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Öğe A Case Report of Tongue Edema due to Laryngeal Mask with Introducer(AVES, 2018) Daskaya, Hayrettin; Ciftci, Taner; Idin, Kadir; Gul, Kursat; Topuz, Ufuk; Olculu, HakkiAirway management using a laryngeal mask is an especially preferred noninvasive technique because of its achievement of hemodynamic stability and ease of application in surgeries that have short surgery time and do not require specific positions such as the prone position. Although it is easily performed, serious complications may manifest rarely because of lack of experience and inappropriate choice of instrumentation. In this case report, clinical management and treatment options of tongue edema that developed because of the forgotten introducer in laryngeal mask application are presented.Öğe Comparing spinal blockade effectiveness and maternal hemodynamics using 25 gauge and 29 gauge spinal needles with the same volumetric flow rate in patients undergoing caesarean section(Taylor & Francis Inc, 2017) Ciftci, Taner; Daskaya, Hayrettin; Efe, SerdarSpinal needles with different diameters can be used to prevent side effects in patients undergoing spinal anaesthesia. However, the velocity of local anaesthetic changes through the spinal needle depending on the diameter of it. Local anaesthetic injection velocity has been reported to be associated with the spinal block level. We aimed to compare spinal needles of different diameters with the same local anaesthetic volumetric flow rate in terms of spinal blockade and hemodynamics in obstetric patients. Eighty-four patients received spinal anaesthesia by either a 25G needle or 29G with the same volumetric flow rate. Block levels, adverse effects, ephedrine given and a success rate of spinal anaesthesia were significantly higher in 25G than in 29G (p<.05). Athough the use of 29G was associated with a low level of block, a sufficient block level was generated for caesarean section. Furthermore, in spite of the technical difficulty, use of 29G was accompanied by a decreased incidence of maternal hypotension, bradycardia and a lowered ephedrine administration.Impact statementLocal spinal anaesthetic injections at faster flows cause turbulent flow leading to lower anaesthesia concentrations.The control of spinal anaesthesia levels has some difficulties due to anatomical repositioning, especially in pregnant patients.Also, it can cause frequent hemodynamic complications including hypotension and bradycardia, complications that may also have inadvertent effects on foetus.In this study, we showed that smaller diameter spinal needles provided safer spinal anaesthesia levels and a lower incidence of hemodynamic complications.Öğe Determining the efficiency of different malnutrition tests in septic patients(Reial Acad Medicina Illes Balears, 2021) Inal, Mehmet Turan; Memis, Dilek; Tek, Seyda Cigdem; Uyar, Ahmet Senol; Ozel, Muhammet Fatih; Ciftci, Taner; Turan, Fatma NesrinBackground and aims: Malnutrition is frequently detected in septic patients and is important cause of mortality. Methods: Numerical rating Scale 2002, Nutrition risk in the critically ill score and adductor pollicis thickness measurement are used to determine malnutrition in 287 septic patients. Results: The mean age was 66,57 +/- 16,31 years. The mean APACHE II score was 16,19 +/- 8,20 while the mean SOFA score was 5,89 +/- 3,49. To NRS 2002 test 171 was accepted as high malnutrition risk while 116 patients was accepted as low malnutrition risk. According to Nutric test, the risk of malnutrition was found to be low in 144 patients and found to be high in 143 patients. The mean APTM was detected as 20,20 +/- 2,21 mm. The cuff-off point for APTM was found as <= 21 mm. Conclusions: high risk of malnutrition was frequently observed in patients with sepsis and mortality was higher in high risk patients. Higher sensitivity was achieved when the tests were combined with each other. As a result, we recommend the use of malnutrition screening tests in patients with sepsis and combining the tests with each other.Öğe Endovascular Stent-Graft Treatment of Giant Celiac Artery Pseudoaneurysm(Int Scientific Information Inc, 2015) Tuncel, Sedat Alpaslan; Gulcu, Aytac; Yilmaz, Erdem; Ciftci, Taner; Goktay, Ahmet YigitBackground: Visceral artery aneurysms (VAAs) comprise an uncommon but life-threatening vascular disease. When rupture is the first clinical presentation, mortality rate reaches 70%. Increased use of crosssectional imaging has led to a greater rate of diagnosis (40-80%) of asymptomatic VAAs. In the past, surgery was the treatment of choice for VAAs carrying high risk of mortality and morbidity. Case Report: A 22-year-old man, who had undergone gastric, pancreatic and aortic surgery 2.5 years earlier, presented with progressive abdominal pain. Multidetector computed tomography scan revealed an 8-cm celiac pseudoaneurysm. We report a giant celiac pseudoaneurysm treated with stent-graft implantation. Conclusions: Endovascular treatment of VAA is a safe and effective method alternative to surgery.Öğe Evaluation of Pre-Delirium Score in Intensive Care Patients(Galenos Yayincilik, 2018) Inal, Mehmet Turan; Memis, Dilek; Inal, Volkan; Uyar, Ahmet Senol; Tek, Seyda Cigdem; Ciftci, Taner; Efe, SerdarObjective: Delirium is frequently seen in intensive care patients and causes prolongation of mechanical ventilation and intensive care stay. In intensive care patients, the pre-delirium score is a test used to detect delirium. We aimed to determine the prognostic value of the pre-delirium score in patients who stayed more than 24 hours in our intensive care unit. Materials and Methods: Between January 1, 2016 and December 31, 2016, pre-delirium scores were calculated for all patients stayed more than 24 hours in surgery, reanimation and internal medicine intensive care units. Pre-delirium score >= 50 was accepted as group 1 and <50 was accepted as group 2. The groups were compared with each other in terms of gender, age, Acute Physiology and Chronic Health Evaluation (APACHE II) scores, duration of hospitalization and mortality rates. Results: While a high pre-delirium score was determined in 196 patients (39.2%), a low pre-delirium score was determined in 304 cases (60.8%) (group 2). In group 1, the mean age was 68.47 +/- 15.83 years and the mean APACHE II score was 22.47 +/- 7.75; in group 2 the mean age was 59.18 +/- 18.48 years and the mean APACHE II score was 15.71 +/- 7.87, which was found significantly higher than group 1 (p<0.05). In group 1, the duration of hospitalization was 19.93 +/- 23.46 days and the mortality rate was 65.3%; in group 2, the duration of hospitalization was 13.02 +/- 20.01 days and the mortality rate was 40.5%. Significant difference determined in terms of duration of hospitalization and mortality (p<0.05). Conclusion: Early recognition and treatment of delirium will lead to significant improvements in the prognosis of intensive care unit patients. We think that the predelirium score can also be used as an important prognostic test in intensive care unit patients.Öğe The Levels and Duration of Sensory and Motor Blockades of Spinal Anesthesia in Obese Patients That Underwent Urological Operations in the Lithotomy Position(Hindawi Ltd, 2015) Ciftci, Taner; Kepekci, Ali Bestemi; Yavasca, Hatice Pjnar; Daskaya, Hayrettin; Inal, VolkanObesity has a significant effect on the cephalic spread of a spinal block (SB) due to a reduction in cerebrospinal fluid (CSF). SB is controlled by the tissue blood flow in addition to the CSF. Some positions and techniques of surgery used can cause changes in hemodynamics. We investigated effects of hemodynamic changes that may occur during Transurethral prostate resection (TURP) and lithotomy position (LP) at the SB level in obese versus nonobese individuals. Sixty patients who had undergone TUR-P operation under spinal anesthesia were divided into a nonobese (BMI < 25 kg/m(2), Group N) or obese (BMI >= 30 kg/m(2), GroupO) group. SB assessments were recorded afterthe LP. SB at 6 and 120 min and the peak SB level were compared between two groups. Hemodynamics were recorded after LP. Peak and 6 min SB levels were similar between the groups, while 120 min SB levels were significantly higher for Group O (P < 0.05). Blood pressure (BP) after the LP was significantly higher for Group N (P < 0.05). LP and TUR-P increased the BP in Group N when compared to Group O. The increase in hemodynamics enhances the blood flow in the spinal cord and may form similar SB levels in nonobese patients to those in obese patients. However, SB time may be longer in obese patients.Öğe Use of the gastro-laryngeal tube in endoscopic retrograde cholangiopancreatography cases under sedation/analgesia(Aves, 2016) Daskaya, Hayrettin; Uysal, Harun; Ciftci, Taner; Baysal, Birol; Idin, Kadir; Karaaslan, KazimBackground/Aims: In this study, we aimed to analyze the effects of Gastro-Laryngeal Tube (GLT) use on intraoperative and postoperative hemodynamic parameters, comfort of the procedure, and patients' satisfaction in endoscopic retrograde cholangiopancreatography (ERCP). Materials and Methods: A total of 80 patients between the ages of 20 and 75 years who were scheduled for elective ERCP were enrolled. The patients were randomly assigned to two groups: groups N and G. Those in group N underwent the procedure with sedation without any airway instruments and those in group G underwent procedure after sedation and airway management with GLT. Intraoperative and postoperative vital signs as well as the satisfaction of the patients were recorded. Results: The duration to esophageal visualization was found to be significantly higher in group N (16 s) than in group G (7 s) (p=0.001). The mean Visual Analogue Scale for Pain (VAS) was significantly higher in group G (1.85) than in group N (0.45) (p=0.016). Group G had higher endoscopist satisfaction scores than group N. The incidence of desaturation during ERCP was significantly higher in group N (60%) than in group G (0%) (p=0.000). Conclusion: In conclusion, ERCP should be performed under optimal conditions to avoid the occurrence of unwanted complications, such as aspiration-related disorders. Therefore, according to the structural properties of GLT, sedation anesthesia application with GLT in ERCP will be safer, more comfortable, and more effective.