Pub Date : 2023-09-28DOI: 10.32552/2023.actamedica.926
Ahmet Hamdi Sakarya
Objective: Region six in Turkey, an underdeveloped area with limited doctors, lacks experienced healthcare professionals, teamwork, assistants, and instruments, which limits the performance of complex procedures. It is generally discouraged to attempt complex microsurgery in these regions. This study aims to demonstrate the feasibility of microsurgery and provide guidance for ambitious young plastic reconstructive surgeons performing microsurgery in underdeveloped areas as part of a compulsory service program. Material and Methods: A retrospective analysis was conducted on patients who underwent free flaps, replantation, and revascularization surgeries performed by the author, the sole plastic surgeon in the rural area, between August 2018 and August 2020. The analysis included operation notes, outpatient clinic notes, as well as pre-operative and post-operative pictures. Results: A total of thirty-six microsurgical operations were performed on thirty-two patients. Two out of nineteen (10.5%) replantation attempts and one out of seventeen (5.8%) free flaps experienced failure. Among the flaps harvested, four were thin and four were super-thin. Furthermore, three out of five (60%) pediatric flaps encountered serious non-surgical complications, while most systemic complications were infection-related. All complications were effectively managed without the need for dispatch. Conclusion: Microsurgery can be safely performed during the compulsory work period in the region six. Tips such as open-loop anastomoses, staff training, and easy means of flap monitoring can facilitate microsurgery. However, it may be prudent to consider avoiding such procedures in pediatric patients due to potential non-surgical complications and challenges with the dispatch system.
{"title":"Feasibility of microsurgery in rural area as part of compulsory health service in Turkey: Replantation, free conventional, perforator, thin, and super thin flaps","authors":"Ahmet Hamdi Sakarya","doi":"10.32552/2023.actamedica.926","DOIUrl":"https://doi.org/10.32552/2023.actamedica.926","url":null,"abstract":"Objective: Region six in Turkey, an underdeveloped area with limited doctors, lacks experienced healthcare professionals, teamwork, assistants, and instruments, which limits the performance of complex procedures. It is generally discouraged to attempt complex microsurgery in these regions. This study aims to demonstrate the feasibility of microsurgery and provide guidance for ambitious young plastic reconstructive surgeons performing microsurgery in underdeveloped areas as part of a compulsory service program. Material and Methods: A retrospective analysis was conducted on patients who underwent free flaps, replantation, and revascularization surgeries performed by the author, the sole plastic surgeon in the rural area, between August 2018 and August 2020. The analysis included operation notes, outpatient clinic notes, as well as pre-operative and post-operative pictures. Results: A total of thirty-six microsurgical operations were performed on thirty-two patients. Two out of nineteen (10.5%) replantation attempts and one out of seventeen (5.8%) free flaps experienced failure. Among the flaps harvested, four were thin and four were super-thin. Furthermore, three out of five (60%) pediatric flaps encountered serious non-surgical complications, while most systemic complications were infection-related. All complications were effectively managed without the need for dispatch. Conclusion: Microsurgery can be safely performed during the compulsory work period in the region six. Tips such as open-loop anastomoses, staff training, and easy means of flap monitoring can facilitate microsurgery. However, it may be prudent to consider avoiding such procedures in pediatric patients due to potential non-surgical complications and challenges with the dispatch system.","PeriodicalId":7100,"journal":{"name":"Acta Medica","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135427390","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}
Pub Date : 2023-09-28DOI: 10.32552/2023.actamedica.924
Murat Kara, Uğur Koçer, Ramazan Arslan, Koray Gürsoy, Seçil Vural, Ayşegül Fırat
Objective: Autologous nerve graft (ANG) is the standard of care in the reconstruction of nerve gaps. However, scarification of a donor nerve, donor-site complications (wound complications, sensory dysfunction, neuroma, etc.) and unpredictable results lead surgeons to search for alternative techniques. Epineural tube graft (ETG) is a good option in the repair of nerve gaps. At this point, the present study aims to analyze the utility of the sliding epineural tube graft (SETG)technique in the reconstruction of nerve gaps. Materials and Methods: Thirty Wistar albino rats were divided into five groups according to the repair technique of a 7 mm nerve defect created on the right sciatic nerve. In Group 1 the defect was left unrepaired as a negative control group. The defect was repaired with ANG in Group 2, with turn-over ETG (TETG) in Group 3, with one-directional SETG (O-SETG) in Group 4 and with bi-directional SETG (B-SETG) in Group 5. On the 12th week of the experiment, electrophysiologic, gross macroscopic and microscopic evaluation of muscle function and microscopic assessments of muscle and nerve samples were performed. The left limb and proximal nerve segment of the defect area were used as the control side. Results: Electrophysiologic, macroscopic (wet muscle weight) and microscopic (axonal count, muscle fiber thickness was superior in the ANG group compared with TETG and SETG techniques. B-SETG showed poor results in all of the aforementioned findings. TETG and O-SETG techniques showed similar neuromuscular functions. Conclusion: Although the ANG technique has some disadvantages depending on the sacrification of a donor nerve and donor side, it has significantly superior reconstructive outcomes compared to ETG techniques. However, since the ETG techniques provide acceptable results, they should be in surgeons’ treatment repertoire because of the unique features of the microsurgical intervention.
{"title":"An effective technique in nerve defect repair: Analysis of sliding epineural tube graft technique and comparison with autologous nerve graft and turn-over epineural tube graft techniques","authors":"Murat Kara, Uğur Koçer, Ramazan Arslan, Koray Gürsoy, Seçil Vural, Ayşegül Fırat","doi":"10.32552/2023.actamedica.924","DOIUrl":"https://doi.org/10.32552/2023.actamedica.924","url":null,"abstract":"Objective: Autologous nerve graft (ANG) is the standard of care in the reconstruction of nerve gaps. However, scarification of a donor nerve, donor-site complications (wound complications, sensory dysfunction, neuroma, etc.) and unpredictable results lead surgeons to search for alternative techniques. Epineural tube graft (ETG) is a good option in the repair of nerve gaps. At this point, the present study aims to analyze the utility of the sliding epineural tube graft (SETG)technique in the reconstruction of nerve gaps. Materials and Methods: Thirty Wistar albino rats were divided into five groups according to the repair technique of a 7 mm nerve defect created on the right sciatic nerve. In Group 1 the defect was left unrepaired as a negative control group. The defect was repaired with ANG in Group 2, with turn-over ETG (TETG) in Group 3, with one-directional SETG (O-SETG) in Group 4 and with bi-directional SETG (B-SETG) in Group 5. On the 12th week of the experiment, electrophysiologic, gross macroscopic and microscopic evaluation of muscle function and microscopic assessments of muscle and nerve samples were performed. The left limb and proximal nerve segment of the defect area were used as the control side. Results: Electrophysiologic, macroscopic (wet muscle weight) and microscopic (axonal count, muscle fiber thickness was superior in the ANG group compared with TETG and SETG techniques. B-SETG showed poor results in all of the aforementioned findings. TETG and O-SETG techniques showed similar neuromuscular functions. Conclusion: Although the ANG technique has some disadvantages depending on the sacrification of a donor nerve and donor side, it has significantly superior reconstructive outcomes compared to ETG techniques. However, since the ETG techniques provide acceptable results, they should be in surgeons’ treatment repertoire because of the unique features of the microsurgical intervention.","PeriodicalId":7100,"journal":{"name":"Acta Medica","volume":"63 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135426435","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}
Pub Date : 2023-09-28DOI: 10.32552/2023.actamedica.898
Remek Kocz, Elizabeth Koch
A rare inherited renal tubulopathy, Bartter Syndrome is characterized by salt-wasting in the kidneys, resulting in the effects resembling those of loop diuretics: hypokalemia, hypochloremia, metabolic alkalosis, and volume contraction leading to low to normal blood pressure. The marked electrolyte and hemodynamic instability that is often seen in these patients can sometimes result in catastrophic consequences. Because of the relative rarity of this condition, there are only sparse reports on anesthetic management that typically involve preoperative testing carried out prior to the day of surgery. We herein describe a case of a 54-year-old patient with Bartter Syndrome who presented to the hospital for an outpatient dental surgery under general anesthesia. Preoperative consultation with a nephrologist helped to establish our strategy in maintaining the patient’s electrolyte balance. Point-of-care blood gas monitoring was carried out at regular intervals and guided the perioperative potassium supplementation. Patient remained stable for the entire course of the surgery and was discharged home the same day after one hour in the recovery unit.
{"title":"Ambulatory management of a patient with bartter syndrome under general anesthesia","authors":"Remek Kocz, Elizabeth Koch","doi":"10.32552/2023.actamedica.898","DOIUrl":"https://doi.org/10.32552/2023.actamedica.898","url":null,"abstract":"A rare inherited renal tubulopathy, Bartter Syndrome is characterized by salt-wasting in the kidneys, resulting in the effects resembling those of loop diuretics: hypokalemia, hypochloremia, metabolic alkalosis, and volume contraction leading to low to normal blood pressure. The marked electrolyte and hemodynamic instability that is often seen in these patients can sometimes result in catastrophic consequences. Because of the relative rarity of this condition, there are only sparse reports on anesthetic management that typically involve preoperative testing carried out prior to the day of surgery. We herein describe a case of a 54-year-old patient with Bartter Syndrome who presented to the hospital for an outpatient dental surgery under general anesthesia. Preoperative consultation with a nephrologist helped to establish our strategy in maintaining the patient’s electrolyte balance. Point-of-care blood gas monitoring was carried out at regular intervals and guided the perioperative potassium supplementation. Patient remained stable for the entire course of the surgery and was discharged home the same day after one hour in the recovery unit.","PeriodicalId":7100,"journal":{"name":"Acta Medica","volume":"19 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135427389","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: Medical and engineering faculty students both choose their majors from the field of science. But the educational process differs between the two majors. In this study we aimed to investigate the personality traits that might affect this preference. Affective Neuroscience Personality Scales (ANPS) could be particularly useful in studying the traits linked to the affective formation of the individual. Materials and Methods: We prepared an online survey form collecting the sociodemographic and clinical data and the ANPS. We investigated the relationship between affective personality traits determined by the ANPS and the selection of the major. Also, we examined the affective personality traits that may influence the development of psychiatric illness in our sample. Results: 219 medical students and 222 engineering students participated the study. Participants’ ages ranged between 18 and 33 (Median=21; IQR=3). Among participants 60,5% were female, 34,7% has a psychiatric illness, 11,3 % had a chronic illness, and 16,8% has a family history of psychiatric illness. ANPS total and subscale scores weren’t different between the groups. The SADNESS subscale scores were associated with the occurrence of the psychiatric illness. Conclusion: The lack of difference between the two groups may indicate that affective personality profile is not a decisive factor in this choice. Our limitations are the small sample size, the lack of representation of our sample and the scarcity of data about other factors that might affect this preference. SADNESS was associated with psychiatric disorders in both groups.
{"title":"Affective neuroscience personality differences between medical school students and engineering school students","authors":"Yasemin Hoşgören Alıcı, Jamal Hasanli, Selvi Ceran","doi":"10.32552/2023.actamedica.882","DOIUrl":"https://doi.org/10.32552/2023.actamedica.882","url":null,"abstract":"Objective: Medical and engineering faculty students both choose their majors from the field of science. But the educational process differs between the two majors. In this study we aimed to investigate the personality traits that might affect this preference. Affective Neuroscience Personality Scales (ANPS) could be particularly useful in studying the traits linked to the affective formation of the individual. Materials and Methods: We prepared an online survey form collecting the sociodemographic and clinical data and the ANPS. We investigated the relationship between affective personality traits determined by the ANPS and the selection of the major. Also, we examined the affective personality traits that may influence the development of psychiatric illness in our sample. Results: 219 medical students and 222 engineering students participated the study. Participants’ ages ranged between 18 and 33 (Median=21; IQR=3). Among participants 60,5% were female, 34,7% has a psychiatric illness, 11,3 % had a chronic illness, and 16,8% has a family history of psychiatric illness. ANPS total and subscale scores weren’t different between the groups. The SADNESS subscale scores were associated with the occurrence of the psychiatric illness. Conclusion: The lack of difference between the two groups may indicate that affective personality profile is not a decisive factor in this choice. Our limitations are the small sample size, the lack of representation of our sample and the scarcity of data about other factors that might affect this preference. SADNESS was associated with psychiatric disorders in both groups.","PeriodicalId":7100,"journal":{"name":"Acta Medica","volume":"14 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135427395","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: The modified NUTRIC Score (mNUTRIC) score is a screening test designed for evaluating patients in intensive care units. In this study, our aim is to assess the ability of this test to predict mortality, length of hospital stay, and the need for mechanical ventilation in COVID-19 patients in the intensive care units. Materials and Methods: In our retrospective study, we evaluated 67 patients admitted to our COVID-19 intensive care unit between October and November 2020. We analyzed their entry scores and conducted general follow-up assessments. Results: In our study, we found that mortality assessment revealed a significant association between older age (p<0.001), the need for mechanical ventilation (p=0.001), and the presence of dysphagia (p<0.001) in patients who did not survive.Statistically significant findings indicate that patients classified as having high mNUTRIC scores had higher rates of 28-day mortality, the need for mechanical ventilation, and the presence of dysphagia compared to those classified as having low nutritional scores. When patients with neurodegenerative diseases were evaluated as a separate group, no significant association was found between high nutritional scores and mortality, the need for mechanical ventilation, or length of hospital stay. Conclusion: The evaluation of nutritional risk in patients being monitored in intensive care is an important step in patient management. The modified NUTRIC score is a preferable assessment test due to its ease of use.
{"title":"Evaluating the modified NUTRIC score as a prognostic tool in the intensive care unit for COVID-19 patients","authors":"Görkem Tutal Gürsoy, Nuriye Kayalı Şendur, Yıldız Hayran, Levent Yamanel, Hesna Bektaş","doi":"10.32552/2023.actamedica.911","DOIUrl":"https://doi.org/10.32552/2023.actamedica.911","url":null,"abstract":"Objective: The modified NUTRIC Score (mNUTRIC) score is a screening test designed for evaluating patients in intensive care units. In this study, our aim is to assess the ability of this test to predict mortality, length of hospital stay, and the need for mechanical ventilation in COVID-19 patients in the intensive care units. Materials and Methods: In our retrospective study, we evaluated 67 patients admitted to our COVID-19 intensive care unit between October and November 2020. We analyzed their entry scores and conducted general follow-up assessments. Results: In our study, we found that mortality assessment revealed a significant association between older age (p<0.001), the need for mechanical ventilation (p=0.001), and the presence of dysphagia (p<0.001) in patients who did not survive.Statistically significant findings indicate that patients classified as having high mNUTRIC scores had higher rates of 28-day mortality, the need for mechanical ventilation, and the presence of dysphagia compared to those classified as having low nutritional scores. When patients with neurodegenerative diseases were evaluated as a separate group, no significant association was found between high nutritional scores and mortality, the need for mechanical ventilation, or length of hospital stay. Conclusion: The evaluation of nutritional risk in patients being monitored in intensive care is an important step in patient management. The modified NUTRIC score is a preferable assessment test due to its ease of use.","PeriodicalId":7100,"journal":{"name":"Acta Medica","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135426284","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}
Pub Date : 2023-09-28DOI: 10.32552/2023.actamedica.888
Sancar Bakircioglu, Ulas Can Kolac, Mert Polat, Abdulsamet Emet, A. Mazhar Tokgozoglu, M. Cemalettin Aksoy, Saygin Kamaci
Objective: Functional limitation or radiological failure after the treatment may rarely be seen after the surgical treatment of Gartland type 3 supracondylar humerus fractures (SCHF). The present study aims to investigate whether the level of fracture relative to the isthmus of the humerus affects the outcomes. Materials and Methods: Children who underwent closed reduction and percutaneous pinning (CRPP) due to Gartland typle III SCHFs between 2010 and 2017 were investigated. There were 108 elbows treated with a mean age of 6.1 years (range, 1.4 to 11.2 yrs.). The radiological (Carrying Angle, Baumann Angle, Humerocapitellar Angle), clinical (Flynn grade with elbow range of motion) and complications were used to evaluate outcomes including fracture level. A reference line connecting medial epicondyle, olecranon fossa and lateral epicondyle was drawn on Anteroposterior (AP) and lateral x-rays. The level of the fracture line was decided based on the reference line. Low fractures included the fractures below or involving the reference line, whereas high fractures included those above the reference line. Results: There were 80 High and 28 Low fractures according to A reference line connecting medial epicondyle, olecranon fossa and lateral epicondyle and passing through the isthmus. Fractures below the humeral isthmus had significantly low Flynn grade (p:0.049) at the latest follow-up of 2.1 years (range, 1 to 5.1 yrs.). There was no statistically significant difference regarding postoperative sixth week Baumann`s angle, carrying angle and humerocapitallar angle between low and high fracture groups. Conclusions: The present study demonstrates the importance of fracture analysis. Surgeons may consider more stable pin configuration in the low type fractures and future research should aim to analyze the SCHF in terms of fracture morphology.
目的:Gartland型肱骨髁上骨折(Gartland type 3肱骨髁上骨折，SCHF)手术治疗后很少出现功能受限或影像学失败。本研究旨在探讨相对于肱骨峡部的骨折程度是否影响预后。材料与方法:对2010年至2017年因Gartland III型schf接受闭合复位和经皮钉钉(CRPP)治疗的儿童进行调查。108例肘部治疗，平均年龄6.1岁(范围1.4 ~ 11.2岁)。影像学(carry角、Baumann角、肱骨角)、临床(肘关节活动范围的Flynn分级)和并发症用于评估包括骨折程度在内的预后。在正位和侧位x线上画一条连接内侧上髁、鹰嘴窝和外侧上髁的参考线。在参考线的基础上确定骨折线的水平。低骨折包括低于或累及参考线的骨折，而高骨折包括高于参考线的骨折。结果:经峡部参照线连接内上髁、鹰嘴窝、外上髁，高骨折80例，低骨折28例。在最近随访2.1年(范围1 ~ 5.1年)时，肱骨峡部以下骨折的Flynn分级明显较低(p:0.049)。低骨折组与高骨折组术后第6周Baumann角、负重角、肱骨角差异无统计学意义。结论:本研究表明骨折分析的重要性。在低型骨折中，外科医生可能会考虑更稳定的针配置，未来的研究应着眼于从骨折形态方面分析SCHF。
{"title":"Gartland Type III Supracondylar humerus fractures in children: Impact of fracture level on outcomes","authors":"Sancar Bakircioglu, Ulas Can Kolac, Mert Polat, Abdulsamet Emet, A. Mazhar Tokgozoglu, M. Cemalettin Aksoy, Saygin Kamaci","doi":"10.32552/2023.actamedica.888","DOIUrl":"https://doi.org/10.32552/2023.actamedica.888","url":null,"abstract":"Objective: Functional limitation or radiological failure after the treatment may rarely be seen after the surgical treatment of Gartland type 3 supracondylar humerus fractures (SCHF). The present study aims to investigate whether the level of fracture relative to the isthmus of the humerus affects the outcomes. Materials and Methods: Children who underwent closed reduction and percutaneous pinning (CRPP) due to Gartland typle III SCHFs between 2010 and 2017 were investigated. There were 108 elbows treated with a mean age of 6.1 years (range, 1.4 to 11.2 yrs.). The radiological (Carrying Angle, Baumann Angle, Humerocapitellar Angle), clinical (Flynn grade with elbow range of motion) and complications were used to evaluate outcomes including fracture level. A reference line connecting medial epicondyle, olecranon fossa and lateral epicondyle was drawn on Anteroposterior (AP) and lateral x-rays. The level of the fracture line was decided based on the reference line. Low fractures included the fractures below or involving the reference line, whereas high fractures included those above the reference line. Results: There were 80 High and 28 Low fractures according to A reference line connecting medial epicondyle, olecranon fossa and lateral epicondyle and passing through the isthmus. Fractures below the humeral isthmus had significantly low Flynn grade (p:0.049) at the latest follow-up of 2.1 years (range, 1 to 5.1 yrs.). There was no statistically significant difference regarding postoperative sixth week Baumann`s angle, carrying angle and humerocapitallar angle between low and high fracture groups. Conclusions: The present study demonstrates the importance of fracture analysis. Surgeons may consider more stable pin configuration in the low type fractures and future research should aim to analyze the SCHF in terms of fracture morphology.","PeriodicalId":7100,"journal":{"name":"Acta Medica","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135427392","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}
Pub Date : 2023-09-28DOI: 10.32552/2023.actamedica.933
Murat İzgi̇, Murat Tümer, Bilge Çelebioğlu
Objective: The aim of this study was to compare the effects of fentanyl, dexmedetomidine, and remifentanil on serum pentraxin 3 levels in patients undergoing on-pump coronary artery bypass surgery. Materials and Methods: In this retrospectively designed study, 36 patients who underwent elective on-pump coronary artery bypass surgery for coronary artery disease in the Cardiovascular Surgery Clinic of our hospital between 01.01.2020 and 31.12.2021 and whose serum pentraxin 3 levels were studied in the pre-operative and post-operative period were included. Patients were divided into 3 groups as fentanyl (Group F), dexmedetomidine (Group D), and remifentanil (Group R) based on the analgesic agent used during the intraoperative period. The data of the patients were obtained by scanning their files and information in the hospital automation system. Results: Demographic characteristics, duration of anesthesia, cardiopulmonary bypass duration, and aortic cross-clamp duration were similar. When serum pentraxin 3 levels were evaluated within groups, the difference between pre-operative and post-operative results was significant. In the intergroup evaluation, only the results obtained from Group F in the pre-operative period were significant compared to the other groups, but there was no significant difference between the results obtained in the post-operative period. Conclusion: When the data of this study were evaluated, it was determined that the analgesic agent used in the intraoperative period of on-pump coronary artery bypass surgery did not significantly affect post-operative serum pentraxin 3 levels.
{"title":"Comparison of the effects of intravenous analgesic agents used in the intraoperative period on pentraxin-3 levels in patients undergoing on-pump coronary artery bypass surgery","authors":"Murat İzgi̇, Murat Tümer, Bilge Çelebioğlu","doi":"10.32552/2023.actamedica.933","DOIUrl":"https://doi.org/10.32552/2023.actamedica.933","url":null,"abstract":"Objective: The aim of this study was to compare the effects of fentanyl, dexmedetomidine, and remifentanil on serum pentraxin 3 levels in patients undergoing on-pump coronary artery bypass surgery. Materials and Methods: In this retrospectively designed study, 36 patients who underwent elective on-pump coronary artery bypass surgery for coronary artery disease in the Cardiovascular Surgery Clinic of our hospital between 01.01.2020 and 31.12.2021 and whose serum pentraxin 3 levels were studied in the pre-operative and post-operative period were included. Patients were divided into 3 groups as fentanyl (Group F), dexmedetomidine (Group D), and remifentanil (Group R) based on the analgesic agent used during the intraoperative period. The data of the patients were obtained by scanning their files and information in the hospital automation system. Results: Demographic characteristics, duration of anesthesia, cardiopulmonary bypass duration, and aortic cross-clamp duration were similar. When serum pentraxin 3 levels were evaluated within groups, the difference between pre-operative and post-operative results was significant. In the intergroup evaluation, only the results obtained from Group F in the pre-operative period were significant compared to the other groups, but there was no significant difference between the results obtained in the post-operative period. Conclusion: When the data of this study were evaluated, it was determined that the analgesic agent used in the intraoperative period of on-pump coronary artery bypass surgery did not significantly affect post-operative serum pentraxin 3 levels.","PeriodicalId":7100,"journal":{"name":"Acta Medica","volume":"98 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135426434","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}
Pub Date : 2023-03-28DOI: 10.32552/2023.actamedica.764
Birce Sunman, Nagehan Emiralioğlu, Beste Özsezen, Dilber Ademhan Tural, Halime Nayir Büyükşahin, İsmail Güzelkaş, Ebru Yalçın, Deniz Doğru, Nural Kiper, Uğur Özçelik
Objectives: The COVID-19 pandemic required precautions for infection control in sleep centers. Our aim was to assess the impact of the COVID-19 pandemic on sleep medicine practices. Methods: Data of patients undergoing polysomnography and positive airway pressure titration studies prior to (2019) and during the pandemic (2020) were analyzed. In addition, the effect of taking appropriate precautions and performing SARS-CoV-2 polymerase chain reaction testing on the safety of sleep medicine practices was investigated. Results: The median age of the patients who underwent sleep studies (polysomnography + positive airway pressure titration studies) in 2019 was 7 (2.5-11.5) years (164 male, 147 female), whilst it was 9 (4-12) years (127 male, 84 female) in 2020. During the outbreak, the frequency of sleep studies increased from 3% (311 tests/10068 total number of outpatient visits in 2019) to 3.7% (211 tests/5666 in 2020). In contrast, the frequency of positive airway pressure titration studies declined from 31.8% (99 positive airway pressure titration studies/311 sleep studies) to 21.8% (46 positive airway pressure titration studies/211 sleep studies) in 2020 compared to 2019. Down syndrome was found to be the most common indication both in 2019 (20.9% of all tests) and 2020 (13.7%). Conclusions: Polysomnographies were performed at a high rate despite the pandemic. However, positive airway pressure titration studies were avoided except for urgent indications because of the potential for aerosolization. In this study, it was shown that sleep studies can be performed safely when necessary precautions are taken.
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