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Öğe Anastezik maddelerin stapes refleks eşiği ve transient evoked otoakustik emisyonlar üzerine etkisi(Trakya Üniversitesi, 2003) Güven, Selis Gülseven; Taş, AbdullahÖZET Stapes refleks eşikleri ve transient evoked otoakustik emisyonların, otolarengolojide tanı ve ayırıcı tanıda getirdiği sonuçların önemi büyüktür. Bazı durumlarda bu testlerin sedatize ya da genel anestezi altındaki hastalarda yapılması gerekmektedir. Anestezik ajanların etki mekanizmaları çok net olmasa da bazı nörotransmitter veya nöromodülatörler üzerinden etkilerini gösterdikleri tahmin edilmektedir. Aym nörotransmitter veya nöromodülatörlerden bazılarının stapes refleks arkı üzerinde ve kokleada da bulunduğunu bildiren bazı çalışmalardan sonra anesteziklerin bu testlerin sonuçları üzerinde etkileri olabileceği görüşü yaygınlaşmıştır. Bu amaçla, cerrahi planlanmış işitmesi normal 50 hasta üzerinde çalışmamızı gerçekleştirdik. Hastaların hepsine midazolam premedikasyonu ve propofol indüksiyonu uyguladık. Anestezi idamesini 10 kişilik hasta gruplarında beş farklı şekilde sürdürdük. Bunlar; I. grupta %70 N2O + %30 O2, II. grupta sevofluran, IH. grupta desfluran, IV. grupta halotan ve V. grupta da propofol+sufentanil verilmesi şeklindeydi. Preoperatif, premedikasyon sonrası, anestezi indüksiyonu sonrası ve anestezinin derin aşamasında olmak üzere toplam dört kez stapes refleks eşikleri ile transient evoked otoakustik emisyon ölçümleri gerçekleştirildi. Yapılan istatistiksel analizler sonucunda midazolamın ipsilateral ve kontralateral stapes refleks eşiklerinde anlamlı bir artışa, transient evoked otoakustik emisyon wave reprodüktibilite değerlerinde anlamlı bir azalışa; propofolün de sadece stapes refleks eşiklerinde anlamlı bir artışa yol açtığım tespit ettik. Diğer anestezik ajanlar da sadece kontralateral refleks eşiklerinde anlamlı bir artışa neden oldu. Bunlardan sevofluran eşiği en fazla yükseltirken, halotan hemen hiç etkilemedi. Anestezi idamesinde kullanılan ajanlarla 60transient evoked otoakustik emisyon wave reprodüktibilite değerlerinde meydana gelen değişiklikler istatistiksel olarak anlamlı bulunmadı. Sonuç olarak odyolojik değerlendirmeler öncesi midazolam premedikasyonundan kaçınılması, genel anestezi altında stapes refleksi ile ilgili ölçümlerde de sevofluranın tercih edilmemesi gerektiği görüşündeyiz. Anahtar Kelimeler: Otoakustik emisyonlar; akustik refleks; genel anestezikler; nitröz oksit; halotan; propofol. 61Öğe Distance Education in Medical Schools: the Experience and Opinions of Academicians and Students(Trakya Üniversitesi, 2020) Çifcibaşı, Hilal Sena; Kef, Berkay; Özyiğit, Irmak İrem; Sayın, Sezin; Göztepe, Aslı; Güven, Selis Gülseven; Atıcı, SerkanAims: This study aims to identify the thoughts and opinions of medical schools’ students and academicians about the distance medical education and examination system that has been rapidly applied during the COVID-19 pandemic Methods: A ques- tionnaire was prepared via Google Forms which consisted of a total of 3 sections. Informed consent was obtained in the first section and participants were directed to “student” or “academician” section. There were 28 questions for the students and 24 questions for the academicians. Categorical variables were demonstrated as numbers and percentages, whereas continuous variables were presented as minimum, maximum, and mean values. Chi-squared test was used to compare preclinic and clinic year students, and the academicians in preclinic, medical, and surgical fields. Results: A total of 321 participants completed the questionnaire. The mean participant ages were 21.4 years and 41.68 years for the students and the academicians, respectively. Only 30% of the students thought the distance education lessons were beneficial while it was 35.5% for the academicians. 25.8% of the academicians and 29.6% of the students were indecisive on the matter. When the examination process was taken into account 67.7% of the academicians and 56.9% of the students thought the online examinations were not reliable. Conclusion: It is predicted that the pandemic process will continue in the next academic years. Considering the current situation, distance education seems to be the best option to ensure that the learning process can continue while protecting the health of students and academicians. Although distance education is not sufficient by itself in medical education during and after the COVID-19 pandemic, it is a method that should be used in almost every field of medical education, especially in the preclinical phase. Both the distance education, and online examination process require improvements and they are needed to be supported with face to face lectures and practices.Öğe Long-Term Evaluation After Supracricoid Partial Laryngectomy(2018) Çiftçi, Elif; Karasalihoğlu, Ahmet Rıfat; Yağız, Recep; Taş, Abdullah; Güven, Selis Gülseven; Adalı, Mustafa Kemal; Koten, MuhsinObjective: Supracricoid partial laryngectomy is one of the partial laryngectomy proce- dures designed to maintain adequate functionality. We intend to determine the effects of voice, res- piration functions that effect life quality in the long term, and how much they differ based on the chosen surgical procedure after supracricoid partial laryngectomy. Material and Methods: We as- sessed 26 patients with supracricoid partial laryngectomy (SCPL) with cricohyoidopexy, 9 patients with SCPL cricohyoidoepiglottopexy and 10 healthy individuals within our research. All of the pa- tients were evaluated with acoustic and perceptual voice analysis, aspiration, dysphagia, voice hand- icap index, laryngostroboscopy one year after supracricoid partial laryngectomy with cricohyoidopexy or cricohyoidoepiglottopexy. Results: Thirty-five patients (34 male, 1 female) were included in the study group to determine the postoperative, long term functional effects of SCPL. We found that, even though patients suffered from disabilities related with voice, findings in fuctional results in supracricoid partial laryngectomy patients were favorable. Conclusion: As a conclusion, SCPL could be performed in chosen cases of advanced laryngeal malignancies as an alternative sur- gical method, preserving swallowing, speaking and swallowing functions, providing acceptable func- tional results as expressed by patients. When SCPL patients were evaluated postoperatively in the long-term, using acoustic voice analysis, laryngostroboscopic examination and voice handicap index, even though they suffered from voice weaknesses, functional results were generally found to be ac- ceptable.