Başkent Üniversitesi Yayınları
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Item Pulmonary Complications and Mortality After Liver Transplant(Başkent Üniversitesi, 2008-12) Bozbas, Serife Savas; Haberal, Mehmet; Karakayali, Hamdi; Sevmis, Sinasi; Arslan, Nevra Gullu; Ergur, Figen Ozturk; Eyuboglu, Fusun OnerObjectives: Pulmonary complications after liver transplant significantly affect mortality and morbidity; however, their relation has not been clearly established. We sought to determine pulmonary complications during the early and late term after liver transplant and identify risk factors for mortality. Materials and Methods: At our institution, 130 liver transplant patients (mean age, 40.1 ± 14.6 years; 71.1% male) were retrospectively evaluated, and 114 adult orthotopic liver transplant patients were included. Cause of liver disease, pulmonary function test results, arterial blood gas analyses, surgery duration, length of stay in the intensive care unit and the hospital, pulmonary complications, and mortality causes were noted. Results: Pulmonary complications were detected in 48 patients (42.1%), pneumonia in 24 patients (21.1%), and pleural effusion in 21 patients (18.4%). Development of pulmonary complications was found to be significantly related to survival (P = .001). Fifty-two patients (45.6%) were smokers, a significant predictor of pulmonary complications (P = .03). There was no relation between pulmonary function test results and orthodeoxia and pulmonary complications and mortality. Early and late survival rates were significantly lower in patients in whom a microorganism was isolated on deep tracheal aspirate culture, while early survival was significantly reduced in the presence of a pleural effusion (P < .005). Conclusions: Pulmonary complications after liver transplant are common. Care must be taken to determine preoperative risk factors, and patients should be observed closely for development of respiratory complications after liver transplant.Item Outcome of Mucormycosis in Liver Transplantation: Four Cases and a Review of Literature(Başkent Üniversitesi, 2003-12) Davari, Hamid Reza; Malekhossini, Seyed Ali; Salahi, Heshmato-allah; Bahador, Ali; Saberifirozi, Mehdi; Geramizadeh, Bita; Lahsaee, Seyed Masoud; Khosravi, Mohammad Bagher; Imanieh, Mohammad Hadi; Bagheri, Mohammad HadiMucormycosis is a rare but highly invasive fungal infection that occurs in transplant recipients. The literature contains descriptions of 12 cases of mucormycosis after orthotopic liver transplantation (OLT). This report describes the fatal courses in four patients at our center who developed mucormycosis after liver transplantation. Of 51 liver transplant recipients who received grafts between December 1993 and April 2003, 4 (7.8%; 3 males and 1 female) developed mucormycosis. The primary liver diseases in the four cases were Wilson’s disease, autoimmune hepatitis, primary biliary cirrhosis, and cryptogenic cirrhosis. Three of the transplants were harvested by another team and shipped to our center. We concluded that selection of poor transplant candidates, prolonged antibiotic therapy and/or hospitalization prior to OLT, and breaks in aseptic technique during harvesting, shipping, and during operation are the main reasons for the high incidence of mucormycosis in our OLT patients.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 Clinicoepidemiological and Outcome Analysis of 770 Burn Patients: A 5-Year Retrospective Study in a Private Sector Tertiary Burn Care Center in Indore, Central India(Başkent Üniversitesi, 2022-09) Rajpal Singh; Shobha Chamania; Sunil Chandiwal; Deepak Tripathi; Deepika Jain; Ankit Mishra; Tasvir Balar; Prashant SrivastavaABSTRACT OBJECTIVES: Burns are a global public health problem and one of the major causes of disability, with more than 8 million disability-adjusted life-years. Our aim was to contribute a comprehensive analyses of existing burn data from Central India. MATERIALS AND METHODS: We reviewed secondary data of burn patients from 5 years (March 2016 to March 2021) from a single center (Choithram Hospital & Research Centre, India). All burn patients except those with nonhealing and old burn wounds were included. We examined the following: age, sex, socioeconomic status, type of burn, total burn surface area, comorbidities, treatment, and outcome, with data analyzed using Statistical Package for Social Sciences version 20.0. RESULTS: Our study included 770 patients (median age of 28.0 y). Male-to-female ratio was 1.26:1. Burns were common in the reproductive age group of 21 to 40 years (48.6%) and in people of a lower socioeconomic status (65.2%). There was predominance of flame burns (82.0%). The most common mode of burning was accidental (79.4%). The median (interquartile range) of total burn surface area among patients was 25% (12%-45%). Flame burns resulted in significantly greater injury (total burn surface area 30.0%) compared with electric (total burn surface area 23.0%) and scald burns (total burn surface area 11.5%). The commonest comorbidities were hypertension (5.2%) and diabetes (4.7%). We observed significant associations between outcome and age, sex, comorbidities, and treatment modalities. Homograft, autograft, or collagen/other dressing or a combination of these compared with conservative treatment resulted in better healing and reduced hospital stay (P < .001). CONCLUSIONS: Age, sex, type of burn, total burn surface area, comorbidities, and treatment modalities were significantly associated with outcome of burn patients.