Fakülteler / Faculties
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Item Case Reports: Should We Do Away with Them?(2017) Firat, Aynur Camkiran; Araz, Coskun; Kayhan, Zeynep; 0000-0002-4927-6660; 0000-0003-0579-1115; 0000-0003-1470-7501; 28235534; AAJ-4576-2021; AAJ-4623-2021Study objective: There has been a gradual decline in the number of case reports published in leading medical journals in recent years. Since case reports are not highly cited they have an adverse effect on the journal impact factor. On the other hand sharing new experiences, challenges, or discoveries with colleagues is essential for medical community. Should case reports be eliminated from the journals or published only in journals devoted to case reports? Design: Observational study. Setting: Web of Science database was searched, between 2005 and 2009, with terms: "anesthesia", "anesthesiology" and "case report" yielding 25 969, 9532, and 661 publications, respectively. Since some reports contained large number of cases, only those involving up to three cases (n = 425) were evaluated by the authors with respect to their type, contribution to knowledge and/or practice (Likert scale) and times they were cited. Main results: Distribution of answers to the statement "Case has added to my knowledge and/or improved my practice" was; 3% (strongly disagree), 10.5% (disagree), 33.2% (neither agree nor disagree), 39.3% (agree) and 13.7% (strongly agree). Average citations per item was 4.43 (1883/425), 7.32 (4838/661), and 7.82 (74 529/ 9532). As to the types of the reports; 50% unexpected event in the course of anesthesia, 31% unusual and instructive cases, 9.6% novel/unique anesthetic techniques, 6% novel use of equipment, 1.6% new information on diseases of importance to anesthesiology and 1% scientific observations. Conclusion: Case reports have been an important source of clinical guidance and scientific insight, and play an important role in medical education. They can be published quickly, providing publication opportunity for juniors and for clinicians who may not have the time or finance to conduct large-scale research. On the other hand some argue, that case reports are irrelevant in current medical practice and education, being at the bottom of the hierarchical ladder of medical evidence. We conclude that case reports should not be done away with but be published in websites and journals like the venue to be launched in 2013 by the International Anesthesia Research Society, devoted entirely to them to meet the need for the publication of interesting cases. (C) 2016 Elsevier Inc. All rights reserved.Item EVALUATION AND MANAGEMENT OF DIFFICULT AIRWAY IN OBESITY: A SINGLE CENTER RETROSPECTIVE STUDY(2016) Ayhan, Asude; Kaplan, Serife; Kayhan, Zeynep; Arslan, Gulnaz; 27276769The primary aim of this single center retrospective study was to evaluate difficult mask ventilation (DMV) and difficult laryngoscopy (DL) in a unique group of obese patients. A total of 427 adult patients with body mass index (BMI) >= 25 and surgically treated for endometrial cancer from 2011 to 2014 were assessed. Additional increase in BMI, comorbidities, bedside screening tests for risk factors, and the tools used to manage the patients were noted and their effects on DMV and/or DL investigated. Every escalation in the number of risk factors increased the probability of DMV 2.2-fold, DL 1.8-fold and DMV+DL 3.0-fold. Among bedside tests, limited neck movement (LNM), short neck (SN) and absence of teeth were significant for DMV (p<0.05), LNM, SN and obstructive sleep apnea for DL (p<0.05), and LNM and SN for DMV+DL (p<0.05). However, a 10-point increase of BMI was not an independent risk factor when patients with BMI >25% were considered. In conclusion, LNM and SN are independent risk factors for developing DMV and/or DL in obese endometrial cancer patients, while BMI increase over 30 was not additionally affecting difficult airway.