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Öğe Airway management with supraglottic airway device at pierre robin sequence(Oxford Univ Press, 2012) Copuroglu, Elif; Colak, Alkin; Sagiroglu, Gonul; Copuroglu, Cem; Gunday, Isil[Abstract Not Available]Öğe Anaesthesia Management of a Child with West Syndrome(Aves, 2014) Sahin, Sevtap Hekimoglu; Copuroglu, Elif; Ugur, Huseyin; Sagiroglu, Gonul; Colak, AlkinWest syndrome (WS) is an epileptic encephalopathy usually occurring during the first year of life and is characterized by severe electroencephalography (EEG) derangement. Most of these patients may develop cerebral palsy, facial malformations, and skeletal deformities. The anaesthesiologist should make the preoperative assessment carefully due to epileptic seizures and should consider the possibility of difficult intubation because of coexisting anatomic malformations during the anaesthesia management of patients with WS. This report presents a case of general anaesthesia management in a left femoral fixation operation in an 11-year-old, 18 kg male patient.Öğe The analysis of the risk factors observed in patients with hip fracture(Galenos Publ House, 2011) Copuroglu, Cem; Unver, Kagan Volkan; Ozcan, Mert; Ciftdemir, Mert; Turan, Fatma Nesrin; Copuroglu, ElifObjective: Hip fractures are frequently seen in the elderly and an important reason of morbidity and mortality. We aimed to analyze the accompanying risk factors of the hip fractured patients who have been treated in our university clinic. Material and Methods: The data of 180 patients, who have been treated in our clinic between December 2008 and July 2010, were evaluated. The preoperative activity level of the patients, fracture type, mechanism of injury and patients' co morbid medical diseases were evaluated and compared with preoperative biochemical markers statistically. Results: The study group included 180 patients (72 male, 108 female) with a mean age of 73.9 (24-103). One hundred eighteen of the patients admitted because of intertrochanteric femur fracture, 54 because of femoral neck fractures and 8 because of subtrochanteric femur fractures. Forty-three (24%) patients had no medical co morbidity while 22 had hypertension, 10 had cancer, 7 had cardiac disease, 6 had diabetes mellitus and 75 (42%) had more than one accompanying co morbidity. Conclusion: Mostly low energy injuries cause osteoporotic fractures in women and medical co morbidities also exist. In order to decrease the morbidity and the mortality of the hip fractures, metabolic disorders should be taken under control simultaneously with the fracture treatment.Öğe A comparison of thoracic or lumbar patient-controlled epidural analgesia methods after thoracic surgery(Bmc, 2014) Sagiroglu, Gonul; Meydan, Burhan; Copuroglu, Elif; Baysal, Ayse; Yoruk, Yener; Karamustafaoglu, Yekta Altemur; Huseyin, SerhatBackground: We aimed to compare patient-controlled thoracic or lumbar epidural analgesia methods after thoracotomy operations. Methods: One hundred and twenty patients were prospectively randomized to receive either thoracic epidural analgesia (TEA group) or lumbar epidural analgesia (LEA group). In both groups, epidural catheters were administered. Hemodynamic measurements, visual analog scale scores at rest (VAS-R) and after coughing (VAS-C), analgesic consumption, and side effects were compared at 0, 2, 4, 8, 16, and 24 hours postoperatively. Results: The VAS-R and VAS-C values were lower in the TEA group in comparison to the LEA group at 2, 4, 8, and 16 hours after surgery (for VAS-R, P = 0.001, P = 0.01, P = 0.008, and P = 0.029, respectively; and for VAS-C, P = 0.035, P = 0.023, P = 0.002, and P = 0.037, respectively). Total 24 hour analgesic consumption was different between groups (175 +/- 20 mL versus 185 +/- 31 mL; P = 0.034). The comparison of postoperative complications revealed that the incidence of hypotension (21/57, 36.8% versus 8/63, 12.7%; P = 0.002), bradycardia (9/57, 15.8% versus 2/63, 3.2%; P = 0.017), atelectasis (1/57, 1.8% versus 7/63, 11.1%; P = 0.04), and the need for intensive care unit (ICU) treatment (0/57, 0% versus 5/63, 7.9%; P = 0.03) were lower in the TEA group in comparison to the LEA group. Conclusions: TEA has beneficial hemostatic effects in comparison to LEA after thoracotomies along with more satisfactory pain relief profile.Öğe The Effect of Cerebral Oxygen Saturation Changes on Early Postoperative Neuropsychological Function in Patients Undergoing Cranial Surgery(Turkish Neurosurgical Soc, 2023) Hekimoglu Sahin, Sevtap; Copuroglu, Elif; Delen, Emre; Tutunculer, Banu; Sut, Necdet; Colak, Alkin; Sagiroglu, GonulAIM: To compare the incidence of postoperative neuropsychological dysfunction in patients managed with cerebral saturation monitoring versus traditional approaches.MATERIAL and METHODS: A hundred patients undergoing elective intracranial surgery were divided into two groups to receive intraoperative management via cerebral saturation monitoring (Group O) or the conventional approach (Group C). The postoperative neuropsychological function was evaluated by the antisaccadic eye movement test (ASEM) and the Mini-Mental State Examination (MMSE). These tests were performed preoperatively and postoperatively on the first, second, and fifth days. The time for the modified Aldrete score to reach 9 (MAS 9), adverse effects, and pain using a Visual Analog Scale (VAS) scores were recorded.RESULTS: Patient characteristics and surgery data were not statistically different. The MAS 9 of group O was significantly lower than that of group C (p<0.001). The MMSE at the postoperative 1, 2, and 5 days were significantly higher in Group O compared to Group C (p<0.001). ASEM was similar between groups. Group O was subdivided according to the type of surgery applied with diagnosis, and there were no statistically significant between-group differences in terms of areas under the curve for the cerebral regional oxygen saturation. There was no between-group difference regarding the mean arterial pressure at any time perioperatively. The heart rate at 80, 90, 100, and 110 min intraoperatively was significantly higher in group C than in Group O.CONCLUSION: Intraoperative cerebral oxygenation monitoring can reduce patient mortality and morbidity by allowing early postoperative neurological evaluation to detect potential neurocognitive deficits.Öğe Effect of Preoperative Anxiety on Depth of Anaesthesia and In Vitro Fertilization Success(Galenos Publ House, 2023) Sahin, Sevtap Hekimoglu; Copuroglu, Elif; Altinpulluk, Ece Yamak; Sut, Necdet; Karamanlioglu, Beyhan; Elter, Koray; Yaman, OzgeObjective: Infertility anxiety may have a harmful effect on embryo quality and fertilization during in vitro fertilization (IVF). Monitoring brain function gives real-time information about the depth of anaesthesia of a patient. This study examined the effect of preoperative anxiety on the depth of anaesthesia and IVF success. Methods: One hundred thirty-one patients who had undergone oocyte retrieval were divided into two groups according to the Beck Anxiety Inventory (BAI): the low-anxious Group L (n = 71) and high-anxious Group H (n = 60). Hemodynamic stability, intraoperative total propofol and fentanyl consumption, good quality embryo (GQE) rate, and fertilization rate were recorded. Results: Fertilization and GQE rates were not significant between groups L and H. Total propofol consumption was significantly higher in group H than in group L. Heart rate (HR) preoperatively and postoperatively and systolic arterial pressure (SAP) preoperatively and diastolic arterial pressure (DAP) postoperatively were significantly increased in group H than in group L. The time for the modified Aldrete score to reach 9 (MAS 9) in group H was significantly higher than that in group L. The effect of variables that were found significantly in the univariate analysis (Propofol, HRpreop, HRpostop, SAPpreop, DAPpostop, and MAS 9) on BAI score. Conclusion: Total propofol consumption was higher in patients with high anxiety levels, but it did not have a negative effect on IVF success.Öğe The Effect of Protocol Guided Therapy to Severe Sepsis Mortality(Galenos Yayincilik, 2011) Copuroglu, Elif; Dikmen, Yalim; Demirkiran, Oktay; Utku, Tughan; Urkmez, SevalAim: The aim of our study was to investigate the effect of protocol-based therapy to the severe sepsis patients and to investigate the accordance with this protocol. Patients and Methods: According to the evidence based guideline therapy, 'Severe Sepsis Treatment Protocol' was evaluated in order to lead the therapy of severe sepsis and septic shock patients. Before starting to our study, all the intensive care stuffs were informed about the diagnostic criteria for sepsis and severe sepsis (Appendix 1). One hundred and forty eight severe sepsis and septic shock patients that underwent therapy between 2003-2004 at Sadi Sun Intensive Care Unit were investigated retrospectively to create our Retrospective Group (RG). The study group was performed on 62 severe sepsis patients, that had underwent 'Severe Sepsis Treatment Protocol' based therapy at the same intensive care unit, between June 2005- June 2006 named as Prospective Group (PG). The mortality rate was compared between two groups. The treatment compliances at the first 6 hours and 24 hours has been evaluated in group PG. Results: Mortality rate was lower in PG, but this difference was not statistically significant (p>0.204). The accordance to the protocol of the first 6 hour therapy bundle and the 24 hour therapy bundle was found % 84.46 and % 59.54 respectively. Conclusion: Our study shows that, protocol-based therapy decreases the mortality in severe sepsis and septic shock patients.Öğe The Effects of Apelin on Mesenteric Ischemia and Reperfusion Damage in an Experimental Rat Model(Galenos Publ House, 2012) Sagiroglu, Tamer; Oguz, Serhat; Sagiroglu, Gonul; Copuroglu, Elif; Yalta, Tulin; Sayhan, Mustafa Burak; Yagci, Mehmet AliObjective: Intestinal ischemia-reperfusion (I/R) injury is associated with high morbidity and mortality rates. There is ongoing research to find an effective preventive or treatment agent. We aimed to evaluate the effects of apelin 13 (AP) on intestinal I/R injury in a rat model. Material and Methods: Twenty-four male Sprague-Dawley rats aged 6-8 weeks and weighing 280 +/- 20 g were equally divided into three groups (control, I/R and I/R+AP). The control group underwent superior mesenteric artery (SMA) mobilization alone without any clamping. In the I/R and I/R+AP groups, an atraumatic microvascular bulldog clamp was placed across the SMA at its point of origin from the aorta. In the I/R+AP group, 2 mu g/kg/d apelin was administered intraperitoneally. After 60 minutes of ischemia, relaparotomy was performed to remove the microvascular clamp on the SMA for 3 hours of reperfusion. After 3 hours, tissue samples were obtained for biochemical [malondialdehyde (MDA) and glutathione (GSH) levels] and histopathological analyses. Results: MDA levels were significantly higher in the I/R group compared to the control group. Although MDA levels were lower in the I/R+AP group compared to the I/R group, the difference was not statistically significant. There was also no significant difference between the I/R+AP and I/R groups regarding GSH levels. The median histopathological grade was significantly lower in the I/R+AP group compared to the I/R group (p=0.001). Conclusion: Apelin appeared to have a positive effect on oxidative injury; this did not reach statistical significance. Thus, the role of apelin and associated findings in the initial treatment of intestinal ischemia needs further large-scale animal studies before human use.Öğe The effects of intravenous and local tranexamic acid on bone healing: An experimental study in the rat tibia fracture model(Elsevier Sci Ltd, 2020) Balkanli, Bahadir; Copuroglu, Cem; Copuroglu, ElifBackground: Tranexamic acid (TXA) is an antifibrinolytic agent. It has long been used to reduce the need for perioperative blood loss in various surgeries. Few studies have investigated the effects of local and intravenous administration of TXA on fracture healing. Thus, we aimed to evaluate if TXA influences hematoma volume and fracture healing in the rat tibia fracture model. Materials and methods: A tibia fracture with intramedullary Kirschner wire fixation was created in all animals. Rats were randomly divided into three groups as local TXA, intravenous TXA, and control. A dose of 50 mg/kg local and intravenous TXA was administered to the study groups. Hematoma volume was measured on the first and third days of the study. The animals were sacrificed on the 14th and 21st days for radiological and histopathological examinations. Results: There was no significant difference between the groups in terms of hematoma volume measured on Day 1 and the mean decrease of hematoma volume from Day 1 to Day 3 (p = 0.158 and p = 0.239, respectively). The total radiological scores of Day 14 and Day 21 were similar in all groups (p > 0.05 for all). There was also no significant difference between the histological staging of the fracture repair on Day 14 and Day 21 for all groups (p > 0.05 for all). Conclusion: Our findings suggest that TXA's local and intravenous application makes no significant difference in fracture healing. (C) 2020 Elsevier Ltd. All rights reserved.Öğe Effects of Preoperative Anxiety on Intraoperative Hemodynamics and Postoperative Pain(Coll Physicians & Surgeons Pakistan, 2019) Bayrak, Aysegul; Sagiroglu, Gonul; Copuroglu, ElifObjective: To determine the effects of the level of the anxiety of the patients on the intraoperative hemodynamic parameters and postoperative pain, patient satisfaction and the stay period at the hospital. Study Design: A descriptive study. Place and Duration of Study: General Surgery, Faculty of Medicine, Trakya University, Edirne, Turkey, from December 2015 to February 2016. Methodology: Seventy-two patients were operated for elective cholecystectomy. They were asked to answer state-trait anxiety inventory (STAI) questionnaire. The patients were classified into two groups as high and low anxiety levels. The targeted variables were compared. Results: There has not been found any significant relationship between the level of anxiety and age, gender, marial status, level of education, profession, general anesthesia, comobidity and postoperative shivering. However, patients with high preoperative anxiety scores had unstable hemodynamic parameters (arterial pressure, heart rate, peripheral oxygen saturation) intraoperatively, increased postoperative pain and analgesic consumption with dissatisfaction. Conclusion: Preoperative anxiety might cause hemodynamic problems in the intraoperative period, increased analgesic need and lower postoperative satisfaction of the patients in the postoperative period. It would be better to dispel the preoperative anxiety by conselling patient regar anesthesia, surgeon, and the institute.Öğe The efficacy of thoracic epidural and paravertebral blocks for post-thoracotomy pain management(Termedia Publishing House Ltd, 2013) Sagiroglu, Gonul; Baysal, Ayse; Copuroglu, Elif; Karamustafaoglu, Yekta Altemur; Sagiroglu, Tamer; Yuksel, Volkan; Huseyin, SerhatIntroduction: The definition of pain focuses mainly on tissue damage and provides information regarding pathophysiological changes in the human being [1]. Patients experience pain as a response to this tissue damage after surgery and the pain intensity after thoracotomies is known to be severe [2]. Aim of the study: Our goal was to investigate the efficacy and adverse effects of thoracic epidural and paravertebral blocks for post-thoracotomy pain management. Material and methods: In a prospective, randomized double blinded study, patients were divided into thoracic epidural (EPI group, n = 30) and paravertebral (PVB group, n = 30) groups. A bolus dose of 10 ml of 0.25% bupivacaine was followed by a continuous infusion of 0.1 ml kg(-1) h(-1) for a total of 24 hours. A visual analog scale (VAS) was used to evaluate pain at rest (VAS-R) and after coughing (VAS-C) at baseline (after extubation), 2, 4, 12 and 24 hours after surgery. The duration of catheter insertion, morphine consumption, complications and side effects were collected. Results: In comparison of EPI and PVB groups, VAS-R and VAS-C scores were similar at baseline and at 2, 4, 12 and 24 hours after surgery (p > 0.05). The incidence of hypotension was higher and the duration of catheter insertion was longer in the EPI group in comparison to the PVB group (p = 0.038, p < 0.0001, respectively). Conclusions: For post-thoracotomy pain, both thoracic epidural analgesia and paravertebral block techniques provide sufficient pain relief. As paravertebral block is an easier and quicker technique with lower incidence of hypotension, it should be considered as a good alternative to thoracic epidural technique to establish postoperative analgesia.Öğe Letter to editor on noninvasive ventilation to prevent reintubation(E-Century Publishing Corp, 2016) Baysal, Ayse; Sagiroglu, Gonul; Copuroglu, ElifWe would like to reply to the comments are as follows: 1-Our patients were published in Letter to Editor entitled Non invasive ventilation to prevent reintubation. Key methodological concerns in cardiothoracic unit by the authors Beyoglu C.A., Ozdilek A., Esquinas A.M. in Int J Clin Exp Med. The main issues that the authors Beyoglu and her collegues have put forward and our answers to these comments are as follows: 1- The patients in our study have a history of cardiac dysfunction and they underwent cardiac or thoracic surgeries and because of these reasons they are not hemoynamically in stable state, 2- The materials and methods have been well presented in our study, 3- The inclusion criterias are well established in our study. We do not wait on room air oxygen until patients have an acute respiratory failure before application of noninvasive ventilation and patient's clinical deterioration while receiving oxygen therapy via face mask is necessary to decide whether patient has respiratory distress or not. These decisions are made depending on acute respiratory failure criterias on textbooks. 4- Cardiac and thoracic surgeries are both included as these operations are involved significantly with postoperative pulmonary dysfunction because of incision on chest wall causing atelectasis, pleural opening, possible phrenic nevre injury, pain, prolonged recumbent position and reduction of diaphragmatic movement, 5- Pain is an important factor for postoperative pulmonary complications and we thank you for your comment and describe our pain relief methodology during our study, 6- The complication rates were statistically not different from each other between the groups, 7- Carbondioxide retention, hypoxia and bradycardia are a part of the definition of failure of noninvasive ventilation and bradycardia is not listed in acute respiratory failure criteria in our study.Öğe Major Extremity Injuries Associated with Farmyard Accidents(Hindawi Ltd, 2012) Copuroglu, Cem; Heybeli, Nurettin; Ozcan, Mert; Yilmaz, Baris; Ciftdemir, Mert; Copuroglu, ElifBackground. The aim of the study is to analyze the major agricultural injuries related to the extremities. Patients. We evaluated a 3-year period including 41 patients. Data on age, sex, injury patterns, anatomical localizations, injury season, length of stay in the hospital, and infections were evaluated, and the patients were examined with SF-36 in the follow-up period. Results. Hand was the most commonly injured part (n: 9) followed by the distal part of the lower limb (cruris) (n: 7) and foot (n: 7). Mean time between trauma and emergency-department arrival was 115 minutes (60-360). Mean length of stay was 24 days (4-150), and mean number of operations during hospitalization was 2.4 (1-30). Deep wound infection was seen in 8 patients. Seasonal distribution for accidents was even for spring and fall (27% each), high for summer (36%), and less for winter (10%). Conclusions. Distal parts of the elbow and knee were affected more frequently. Due to the high microbiological load and high incidence of crush-type injuries, repetitive debridements and long duration of hospital stay were needed. Attention should be paid in the harvesting times to the farmyard injuries. Due to the seasonal variation, more resources should be allocated to treat the increasing incidence of injury over the period from spring to fall.Öğe A New Tube Gastrostomy Model in Animal Experiments(Derman Medical Publ, 2013) Sezer, Atakan; Sagiroglu, Tamer; Copuroglu, Elif; Yagci, Mehmet Ali; Oltulu, Cagatay; Sut, NecdetAim: The orogastric route is the most preferred application method in the vast majority of the animal experiments in which application can be achieved by adding the material to the water of the experiment animal, through an orogastric tube or with a surgically managed ostomy. Material and Method: This experiment was constructed with twelve male Sprague-Dawley rats which were randomly assigned to one of two groups consist of control group (group C, n:6) and tube gastrostomy group (group TG, n:6). A novel and simple gastrostomy tube was derivated from a silicone foley catheter. Tube gastrostomy apparatus was constituted with a silicone foley catheter (6 French). In the group TG an incision was performed, and the stomach was visualized. A 1 cm incision was made in the midline and opening of the peritoneum. Anchoring sutures were placed and anterior gastric wall was lifted. The gastric wall is then opened. The apparatus was placed into the stomach and pulled through from a tunnel under the skin and fixed to the lateral abdominal wall with a 2/0 silk suture. Result: The procedure was ended in the 10th day of experiment. No mortality was observed in group C. The rats were monitored daily and no abnormal behavior consists of self harming incision site, resistance to oral intake or attending to displace. There was statistically significant difference in increasing alanine transaminase level (p<0.05) and decrease in the total protein and body weight (p<0.05) at the group TG at the end of experiment. There was significant increase in urea levels in Group C (p<0.05) at the end of experiment. The statistically significant decrease was observed in the same period in group C between aspartate transaminase, albumin, total protein, and body weight (p<0.05). Glucose (p=0.047) and aspartate transaminase (p=0.050) level decrease changes and weight loose (p=0.034) from preoperative period to the end of the experiment between gastrostomy and laparotomy groups were statistically significantly. Discussion: Here in we presented a novel and simple tube gastrostomy model in an experimental rat model in which rats had unrestrained movements. We believe that this new constructed tube gastrostomy model may be an alternative route for the experimental models in which orogastric route is unavailable to use.Öğe PREDICTING MORTALITY AND MORBIDITY OF GERIATRIC FEMORAL FRACTURES USING A MODIFIED FRAILTY INDEX AND PERIOPERATIVE FEATURES: A PROSPECTIVE, MULTICENTRE AND OBSERVATIONAL STUDY(Gunes Kitabevi Ltd Sti, 2018) Saricaoglu, Fatma; Aksoy, Semsi Mustafa; Yilmazlar, Aysun; Ozkan, Derya; Copuroglu, Elif; Unlusoy, Eser Ozlem; Ekmekci, PerihanIntroduction: Femoral fracture is associated with high geriatric mortality. Frailty is the increased vulnerability to stressors resulting from aging-associated decreases in physiological reserve. We aimed to predict 30-365-day postoperative mortality and morbidity rates using modified frailty index and perioperative characteristics in geriatric femoral fractures. Materials and Method: Using a prospective observational design, data were collected from patients >65 years undergoing femoral fracture surgery from 13 different hospitals in 2016 and 2017. Post-discharge follow-up periods were 30, 90, 180, and 365 days. Age, sex, modified frailty index and anaesthesia types used during surgery were recorded. Renal markers, troponin I and haemoglobin levels were examined preoperatively and postoperatively at 24 and 72 hours. Results: We included 392 patients in this study. The age of the patients were between 65 and 101 (mean, 79 +/- 11.9). Median modified frailty index was 5 (interquartile range, 2-7). Increase in modified frailty index increased mortality rate. Mortality rate at postoperative 30 days was 9.8%, while overall study mortality rate was 23%. Spinal anaesthesia was administered in 205 patients (52.3%, most frequent), followed by general in 110 (28.1%), peripheral nerve blocks in 21 (5.4) and spinal-epidural in 43 (11%). Anaesthesia type affected both intensive care unit (p<0.001) and total hospitalization (p<0.012) duration. A logistic regression model revealed that frailty index, preoperative creatinine and centre type were independent mortality predictors. Conclusion: Increased modified frailty index was associated with higher postoperative mortality risk, thus providing an additional way for improving risk stratification. Preoperative creatinine increase and centre types are determining factors in mortality.Öğe Protective effect of everolimus on renal ischemia reperfusion injury in rats(Medknow Publications & Media Pvt Ltd, 2014) Sagiroglu, Tamer; Sezer, Atakan; Torun, Nese; Yalta, Tulin; Yagci, Mehmet Ali; Sagiroglu, Gonul; Copuroglu, ElifThe aim of this study was to determine the effect of everolimus and tacrolimus pretreatments on renal morphology and function in a rat ischemia reperfusion (I/R) model. Twenty-eight male Sprague-Dawley rats were randomly assigned to saline sham operation, saline I/R (IR), tacrolimus I/R (TRL I/R) and everolimus I/R (ERL I/R) groups. Saline and active treatments were administered intraperitoneally for seven consecutive days before the surgery. The suprarenal aorta was clamped to achieve warm ischemia, except in the sham group. Right nephrectomy was performed in all animals and histology was examined. Renal function was assessed on post-operative Day 7 by Tc-99m dimercaptosuccinic acid (DMSA) scintigraphy, glomerular filtration rate (GFR) and serum biochemistry. Both everolimus and tacrolimus preserved serum creatinine and blood urea nitrogen levels, but only everolimus preserved GFR (0.74 +/- 0.36, 1.20 +/- 0.37 and 2.24 +/- 0.32 mL/min for I/R, TRL I/R and ERL I/R, respectively, P < 0.001). %ID values for sham, I/R, TRL I/R and ERL I/R were 55 +/- 3, 47 +/- 4, 45 +/- 6 and 62 +/- 7 (P < 0.001). On histologic evaluation, ERL I/R showed less tubular damage and necrosis than I/R, as well as TRL I/R. Within the confines of this rat warm ischemia model, everolimus pre-treatment was useful in preserving renal function following I/R injury. The possibility of using everolimus as a pre-conditioning agent for I/R injury in kidney transplantation should be further explored.Öğe Pseudo-arthrosis of the spine of the scapula: a case report with a delayed diagnosis(Springer Heidelberg, 2014) Copuroglu, Cem; Tan, Levent; Copuroglu, Elif; Ciftdemir, Mert; Ozcan, MertScapular spine fractures are rare injuries. The aim of this study was to evaluate a late-diagnosed scapular spine pseudo-arthrotic patient. Because of the surrounding soft tissue mass and overlapping of the scapula with the thoracal bones on a roentgenogram, diagnosis may be missed or delayed for years. We present a case of scapular spine pseudo-arthrosis in a 50-year-old man, who sustained a traffic accident 2 years ago. He was treated as a soft tissue injury of the left shoulder and later as a rotator cuff tear. His scapular spine fracture was diagnosed as pseudo-arthrosis of the scapular spine with a diagnostic delay of 2 years. Isolated scapular spine fractures are rare, usually associated with other injuries and frequently treated non-operatively. Sagging of the acromion as a result of a scapular spine fracture may mimic supraspinatus outlet impingement. If a painful pseudo-arthrosis limits the function of a shoulder, fractured ends should be fixed until union occurs. Although scapular spine fractures are rarely seen, they must take place in the differential diagnosis of impingement syndromes of the shoulder.Öğe Pulmonary Embolism During Hepatoblastoma Resection(Aves, 2020) Colak, Alkin; Basaran, Umit Nusret; Copuroglu, Elif; Sag, Fatih; Cakici, Zafer; Kiray, GuvenAlthough hepatoblastoma is rare, it is the most malignant tumour of childhood. Treatment is usually done by surgical resection and chemotherapy. The mortality and morbidity have decreased due to improvements in the treatments. In this process, hepatic resection has a risk of pulmonary embolism, and this condition could be fatal. In this case, a 9-month-old patient who was treated with chemotherapy and then underwent hepatectomy was presented. We used non-invasive methods such as the perfusion index (PI), the plethysmographic variability index (PVI) (Massimo Radical 7) and non-invasive total haemoglobin measurement (SpHb) rather than invasive measurements. During closure of the surgical skin incision, the end-tidal CO2 (ETCO2) value dropped, after which arrhythmia and bradycardia resulted in cardiac arrest. Cardiopulmonary resuscitation (CPR) was initiated. However, the patient did not respond to CPR. We concluded that heparin may be administered to reduce the risk of thrombosis in patients undergoing liver surgery.Öğe Risk factors for early mortality and morbidity after pneumonectomy(Baycinar Medical Publ-Baycinar Tibbi Yayincilik, 2014) Sagiroglu, Gonul; Copuroglu, Elif; Meydan, Burhan; Tasci, Erdal; Karamustafaoglu, Y. Altemur; Baysal, Ayse; Yoruk, YenerBackground: This study aims to investigate possible risk factors which affect the mortality and morbidity of pneumonectomy patients due to the non-small cell lung cancer (NSCLC). Methods: Demographic, clinical and pathological features of 100 patients (96 males, 4 females; mean age 58.4 +/- 8.9 years; range 38 to 82 years) who underwent pneumonectomy between April 2008 and October 2009 were retrospectively analyzed. Results: The morbidity and mortality rates were found to be 56% and 14%, respectively. The complications included cardiopulmonary in 46%, bleeding in 7%, and wound infection in 3% patients. There was no significant effect of age, sex, smoking habit, diabetes, hypertension, and coronary artery disease on 30-day morbidity and mortality. Neoadjuvant therapy (p=0.049), right pneumonectomy (p=0.01), and intraoperative blood transfusion (p=0.049) were associated with significantly increased morbidity. The duration of intensive care unit and hospital stays was significantly longer in patients with respiratory failure and bronchopleural fistula. Conclusion: Pneumonectomy is a high-risk procedure in patients with neoadjuvant therapy, right pneumonectomy, and intraoperative blood transfusion. However, we believe that it is possible to reduce the risk factors with careful preoperative evaluation, rigorous anesthetic assessment and surgical interventions.Öğe Unrecognized osteogenesis imperfecta syndrome: the strategies for general anesthesia maintenance and recovery(Oxford Univ Press, 2012) Copuroglu, Elif[Abstract Not Available]
