Tıp Fakültesi / Faculty of Medicine

Permanent URI for this collectionhttps://hdl.handle.net/11727/1403

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2017 - 20192

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Author: search.filters.author.Birtay, TayfunHas files: No

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    Association Between Vascular Access Type and Visceral and Peripheral Body Fat, Nutritional and Inflammatory Parameters in Incident Hemodialysis Patients
    (2017) Birtay, Tayfun; Saba, Tonguc; Haberal, Cevahir; Genctoy, Gultekin; 0000-0002-5145-2280; AAJ-5551-2021
    OBJECTIVE: Central venous catheters (CVCs) are preferred when a patent arteriovenous fistula (AVF) cannot be created. CVCs have been shown to be associated with increased inflammation and mortality. In the present study, we aimed to investigate a probable association between the vascular access type and BMI, total body fat, truncal fat, muscle mass, visceral (periaortic) fat, and the malnutrition inflammation atherosclerosis and calcification score (MIAC) in hemodialysis patients MATERIAL and METHODS: A total of 119 patients were involved. Ninety patients had patent AVF and 29 patients were undergoing hemodialysis via permanent jugular catheter. Two-dimensional echocardiography was performed to detect valvular calcification. Computed tomography was performed in all patients to detect the amount of thoracic periaortic fat tissue (T-PAFT). Biochemical analyses were performed using c8000 Architect. MIAC scores were calculated using valvular calcification, albumin, and CRP. Total body fat and truncal fat were detected using the bio impedance analysis method. Aortic calcification score (AoCS) was calculated using routine chest x-rays RESULTS: MIAC and AoCS was higher in patients with CVC (p=0.02 and 0.032). T-PA FT was higher in patients with AV (1631.5 +/- 645 vs 1112.2 +/- 606.8; p=0.035). CRP was higher in patients with CVC (p=0.04). Hemodialysis vintage, calcium and albumin were lower in patients with CVC Truncal fat (%), cholesterol and 25-OH vitamin D levels were lower in patients with CVC (p=0.04, p=0.02, p=0.03). T-PA FT was a significant predictor of vascular access type in favour of AVF (t=-2.17; p=0.04) CONCLUSION: The present study revealed that HI) patients with CVC had increased inflammation and decreased nutrition, visceral and truncal fat. Further prospective studies are needed to illuminate the relationship between vascular access type, nutritional parameters and body composition in HD patients.
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    Comparison of Single-Dose Infraclavicular Brachial Plexus Block and Continuous Infraclavicular Brachial Plexus Block Applications in the Treatment of Finger Amputations
    (2019) Sahin, Mehmet Sukru; Cakmak, Gokhan; Birtay, Tayfun; 31814664
    Introduction The aim of this study is to evaluate the replantation success of single-dose infraclavicular brachial plexus block and continuous infraclavicular brachial plexus block (CIBPB) applied with bupivacaine and prilocaine in patients with finger amputation. Materials and Methods This prospective randomized nonblinded study was conducted between January 2012 and September 2017, and 47 patients, all male, were included. Patients were randomly separated into two groups as 23 patients CIBPB applied group (group A) and 24 patients single-dose infraclavicular block applied group (group B). In group B, after the effect of block is ceased, intravenous patient-controlled (PC) opioid analgesia and, where necessary, 1 mg/kg meperidine and 75 mg diclofenac sodium intramuscularly were alternately administered at 4 to 6 hours intervals. The average ages were 30.7 +/- 10.06 and 29 +/- 9.08, respectively. Replantations were applied as being two venous anastomoses to one artery, where possible. Hourly skin temperatures of fingers of the hands in which both surgeries applied and no surgery applied in both the groups were measured for 3 days with an infrared thermometer. Also, Numerical Rating Scale (NRS) evaluations in both the groups were performed in 3-hour intervals for 3 days. Results Replantations were successful in 22 patients in whom CIBPB was applied (95.6%) and in 19 patients in whom single block was applied (79.16%). Regarding the finger temperatures, no significant difference was detected between both the groups for 3 days following the operation. No significant difference was found between the length of hospital stays (4.73 +/- 2.21-4.71 +/- 1.53) and duration of operations (2.90 +/- 0.73-2.83 +/- 0.58). There was no significant difference between the temperature values of both the groups. NRS scores of group A were statistically significantly lower than those of group B. Conclusion In this prospective randomized study performed by using bupivacaine and prilocaine on 24 patients, the success rate of finger replantations with CIBPB was found to be higher. CIBPB is a very beneficial method that should be taken in consideration in hand injuries with anastomosis and high risk of vasospasm. Further studies with more number of cases would help reduce the question marks related with the success of this method.