Tıp Fakültesi / Faculty of Medicine

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

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search.filters.applied.f.rights: search.filters.rights.info:eu-repo/semantics/closedAccessSubject: search.filters.subject.Colonoscopy

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    Addition of Low-Dose Ketamine to Midazolam-Fentanyl-Propofol-Based Sedation for Colonoscopy: A Randomized, Double-Blind, Controlled Trial
    (2015) Tuncali, Bahattin; Pekcan, Yonca Ozvardar; Celebi, Arzu; Zeyneloglu, Pinar; 0000-0002-7898-2943; 0000-0002-0991-7435; 0000-0003-2312-9942; 25801162; AAJ-7840-2021; AAD-5696-2021; C-3736-2018
    Study Objective: To evaluate the effects of low-dose ketamine on midazolam-fentanyl-propofol-based sedation for outpatient colonoscopy. Design: Prospective, randomized, double-blinded, placebo-controlled trial. Setting: Gastroenterology unit at a practice and clinical research center. Subjects: Ninety-seven healthy American Society of Anesthesiology physical status 1 volunteers. Interventions: Subjects were randomized to receive midazolam (0.02 mg/kg), fentanyl (1 mu g/kg), and ketamine (0.3 mg/kg) and midazolam (0.02 mg/kg), fentanyl (1 mu g/kg), and placebo (0.9% sodium chloride) in group K and group C, respectively. In both groups, incremental doses of propofol were used to maintain a Ramsay sedation score of 3 to 4. Measurements: Values of heart rate, blood pressure, oxygen saturation, and respiratory rate were measured. Procedure times, recovery times, drug doses used, complications associated with the sedation, and physician and patient satisfaction were also recorded. Main Results: In group K, mean amount of propofol used and mean induction time (P < .001), the need for the use of jaw thrust maneuver and mask ventilation, and the incidence of disruptive movements were significantly lower (P < .05) and gastroenterologist satisfaction at the beginning of the procedure was significantly superior (P < .05). Mean systolic blood pressures at 4, 6, 8, and 10 minutes (P < .01); diastolic blood pressures at 4, 6, and 8 minutes (P < .05); respiratory rates at 4, 6, 8, 10, 15, 20, and 25 minutes (P < .01); and oxygen saturation at 6, 8, 10, 15, and 20 minutes (P < .05) were significantly lower in group C. Patient satisfaction scores, recovery times, and discharge times were similar. No patient in either group experienced unpleasant dreams or hallucination in the postanesthesia care unit and on the first postoperative day. Conclusions: Addition of low-dose ketamine to midazolam-fentanyl-propofol-based sedation for outpatient colonoscopy resulted in more rapid and better quality of sedation, less propofol consumption, more stable heinodynamic status, and less adverse effects with similar recovery times in adult patients. (C) 2015 Elsevier Inc. All rights reserved.
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    Single and Multiple Food Allergies in Infants with Proctocolitis
    (2018) Koksal, B. T.; Baris, Z.; Ozcay, F.; Ozbek, O. Yilmaz; 0000-0002-5214-516X; 0000-0001-9580-7656; 28739021; ABG-5684-2020; AAB-4153-2020; AAF-2109-2021
    Background: Food protein-induced allergic proctocolitis is a frequent cause of rectal bleeding in infants. Characteristics of infants with multiple food allergies have not been defined. Objective: This study aimed to identify characteristics of infants with proctocolitis and compare infants with single and multiple food allergies. Methods: A total of 132 infants with proctocolitis were evaluated retrospectively. All of the infants were diagnosed by a paediatric allergist and/or a paediatric gastroenterologist according to guidelines. Clinical features of the infants, as well as results of a complete blood count, skin prick test, specific immunoglobulin E, and stool examinations or colonoscopy were recorded. Results: Cow's milk (97.7%) was the most common allergen, followed by egg (22%). Forty-five (34.1%) infants had allergies to more than one food. Infants with multiple food allergies had a higher eosinophil count (613 +/- 631.2 vs. 375 +/- 291.9) and a higher frequency of positive specific IgE and/or positive skin prick test results than that of patients with a single food allergy. Most of the patients whose symptoms persisted after two years of age had multiple food allergies. Conclusions: There is no difference in clinical presentations between infants with single and multiple food allergies. However, infants with multiple food allergies have a high blood total eosinophil count and are more likely to have a positive skin prick test and/or positive specific IgE results. (C) 2017 SEICAP. Published by Elsevier Espana, S.L.U. All rights reserved.
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    Does the Presence of Endometrial Polyp Predict Colorectal Polyp ?
    (2016) Unler, Gulhan Kanat; Gokturk, Huseyin Savas; Toprak, Erzat; Erinanc, Ozgur Hilal; Korkmaz, Huseyin; https://orcid.org/0000-0003-0182-002X; https://orcid.org/0000-0002-2877-1232; https://orcid.org/0000-0003-1401-6356; 26897266; ABI-5902-2020; AAL-1268-2021
    Introduction: Endometrial polyps (EPs) and colorectal polyps (CPs) are common disorders and the incidence of both increase rapidly with aging. CPs are focal lesions and incidence increases with age. Aim: In this study, we aimed to analyze retrospectively the relationship between the EPs and CPs sharing similar clinical and genetic factors in their etiopathogenesis. Materials and Methods: This study was retrospectively performed between 2010 and 2013 and it included patients diagnosed to have eEPs. The study group and the control group consisted of patients who were diagnosed with or without EPs and who underwent colonoscopy at the same period. Results: The study group was formed by 57 patients with diagnosis of EP who underwent colonoscopy during the same period. The control group consisted of 71 patients without EP examined with colonoscopy. Among 128 patients assessed in this study, 24 were diagnosed with CPs, all of which were adenomatous polyps smaller than 1 cm. No hyperplastic or inflammatory polyps were diagnosed. While 18 of 57 patients with EPs had CPs, 6 of 71 control subjects had CPs. Hence, the risk of having CP was 5 times greater in patients with EP compared to those without (P < 0.05). Conclusion: The present study demonstrated that the prevalence of CPs increased significantly in postmenopausal patients with EPs. Recommending colonoscopy to these patients irrespective of age may be beneficial for detecting more CPs and preventing colorectal cancer.