aminotransferaz ve kreatinin fosfokinaz enzim düzeylerinin seyri ve doku hasarının düzeyini belirlemek amaçlanmıştır. \u0000Yöntemler: Eskişehir Şehir Hastanesi Yanık Merkezi Yanık Yoğun Bakımı’nda Temmuz 2019-0cak 2022 tarihleri arasında yanık sonrası 24 saat içinde yoğun bakıma yatışı yapılan 18 yaş üzeri hastaların yaş ve cinsiyet gibi demografik verilerine ek olarak yanık tipleri kayıt edildi. Kronik hastalık öyküsü, mükerrer yatışı bulunan ve hastane yatış süresi 5 günün altında olan hastalar kapsam dışı tutuldu. Hastaların yatışlarının bir, üç ve beşinci gününde aspartat aminotransferaz, alanin aminotransferaz ve kreatinin fosfokinaz düzeyleri değerlendirildi. \u0000Bulgular: Çalışma kapsamına alınan 131 hastanın 95’i (%72.52) erkek cinsiyette olup, ortanca yaş 35 (18-92) yıl olarak saptandı. Yanık tipine göre; elektrik akımına maruziyet ile yanık 20, alev yanığı 38, haşlanma yanığı 43, temas yanığı 12, kimyasal yanık 4, alev-inhalasyon yanığı 14 olarak saptandı. Yalnızca elektrik akımı yanıkları ve alev-inhalasyon yanık hastalarında yatış anında ve takipte aspartat aminotransferaz, alanin aminotransferaz ve kreatinin fosfokinaz düzeyleri yüksekti (p<0,05). \u0000Sonuç: Bu çalışmada elektrik yanıklarında ve alev-inhalasyon tipi yanıklarda doku hasarı, karaciğer ve iskelet kası hipoksisi gibi pek çok karmaşık mekanizmalarla aspartat aminotransferaz, alanin aminotransferaz ve kreatinin fosfokinaz düzeylerinin arttığı söylenebilir. Her yanık türünün kendine özgü hasarı, takibi ve tedavisi vardır. Bu çalışma ile yanık tipine göre doku hasarı değerlendirilerek yanık türüne göre takip ve uygulanacak tedavilere katkı sağlayacağına inanıyoruz.\u0000","PeriodicalId":348820,"journal":{"name":"Eskisehir Medical Journal, Eskisehir City Hospital","volume":"91 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134156779","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Muslih Ürün, Y. Sezgin, Yonca YILMAZ ÜRÜN, A. Uçan, Sinem Gürcü, F. Tugrul
Giriş: Fazla kilo, normal aralığın üzerindeki bir ağırlığı ifade eder. Vücut kitle indeksi (VKİ), kilogram cinsinden ağırlığın metre cinsinden boyun karesine bölünmesiyle tanımlanır. VKİ, zayıf, normal kilolu, fazla kilolu ve obezitenin belirlenmesinde yaygın olarak kabul görmektedir. Kanser, dünyada kardiyovasküler hastalıklardan sonra en yaygın ölüm nedenidir ve kanser tedavisinde ilaç maliyetleri gelişmiş ülkelerde bile önemli bir ekonomik yük getirmektedir. Çalışmamızda 2021 yılında sadece Eskişehir Şehir Hastanesinde kiloya göre dozlanan ve damardan hedefe yönelik tedavi ajanları alan hastaların yıllık ek maliyetini hesapladık. Yöntemler: 2021 takvim yılı içinde, dozu vücut ağırlığına göre hesaplanan ve intravenöz tedavi kullanılan hedefe yönelik ilaçlar çalışmamıza dahil edildi. Çalışmada VKİ hesaplandı. VKİ 25 ve üzeri hastaların fazla kiloları, üst sınır 25 kabul edilerek kayıt edildi. Çalışmadaki 185 hastanın 129'u (%69,7) kadın, 56'sı (%30,3) erkektir. Bulgular: Çalışmaya 129 (%69,7) kadın ve 56 (%30,3) erkek olmak üzere toplam 185 hasta dahil edildi. Katılımcıların ortalama ağırlığı 71 kg (40-122 kg) idi. 2021 yılında hastanemiz çalışmamızda kullandığımız altı ilaç için toplam 4.450.673 TL, kilo fazlalığı nedeniyle toplam 598.714 TL ödeme yapmıştır. Sonuç: Obezite, kanser gibi bütün yaş gruplarını etkileyen ve günümüzün önde gelen başlıca sağlık sorunlarından biridir. Obezitenin sağlık sistemine getirdiği ilave maliyet bilinmektedir. Obezitenin kanser tedavisinde oluşturduğu maliyeti inceleyen bu çalışmada ilaç tüketiminde kilo sebebi ile artış olduğu bulunmuştur. Obezitenin önlenmesi ve tedavisi için daha fazla çabaya ihtiyaç olduğu açıktır.
{"title":"ADDITIONAL COST OF OVERWEIGHT IN MEDICATION OF CANCER PATIENTS","authors":"Muslih Ürün, Y. Sezgin, Yonca YILMAZ ÜRÜN, A. Uçan, Sinem Gürcü, F. Tugrul","doi":"10.48176/esmj.2023.115","DOIUrl":"https://doi.org/10.48176/esmj.2023.115","url":null,"abstract":"Giriş: Fazla kilo, normal aralığın üzerindeki bir ağırlığı ifade eder. Vücut kitle indeksi (VKİ), kilogram cinsinden ağırlığın metre cinsinden boyun karesine bölünmesiyle tanımlanır. VKİ, zayıf, normal kilolu, fazla kilolu ve obezitenin belirlenmesinde yaygın olarak kabul görmektedir. Kanser, dünyada kardiyovasküler hastalıklardan sonra en yaygın ölüm nedenidir ve kanser tedavisinde ilaç maliyetleri gelişmiş ülkelerde bile önemli bir ekonomik yük getirmektedir. Çalışmamızda 2021 yılında sadece Eskişehir Şehir Hastanesinde kiloya göre dozlanan ve damardan hedefe yönelik tedavi ajanları alan hastaların yıllık ek maliyetini hesapladık.\u0000Yöntemler: 2021 takvim yılı içinde, dozu vücut ağırlığına göre hesaplanan ve intravenöz tedavi kullanılan hedefe yönelik ilaçlar çalışmamıza dahil edildi. Çalışmada VKİ hesaplandı. VKİ 25 ve üzeri hastaların fazla kiloları, üst sınır 25 kabul edilerek kayıt edildi. Çalışmadaki 185 hastanın 129'u (%69,7) kadın, 56'sı (%30,3) erkektir.\u0000Bulgular: Çalışmaya 129 (%69,7) kadın ve 56 (%30,3) erkek olmak üzere toplam 185 hasta dahil edildi. Katılımcıların ortalama ağırlığı 71 kg (40-122 kg) idi. 2021 yılında hastanemiz çalışmamızda kullandığımız altı ilaç için toplam 4.450.673 TL, kilo fazlalığı nedeniyle toplam 598.714 TL ödeme yapmıştır.\u0000Sonuç: Obezite, kanser gibi bütün yaş gruplarını etkileyen ve günümüzün önde gelen başlıca sağlık sorunlarından biridir. Obezitenin sağlık sistemine getirdiği ilave maliyet bilinmektedir. Obezitenin kanser tedavisinde oluşturduğu maliyeti inceleyen bu çalışmada ilaç tüketiminde kilo sebebi ile artış olduğu bulunmuştur. Obezitenin önlenmesi ve tedavisi için daha fazla çabaya ihtiyaç olduğu açıktır. \u0000","PeriodicalId":348820,"journal":{"name":"Eskisehir Medical Journal, Eskisehir City Hospital","volume":"79 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121757365","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
C. Çöteli, Furkan Külekçi̇, Özge Çakmak Karaaslan, Murat Oğuz Özilhan, E. Aruğaslan, H. T. Gürsoy, M. A. Erdöl, S. Baştuğ, Ahmet Kasapkara
Giriş: Miyokard enfarktüsü tablosu ile başvuran COVID-19 hastalarında mortalite ve morbidite verileri hastaların uzun süreli takiplerinin olmaması nedeniyle kısıtlıdır. Bu çalışmada bu hasta grubunun mortalite prediktörlerinin araştırılması amaçlanmıştır. Yöntemler: COVID-19 enfeksiyonu mevcut olan ve yüksek riskli miyokard enfarktüsü nedeniyle invaziv koroner anjiyografi yapılan 80 hasta çalışmaya dahil edilmiştir. Tüm hastalar ilk başvurudan sonra en az 1 yıl süre ile takip edilmiştir. Hastaların mortalite verileri ve medikal kayıtları hastanenin medikal kayıt programından retrospektif olarak alınmıştır. Bulgular: Otuz dört hastanın (%42,5) ilk başvurudan sonraki bir yıllık takipte öldüğü izlendi. Bu hastaların 30’u (%88,2) ilk başvurudaki hastane yatışı sonlanmadan öldü. Medyan kapı balon süresi 107,5 dk (17-1278) olarak izlendi. 49 hastaya (%61,25) invaziv koroner anjiyografi sırasında perkütan koroner girişim uygulandı. Yüksek ferritin ve LDH seviyelerinin mortalite ile bağımsız olarak ilişkili olduğu izlendi (OR: 1,006, CI %95: 1,001-1,01, p: 0,011; OR:1,005, CI %95: 1,001-1,009, p:0,025; sırasıyla). Ferritin için kestirim değeri 211 mcg/L (AUC:0.762, sensitivite: 73.5%, spesifite 63%, p:<0.001) ve LDH için kestirim değeri 492 U/L (AUC:0.863, sensitivite: 79.4%, spesifite 80.4%, p:<0.001) olarak hesaplandı. Sonuç: İnvaziv medikal tedaviye rağmen miyokard enfarktüsü gelişen COVID-19 hastalarında mortalite oranı yüksektir. Çalışmada artmış LDH ve ferritin seviyelerinin mortalite prediktörü olduğu izlenmiştir.
{"title":"THE PREDICTORS OF MORTALITY IN PATIENTS WHO WERE REFERRED TO CORONARY ANGIOGRAPHY DUE TO MYOCARDIAL INFARCTION AND HAD COVID-19","authors":"C. Çöteli, Furkan Külekçi̇, Özge Çakmak Karaaslan, Murat Oğuz Özilhan, E. Aruğaslan, H. T. Gürsoy, M. A. Erdöl, S. Baştuğ, Ahmet Kasapkara","doi":"10.48176/esmj.2023.112","DOIUrl":"https://doi.org/10.48176/esmj.2023.112","url":null,"abstract":"Giriş: Miyokard enfarktüsü tablosu ile başvuran COVID-19 hastalarında mortalite ve morbidite verileri hastaların uzun süreli takiplerinin olmaması nedeniyle kısıtlıdır. Bu çalışmada bu hasta grubunun mortalite prediktörlerinin araştırılması amaçlanmıştır.\u0000Yöntemler: COVID-19 enfeksiyonu mevcut olan ve yüksek riskli miyokard enfarktüsü nedeniyle invaziv koroner anjiyografi yapılan 80 hasta çalışmaya dahil edilmiştir. Tüm hastalar ilk başvurudan sonra en az 1 yıl süre ile takip edilmiştir. Hastaların mortalite verileri ve medikal kayıtları hastanenin medikal kayıt programından retrospektif olarak alınmıştır.\u0000Bulgular: Otuz dört hastanın (%42,5) ilk başvurudan sonraki bir yıllık takipte öldüğü izlendi. Bu hastaların 30’u (%88,2) ilk başvurudaki hastane yatışı sonlanmadan öldü. Medyan kapı balon süresi 107,5 dk (17-1278) olarak izlendi. 49 hastaya (%61,25) invaziv koroner anjiyografi sırasında perkütan koroner girişim uygulandı. Yüksek ferritin ve LDH seviyelerinin mortalite ile bağımsız olarak ilişkili olduğu izlendi (OR: 1,006, CI %95: 1,001-1,01, p: 0,011; OR:1,005, CI %95: 1,001-1,009, p:0,025; sırasıyla). Ferritin için kestirim değeri 211 mcg/L (AUC:0.762, sensitivite: 73.5%, spesifite 63%, p:<0.001) ve LDH için kestirim değeri 492 U/L (AUC:0.863, sensitivite: 79.4%, spesifite 80.4%, p:<0.001) olarak hesaplandı.\u0000Sonuç: İnvaziv medikal tedaviye rağmen miyokard enfarktüsü gelişen COVID-19 hastalarında mortalite oranı yüksektir. Çalışmada artmış LDH ve ferritin seviyelerinin mortalite prediktörü olduğu izlenmiştir.\u0000","PeriodicalId":348820,"journal":{"name":"Eskisehir Medical Journal, Eskisehir City Hospital","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122240685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: Methemoglobin, an abnormal form of hemoglobin, is one of the causes that should be considered primarily in severe central cyanosis. Methylene blue and ascorbic acid are used as the first-line therapies in methemoglobinemia. Experience with the use of oxygen therapy is not sufficient to conclude the duration of therapy. The aim of the present study is to find out the effects of oxygen therapy on drug or toxic agent-induced methemoglobinemia. Material and Method: First group rats (n=6) were administered 100 mg/kg prilocaine intraperitoneally, and the rats were kept at room temperature. The second group of oxygen group rats (n=6) were administered 100% oxygen at 10 liters/min. All rats were observed for 180 minutes, and blood gas and biochemical analyses were performed at the end of the experiment period. Results: Fifty percent of the rats in the room air group (n=3) died spontaneously at the end of the trial period, while all rats in the oxygen group (n=6) survived to the end of the trial period. When evaluated in terms of survival, a statistical difference was found between the groups (p <0.05). In addition, although there was a significant difference in oxygen saturation levels between the groups (p <0.05), there was no significant increase in partial arterial oxygen pressure, the primary determinant of oxygenation. Conclusion: This study revealed that rats are not suitable for this type of experimental study. Prilocaine doses did not cause high levels of methemoglobinemia due to mortality, so the goal and target could not be met. It has been concluded that this study can serve as a guide for choosing methodologies to be employed in planned future investigations of the topic.
{"title":"DETERMINATION OF TREATMENT TIME AND EFFICACY WITH OXYGEN IN EXPERIMENTAL METHEMOGLOBINEMIA MODEL","authors":"M. Korkut","doi":"10.48176/esmj.2023.103","DOIUrl":"https://doi.org/10.48176/esmj.2023.103","url":null,"abstract":"Introduction: Methemoglobin, an abnormal form of hemoglobin, is\u0000one of the causes that should be considered primarily in severe central\u0000cyanosis. Methylene blue and ascorbic acid are used as the first-line\u0000therapies in methemoglobinemia. Experience with the use of oxygen\u0000therapy is not sufficient to conclude the duration of therapy. The aim of\u0000the present study is to find out the effects of oxygen therapy on drug\u0000or toxic agent-induced methemoglobinemia.\u0000Material and Method: First group rats (n=6) were administered 100\u0000mg/kg prilocaine intraperitoneally, and the rats were kept at room\u0000temperature. The second group of oxygen group rats (n=6) were\u0000administered 100% oxygen at 10 liters/min. All rats were observed\u0000for 180 minutes, and blood gas and biochemical analyses were\u0000performed at the end of the experiment period.\u0000Results: Fifty percent of the rats in the room air group (n=3) died\u0000spontaneously at the end of the trial period, while all rats in the oxygen\u0000group (n=6) survived to the end of the trial period. When evaluated in\u0000terms of survival, a statistical difference was found between the groups\u0000(p <0.05). In addition, although there was a significant difference in\u0000oxygen saturation levels between the groups (p <0.05), there was no\u0000significant increase in partial arterial oxygen pressure, the primary\u0000determinant of oxygenation.\u0000Conclusion: This study revealed that rats are not suitable for this\u0000type of experimental study. Prilocaine doses did not cause high levels\u0000of methemoglobinemia due to mortality, so the goal and target could\u0000not be met. It has been concluded that this study can serve as a\u0000guide for choosing methodologies to be employed in planned future\u0000investigations of the topic.","PeriodicalId":348820,"journal":{"name":"Eskisehir Medical Journal, Eskisehir City Hospital","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129059007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Intracavitary brachytherapy treatment has a very important role in patients with locally advanced cervical cancer. Brachytherapy is a very painful procedure, especially in patients in whom cervical opening cannot be achieved, and requires analgesia and immobilization. The American Brachytherapy Association (ABA) recommends the use of conscious sedation as much as possible in intracavitary high-doserate (HDR) applications of patients diagnosed with cervical cancer. In this review, we wanted to discuss the types and necessity of analgesia in the application of intracavitary brachytherapy in patients diagnosed with cervical cancer, which is an important health problem in our country.
{"title":"ANALGESIA IN INTRACAVITARY CERVICAL BRACHYTHERAPY APPLICATIONS","authors":"Ebru Özen","doi":"10.48176/esmj.2023.105","DOIUrl":"https://doi.org/10.48176/esmj.2023.105","url":null,"abstract":"Intracavitary brachytherapy treatment has a very important role in\u0000patients with locally advanced cervical cancer. Brachytherapy is a very\u0000painful procedure, especially in patients in whom cervical opening\u0000cannot be achieved, and requires analgesia and immobilization. The\u0000American Brachytherapy Association (ABA) recommends the use of\u0000conscious sedation as much as possible in intracavitary high-doserate\u0000(HDR) applications of patients diagnosed with cervical cancer. In\u0000this review, we wanted to discuss the types and necessity of analgesia\u0000in the application of intracavitary brachytherapy in patients diagnosed\u0000with cervical cancer, which is an important health problem in our\u0000country.","PeriodicalId":348820,"journal":{"name":"Eskisehir Medical Journal, Eskisehir City Hospital","volume":"125 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123724069","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: The aim of this study was to determine the indications of Percutaneous endoscopic gastrostomy (PEG) patients treated in a secondary state Burdur hospital over a period of three years, the unit where the patient was hospitalized, survival time with PEG therapy, and the complications observed in these patients. Methods: Patients who underwent PEG in the endoscopy unit of our hospital, between January 2019 and January 2022, were retrospectively evaluated. Age, gender, the unit of inpatient, indications for PEG therapy, complications after PEG, and survival status of the patients were recorded in the form of case reports. Patients with coagulation disorders, hemodynamic instability, peritonitis, sepsis, infection at the insertion area, peritonitis carcinomatosis, a history of total gastrectomy and gastric varices were excluded. Results:The median age of the 120 patients included in the study was 79 (17–100) years, and 66 (55%) of the patients were male. Complications were observed in 14 (11.7%) patients, all of which were minor, including seven (5.8%) PEG site infections, three (2.5%) PEG site leakages, three (2.5%) PEG occlusions, and one (0.9%) PEG removal. It was determined that 73 (60.8%) patients survived at least 30 days; the patients were most frequently referred by the neurology unit, with a rate of 52.7%. The most common indications for PEG insertion were cerebrovascular disease (56.7%) and dementia (29.2%). Conclusion: Maintenance of nutritional requirements via PEG allows for the preservation of mucosal integrity and barrier function, intestinal immune response, and normal flora. It is superior to other enteral feeding methods due to the lower risk of aspiration. In conclusion, our study, which presented the experiences of the PEG insertion and therapy in a secondary state hospital, stated that the complication rates, indications, and referring clinics were found to be consistent with available literature.
{"title":"PERCUTANEOUS ENDOSCOPIC GASTROSTOMY RESULTS IN A SECONDARY STATE HOSPITAL","authors":"K. Yetis Gülsoy, Ferit Yeşil","doi":"10.48176/esmj.2023.96","DOIUrl":"https://doi.org/10.48176/esmj.2023.96","url":null,"abstract":"Introduction: The aim of this study was to determine the indications\u0000of Percutaneous endoscopic gastrostomy (PEG) patients treated in a\u0000secondary state Burdur hospital over a period of three years, the unit\u0000where the patient was hospitalized, survival time with PEG therapy,\u0000and the complications observed in these patients.\u0000Methods: Patients who underwent PEG in the endoscopy unit\u0000of our hospital, between January 2019 and January 2022, were\u0000retrospectively evaluated. Age, gender, the unit of inpatient, indications\u0000for PEG therapy, complications after PEG, and survival status of the\u0000patients were recorded in the form of case reports. Patients with\u0000coagulation disorders, hemodynamic instability, peritonitis, sepsis,\u0000infection at the insertion area, peritonitis carcinomatosis, a history of\u0000total gastrectomy and gastric varices were excluded.\u0000Results:The median age of the 120 patients included in the study\u0000was 79 (17–100) years, and 66 (55%) of the patients were male.\u0000Complications were observed in 14 (11.7%) patients, all of which\u0000were minor, including seven (5.8%) PEG site infections, three (2.5%)\u0000PEG site leakages, three (2.5%) PEG occlusions, and one (0.9%)\u0000PEG removal. It was determined that 73 (60.8%) patients survived\u0000at least 30 days; the patients were most frequently referred by the\u0000neurology unit, with a rate of 52.7%. The most common indications for\u0000PEG insertion were cerebrovascular disease (56.7%) and dementia\u0000(29.2%).\u0000Conclusion: Maintenance of nutritional requirements via PEG allows\u0000for the preservation of mucosal integrity and barrier function, intestinal\u0000immune response, and normal flora. It is superior to other enteral\u0000feeding methods due to the lower risk of aspiration. In conclusion,\u0000our study, which presented the experiences of the PEG insertion and\u0000therapy in a secondary state hospital, stated that the complication\u0000rates, indications, and referring clinics were found to be consistent\u0000with available literature.","PeriodicalId":348820,"journal":{"name":"Eskisehir Medical Journal, Eskisehir City Hospital","volume":"51 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132386503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Aim: This study aimed to examine the effects of sodium glucose cotransporter 2 inhibitors (SGLT-2i) on lipid levels at 12 weeks of follow-up in newly diagnosed hypertensive (NDHT) patients with type 2 diabetes mellitus (T2DM). Methodsː This retrospective study, 236 NDHT patients with T2DM were included. The SGLT-2i group consisted of patients who received SGLT-2i (empagliflozin or dapagliflozin) in addition to stable triple combination treatment. The control group was selected over NDHT patients with T2DM who did not receive SGLT-2i and matched with the SGLT-2i group in terms of baseline risk factors by propensity score. The laboratory findings of the patients were compared retrospectively at the time of diagnosis of NDHT (baseline) and at 12-month followup. Resultsː The decrease in fasting blood glucose and hemoglobin A1C levels was higher in the SGLT-2i group than control group. Although both groups received similar antihypertensive therapy, the improvement in lipid profile was higher in the SGLT-2i group. Glycemic control and side effects were similar in empagliflozin and dapagliflozin groups. However, greater improvement in lipid profiles was detected in dapagliflozin users. Conclusionsː In NDHT patients with T2DM, the addition of SGLT2i to treatment management in cases where glycemic control is not achieved is associated with more improvement of the lipid profile without significant side effects. However, the effects of various SGLT2i agents on this improvement may be different.
{"title":"EFFECT OF SODIUM GLUCOSE CO-TRANSPORTER 2 INHIBITORS ON LIPID LEVELS IN NEWLY DIAGNOSED HYPERTENSIVE PATIENTS WITH TYPE 2 DIABETES MELLITUS","authors":"Birsen Doğanay, Özlem Özcan Çelebi","doi":"10.48176/esmj.2023.108","DOIUrl":"https://doi.org/10.48176/esmj.2023.108","url":null,"abstract":"Aim: This study aimed to examine the effects of sodium glucose\u0000cotransporter 2 inhibitors (SGLT-2i) on lipid levels at 12 weeks of\u0000follow-up in newly diagnosed hypertensive (NDHT) patients with type\u00002 diabetes mellitus (T2DM).\u0000Methodsː This retrospective study, 236 NDHT patients with T2DM\u0000were included. The SGLT-2i group consisted of patients who received\u0000SGLT-2i (empagliflozin or dapagliflozin) in addition to stable triple\u0000combination treatment. The control group was selected over NDHT\u0000patients with T2DM who did not receive SGLT-2i and matched with the\u0000SGLT-2i group in terms of baseline risk factors by propensity score.\u0000The laboratory findings of the patients were compared retrospectively\u0000at the time of diagnosis of NDHT (baseline) and at 12-month followup.\u0000Resultsː The decrease in fasting blood glucose and hemoglobin\u0000A1C levels was higher in the SGLT-2i group than control group.\u0000Although both groups received similar antihypertensive therapy, the\u0000improvement in lipid profile was higher in the SGLT-2i group. Glycemic\u0000control and side effects were similar in empagliflozin and dapagliflozin\u0000groups. However, greater improvement in lipid profiles was detected\u0000in dapagliflozin users.\u0000Conclusionsː In NDHT patients with T2DM, the addition of SGLT2i to treatment management in cases where glycemic control is not\u0000achieved is associated with more improvement of the lipid profile\u0000without significant side effects. However, the effects of various SGLT2i agents on this improvement may be different.","PeriodicalId":348820,"journal":{"name":"Eskisehir Medical Journal, Eskisehir City Hospital","volume":"104 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124685533","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ebru Özen, A. Çolak, Sevtap Hekimoglu Sahin, M. Arar
Introduction: Cigarettes and tobacco, which are used in different ways, are widely used all over the world, despite the known harm to health. Today, the relationship between many diseases and smoking has been shown. Pulmonary complications are the most important cause of mortality and morbidity in the postoperative period, and smoking is one of the most important risk factors for the development of postoperative pulmonary complications. In this study, we aimed to investigate the effect of different fresh gas flows (4 and 6 lt/min) on carboxyhemoglobin levels in smokers and non-smokers who were operated on electively. Methods: A total of 100 patients, aged between 18-80, in the American Society of Anesthesiology risk score I-II risk group, who were scheduled for elective surgery under general anesthesia, were included in the study. Preoperatively, cases were divided into two groups smokers (n = 50) and non-smokers (n = 50). Pre-induction, post-induction, postintubation, intraoperatively every 30 minutes, post-operative, postextubation, postoperative 30th and 60th minutes, peak heart rate, systolic arterial pressure (mmHg), diastolic arterial pressure (mmHg), SpO2, End-tidal carbon dioxide, and carboxyhemoglobin values were measured and recorded. Results: There was no difference between the cases included in the study in terms of gender, age, amount of cigarette smoked, operation time, and extubation time. When compared according to different fresh gas flow rates (n = 25), no statistically significant difference was found between the groups in terms of carboxyhemoglobin values measured at different times before, during, and after the operation. Conclusion: This situation is attributed to the elimination of carboxyhemoglobin from the blood during this period, due to the cessation of smoking in patients scheduled for elective surgery after the preoperative evaluation until the operation.
{"title":"THE EFFECTS OF FRESH GAS FLOW ON CARBOXYHEMOGLOBIN LEVELS IN SMOKERS AND NON-SMOKERS DURING GENERAL ANESTHESIA","authors":"Ebru Özen, A. Çolak, Sevtap Hekimoglu Sahin, M. Arar","doi":"10.48176/esmj.2023.100","DOIUrl":"https://doi.org/10.48176/esmj.2023.100","url":null,"abstract":"Introduction: Cigarettes and tobacco, which are used in different\u0000ways, are widely used all over the world, despite the known harm to\u0000health. Today, the relationship between many diseases and smoking\u0000has been shown. Pulmonary complications are the most important\u0000cause of mortality and morbidity in the postoperative period, and\u0000smoking is one of the most important risk factors for the development\u0000of postoperative pulmonary complications. In this study, we aimed to\u0000investigate the effect of different fresh gas flows (4 and 6 lt/min) on\u0000carboxyhemoglobin levels in smokers and non-smokers who were\u0000operated on electively.\u0000Methods: A total of 100 patients, aged between 18-80, in the American\u0000Society of Anesthesiology risk score I-II risk group, who were scheduled\u0000for elective surgery under general anesthesia, were included in the\u0000study. Preoperatively, cases were divided into two groups smokers (n\u0000= 50) and non-smokers (n = 50). Pre-induction, post-induction, postintubation,\u0000intraoperatively every 30 minutes, post-operative, postextubation,\u0000postoperative 30th and 60th minutes, peak heart rate,\u0000systolic arterial pressure (mmHg), diastolic arterial pressure (mmHg),\u0000SpO2, End-tidal carbon dioxide, and carboxyhemoglobin values were\u0000measured and recorded.\u0000Results: There was no difference between the cases included in the\u0000study in terms of gender, age, amount of cigarette smoked, operation\u0000time, and extubation time. When compared according to different fresh\u0000gas flow rates (n = 25), no statistically significant difference was found\u0000between the groups in terms of carboxyhemoglobin values measured\u0000at different times before, during, and after the operation.\u0000Conclusion: This situation is attributed to the elimination of\u0000carboxyhemoglobin from the blood during this period, due to the\u0000cessation of smoking in patients scheduled for elective surgery after\u0000the preoperative evaluation until the operation.","PeriodicalId":348820,"journal":{"name":"Eskisehir Medical Journal, Eskisehir City Hospital","volume":"15 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129713982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: In this study, it was aimed to determine the level of health literacy and related factors in Bursa. Methods: It was determined by the simple random random sampling method from the population of the Family Physicians in Bursa and the 17 districts of Bursa were weighted according to their populations, and the districts where less than 50 questionnaires would be applied were excluded from the scope of the study. In June-July 2018, 2200 people were surveyed, 188 surveys were excluded from the research due to inadequacies in the data and a total of 2012 surveys were evaluated. Results: As a result of the logistic regression analysis of the factors age, education, health status, income level and reading habits were found to be associated with having sufficient health literacy level. Accordingly, adequate level of health literacy; in individuals aged 15- 44, 1.25 times compared to individuals aged 45 and over, 1.36 times more than those with a high school or higher education, secondary school and below, 1.81 times more than those with good health and poor health, it was observed that it was 1.32 times higher in those with a good income level than those with a low income level and 1.45 times more in those with a habit of reading books than in those without a habit of reading. Conclusion: In our health literacy study conducted in Bursa province, we showed the relationship between age, education status, income level, education level, reading habits and health literacy. Health literacy; a concept that has been put forward for the last twenty years for health service delivery, is known to be effective in a wide process ranging from cost-effective patient-physician satisfaction, where it can change the results of health service expectations. In order to protect the society without the need for rehabilitation without getting sick for a total welfare, screening and education activities should increasingly continue
{"title":"HEALTH LITERACY LEVEL OF A PROVINCE AND FACTORS AFFECTING IT","authors":"A. Timur, Salih Metin","doi":"10.48176/esmj.2023.104","DOIUrl":"https://doi.org/10.48176/esmj.2023.104","url":null,"abstract":"Objective: In this study, it was aimed to determine the level of health\u0000literacy and related factors in Bursa.\u0000Methods: It was determined by the simple random random sampling\u0000method from the population of the Family Physicians in Bursa and the\u000017 districts of Bursa were weighted according to their populations, and\u0000the districts where less than 50 questionnaires would be applied were\u0000excluded from the scope of the study. In June-July 2018, 2200 people\u0000were surveyed, 188 surveys were excluded from the research due to\u0000inadequacies in the data and a total of 2012 surveys were evaluated.\u0000Results: As a result of the logistic regression analysis of the factors\u0000age, education, health status, income level and reading habits were\u0000found to be associated with having sufficient health literacy level.\u0000Accordingly, adequate level of health literacy; in individuals aged 15-\u000044, 1.25 times compared to individuals aged 45 and over, 1.36 times\u0000more than those with a high school or higher education, secondary\u0000school and below, 1.81 times more than those with good health and\u0000poor health, it was observed that it was 1.32 times higher in those\u0000with a good income level than those with a low income level and 1.45\u0000times more in those with a habit of reading books than in those without\u0000a habit of reading.\u0000Conclusion: In our health literacy study conducted in Bursa province,\u0000we showed the relationship between age, education status, income\u0000level, education level, reading habits and health literacy. Health\u0000literacy; a concept that has been put forward for the last twenty years\u0000for health service delivery, is known to be effective in a wide process\u0000ranging from cost-effective patient-physician satisfaction, where it can\u0000change the results of health service expectations. In order to protect\u0000the society without the need for rehabilitation without getting sick for\u0000a total welfare, screening and education activities should increasingly\u0000continue","PeriodicalId":348820,"journal":{"name":"Eskisehir Medical Journal, Eskisehir City Hospital","volume":"27 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128409212","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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