Aim We aimed to evaluate the indications for tracheostomy and early complications in patients who underwent percutaneous tracheostomy with the Griggs method in our clinic. Material and Method This study is retrospective and observational. Demographic data, hospitalization diagnoses, days of opening tracheostomy, days of intensive care hospitalization, indications for tracheosotomy and early complications of tracheostomy were recorded and evaluated in a total of 78 patients between the ages of 23-93 who underwent percutaneous tracheostomy with the Griggs method between January 2021 and September 2022. Results A total of 78 patients were included in the study. Of the patients, 42 (54%) were female and 36 (46%) were male. In the patients included in the study, the earliest tracheostomy day was the 7th day of intubation and the latest tracheostomy day was the 32nd day of intubation. The mean day in terms of tracheostomy day was 23rd day of intubation. In terms of early complications, bleeding was observed in 5 (6.5%) patients, tracheoesophageal fistula in 1 (1.3%) patient, and pneumothorax in 1 (1.3%) patient. No complications were encountered in 71 (90.9%) patients.
{"title":"Our experiences of percutaneous tracheostomy in intensive care unit","authors":"V. G. Soylu, Ayşe Yılmaz","doi":"10.51271/kmj-00105","DOIUrl":"https://doi.org/10.51271/kmj-00105","url":null,"abstract":"Aim\u0000We aimed to evaluate the indications for tracheostomy and early complications in patients who underwent percutaneous tracheostomy with the Griggs method in our clinic.\u0000Material and Method\u0000This study is retrospective and observational. Demographic data, hospitalization diagnoses, days of opening tracheostomy, days of intensive care hospitalization, indications for tracheosotomy and early complications of tracheostomy were recorded and evaluated in a total of 78 patients between the ages of 23-93 who underwent percutaneous tracheostomy with the Griggs method between January 2021 and September 2022.\u0000Results\u0000A total of 78 patients were included in the study. Of the patients, 42 (54%) were female and 36 (46%) were male. In the patients included in the study, the earliest tracheostomy day was the 7th day of intubation and the latest tracheostomy day was the 32nd day of intubation. The mean day in terms of tracheostomy day was 23rd day of intubation. In terms of early complications, bleeding was observed in 5 (6.5%) patients, tracheoesophageal fistula in 1 (1.3%) patient, and pneumothorax in 1 (1.3%) patient. No complications were encountered in 71 (90.9%) patients.","PeriodicalId":369732,"journal":{"name":"Kastamonu Medical Journal","volume":"3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133690728","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}
ABSTRACT Aims:It was aimed to evaluate the effect of yogurt consumption containing Streptococcus thermophilus, Lactobacillus delbrueckii subsp. bulgaricus and Lactobacillus acidophilus probiotic bacteria on the celiac markers, biochemical values and clinical symptoms of celiac diseas. Methods:Fifty celiac patients with positive anti-tissue transglutaminase(anti-tTG) IgA values were evaluated prospectively. The patients were divided into two groups. One group was recommended only gluten-free diet(GFD),while the other group was recommended to eat 200 mL probiotic yogurt containing Streptococcus thermophilus, Lactobacillus delbrueckii subsp. bulgaricus and Lactobacillus acidophilus daily in addition to GFD. The change in biochemical values, vitamin levels, celiac markers and clinical symptoms of both groups was examined after three months of yogurt consumption. Results:Anti-tTg IgA,anti-deamidated gliadin peptide antibody(anti-DGP) IgA and anti-endomysium antibody(EMA) levels of the two groups decreased significantly after three months in both groups.There was a significant decrease in EMA levels in the probiotic yogurt+GFD group(p=0.025) when compared with GFD group. Vitamin D and ferritin levels of the probiotic yogurt+GFD group increased significantly after three months(respectively p=0.004;p=0.039). Folate, vitamin D and iron levels of GFD group increased significantly(respectively p=0.002;p=0.007;p=0.007). In both groups, clinical symptoms significantly decreased after three months. There was a significant decrease in the abdominal pain symptoms in the probiotic yogurt+GFD group when compared with GFD group(p=0.012). Conclusion:Gluten-free diet and consumption of yogurt containing Streptococcus thermophilus, L. delbrueckii ssp. bulgaricus and Lactobacillus acidophilus were found to be statistically significant in decreasing EMA levels and abdominal pain from irritable bowel syndrome (IBS) type symptoms of celiac patients when compared with GFD only.
{"title":"Evaluation of the effect of probiotics on celiac patients","authors":"B. Çalışır, A. Adiloğlu, R. Berkem","doi":"10.51271/kmj-0083","DOIUrl":"https://doi.org/10.51271/kmj-0083","url":null,"abstract":"ABSTRACT \u0000Aims:It was aimed to evaluate the effect of yogurt consumption containing Streptococcus thermophilus, Lactobacillus delbrueckii subsp. bulgaricus and Lactobacillus acidophilus probiotic bacteria on the celiac markers, biochemical values and clinical symptoms of celiac diseas. \u0000Methods:Fifty celiac patients with positive anti-tissue transglutaminase(anti-tTG) IgA values were evaluated prospectively. The patients were divided into two groups. One group was recommended only gluten-free diet(GFD),while the other group was recommended to eat 200 mL probiotic yogurt containing Streptococcus thermophilus, Lactobacillus delbrueckii subsp. bulgaricus and Lactobacillus acidophilus daily in addition to GFD. The change in biochemical values, vitamin levels, celiac markers and clinical symptoms of both groups was examined after three months of yogurt consumption. \u0000Results:Anti-tTg IgA,anti-deamidated gliadin peptide antibody(anti-DGP) IgA and anti-endomysium antibody(EMA) levels of the two groups decreased significantly after three months in both groups.There was a significant decrease in EMA levels in the probiotic yogurt+GFD group(p=0.025) when compared with GFD group. Vitamin D and ferritin levels of the probiotic yogurt+GFD group increased significantly after three months(respectively p=0.004;p=0.039). Folate, vitamin D and iron levels of GFD group increased significantly(respectively p=0.002;p=0.007;p=0.007). In both groups, clinical symptoms significantly decreased after three months. There was a significant decrease in the abdominal pain symptoms in the probiotic yogurt+GFD group when compared with GFD group(p=0.012). \u0000Conclusion:Gluten-free diet and consumption of yogurt containing Streptococcus thermophilus, L. delbrueckii ssp. bulgaricus and Lactobacillus acidophilus were found to be statistically significant in decreasing EMA levels and abdominal pain from irritable bowel syndrome (IBS) type symptoms of celiac patients when compared with GFD only.","PeriodicalId":369732,"journal":{"name":"Kastamonu Medical Journal","volume":"101 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131834784","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}
Ç. Kılınç, Melike Yaşar Duman, B. Çalışır, N. Çöplü, Rıdvan Özbek, C. Demir, Zafer Ergül, Enis Fuat Tüfekci
Aim: This study purposed to determine anti-spike IgG levels at the fourth week after the second dose in healthcare workers (HCWs) who had two doses of the CoronaVac vaccine (Sinovac Life Sciences, Beijing, China). The second purpose of the study was to evaluate several factors that may affect antibody levels. Material and Method: The study was performed at Kastamonu Training and Research Hospital. A total of 197 HCWs of both genders aged 20-63 were included in this study. Antibody levels that neutralize the SARS-CoV-2 spike protein S1 subunit were determined using the SARS-CoV-2 IgG II Quant kit from serum samples collected from the subjects between 10-16 March 2021. Also, a questionnaire containing information about demographic and clinical data was administered to all subjects. It was statistically investigated whether these data affected the anti-spike IgG levels. Results: All subjects had anti-spike IgG levels positive. The median value of the subjects' anti-spike IgG levels was calculated as 860.2 AU/mL (519.1-1674.1 AU/mL). Anti-spike IgG levels were statistically higher in non-smokers and Rh-positive subjects versus the smokers and Rh-negative subjects (p=0.001 and p=0.046, respectively). However, age groups, gender, COVID-19 history, blood type, and seasonal influenza vaccine did not significantly affect anti-spike IgG levels in the subjects (p>0.05). Conclusion: Anti-spike IgG responses were positive in all HCWs who received the CoronaVac vaccine. Besides, the results showed that smoking and Rh-factor affect the anti-spike IgG response. On the other hand, further studies need to examine more parameters with a larger number of subjects.
{"title":"Evaluation of anti-spike IgG response after inactivated COVID-19 vaccine in healthcare workers","authors":"Ç. Kılınç, Melike Yaşar Duman, B. Çalışır, N. Çöplü, Rıdvan Özbek, C. Demir, Zafer Ergül, Enis Fuat Tüfekci","doi":"10.51271/kmj-0085","DOIUrl":"https://doi.org/10.51271/kmj-0085","url":null,"abstract":"Aim: This study purposed to determine anti-spike IgG levels at the fourth week after the second dose in healthcare workers (HCWs) who had two doses of the CoronaVac vaccine (Sinovac Life Sciences, Beijing, China). The second purpose of the study was to evaluate several factors that may affect antibody levels. \u0000Material and Method: The study was performed at Kastamonu Training and Research Hospital. A total of 197 HCWs of both genders aged 20-63 were included in this study. Antibody levels that neutralize the SARS-CoV-2 spike protein S1 subunit were determined using the SARS-CoV-2 IgG II Quant kit from serum samples collected from the subjects between 10-16 March 2021. Also, a questionnaire containing information about demographic and clinical data was administered to all subjects. It was statistically investigated whether these data affected the anti-spike IgG levels. \u0000Results: All subjects had anti-spike IgG levels positive. The median value of the subjects' anti-spike IgG levels was calculated as 860.2 AU/mL (519.1-1674.1 AU/mL). Anti-spike IgG levels were statistically higher in non-smokers and Rh-positive subjects versus the smokers and Rh-negative subjects (p=0.001 and p=0.046, respectively). However, age groups, gender, COVID-19 history, blood type, and seasonal influenza vaccine did not significantly affect anti-spike IgG levels in the subjects (p>0.05). \u0000Conclusion: Anti-spike IgG responses were positive in all HCWs who received the CoronaVac vaccine. Besides, the results showed that smoking and Rh-factor affect the anti-spike IgG response. On the other hand, further studies need to examine more parameters with a larger number of subjects.","PeriodicalId":369732,"journal":{"name":"Kastamonu Medical Journal","volume":"18 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115281658","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 Sepsis is still one of the most common causes of death, despite advances in treatment and technologies. Invasive monitoring in sepsis can improve survival. In this study, we aimed to compare the efficacy of hemodynamic monitoring in the fluid treatment of patients with septic shock. Material and Method Forty septic shock patients were divided into two groups. Group I (n = 20) was monitored with central venous pressure, and Group II (n = 20) with a cardiac output device (EV1000). Arterial blood gases were analyzed four times daily for the groups, and lactate values, diuresis status, need for dialysis, and inotrope need was recorded. For Group I, the central venous pressure and mean arterial pressure values were recorded for group II, cardiac output, cardiac index, stroke volume, stroke volume index, and mean arterial pressure values. Results There was a significant difference between the mean arterial pressures of the groups on the 1st and 2nd days (p = 0.034 and p = 0.026, respectively). In Group II, mean arterial pressures were higher on days 1 and 2. There was no significant difference between the other data recorded. Conclusion We observed no significant difference between central venous pressure monitoring and invasive monitoring in septic shock patient follow-up.
{"title":"Invasive hemodynamic monitoring for fluid management in septic shock patients","authors":"Ö. Taşkın, A. Daş, Canan Balcı","doi":"10.51271/kmj-00106","DOIUrl":"https://doi.org/10.51271/kmj-00106","url":null,"abstract":"Aim\u0000Sepsis is still one of the most common causes of death, despite advances in treatment and technologies. Invasive monitoring in sepsis can improve survival. In this study, we aimed to compare the efficacy of hemodynamic monitoring in the fluid treatment of patients with septic shock.\u0000Material and Method\u0000Forty septic shock patients were divided into two groups. Group I (n = 20) was monitored with central venous pressure, and Group II (n = 20) with a cardiac output device (EV1000). Arterial blood gases were analyzed four times daily for the groups, and lactate values, diuresis status, need for dialysis, and inotrope need was recorded. For Group I, the central venous pressure and mean arterial pressure values were recorded for group II, cardiac output, cardiac index, stroke volume, stroke volume index, and mean arterial pressure values.\u0000Results\u0000There was a significant difference between the mean arterial pressures of the groups on the 1st and 2nd days (p = 0.034 and p = 0.026, respectively). In Group II, mean arterial pressures were higher on days 1 and 2. There was no significant difference between the other data recorded.\u0000Conclusion\u0000We observed no significant difference between central venous pressure monitoring and invasive monitoring in septic shock patient follow-up.","PeriodicalId":369732,"journal":{"name":"Kastamonu Medical Journal","volume":"94 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127138758","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}
M. A. Narsat, Sedat Gülten, Eren Yıldız, Özlem Durak, Ayşe Yılmaz
Introduction: Appendicitis is the common emergency surgery performed in the pediatric age group. However, it has been reported in recent studies that some appendicitis cases will benefit from antibiotic treatment and that they can be followed up without surgery. In our study, it was aimed to compare the pre-operative inflammatory markers with the pathology results of the patients who were operated for appendicitis in our clinic and to reveal their success in the distinction between acute appendicitis and complicated appendicitis. Materials and Methods: The data of 98 patients who were operated with a pre-diagnosis of appendicitis in the pediatric surgery clinic of our hospital between 2019 and 2021 were retrospectively analyzed. Acute appendicitis and complicated appendicitis grouping was made according to pathological diagnoses. The inflammatory markers were evaluated. Results: According to the pathological grouping, 51 (56.7%) patients are in the acute appendicitis group. It was observed that only the change in the CRP value in the binary regression evaluation created for the parameters whose difference was significant evaluation increased the complicated appendicitis probability 1.028 times. It was seen that the CRP value of 34.65 was a parameter that could distinguish between acute appendicitis and complicated append with 79.5% sensitivity and 78.4% specificity. Conclusion: The treatment of appendicitis in children is a subject that is still being studied and has many points that have not been clarified. Among the markers that can be used in treatment planning, CRP gives usable results. More detailed and larger series are needed for other markers.
{"title":"Comparison of inflammatory markers in the differentiation of uncomplicated appendicitis and complicated appendicitis","authors":"M. A. Narsat, Sedat Gülten, Eren Yıldız, Özlem Durak, Ayşe Yılmaz","doi":"10.51271/kmj-0072","DOIUrl":"https://doi.org/10.51271/kmj-0072","url":null,"abstract":"Introduction: \u0000Appendicitis is the common emergency surgery performed in the pediatric age group. However, it has been reported in recent studies that some appendicitis cases will benefit from antibiotic treatment and that they can be followed up without surgery. In our study, it was aimed to compare the pre-operative inflammatory markers with the pathology results of the patients who were operated for appendicitis in our clinic and to reveal their success in the distinction between acute appendicitis and complicated appendicitis. \u0000Materials and Methods: \u0000The data of 98 patients who were operated with a pre-diagnosis of appendicitis in the pediatric surgery clinic of our hospital between 2019 and 2021 were retrospectively analyzed. Acute appendicitis and complicated appendicitis grouping was made according to pathological diagnoses. The inflammatory markers were evaluated. \u0000Results: \u0000According to the pathological grouping, 51 (56.7%) patients are in the acute appendicitis group. It was observed that only the change in the CRP value in the binary regression evaluation created for the parameters whose difference was significant evaluation increased the complicated appendicitis probability 1.028 times. It was seen that the CRP value of 34.65 was a parameter that could distinguish between acute appendicitis and complicated append with 79.5% sensitivity and 78.4% specificity. \u0000Conclusion: \u0000The treatment of appendicitis in children is a subject that is still being studied and has many points that have not been clarified. Among the markers that can be used in treatment planning, CRP gives usable results. More detailed and larger series are needed for other markers.","PeriodicalId":369732,"journal":{"name":"Kastamonu Medical Journal","volume":"147 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132373519","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}
Tuğçehan SEZER AKMAN, Tülin Arici, Hale Kefeli Çelik
Covid 19 infection can affect immune system functions. Although age is seen as a major factor for the development of Herpes Zoster (HZ), immunosuppression or disease-related immune system dysfunction can progress with the reactivation of Varicella Zoster Virus (VZV). A 57-year-old male patient presented with painful lesions on his body after Covid 19 infection and was diagnosed with HZ. The patient was admitted to the algology outpatient clinic due to Postherpetic Neuralgia (PHN) 4 months after the onset of the rash. Our aim is to draw attention to the possibility of HZ and PHN development after Covid 19 infection.
{"title":"Herpes zoster after COVID-19 disease","authors":"Tuğçehan SEZER AKMAN, Tülin Arici, Hale Kefeli Çelik","doi":"10.51271/kmj-00108","DOIUrl":"https://doi.org/10.51271/kmj-00108","url":null,"abstract":"Covid 19 infection can affect immune system functions. Although age is seen as a major factor for the development of Herpes Zoster (HZ), immunosuppression or disease-related immune system dysfunction can progress with the reactivation of Varicella Zoster Virus (VZV). A 57-year-old male patient presented with painful lesions on his body after Covid 19 infection and was diagnosed with HZ. The patient was admitted to the algology outpatient clinic due to Postherpetic Neuralgia (PHN) 4 months after the onset of the rash. Our aim is to draw attention to the possibility of HZ and PHN development after Covid 19 infection. \u0000 ","PeriodicalId":369732,"journal":{"name":"Kastamonu Medical Journal","volume":"14 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130334031","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}
Aims: In laparoscopic cholecystectomy surgery (LCS), for anesthesiologist and surgeons postoperative analgesia method is still problem. The aim of this study is to evaluate the effect of preoperative paravertebral block (PVB) application as a part of multimodal analgesia on postoperative pain management in this surgery. Methods: In this prospective, randomized, single blinded study, over 18 years old, 70 (ASA I-II) patients who underwent elective LCS were included. In the control group, analgesia was managed with only traditional multimodal analgesia methods, while ultrasound- guided PVB (20 ml of 0.5% bupivacaine,T7 level) was added to multimodal anagesia in the study group. Postoperative pain reduction was evaluated using VAS at 1, 6, 12 and 24 hours postoperatively, and morphine consumption amount was caLCSulated with IV patient-controlled analgesia in the postoperative period. Results: Demographic data were similar in both groups. VAS scores at 1 and 6 hours were statistically significantly lower in the PVB group (p<0.05). When evaluated in terms of morphine consumption, it was observed that significantly less morphine was consumed in the PVB group compared to the control group in the first 24-hour period (p< 0.001). Shoulder pain was seen only in 3 patients in the control group. Conclusions: In LCS, it was observed that PVB application under the guidance of US increased the effectiveness of multimodal anagesia and decreased postoperative morphine consumption. In addition, problems such as postoperative nausea, vomiting and shoulder pain were less common.
目的:在腹腔镜胆囊切除术(LCS)中，对于麻醉师和外科医生来说，术后镇痛方法仍然是一个难题。本研究的目的是评估术前椎旁阻滞(PVB)应用作为多模式镇痛的一部分对该手术术后疼痛管理的影响。方法:在这项前瞻性、随机、单盲研究中，纳入了年龄超过18岁的70例(ASA I-II)选择性LCS患者。对照组仅采用传统的多模态镇痛方法进行镇痛，研究组在超声引导下加入PVB(0.5%布比卡因，T7水平20 ml)进行多模态镇痛。术后1、6、12、24小时采用VAS评估术后疼痛减轻程度，术后静脉自控镇痛计算吗啡用量。结果:两组人口统计学数据相似。PVB组患者1、6 h VAS评分均低于对照组，差异有统计学意义(p<0.05)。在吗啡消耗方面，观察到PVB组在前24小时内吗啡消耗明显少于对照组(p< 0.001)。对照组仅3例患者出现肩痛。结论:在LCS中，在US指导下应用PVB可提高多模态麻醉的有效性，减少术后吗啡的消耗。此外，术后恶心、呕吐和肩痛等问题也不常见。
{"title":"The effect of paravertebral block as a part of multimodal analgesia for laparoscopic cholecystectomy surgery","authors":"Berrin Koşar, Y. Gürkan, K. Toker, M. Solak","doi":"10.51271/kmj-0066","DOIUrl":"https://doi.org/10.51271/kmj-0066","url":null,"abstract":"Aims: In laparoscopic cholecystectomy surgery (LCS), for anesthesiologist and surgeons postoperative analgesia method is still problem. The aim of this study is to evaluate the effect of preoperative paravertebral block (PVB) application as a part of multimodal analgesia on postoperative pain management in this surgery. \u0000Methods: In this prospective, randomized, single blinded study, over 18 years old, 70 (ASA I-II) patients who underwent elective LCS were included. In the control group, analgesia was managed with only traditional multimodal analgesia methods, while ultrasound- guided PVB (20 ml of 0.5% bupivacaine,T7 level) was added to multimodal anagesia in the study group. Postoperative pain reduction was evaluated using VAS at 1, 6, 12 and 24 hours postoperatively, and morphine consumption amount was caLCSulated with IV patient-controlled analgesia in the postoperative period. \u0000Results: Demographic data were similar in both groups. VAS scores at 1 and 6 hours were statistically significantly lower in the PVB group (p<0.05). When evaluated in terms of morphine consumption, it was observed that significantly less morphine was consumed in the PVB group compared to the control group in the first 24-hour period (p< 0.001). Shoulder pain was seen only in 3 patients in the control group. \u0000Conclusions: In LCS, it was observed that PVB application under the guidance of US increased the effectiveness of multimodal anagesia and decreased postoperative morphine consumption. In addition, problems such as postoperative nausea, vomiting and shoulder pain were less common.","PeriodicalId":369732,"journal":{"name":"Kastamonu Medical Journal","volume":"209 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123327162","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}
D. S. Karagöz Özen, A. Ergi̇n, O. Demir, M. Demirağ
A 29-year-old man applied to the internal medicine outpatient clinic with fatigue and high plasma glucose levels. He had type 1 Diabetes Mellitus for 10 years and was using insulin glargine U300 and insulin glulisine for treatment. His glycosylated hemoglobin level was 16.7%, and he was hospitalized. Insulin doses were calculated as 1 unite/kg /day; glulisine 3x8 unit/day and glargine U300 1x18 unit/day were ordered. Although we increased the total insulin dosage to 1,5 units/kg/day, the plasma glucose measurements did not improve. The short-acting insulin analog was switched to insulin aspart based on the fact that insulin autoantibodies might cause this situation. On aspart treatment, the patient suffered from hypoglycemia with the same doses of glulisine. The occurrence of insulin autoantibodies against glulisine was confirmed clinically. Basal insulin dose was reduced to 20 units, and aspart 3x6 units/day was enough for plasma glucose control. Hyperglycemia due to autoantibodies against analog insulins is very rare. Here we report a type 1 Diabetes Mellitus patient who was on glulisine treatment for 10 years, and whose blood glucose measurements deteriorated recently. Hyperglycemia was regulated after the insulin switch from glulisine to aspart. This rare case report must be kept in mind in hyperglycemic patients with a history of long-time analog insulin treatment.
{"title":"A case of type 1 Diabetes mellitus unresponsive to insulin glulisine","authors":"D. S. Karagöz Özen, A. Ergi̇n, O. Demir, M. Demirağ","doi":"10.51271/kmj-0075","DOIUrl":"https://doi.org/10.51271/kmj-0075","url":null,"abstract":"A 29-year-old man applied to the internal medicine outpatient clinic with fatigue and high plasma glucose levels. He had type 1 Diabetes Mellitus for 10 years and was using insulin glargine U300 and insulin glulisine for treatment. His glycosylated hemoglobin level was 16.7%, and he was hospitalized. Insulin doses were calculated as 1 unite/kg /day; glulisine 3x8 unit/day and glargine U300 1x18 unit/day were ordered. Although we increased the total insulin dosage to 1,5 units/kg/day, the plasma glucose measurements did not improve. The short-acting insulin analog was switched to insulin aspart based on the fact that insulin autoantibodies might cause this situation. On aspart treatment, the patient suffered from hypoglycemia with the same doses of glulisine. The occurrence of insulin autoantibodies against glulisine was confirmed clinically. Basal insulin dose was reduced to 20 units, and aspart 3x6 units/day was enough for plasma glucose control. \u0000Hyperglycemia due to autoantibodies against analog insulins is very rare. Here we report a type 1 Diabetes Mellitus patient who was on glulisine treatment for 10 years, and whose blood glucose measurements deteriorated recently. Hyperglycemia was regulated after the insulin switch from glulisine to aspart. This rare case report must be kept in mind in hyperglycemic patients with a history of long-time analog insulin treatment.","PeriodicalId":369732,"journal":{"name":"Kastamonu Medical Journal","volume":"33 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134466786","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}
M. A. Narsat, Eren Yıldız, Gulsah Bicer, Özlem Durak, Ayşe Yılmaz
In this article, we will share our case of intrauterine left ovarian torsion located entirely in the right half of the abdomen and its features. She was admitted to the pediatric surgery outpatient clinic due to an intra-abdominal mass lesion. In her history, it was learned that she had a known and unclear diagnosis of an intrauterine mass for seven months. Abdominal magnetic resonance imaging was performed for the cross-sectional evaluation of the lesion. In the right lower quadrant of the abdomen, 35x30 millimeter septated T1 hypointense T2 hyperintense nodular lesion without contrast enhancement and a collection of fluid around the lesion were seen, extending posterior to the cecum and inferiorly to the right adnexal region in the right lower quadrant of the abdomen. The mass was excised by performing salpingoopherectomy. Today, more intrauterine problems can be detected thanks to pregnancy follow-ups and fetal imaging, and intrauterine torsion is one of the fetal pathologies that should be considered. Although the common approach is excision, we think that with the development of early postnatal or fetal surgery opportunities in the future, it will be possible to treat these lesions without causing organ loss.
{"title":"Intrauterine left ovarian torsion located in the right abdominal quadrant: Case report","authors":"M. A. Narsat, Eren Yıldız, Gulsah Bicer, Özlem Durak, Ayşe Yılmaz","doi":"10.51271/kmj-0065","DOIUrl":"https://doi.org/10.51271/kmj-0065","url":null,"abstract":" \u0000In this article, we will share our case of intrauterine left ovarian torsion located entirely in the right half of the abdomen and its features. She was admitted to the pediatric surgery outpatient clinic due to an intra-abdominal mass lesion. In her history, it was learned that she had a known and unclear diagnosis of an intrauterine mass for seven months. Abdominal magnetic resonance imaging was performed for the cross-sectional evaluation of the lesion. In the right lower quadrant of the abdomen, 35x30 millimeter septated T1 hypointense T2 hyperintense nodular lesion without contrast enhancement and a collection of fluid around the lesion were seen, extending posterior to the cecum and inferiorly to the right adnexal region in the right lower quadrant of the abdomen. The mass was excised by performing salpingoopherectomy. Today, more intrauterine problems can be detected thanks to pregnancy follow-ups and fetal imaging, and intrauterine torsion is one of the fetal pathologies that should be considered. Although the common approach is excision, we think that with the development of early postnatal or fetal surgery opportunities in the future, it will be possible to treat these lesions without causing organ loss.","PeriodicalId":369732,"journal":{"name":"Kastamonu Medical Journal","volume":"119 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128618280","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}
Ultrasonography is an imaging tool that is increasingly used in the diagnosis and follow-up of many lung and heart diseases. Full lung ultrasonography is the examination of both hemithorax and protocols and image definitions have been created to make the examination more systematic and accurate. Cardiac ultrasonography is used to evaluate a moving organ. It requires users to be able to detect and interpret dynamic and variable values. Another feature of ultrasonography is its ability to guide interventional procedures. Ultrasonography will develop in the future and will be used more as a modern diagnostic tool in lung and heart evaluation by specialists.
{"title":"Lung and cardiac ultrasonography in intensive care","authors":"Z. Doğanay, Ayşe Yılmaz, V. G. Soylu","doi":"10.51271/kmj-0073","DOIUrl":"https://doi.org/10.51271/kmj-0073","url":null,"abstract":"Ultrasonography is an imaging tool that is increasingly used in the diagnosis and follow-up of many lung and heart diseases. Full lung ultrasonography is the examination of both hemithorax and protocols and image definitions have been created to make the examination more systematic and accurate. Cardiac ultrasonography is used to evaluate a moving organ. It requires users to be able to detect and interpret dynamic and variable values. Another feature of ultrasonography is its ability to guide interventional procedures. Ultrasonography will develop in the future and will be used more as a modern diagnostic tool in lung and heart evaluation by specialists.","PeriodicalId":369732,"journal":{"name":"Kastamonu Medical Journal","volume":"86 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133850587","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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