Başkent Üniversitesi Makaleler
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Item A Study on Employment in Non-Life Insurance Companies: Fuzzy Regression Example(Başkent Üniversitesi, 2022-12-12) Akgül ,Yusuf; Çamlıbel,Fuat; Şengönül , AhmetPurpose: In this study, factors affecting employment in non - life insurance companies were examined. These factors are the financial variables of insurance companies, including financial profit-loss, total net premiums, total assets and technical profit-loss. Methodology: Fuzzy regression method was used as the solution method. Findings: According to the results, the change interval of the financial variables was found significant at h = 09. As a result, the change interval in total assets was % 0.0906, the financial profit was nearly “0”, technical profit/loss was % 0.0392 and the sum of premiums was % 62,04. Also, real employment data was found to be closer to the upper regression limit. Implications: The results obtained by the fuzzy regression method are quite better from the panel data solution method in terms of the consistency of the estimates. When it is desired to generate prediction models for the employment with financial variables of the companies in the sector, the fuzzy regression method is good at creating meaningful models and gives more consistent information about the coefficient of the related arguments. If the results of the study will be interpreted economically and socially; it was observed how internal variables, which are thought to affect the employment capacity of insurance companies, affect employment in insurance companies. It is observed that the increase in the size of premium gain in insurance companies has a positive effect on its employment. This effect will have positive effects on creating new employment in the insurance sector. This increase in employment will also have positive effects for the country's economy. Limitations: However, developing technology and making many insurance transactions online will cause companies to decrease their employment capacity even if their premium gain size increases. For example, there will be a decrease in needed field sales staff and number of agencies. In this case, on the contrary, it will increase the number of unemployed people in insurance sector and in the country. The decrease in employment and increasing unemployment will affect both people and the country's economy negatively. Economically, a negative outlook will occur in the domestic and foreign markets.Item A Case of Falling Into an Acid Tank From Height After High-Voltage Electrocution(Başkent Üniversitesi, 2024-12) Burak Özkan; Abdullah Kızmaz; Uğur Bak; Khalid Zeynalov; Süleyman Savran; Abbas Albayati; Çağrİ A. Uysal; Mehmet HaberalIn this case report, we present the management of a dramatic and rare combination of injuries: high-voltage electrical injury, chemical burn, and open tibial and calcaneal fractures resulting from a fall from height. The patient underwent early fasciotomies. After treatments administered by a multidisciplinary team consisting of plastic surgeons, general surgeons, orthopedic specialists, anesthesiologists, and physiotherapists, the patient was discharged without extremity loss after a 135-day hospital stay. This case report discusses the importance of early fasciotomy and debridement in management of extensive burns and fall-related injuries, the potential for extended hospitalization for reconstruction, and the necessity of a multidisciplinary approach.Item Are Perianal Burns Really that Dangerous?(Başkent Üniversitesi, 2023-06) Ebral Yiğit; Güler TekeşABSTRACT OBJECTIVES: This study aimed to evaluate burns involving the genitals, perineum, and buttocks of pediatric patients and to compare mortality-related factors with the existing literature. MATERIALS AND METHODS: We retrospectively investigated 67 pediatric patients admitted for emergency surgery at the Burn Center of Gazi Yaşargil Training and Research Hospital, Turkey, between January 2019 and June 2022. RESULTS: Mean age of the 67 patients was 3.37 ± 3.73 years. The patients mostly resided in the city, and 17 patients were admitted to the hospital within 1 or more days of the injury. Patients in the 0- to 4-year age group ranked highest in occurrence of perineal burns; the incidence gradually decreased after 4 years of age. Scalding occurred in 59 patients, flame burns in 4 patients, and perineal injuries from electrical burns in 4 patients. Perineal wound culture results were positive for 40.9% patients, with Staphylococcus epidermis being the most common bacteria (37.9%). No patient underwent colostomy as a result of a perianal burn; 2 patients (3.0%) developed sepsis, and 1 patient (1.5%) died. CONCLUSIONS: The risk of temporary colostomy or ileostomy is reduced in perineal burns when there is adequate early, aggressive, and extensive debridement, in addition to antimicrobial therapy.Item A New Method for Determining the Volume Of Blood Loss During Necrectomy in Patients With Deep Burns(Başkent Üniversitesi, 2023-06) Evgenij V. Zinoviev; Denis O. Vagner; Alexander E. ChukharevABSTRACT OBJECTIVES: Most surgery manuals indicate that, for excisions of a burn scab on an area of 1 cm2 with skin plasty, blood loss, taking into account donor zones, is about 1 mL. This volume of alleged blood loss plays an essential role in planning surgical treatment of patients with burn injuries. To date, when volume of lost blood is calculated with the use of existing methods for determining intraoperative blood loss, it is not recommended to excise necrotic tissues on an area of more than 15% of the body surface. In this study, our aim was to develop a new formula for determining intraoperative blood loss during necrectomy in patients with deep burns. MATERIALS AND METHODS: We developed and proposed our own, original method for determining the volume of intraoperative blood loss, based on taking into account hemoglobin and hematocrit indicators, as well as differentiated calculation of the volume of circulating blood. This technique was tested on 109 patients with deep burns (per ICD-10), who were admitted to our department from January 2022 to December 2022 because of thermal lesions. We processed obtained data using Microsoft Office Excel and used generally accepted methods of nonparametric statistics. RESULTS: With the new formula, we determined blood loss of 0.52 mL per 1 cm2 of excised tissue, which is 2 times less than predicted by traditional methods. CONCLUSIONS: Our results showed that the expected intraoperative blood loss may not be 1 mL/1 cm2, as currently prescribed in clinical guidelines, but 0.5 mL/1 cm2 of the excised tissue. Our results allow for possible expansion of the removal of the burn eschar before the development of infectious complications.Item A Case of Progressive Mortal Thrombosis: Phlegmasia Cerulea Dolens(Başkent Üniversitesi, 2023-03) Khalid Zeynalov; Burak Ozkan; Tankut Akay; A. Cagri Uysal; Mehmet HaberalABSTRACT Phlegmasia cerulea dolens is a very rare set of conditions associated with acute, massive venous thromboembolism. Medical and surgical options can be combined in treatment. Patients may experience sudden onset and severe leg pain, edema, cyanosis, compartment syndrome, and post-venous gangrene amputation and death. Medical and surgical treatments can be combined in treatment. Anticoagulants, thrombectomy, percutaneous procedures and amputations are among the treatment options. We present a 60-year-old female patient with a diagnosis of diabetes mellitus with swelling, pain, and discoloration in the left lower extremity who died due to progressive venous thrombosis despite various treatment modalities. Wound debridement and thrombectomy were performed. On day 10 of hospitalization, the patient was intubated to treat resistant low saturation. Despite the interventions, the patient died on day 10 of hospitalization due to cardiopulmonary arrest. Early diagnosis and treatment are vitally important. As in the case we presented, sometimes patients die as a result of rapid clinical progression and side effects, despite the use of different medical and surgical treatments.Item Burn Cachexia: Diagnosis and Nutrition Support(Başkent Üniversitesi, 2023-03) Pratibha Sharma; Rajpal Singh; Shree Prakash Jaiswal; Sunil ChandiwalABSTRACT Abstract Burn cachexia is a condition in which patients with major burns, especially patients with >20% total burn surface, present with significant rapid weight loss, muscle loss, and fat loss. Burn cachexia is also known as wasting syndrome and is characterized by severe weight loss, muscle and fat loss, fatigue, and anorexia. The current definition of burn cachexia includes association of an underlying disease condition characterized with muscle loss and with or without reduction in fat mass. Cachexia is driven by the molecular pathway known as the ubiquitin-proteolytic pathway. Cytokine activity plays a crucial role in the pathogenesis of cachexia; the consequent inflammation is the main cause of cachexia in major burns, and inflammatory cytokines are upregulated by reactive oxygen species that are triggered by nuclear transcription factor NF-κB. Some other well-known pathways are mitochondrial dysfunction and autophagy, endoplasmic reticulum stress, and insulin resistance. Burn cachexia is inflammation that induces protein degradation and increases cell death. Identification of burn-induced cachexia is a difficult challenge and, if untreated, can lead to death. Nutrition support is an extremely important part of burn management with cachexia and requires special attention. In this case report, we share the practical aspects of burn cachexia diagnosis and application of nutrition to prevent mortality. Our case involved a young male patient with electric burn injury who was diagnosed with burn-induced cachexia who had a successful outcome.Item ARTICLE Course of the Wound Process With the Use of Modern Technologies in Local Treatment of Patients With Burns(Başkent Üniversitesi, 2023) Fayazov Abdulaziz Jalilovich; Ruzimuratov Dilmurod Abdimuratovich; Kamilov Utkur Raimovich; Magdiev Shukhrat AlisherovichABSTRACT OBJECTIVES: We aimed to assess the wound-healing process using modern temporary wound dressings in local treatment of patients with burns. MATERIALS AND METHODS: From 2014 to the first half of 2022, the Department of Combustiology of the Republican Research Center of Emergency Medicine, Republic of Uzbekistan, conducted local treatment of 225 patients with superficial burns and 105 patients with deep IIIB/IV degree burns (age range, 1-60 years; mean age 17.5 ± 16.4 years). Most were children and adolescents (n = 146, aged 1-18 years); 79 were people of working age (age range, 19-60 years). The control group (115 patients with superficial burns, 55 patients with deep burns) received traditional local treatment using water-soluble ointments. The study group (110 patients with superficial burns, 50 patients with deep burns) received temporary wound dressings produced by New Dressing Materials CJSC, Russia (Parapran and Voskopran), with various options for local treatment. RESULTS: In 105 patients with deep burns, 122 necrectomy (early-delayed and delayed), 18 osteonecrectomy, and 134 autodermoplasty surgeries were performed. Fifty-two patients with traditional treatment received chemical necrectomy using 20% to 40% salicylic ointment. Less cases of toxic hepatitis, along with improving local reparative properties, were shown in patients who had active surgical tactics in the early stages after injury and temporary wound dressing than in the control group. Local treatment with temporary wound dressing in patients with extensive burns contributed to reduced purulent-septic complications, with no patients having burn sepsis. However, in severely burned patients in the control group, 3 patients (1.8%) had burn sepsis. CONCLUSIONS: Traditional methods of treatment are not acceptable for providing high-quality and qualified care for deep burns. Temporary wound dressings can reduce recovery time, being the most physiologically acceptable covering of burn surface wounds and achieving its main goal of early formation of granulation tissue, reducing secondary inflammatory processes.Item Beyond Breastfeeding:Prolactin's Powers in Burn Wounds(Başkent Üniversitesi, 2023-03) Arnaldo Acosta; Matthew Araujo; Santiago J. SantelisABSTRACT Burn injuries represent a significant health care challenge worldwide that requires effective interventions to optimize patient outcomes. Prolactin, a versatile hormone traditionally associated with lactation, has emerged as a promising factor with potential implications beyond its classical role. In this review article, we aim to synthesize and analyze the existing literature on the role of prolactin in burn injuries, focusing on its impact on inflammation, immune response, tissue repair, and potential neuroprotective effects. By exploring the mechanisms underlying prolactin's actions, this article provides insights into the therapeutic potential of prolactin in burn injury management.Item A Rehabilitation Case Management Model for Severely Burned Victims(Başkent Üniversitesi, 2022-12) Emilio Gonzalez SilvaABSTRACT In Chile, since 2007, the treatment of people with major burns is protected by the Explicit Health Guarantees Law, which guarantees access, opportunity, and financing to public and private providers that offer treatment compliance and follow-up. This includes the Emergency Hospital of Public Assistance, located in Santiago, the main National Reference Center for the management of burns in adults throughout the national territory. To favor the counter-referral of severely burned patients after their care at the National Reference Center Emergency Hospital of Public Assistance, a follow-up process has been designed during all in-hospital rehabilitation phases. This has been named the Rehabilitation Case Management model, with the additional emergence of the rehabilitation case manager.Item Bioelectrical Impedance Analysis: Advanced Technique To Obtain Nutritional Risk in a Patient With Major Burns(Başkent Üniversitesi, 2022-09) Pratibha Sharma; Rajpal Singh; Shree Prakash Jaiswal; Sunil ChandiwalABSTRACT Patients with major burns are similar to critically ill patients; knowing their premorbid nutritional status at the time of hospitalization is important for further interventions. Bioelectrical impedance analysis is an advanced technique that helps to assess the detailed information on body composition, including basal metabolic rate, fat percentage, muscle mass, total body protein, bone health, segmental distribution of muscles and fat, and extra- and intracellular water. Patients with burns and high percentage of total burn surface area are known to be in a hypermetabolic state; a prolonged period of hypermetabolism with insufficient nutrient supply can lead to catabolism and cachexia. Finding the patient's nutritional status at the beginning of hospitalization helps to prevent further complications and to support faster recovery. Here, we present a nutritional risk analysis by using bioelectrical impedance in a patient with catabolic symptoms and major burns for management of nutrition with successful outcome.