Sağlık Hizmetleri Meslek Yüksekokulu / Vocational School of Health Services
Permanent URI for this collectionhttps://hdl.handle.net/11727/3080
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Item Anaesthetic Management for Orthotopic Liver Transplantation in A Patient with Glycogen Storage Disease Type Iiia(2023) Haka, D.; Cekmen, N.; 0000-0001-7448-8203Glycogen storage disease (GSD) type III is a metabolic disorder caused by a deficiency in amylo-1,6-glucosidase enzyme, which is responsible for the breakdown of the glycogen molecule, resulting in glycogen accumulating in the organs, hypoglycaemia, muscle weakness, liver dysfunction, delayed anaesthetic recovery, excessive surgical bleeding, cardiomyopathy and end-organ dysfunction. This case report presents a child with GSD type IIIa who underwent orthotopic liver transplantation (OLT) with her mother as a donor. A multidisciplinary approach should be provided to optimise the preoperative period and minimise complications in these patients.Item Bibliometric Analysis of Articles Published in Cukurova Medical Journal Between 2011 and 2022(2023) Polat, Sema; Tunc, Mahmut; Ozsahin, Esin; Tamam, Lut; Goker, Pinar; 0000-0003-1373-4700Purpose: This study aimed to perform a bibliometric analysis of the abstracts and keywords in articles published in the Cukurova Medical Journal from 2011 to 2022. Materials and Methods: We compiled and analyzed all articles published in the Cukurova Medical Journal between 2011 and 2022, totaling 1734 articles, using VOSviewer software (version 1.6.19). This analysis focused on the terms in the abstracts and the keywords of these articles. Results: The study identified 27,409 unique terms and 4,040 unique keywords in the abstracts of the 1734 articles. The most common terms were 'surgery' (333 occurrences), 'pain' (263), 'infection' (201), 'measurement' (192), 'rat' (185), 'tumor' (177), 'covid' (157), 'pregnancy' (148), 'questionnaire' (144), and 'drug' (142). The top keywords were 'children' (43 occurrences), 'quality of life' (37), 'covid-19' (34), 'nursing' (32), 'pregnancy' (28), 'depression' (27), 'mortality' (26), 'anxiety' (24), 'child' (22), and 'obesity' (17). Conclusion: This is the first bibliometric analysis of keywords and terms used in the Cukurova Medical Journal, offering insights into the evolving topics of interest in the journal's publications. It also provides valuable information for researchers looking to submit articles to the journal, highlighting prevalent themes and content areas.Item Factors Affecting Nurses' Professional Commitment During the COVID-19 Pandemic: A Cross-Sectional Study(2021) Duran, Secil; Celik, Isa; Ertugrul, Bekir; Ok, Serife; Albayrak, Sevil; 33794061Aim This study aims to investigate the factors affecting nurses' professional commitment during the COVID-19 pandemic. Background Commitment to a profession requires doing the best for that profession. In the case of the nursing profession, professional commitment gains greater importance in times of crisis, like the COVID-19 pandemic. Methods This cross-sectional study was conducted with 389 nurses in the Turkish state hospital. Institutional permissions, ethical approval and written consents from the participants were obtained before carrying out the study. Results The participants' mean Perceived Organizational Obstruction Scale score was 20.07 +/- 8.06 (min = 5.0, max = 35.0), and their mean Nursing Professional Commitment Scale score was 71.20 +/- 11.94 (min = 30.0, max = 103.0). Socio-demographic variables and perception of organisational obstruction predicted 36.7% of the variance in the professional commitment (p < .001). Conclusion A road map based on the study results was developed for hospitals and nurse managers to maintain and increase nurses' professional commitment. Implications for Nursing Management The results of this study may help institutions and nurse managers understand the factors affecting professional commitment during the pandemic as a whole, as well as determine primary strategies based on the importance of these factors.Item Value of cardiopulmonary exercise testing in the diagnosis of coronary artery disease(2019) Akinci Ozyurek, Berna; Savas Bozbas, Serife; Aydinalp, Alp; Bozbas, Huseyin; Ulubay, Gaye; 31414640Introduction: Respiratory and cardiac functions in association with skeletal and neurophysiologic systems can be evaluated with cardiopulmonary exercise testing (CPET). Compared to treadmill exercise test, CPET provides more comprehensive data about the hemodynamic response to exercise. Materials and Methods: We aimed to evaluate the relationship with CPET findings and coronary lesions identified on angiography in patients with angina pectoris who underwent teradmill exercise, CPET and coronary angiography (CAG). By this way we sought to examine the CPET parameters that might be predictive for coronary artery disease (CAD) before diagnostic exercise test results and ischemia symptoms develop. Thirty patients in whom CAG was planned because of symptoms and exercise test results were enrolled in the study. Oxygen consumption (VO2), carbon dioxide production (VCO2), minute ventilation (VE), maximum work rate (WR), Delta VO2/Delta WR and O-2 pulse (VO2/HR) values were calculated. Significant CAD was defined as >= 50% narrowing in at least one of the coronary arteries. Results: The mean age was 60.4 +/- 8.9 years ve 21 (65.6%) of subjects were male. On CAG, CAD was detected in 19 (59.4%) patients. Maximum heart rate, heart rate reserve (HRR), VE/VCO2 measured at anaerobic threshold AT) and VO2 (mL/kg/min) were significantly differed in patients with CAD than those without (p= 0.031; p= 0.041; p= 0.028; p= 0.03 respectively). Peak VO2, VO2/WR and O-2 pulse values were higher in patients with normal angiographic results than those with CAD but the difference did not reach to statistical significance. Conclusion: The findings of our study indicate that among CPET parameters AT VE/VCO2, ATVO(2) (mL/kg/dk) and HRR can have predictive value in the diagnosis of CAD. We think that these parameters might be used in the evaluation of patients with angina and dyspnea suspected of CAD. In conclusion parameters obtained during the test that are not influenced by patient's effort might increase the value of CPET in the diagnosis CAD.Item Efficacy of ultrasound-guided bilateral erector spinae plane block in pediatric laparoscopic cholecystectomy: Case series(2019) Karaca, Omer; Pinar, Huseyin Ulas; 0000-0003-0473-6763; 31741347; Q-2420-2015Postoperative opioid administration can cause various side effects, such as drowsiness, respiratory distress, postoperative nausea, and vomiting. The use of non-opioid medications as part of a multimodal analgesia method has been increasingly suggested in the management of acute postsurgical pain. Erector spinae plane block (ESPB), which is a regional anesthesia technique, blocks both visceral and somatic nerve fibers.Though it is infrequently used in young patients, presently described is a series of cases in which ESPB was successfully used in the performance of pediatric laparoscopic cholecystectomy. Ultrasound-guided bilateral ESPB was performed on 4 patients who underwent a laparoscopic cholecystectomy. An injection of 0.25% bupivacaine was administered into the interfascial area on each side in the pre-incisional period after the anesthesia induction (total anesthetic: 2.5 mg/kg). Postoperative pain control was planned at 10 mg/kg intravenous paracetamol every 8 hours. Numeric rating scale pain scores were less than 3 points in the post-anesthetic care unit, and at 1, 2, 4, 8, 12, and 24 hours. No rescue analgesic (1 mg/kg tramadol) was needed. None of the typical complications, such as drowsiness or nausea, were observed and no block-related complications were recorded. Bilateral ESPB that is a part of multimodal analgesia regimen can provide effective analgesia for pediatric laparoscopic cholecystectomy patients in the first 24 hours postoperatively.Item Effects of self-ligating and conventional brackets on halitosis and periodontal conditions(2015) Kaygisiz, Emine; Uzuner, Fatma Deniz; Yuksel, Sema; Taner, Levent; Culhaoglu, Rana; Sezgin, Yasemin; Ates, Can; 25101909Objective: To evaluate the effects of fixed orthodontic treatment with steel-ligated conventional brackets and self-ligating brackets on halitosis and periodontal health. Materials and Methods: Sixty patients, at the permanent dentition stage aged 12 to 18 years, who had Angle Class I malocclusion with mild-to-moderate crowding were randomly selected. Inclusion criteria were nonsmokers, without systematic disease, and no use of antibiotics and oral mouth rinses during the 2-month period before the study. The patients were subdivided into three groups randomly: the group treated with conventional brackets (group 1, n = 20) ligated with steel ligature wires, the group treated with self-ligating brackets (group 2, n = 201, and the control group (group 3, n = 20). The periodontal records were obtained 1 week before bonding (T1), immediately before bonding (T2), 1 week after bonding (T3), 4 weeks after bonding (T4), and 8 weeks after bonding (T5). Measurements of the control group were repeated within the same periods. The volatile sulfur components determining halitosis were measured with the Halimeter at T2, T3, T4, and T5. A two-way repeated measures of analysis of variance (ANOVA) was used to compare the groups statistically. Results: No statistically significant group x time interactions were found for plaque index, gingival index, pocket depth, bleeding on probing, and halitosis, which means three independent groups change like each other by time. The risk of tongue coating index (TCI) being 2 was 10.2 times higher at T1 than at T5 (P < .001). Therefore, the probability of higher TCI was decreased by time in all groups. Conclusions: The self-ligating brackets do not have an advantage over conventional brackets with respect to periodontal status and halitosis.Item The role of shear wave elastography in the diagnosis of chronic autoimmune thyroiditis(2015) Hekimoglu, Koray; Donmez, Fuldem Yildirim; Arslan, Serdar; Ozdemir, Adnan; Demir, Canan; Yazici, Canan; 26343080Aims: The aim of this study is to assess the applicability of shear wave elastography (SWE) in the diagnosis of chronic autoimmun thyroiditis (CAT) patients. Material and methods: The study group consisted of 50 patients with first-diagnosed CAT and 40 control subjects (CS). In all patients with CAT and CS, sonoelastographic measurements were made in both thyroid lobes. Optimal cut-off values were chosen to maximize the sum of sensitivity and specificity. Positive predictive value (PPV), negative predictive value (NPV), and accuracy values were also calculated. Results: Quantitative elastographic analysis evaluated by SWE in CAT patients (2.56 +/- 0.30 m/s) was significantly higher compared with CS (1.63 +/- 0.12 m/s) (p<0.001). The optimal cut-off value was 2.42 m/s. SWE had 77% sensitivity, 71% specificity, 92% PPV, 81% NPV, and 87% accuracy for the presence of CAT. Conclusions: Our data indicate that SWE correctly defines the elasticty of thyroid parenchyma, and this technique may assist in the diagnosis and treatment monitoring of CAT.Item Portopulmonary hypertension in liver transplant candidates(2016) Bozbas, Serife Savas; Bozbas, Huseyin; 26877607Pulmonary vascular disorders including portopulmonary hypertension (PoPHT) are among the common complications of liver disease and are prognostically significant. Survival is very low without medical treatment and liver transplantation. With advances in medical therapy for elevated pulmonary artery pressure (PAP) and liver transplant surgery, survival of patients with PoPHT and advanced liver disease is significantly improved. Because of the prognostic significance of PoPHT and the limited donor pool, a comprehensive preoperative cardio-pulmonary assessment is of great importance in cirrhotic patients prior to transplant surgery. Therefore, a detailed transthoracic Doppler echocardiographic examination must be an essential component of this evaluation. Patients with mild PoPHT can safely undergo liver transplant surgery. In cases of moderate to severe PoPHT, right heart catheterization (RHC) should be performed. In patients with moderate to severe PoPHT on RHC (mean PAP 35-45 mmHg), vasodilator therapy should be attempted. Liver transplantation should be encouraged in cases that demonstrate a positive response. Bridging therapy with specific pulmonary arterial hypertension treatment agents should be considered until the transplant surgery and should be continued during the peri-and post-operative periods as needed.Item Consensus report for workshop on ⇜early diagnosis and intervention in cerebral Palsy” Turkey’s approach to babies at risk and suggestions 1. National congress on babies at risk (1-4 March 2018, the Ankara Hotel)(2018) Karadavut, K.İ.; Biri, A.; Şenbil, N.; Gülümser, Ö.; Aydın, R.; Sezgin, M.; El, Ö.; Karaca, Ş.B.; Kuzan, N.D.; Atay, G.; Üstünyurt, Z.; Gülümser, Ö.; Saltık, S.; Yüksel, D.; Armangil, D.; Alan, S.; Biri, A.; Akarsu, S.; Koçbulut, E.; Karaaslan, B.T.; Kahraman, A.; Altunalan, T.; Taşkın, S.; Kalkır, Ö.The workshop on “Early Diagnosis and Intervention in Cerebral Palsy” aimed to reflect the current situation of and the challenges encountered in the early diagnosis and intervention in cerebral palsy in babies at risk, in order to raise awareness in the corresponding community by putting forth suggestions for providing solutions to these problems, and also, to provide a model suggestion suitable for the whole country. In the direction of these purposes, problems encountered in the prenatal, natal, and postnatal periods, and the corresponding suggestions were discussed, and vital topics concerning numerous disciplines, especially for the postnatal period, were emphasized in the workshop. With the aim of providing a solution to the current problems in the country regarding the matter, by employing an interdisciplinary approach, the establishment of Monitoring Centers for the Babies at Risk was proposed, and a model for these centers was created. Implications derived from this workshop will establish a foundation for the creation of a special strategic plan for the early diagnosis and intervention in cerebral palsy for the babies at risk. Copyright © 2018 by Türkiye Klinikleri.Item Analysis of the treatment costs of HIV/AIDS in Turkey(2016) Malhan, Simtem; Zengin, Tuba Elbir; Yenilmez, Fatma Betul; Dalgic, Canan; Cerci, Pamir; Oksuz, Ergun; Unal, Serhat; 0000-0002-5723-5965; K-8238-2012OBJECTIVE: Infection with the human immunodeficiency virus (HIV), the causative agent of acquired immune deficiency syndrome (AIDS), is a major global health problem. Patients with HIV can live normal lives with today's new treatment options. As the treatment is generally successful, the life expectancy of patients infected with HIV is rising. As a result, the economic burden of HIV treatment on health systems is set to increase. According to the Ministry of Health, there were more than 6000 HIV-positive patients in Turkey in 2013. The aim of this study was to determine the direct costs of HIV treatment in Turkey. METHOD: A retrospective data analysis was performed from the reimbursement agency perspective. Data for 252 patients at a university hospital in Ankara from 2001 to 2012 were used for the analysis. The average costs of treatment per HIV patient and the average costs per HIV patient, depending on the state of the patient's health, were calculated. The latter was determined according to the number of CD4 cells/ml, as defined by the CDC's classification system for HIV infection. The cost of treatment was calculated based on published reimbursement prices in 2013, per patient per year. RESULTS: The CD4 values of 25.3%, 29%, and 45.7% of the 252 patients were < 100 cells/mm(3), 100-300 cells/mm(3), and > 300 cells/mm(3), respectively. The treatment costs per patient per year for 2013 for those with CD4 values of < 100 cells/ mm(3), 100-300 cells/mm(3), and > 300+ cells/mm(3) were $ 5,637.04, $ 2,211.54, and $ 2,182.35, respectively. The weighted average of the treatment cost per patient was $ 3,344.64 for 2013. CONCLUSION: This analysis is unique to Turkey and calculates the cost only of HIV treatment in Turkey. Lower CD4 values are associated with higher treatment costs. Appropriate HIV treatment is crucial for controlling CD4 values and lowering the treatment costs of HIV patients. These findings need to be considered by policy makers who may need to focus on HIV.