Browsing by Author "Cinar, Ozlem"

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Combined catheter thrombus fragmentation and percutaneous thrombectomy in a patient with massive pulmonary emboli and acute cerebral infarct
(2015) Ugurlu, Aylin Ozsancak; Cinar, Ozlem; Caymaz, Ismail; Cevik, Halime; Gumus, Burcak; 25550253
The Effect of Tramadol Plus Paracetamol on Consumption of Morphine After Coronary Artery Bypass Grafting
(2017) Altun, Dilek; Cinar, Ozlem; Ozker, Emre; Turkoz, Ayda; 0000-0003-2279-3083; 28183564; AAR-7467-2020
Study of objective: To compare the effects of oral tramadol + paracetamol combination on morphine consumption following coronary artery bypass grafting (CABG) in the patient-controlled analgesia (PCA) protocol. Design: A prospective, double-blind, randomized, clinical study. Setting: Single-institution, tertiary hospital. Patients: Fifty cardiac surgical patients undergoing primary CABG surgery. Interventions: After surgery, the patients were allocated to 1 of 2 groups. Both groups received morphine according to the PCA protocol after arrival to the coronary intensive care unit (bolus 1 mg, lockout time 15 minutes). In addition to morphine administration 2 hours before operation and postoperative 2nd, 6th, 12th, 18th, 24th, 30th, 36th, 42th, and 48th hours, group T received tramadol + paracetamol (Zaldiar; 325 mg paracetamol, 37.5 mg tramadol) and group P received placebo. Sedation levels were measured with the Ramsay Sedation Scale, whereas pain was assessed with the Pain Intensity Score during mechanical ventilation and with the Numeric Rating Scale after extubation. If the Numeric Rating Scale score was.>_.3 and Pain Intensity Score was >= 3, 0.05 mg/kg morphine was administered additionally. Measurements: Preoperative patient characteristics, risk assessment, and intraoperative data were similar between the groups. Main results: Cumulative morphine consumption, number of PCA demand, and boluses were higher in group P (P < .01). The amount of total morphine (in mg) used as a rescue analgesia was also higher in group P (5.06 +/- 1.0), compared with group T (2.37 +/- 0.52; P < .001). The patients who received rescue doses of morphine were 8 (32%) in group T and 18 (72%) in group P (P < .001). Duration of mechanical ventilation in group P was longer than group T (P < .01). Conclusion: Tramadol + paracetamol combination along with PCA morphine improves analgesia and reduces morphine requirement up to 50% after CABG, compared with morphine PCA alone. (C) 2016 Elsevier Inc. All rights reserved.
Multiple Brain Abscesses Due to Phialemonium in a Renal Transplant Recipient: First Case Report in the Literature
(2015) Aydin, Mehtap; Ozcelik, Umit; Cevik, Halime; Cinar, Ozlem; Evren, Ebru; Demirag, Alp; 0000-0003-1073-2494; 0000-0003-4044-9366; 26640919; AAG-8651-2021; HLX-0937-2023; JAZ-1759-2023
Fungal brain abscesses are a rare but serious complication in transplant recipients. Phialemonium organisms are rare causes of invasive mold infections. Here, we present the first case of a renal transplant recipient with multiple brain abscesses caused by Phialemonium infection A. A 51-year-old female kidney transplant recipient was admitted with pneumonia of an unknown cause and treated with empiric intravenous antibiotics. Her treatment was uneventful, and she was discharged 1010 days later. After 5 days, she was readmitted with fever, cerebral palsy, and speech disorder. The patient had undergone living-donor renal transplant 7 months earlier. A cranial computed tomography and magnetic resonance imaging were performed for a possible cerebro vascular pathology. The magnetic resonance imaging scan showed multiple brain abscesses located at the left parietal, frontal and occipital lobes; right parietal and occipital lobes; right basal ganglia; and left cerebellum. The patient received meropenem, linezolid, sulfamethoxazole and trimethoprim, and AmBisome for probable pathogenic infection, and immunosuppressive agents dosage was reduced increasingly immuno suppressed. We identified Phialemonium in cerebrospinal fluid culture. The patient received voriconazole 200 mg twice daily. Lesions could not be drained due to lack of capsula formation. The patient died on the 30th day of antifungal therapy. Phialemonium organisms, although a rare cause of fungal infections, are associated with a high mortality rate in immunocompromised patients. To our knowledge, this is the first case report in the literature describing multiple brain abscesses due to Phialemonium in a transplant recipient. Clinicians recipient should be alert about these rare opportunistic fungi in the differential diagnosis of brain abscess, and bronchoscopy and broncho alveolar lavage are recommended for transplant patients when they are admitted with pneumonia exclude fungal infections.
Ultrasound guided continuous paravertebral block in a patient with coronary heart disease and sleep apnea syndrome
(2016) Esen, Bilgiser; Bircan, Huseyin Yuce; Cinar, Ozlem; Turkoz, Ayda; 27225612
The case of a 77-year-old patient with severe coronary heart disease who underwent radical mastectomy with axillary lymph node dissection by ultrasound-guided continuous paravertebral block (CPVB) is described in the present report. Radical mastectomy with axillary dissection is a surgical procedure that necessitates endotracheal intubation and is usually performed under general anesthesia, which carries heightened risk for patients with coronary heart disease (CHD) and sleep apnea syndrome (SAS). Ultrasound-guided CPVB is a simple and safe alternative technique that allows for the use of anesthesia and postoperative analgesia with minimal side effects.