TR-Dizin Açık Erişimli Yayınlar
Permanent URI for this collectionhttps://hdl.handle.net/11727/10759
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Item EVALUATION OF EPICARDIAL FAT AND CAROTID AND FEMORAL INTIMA-MEDIA THICKNESSES IN GERIATRIC PATIENTS WITH END-STAGE RENAL DISEASE(2020) Gunesli, Aylin; Yilmaz, Mustafa; Yalcin, Cigdem; Tekkarismaz, Nihan; Alkan, Ozlem; 0000-0002-2557-9579; 0000-0001-5483-8253; 0000-0001-7631-7395; S-6973-2016; AAM-4284-2021; AAD-9088-2021Introduction: Although atherosclerotic cardiovascular diseases and cardiovascular risks are known to increase in patients with end-stage renal disease, it is not clear whether these risks increase in the geriatric patient population as well. This study aims to evaluate these risks in geriatric patients with end-stage renal disease by evaluating epicardial fat and carotid and femoral intima-media thicknesses, known as markers, for subclinical atherosclerosis and cardiovascular risks. Materials and Methods: This cross-sectional study included 52 patients who started to receive chronic hemodialysis treatment after the age of 65 years (mean age 73.92 +/- 5.63) years with end-stage renal failure and 51 healthy volunteers (mean age: 74.49 +/- 4.63 years). Epicardial fat and carotid and femoral intima-media thicknesses were measured and compared between these groups. Results: Carotid intima-media and epicardial fat thicknesses were significantly higher in the patient group than in the control group (0.91 +/- 0.08 vs. 0.71 +/- 0.1 mm, p<0.001 and 0.84 +/- 0.17 vs. 0.75 +/- 0.17 cm, p=0.01, respectively). However, no significant difference was observed in femoral intima-media thickness between the two groups (0.58 +/- 0.07 vs. 0.56 +/- 0.97 mm, p=0.266). Correlation analysis revealed a significant positive correlation between the duration of dialysis and epicardial fat and carotid intima-media thicknesses (r=0.611, p<0.001 and r=0.337, p=0.015, respectively). Furthermore, regression analysis revealed a significant relationship between the duration of dialysis and carotid intima-media thickness (beta=0.657, p=0.001). Conclusion: Epicardial fat and carotid intima-media thicknesses increase in geriatric patients with end-stage renal disease but with no significant changes in femoral intima-media thickness, indirectly suggesting that subclinical atherosclerosis and cardiovascular risks are increased in these patients.Item Treatment with ultrasound guided percutaneous cholecystostomy in acute cholecystitis: 10-year a single-center experience(2017) Ozyer, Umut; Yildirim, Muge; Yildirim, Utku Mahir; 0000-0002-4300-009X; AAK-9071-2021; AAK-9071-2021Purpose: Evaluating the technical success, clinical outcomes and safety of ultrasound-guided percutaneous cholecystostomy (PC) in patients with acute cholecystitis. Material and Methods: Medical records of patients diagnosed as acute cholecystitis and treated with PC from year 2000 to 2011 were retrospectively examined. ASA scores, leukocyte counts, gall stone presence, bile cultures, additional interventions, interval surgery, procedure-related complications and mortality were reviewed. Results: PC catheters were placed in 127 patients (72 male, 55 female) aged from 31 to 100 years. Technical success of the procedure was 100%. Clinical success was obtained in 86% of the patients. No procedure related mortality or early major complications were observed. Minor complication rate was 7% (9/127) and late major complication rate was 3% (4/127). Thirty day in-hospital mortality rate was 8% (10/127). Six patients died after interval cholecystectomy and 4 patients died before the operation. PC served as a definitive treatment in 74% (17/23) of the patients with acalculous cholecystitis. Fifty-eight percent (31/53) of the patients with acute calculous cholecystitis were treated only with percutaneous cholecystostomy and only 10% (3/31) had recurrent cholecystitis in follow up. Conclusion: PC can be preferred over primary cholecystectomy in acute cholecystitis patients. The procedure has high technical success, high clinical response and low complication rates. It can also serve as a definitive treatment option in patients with high surgical risk.