Wos Açık Erişimli Yayınlar
Permanent URI for this collectionhttps://hdl.handle.net/11727/10754
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Item In-Hospital Cardiac Complications in Legionnaires' disease: A Single Center Experience of 32 Patients(2021) Akinci, Sinan; Coner, Ali; 0000-0001-5250-5404; 0000-0002-5711-8873; AAD-5564-2021; ABD-7321-2021Introduction: Legionella species frequently causes Legionnaires' disease (LD), a community-acquired pneumonia (CAP). Although data on cardiac events during the course of CAP can be found in the literature, there has been little research on the same issue in LD patients specifically. This study aimed to investigate cardiac complications in the course of LD. Materials and Methods: A total of 32 patients hospitalized with CAP and who received a definitive diagnosis of Legionella infection were identified from the hospital database and included in the study population. The patients' electronic and written records were evaluated for possible cardiac complications. Results: Mean age was 65 +/- 13.5 years and 50% of the subjects were males. Seven patients died during hospitalization. Cardiovascular events were detected in 11 patients. New-onset atrial fibrillation was the most frequent event and was detected in 8 patients (25%), while two patients experienced a myocardial infarction, and one patient was diagnosed with myocarditis. The cardiovascular events were significantly related to the pneumonia severity index (PSI) score and need for intensive care unit. Conclusion: Although LD rarely involves the heart, it can often cause cardiac complications, and the frequency increases in parallel with the severity of the disease. This study indicates that patients with LD should be carefully followed for possible cardiac complications.Item Effect of Antithrombotic Therapy on Development of Acute Subdural Hematoma After Burr Hole Drainage of Chronic Subdural Hematoma(2020) Yuksel, Mehmet Onur; Cevik, Serdar; Erdogan, Baris; Tunckale, Tamer; Katar, Salim; Isik, Semra; Caliskan, Tezcan; Evran, Sevket; 32996579AIM: To evaluate the relationship between the time from cessation of anticoagulant/antiplatelet medication to surgery and risk of postoperative acute subdural hematoma (ASDH) after burr hole drainage of chronic subdural hematoma (CSDH). MATERIAL and METHODS: A retrospective study of patients who underwent burr hole drainage of CSDH between December 2014 and December 2019 was performed. Demographic and clinical data regarding age, gender, medication (antithrombotic therapy), smoking, daily alcohol consumption, history of head trauma, presenting symptoms, and neurological examination were collected from the medical records. Patients were divided into 3 groups based on time from referral to surgery: <24 hours, 24-72 hours, and >72 hours. RESULTS: One hundred seventeen patients underwent burr hole drainage of CSDH during the 5-year study period. Seventy-two patients were male (61.5%) and 45 were female (38.5%). Mean age was 70.5 +/- 7.2 years. Postoperative ASDH occurred in 2 of the 32 patients (6.3%) who were not taking antithrombotic medication and 6 of the 85 patients (7.1%) who were taking antithrombotic medication. The difference was not significant (p=0.797). CONCLUSION: The risk of ASDH after burr hole drainage of CSDH was not affected by antithrombotic medication. Although the literature suggests that antiplatelet and anticoagulant drugs to be discontinued between 5 and 7 days before surgery, our results showed that acute hemorrhage was not detected in any patient who underwent surgery more than 72 hours after referral.Item Surgical Interventions for Late Complications of Arteriovenous Fistulas(2014) Belli, Sedat; Yabanoglu, Hakan; Aydogan, Cem; Parlakgumus, Alper; Yildirim, Sedat; Haberal, Mehmet; 25058786Our aim was to determine the most effective surgical treatment for arteriovenous fistula (AVF) complications after all other methods of salvage have failed. We evaluated 110 patients for 139 complications that occurred after the initial AVF placement and for whom surgical intervention was the last hope for retaining fistula access. Vascular steal syndrome and venous hypertension were the most common complications seen in our patients. The anastomoses of 17 of the vascular steal syndrome cases were narrowed either by stitches or by a polytetrafluoroethylene graft. The second most performed revision surgery was excision of the aneurysm and repair with primary suturing, followed by excision of the aneurysm and interposition grafting. Successful surgical outcomes were achieved in 111 of 139 procedures after revision surgery without constructing a new AVF. AVF salvage surgery is of paramount importance in order to increase the patency rate, which prolongs survival and increases the patient's quality of life.Item Surgical and interventional management of complications caused by acute pancreatitis(2014) Karakayali, Feza Y.; 25309073Acute pancreatitis is one of the most common gastrointestinal disorders worldwide. It requires acute hospitalization, with a reported annual incidence of 13 to 45 cases per 100000 persons. In severe cases there is persistent organ failure and a mortality rate of 15% to 30%, whereas mortality of mild pancreatitis is only 0% to 1%. Treatment principles of necrotizing pancreatitis and the role of surgery are still controversial. Despite surgery being effective for infected pancreatic necrosis, it carries the risk of long-term endocrine and exocrine deficiency and a morbidity and mortality rate of between 10% to 40%. Considering high morbidity and mortality rates of operative necrosectomy, minimally invasive strategies are being explored by gastrointestinal surgeons, radiologists, and gastroenterologists. Since 1999, several other minimally invasive surgical, endoscopic, and radiologic approaches to drain and debride pancreatic necrosis have been described. In patients who do not improve after technically adequate drainage, necrosectomy should be performed. When minimal invasive management is unsuccessful or necrosis has spread to locations not accessible by endoscopy, open abdominal surgery is recommended. Additionally, surgery is recognized as a major determinant of outcomes for acute pancreatitis, and there is general agreement that patients should undergo surgery in the late phase of the disease. It is important to consider multidisciplinary management, considering the clinical situation and the comorbidity of the patient, as well as the surgeons experience. (C) 2014 Baishideng Publishing Group Inc. All rights reserved.Item Bone Cement Leakage in Transpedicular Percutaneous Vertebroplasty: Analysis of 20 Patients(2018) Civi, Soner; Durdag, Emre; Suner, Halil Ibrahim; Kardes, Ozgur; Tufan, Kadir; 0000-0002-1055-5152; 0000-0003-2854-941X; 0000-0001-6939-5491; 0000-0002-5957-8611; 0000-0003-1509-4575; U-2400-2018; P-5895-2018; AAK-1734-2021; AAJ-5381-2021; AAK-1686-2021Objective: Percutaneous vertebroplasty (PVP) is one of the frequently preferred interventional methods in spinal surgery. Although it is classified as minimally invasive, the most common complication of this procedure is bone cement leakage. Leakage of bone cement is often asymptomatic, but can lead to serious complications such as paraplegia and pulmonary embolism. In this study, we aimed to investigate the complications and consequences of cement leakage in the percutaneous vertebroplasty procedure. Methods: Between 2009 and 2015, 20 (14 female and 6 male, mean age 69.7) patients who underwent percutaneous vertebroplasty to 26 vertebrae were included in the study. 17 vertebrae were treated for osteoporotic compression (65.3%), 4 vertebrae for pathologic compression fractures (15.3%), 4 vertebrae for traumatic compression fractures (15.3%) and 1 vertebrae for painful hemangioma (3.8%). Leakage localizations of bone cement were classified as venous plexus, paravertebral soft tissue, spinal canal, intervertebral foramen, into the niddle channel and intervertebral disc space. Results: Twelve vertebrae showed no leakage (46.1%). 5 vertebrae had leakage into the niddle channel (19.2%), and 3 had leakage to vertebra disc space leakage (11.5%) and 2 vertebrae had to venous plexus and paravertebral tissue leakage (7.6%) Foraminal and spinal canal leakage (3.8%) was observed in one patient on single level. Radicular pain was seen in one patient. Partial pain control was observed in 20% of the patients while 80% of the patients had complete pain control on follow ups. Conclusion: Major complications following percutaneous vertebroplasty are mostly due to bone cement leaks. In order to prevent major complications, it is necessary to determine the possible causes of leakage. Performing the application with the correct technique with properly prepared bone cement is essential. Also usage of contast dye may be useful for pre-injection risk of leakage complications.Item Proteinuria in preeclampsia: is it important?(2018) Okten, Sabri Berkem; Ozkara, Atilla; Kaya, Aski Ellibes; Basbug, Alper; Dogan, Ozan; Caglar, Mete; Kumru, Selahattin; 0000-0001-7473-761X; 30084477Objectives: Our aim is to evaluate the laboratory results arid proteinuria levels of preeclamptic women arid their relationships to maternal and fetal outcomes. Material and methods: One hundred preeclamptic pregnant women who gave birth in our clinic between 2013 and 2015 were included in our study retrospectively. The data collected from the patients included gestational week, age, gravidity, parity, abortus history, blood pressure, biochemical parameters, delivery method, maternal hospitalization time, cesarean indication, complications, blood products required, plasmapheresis use and dialysis need. The details about the newborns were recorded retrospectively. The relationships between preeclampsia signs and maternal and neonatal outcomes were analyzed. The protein amounts were analyzed via 24-hour collected urine analyses and spot urine analyses. Results: A statistically significant positive correlation was observed between neonatal intensive care unit needs and proteinuria levels. Fetal growth restriction, respiratory distress syndrome and sepsis were observed as the level of proteinuria increased, but the result was not statistically significant. Eclampsia was observed only in patients with massive proteinuria, and it was statistically significant. An increase in cesarean sections, placental abruptions, antihypertensive drug needs and blood product replacement rates was observed as the amount of proteinuria increased in preeclamptic women, but the results were not statistically significant. Conclusions: The severity of preeclampsia cannot be determined by the level of proteinuria. However, when massive proteinuria is detected, the clinician should be more cautious about maternal and fetal complications.