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Öğe A Rare Case : Pulmonary Supravalvular Stenosis with Moderate Gradient Causing An Atrial Right To Left Shunt Across The Reopened Foramen Ovale(Çanakkale Onsekiz Mart Üniversitesi, 2014) Özcan, Sedat; Civan, Murat; Kurt, Tolga; Ekinci, Selim; Ziyrek, Murat; Toman, HüseyinSupravalvular pulmonary stenosis accompanied by a right to left shunt is a rare echocardiographic finding in adults. We report a case of adult pulmonary supravalvular membranous stenosis with an atrial right to left shunt developed through a previously undiagnosed patent foramen ovale (PFO).The peculiarity of our case is that foramen ovale reopened despite a moderate pulmonary trunk gradient over a six year period. This congenital anomaly is a condition to be differentiated from valvular pulmonary stenosis as both anomalies require different modalities of treatment (surgical or catheter).Öğe Adjunctive Hyperbaric Oxygen Therapy or Alone Antibiotherapy? Methicillin Resistant Staphylococcus aureus Mediastinitis in a Rat Model(Soc Brasil Cirurgia Cardiovasc, 2015) Kurt, Tolga; Vural, Ahmet; Temiz, Ahmet; Ozbudak, Ersan; Yener, Ali Umit; Sacar, Suzan; Sacar, MustafaObjective: In the post-sternotomy mediastinitis patients, Staphylococcus aureus is the pathogenic microorganism encountered most often. In our study, we aimed to determine the efficacy of antibiotic treatment with vancomycin and tigecycline, alone or in combination with hyperbaric oxygen treatment, on bacterial elimination in experimental S. aureus mediastinitis. Methods: Forty-nine adult female Wistar rats were used. They were randomly divided into seven groups, as follows: non-contaminated, contaminated control, vancomycin, tigecycline, hyperbaric oxygen, hyperbaric oxygen + vancomycin and hyperbaric oxygen + tigecycline. The vancomycin rat group received 10 mg/kg/day of vancomycin twice a day through intramuscular injection. The tigecycline group rats received 7 mg/kg/day of tigecycline twice a day through intraperitoneal injection. The hyperbaric oxygen group underwent 90 min sessions of 100% oxygen at 2.5 atm pressure. Treatment continued for 7 days. Twelve hours after the end of treatment, tissue samples were obtained from the upper part of the sternum for bacterial count assessment. Results: When the quantitative bacterial counts of the untreated contaminated group were compared with those of the treated groups, a significant decrease was observed. However, comparing the antibiotic groups with the same antibiotic combined with hyperbaric oxygen, there was a significant reduction in microorganisms identified (P<0.05). Comparing hyperbaric oxygen used alone with the vancomycin and tigecycline groups, it was seen that the effect was not significant (P<0.05). Conclusion: We believe that the combination of hyperbaric oxygen with antibiotics had a significant effect on mediastinitis resulting from methicillin-resistant Staphylococcus aureus. Methicillin-resistant Staphylococcus aureus mediastinitis can be treated without requiring a multidrug combination, thereby reducing the medication dose and concomitantly decreasing the side effects.Öğe Aksaray ilinde meydana gelen motosiklet kazalarına bağlı kas iskelet sistemi yaralanmaları(2013) Kömürcü, Erkam; Arık, Kasım; Hatay, Umut Gölge; Nusran, Gürdal; Kurt, TolgaSon yıllarda motosiklet kullanımının artmasıyla birlikte motosiklete bağlı kazalar ve bu kazalara bağlı gelişen sakatlıklar ve ölüm oranlarında artış gözlenmektedir. Çalışmamızda motosikletin yaygın olarak kullanıldığı Aksaray ilinde motosiklet kazalarına bağlı kas iskelet sistemi yaralanmalarının değerlendirilmesi amaçlandı. Gereç ve Yöntem Aksaray Devlet Hastanesi Acil Servisine başvuran motosiklet kazalarına bağlı yaralanması saptanan 189 hastanın dosyaları retrospektif olarak incelendi. Hastaların yaş, cinsiyet ve travmaları kaydedildi. Kas iskelet sistemi yaralanması saptanan olgular travmanın yerleşim yerine göre gruplandırıldı, gelişen morbitide ve mortalite değerlendirildi. Bulgular Hastaların (n=189) 168i erkek (%89.9), 21i (%11.1) kadındı. Hastaların 147sinde (%77.8) kas iskelet sistemi yaralanması mevcuttu. Hastaların birden çok ekstremite ve izole ekstremite yaralanması sırasıyla 26 (%17.69) ve 70 (%47.62) idi. 51inde (%34.69) sadece yumuşak doku travması saptandı. Kırık ve çıkıkların dağılımı şu şekildeydi: 74 (%54.81) alt ekstremite, 48 (%35.56) üst ekstremite, 9 (%6.67) pelvis, 4 adet (%2.96) vertebraydı. Ekstremite yaralanmalarında sıklık sırasına göre; femur (%27.41) ve tibiayı (%19.26), el ve el bileği (%9.63) yaralanmaları izlemekteydi. Çoklu organ yaralanması olan 7 hasta hayatını kaybetti ve kas iskelet sistemi yaralanması olan 22 hastada ekstremitenin fonksiyonunu kaybetmesinden dolayı kalıcı sakatlık gelişti. Komplikasyon olarak 2 hastada pulmoner emboli, 1 hastada osteomiyelit saptandı. Yaralanmaların en sık temmuz ayında saat 23:00 03:00 ve 04:00-07:00 arasında olduğu görüldü. Kayıtlarda hastaların 48 inin (%32.70) alkollü olduğu saptandı. Sonuç Motosiklet kazasına bağlı gelişen kas iskelet sistemi yaralanmaları yaşam boyu devam eden sakatlıklara ve ölümlere neden olabilmektedir. Bu konuda toplumsal bilinç arttırılmalı, motosiklet kullanımı konusunda eğitim programları daha etkin ve yaygın hale getirilmelidir.Öğe An evaluation of rivaroxaban and clopidogrel in a rat lower extremity ischemia-reperfusion model: An experimental study(Baycinar Medical Publ-Baycinar Tibbi Yayincilik, 2019) Ozbudak, Ersan; Eraldemir, Fatma Ceyla; Arikan, Ali Ahmet; Sahin, Deniz; Kir, Hale Maral; Kurt, Tolga; Gulasti, Omer FarukBackground: This study aims to compare clopidogrel and rivaroxaban against ischemia-reperfusion injury after a long reperfusion time and to investigate its effects on various tissues. Methods: A total of 40 Wistar rats were included in the study and were randomly divided into four groups (n=10 per group). Groups were defined as follows: control (Group 1), sham (Group 2), clopidogrel pre-treatment (Group 3), and rivaroxaban pre-treatment (Group 4). Ischemia (6 h) and reperfusion (8 h) were induced at the lower hind limb in Groups 2, 3, and 4. The ischemic muscle, heart, kidney, liver, and plasma tissues of the subjects were obtained to test for the oxidant (malondialdehyde) and antioxidants (glutathione, superoxide dismutase, and nitric oxide). Results: Malondialdehyde levels were significantly higher in the sham group, compared to the controls in all tissues. Clopidogrel and rivaroxaban pre-treatment significantly decreased malondialdehyde levels, compared to the heart, ischemic muscle, liver, and blood tissues of the sham group. Kidney malondialdehyde levels were reduced only by rivaroxaban. Group 4 had significantly decreased malondialdehyde levels, compared to Group 3 in ischemic muscle (p<0.010). The glutathione reduction, compared to sham group, in the kidney was only significant for Group 4 (p<0.050). With clopidogrel and rivaroxaban pretreatment, nitric oxide levels significantly decreased only in the heart tissue, compared to sham group (p<0.001 and p<0.050, respectively). Conclusion: The study results suggest that rivaroxaban and clopidogrel are effective in reducing ischemia-reperfusion injury in the heart, ischemic muscle, liver, and blood. Rivaroxaban also protects the kidneys and is superior to clopidogrel in ischemic muscle protection.Öğe Can the ankle brachial pressure index (ABPI) and carotis intima media thickness (CIMT) be new early stage markers of subclinical atherosclerosis in patients with rheumatoid arthritis?(Springer Wien, 2015) Kurt, Tolga; Temiz, Ahmet; Gokmen, Ferhat; Adam, Gurhan; Ozcan, Sedat; Ozbudak, Ersan; Sacar, MustafaIt takes years for atherosclerosis to manifest symptoms. However, it needs to be identified earlier because of the premature cardiovascular risk factors in patients with rheumatoid arthritis (RA). In this study, we aimed to investigate the effect of atherosclerosis on the ankle brachial pressure index (ABPI) and carotis intima media thickness (CIMT) in patients with RA. RA patients attending the rheumatology clinic were examined retrospectively; then we called them for the measurements of ABPI and CIMT prospectively. Subjects were divided into four groups, as follows (Table 1): group 1 comprised RA patients with an ABPI less than 0.9; group 2 included RA patients with an ABPI between 0.9 and 1.2; group 3 was made up of RA patients with an ABPI greater than 1.2; and group 4 included patients without RA with an ABPI between 0.9 and 1.2 as a control group. Patients' demographic data were recorded. Hypertension (HT), diabetes mellitus, ABPI and CIMT measurements were taken by specialists. Duration of RA and disease scores (disease activity score-28, health assessment questionnaire score and visual assessment score) were recorded. The prevalence of peripheral vascular disease in patients with RA was twice as high as that in the normal population of equivalent age. Patients in group 2, with RA and normal ABPI, exhibited a significant higher mean in CIMT (mm) compared with the control group (p < 0.01), despite having normal ABPI. This confirms that these patients have a higher risk of stroke compared with the control group. Group 1's newly diagnosed HT (p < 0.01) and systolic blood pressure (SBP) values (p < 0.01) were higher and statistically significant when compared with the group 4 (control group); in addition, significant plaque levels were observed in the carotid arteries (p < 0.01). Group 3 patients had a similar history of HT and increased SBP compared with patients in group 4 (p < 0.01), and had similar characteristics to with group 1. No statistically significant differences were found between the groups in terms of inflammatory markers such as C-reactive protein and rheumatoid factor, anti-cyclic citrullinated peptide and white blood cell counts. Based on the present findings, patients with RA need to be evaluated in the early stage of the disease for subclinical peripheral artery disease using the ABPI, as well as CIMT, which is also a non-invasive technique, in terms of cerebrovascular events. Inflammatory markers exhibited no statistically significant difference. We think that the atherosclerotic process stems not only from the inflammatory effects of RA, but also perhaps from its immunological nature.Öğe Drug-eluting Vein Graft with Acetylsalicylic Acid-Ticagrelor- Unfractionated Heparin Complex Inhibits Early Graft Thrombosis(Galenos Publ House, 2020) Aksit, Ercan; Kurt, Tolga; Buyuk, Basak; Cokkalender, OmerBackground: Bypass graft surgery remains to be an important treatment option for left main and multivessel coronary artery disease. Approximately 2% of saphenous vein grafts are lost immediately after the coronary artery bypass graft operations and 12% in the first month due to thrombosis. Aims: To administer one anticoagulant and two antiplatelet agents in a way that locally affects the vein graft before the bypass operation and to thereby analyse their effects on early graft thrombosis. Study Design: Animal experimentation. Methods: Since ticagrelor was used locally for the first time in this study; its efficacy in combination with other drugs (acetylsalicylic acid, acetylsalicylic acid and ticagrelor, and acetylsalicylic acid + ticagrelor unfractionated heparin) was examined on rats including control (untreated) and sham (pluronic gel) group (n=14 for each group). Before the tunica adventitia layer of the femoral veins was bypassed to the femoral artery, it was coated with the drug-eluting pluronic F-127 gel. The presence or absence of thrombus in the vein graft samples was recorded under light microscopy. In vein graft preparations where thrombus was detected, the thrombus area (mu m(2)) was calculated using the Axiovision software. Immunohistochemical staining was performed with the anti-rat von Willebrand factor polyclonal antibody kit. Results: The number of preparations containing thrombus was significantly lower in the acetylsalicylic acid + ticagrelor + unfractionated heparin group than in the acetylsalicylic acid, control, and sham groups, according to the comparisons made on the Is/ and 3rd days (p=0.00I and 0.02. respectively). von Willebrand factor staining was significantly lower in the acetylsalicylic acid + ticagrelor + unfractionated heparin group than in the other groups on the 3rd day (p=0.005). Conclusion: Locally effective acetylsalicylic acid-ticagrelor-unfractionated heparin complex has been shown to significantly reduce thrombus formation in vein grafts in this experimental model. Local administration of these drugs, which are routinely administered orally just before stent implantations, on the vein graft before the bypass is performed can prevent the loss of vein grafts due to thrombus, thereby reducing the mortality and morbidity of these patients.Öğe Epidural Anesthesia in a Patient with High Cardiac Risk(2015) Doğu, Tuğba; Şahin, Hasan; Kurt, Tolga; Kiraz, Hasan Ali; Altınışık, Uğur; Toman, Hüseyin; Şimşek, TuncerCardiac morbidity is the most common cause postoperative mortality furthermore anesthesia technics are associated with cardiac morbidity and mortality. A 48-year-old male, 90 kg, ASA physical status IV patient underwent femoropopliteal bypass under epidural anesthesia. Comorbidities included atrial fibrillation, dilated cardiomyopathy and 20% left ventricular ejection fraction. Epidural anesthesia was established with bupivacaine and fentanyl at L3-L4 intervertebral space. Hemodynamic stability and pain relief were established during and after the surgery. We consider that epidural anesthesia is preferable as an alternative regarding the risks of spinal anesthesia and general anesthesia for high cardiac risky patients.Öğe Ergotamine-induced vasospastic ischemia mimicking arterial embolism: unusual case(Turkish Assoc Trauma Emergency Surgery, 2014) Adam, Gurhan; Kurt, Tolga; Cinar, Celal; Sariyildirim, Abdullah; Resorlu, Mustafa; Uysal, Fatma; Yener, Ali UmitErgotamine toxicity is an important and rare condition, including tachycardia, arterial spasm which occurring as a result of accidental overdosing or drug interactions. We assessed the consequences of delayed diagnosis of peripheral arterial vasoconstriction occurring after simultaneous macrolide use by a 35-year-old woman using an ergot-derived drug for migraine. Diagnosis of ergotamine intoxication begins with suspicion. Interventional radiologists and surgeons should be aware of this acute dangerous condition.Öğe Evaluation of Platelet Distribution Width and Mean Platelet Volume in Patients With Carotid Artery Stenosis(Sage Publications Inc, 2015) Adam, Gurhan; Kocak, Erdem; Ozkan, Adile; Resorlu, Mustafa; Cinar, Celal; Bozkaya, Halil; Kurt, TolgaPlatelets contribute to the pathogenesis of atherosclerosis. Platelet activation has been linked with increased mean platelet volume (MPV) and platelet distribution width (PDW). We investigated the association between PDW, MPW, and the degree of carotid artery stenosis (CS). Patients (n = 229) were divided into 3 groups according to the North American Symptomatic Carotid Endarterectomy Trial criteria. Demographic and clinical features were collected retrospectively. Correlation analysis showed a positive association between PDW and the degree of CS. However, there was no significant correlation between CS and MPV. Moreover, we observed that PDW and low-density lipoprotein cholesterol were independent predictors of the degree of CS. This study showed that PDW, not MPV, is related to the degree of CS. Platelet distribution width could be a useful biomarker for CS. Whether targeting PDW will be of clinical benefit remains to be established.Öğe HOW IMPORTANT IS EARLY DIAGNOSIS OF SUBCLINICAL ATHEROSCLEROSIS IN PRIMARY SJOGREN'S SYNDROME PATIENTS?(Carbone Editore, 2015) Kurt, Tolga; Gokmen, Ferhat; Adam, Gurhan; Ozcan, Sedat; Ozbudak, Ersan; Akbal, Ayla; Temiz, AhmetIntroduction: Cardiovascular (CV) disease is observed with increasing frequency in patients with systemic vasculitis. The use of carotid intima media thickness (CIMT) and ankle brachial pressure index (ABPI) may help to identify high-risk primary Sjogren's syndrome (PSS) patients. The objective of this study is to determine abnormal ABPI and CIMT values in the patient group with PSS and compare them clinically and serologically with a control group. Materials and methods: Our study comprised a total of 124 patients who were diagnosed with PSS according to the American-European Consensus Group Sjogren's syndrome classification criteria and monitored for more than 3 years, and a control group. CIMT and ABPI measurements were completed by specialists. The patients were also evaluated serologically. Results: All of the PSS patients had xerophthalmia findings, the second most common symptom was xerostomia. The mean disease duration was 80.4 +/- 25.6 months. Nine PSS patients (41%) had ABPI less than 0.9. In the control group II (II%) patients had ABPI less than 0.9. When the two groups were compared, the difference was found to be significant (p<0.05). PSS patients also exhibited a statistically significant increase in mean CIMT values (mm; p<0.05). When the PSS patients with ABPI less than 0.9 were compared with other PSS patients and the control group, there was no significant difference in terms of anti-Sjogren's syndrome related antigen A (anti-SSA) and anti-Sjogren's syndrome related antigen B (anti-SSB), C-reactive protein (CRP), rheumatoid factor (RF) or Anti-Cyclic Citrullinated Peptide (anti-CCP) positivity (p>0.05). Conclusion: Similar to patients with systemic vasculitis, PSS patients should be assessed for subclinical peripheral arterial diseases in the early stage and monitored closely with ABPI and CIMT measurements. The atherosclerotic process observed in PSS patients may be due not only to the inflammatory effect, but to many multifactorial issues such as immunological and genetic effects.Öğe How important is early diagnosis of subclinical atherosclerosis in primary Sjogren's syndrome patients?(Acta Medica Mediterranea, 2015) Kurt, Tolga; Gokmen, Ferhat; Adam, Gurhan; Ozcan, Sedat; Ozbudak, Ersan; Akbal, Ayla; Temiz, AhmetIntroduction: Cardiovascular (CV) disease is observed with increasing frequency in patients with systemic vasculitis. The use of carotid intima media thickness (CIMT) and ankle brachial pressure index (ABPI) may help to identify high-risk primary Sjogren's syndrome (PSS) patients. The objective of this study is to determine abnormal ABPI and CIMT values in the patient group with PSS and compare them clinically and serologically with a control group. Materials and methods: Our study comprised a total of 124 patients who were diagnosed with PSS according to the American-European Consensus Group Sjogren's syndrome classification criteria and monitored for more than 3 years, and a control group. CIMT and ABPI measurements were completed by specialists. The patients were also evaluated serologically. Results: All of the PSS patients had xerophthalmia findings, the second most common symptom was xerostomia. The mean disease duration was 80.4±25.6 months. Nine PSS patients (41%) had ABPI less than 0.9. In the control group 11 (11%) patients had ABPI less than 0.9. When the two groups were compared, the difference was found to be significant (p<0.05). PSS patients also exhibited a statistically significant increase in mean CIMT values (mm; p<0.05). When the PSS patients with ABPI less than 0.9 were compared with other PSS patients and the control group, there was no significant difference in terms of anti-Sjogren's syndrome related antigen A (anti-SSA) and anti-Sjogren's syndrome related antigen B (anti-SSB), C-reactive protein (CRP), rheumatoid factor (RF) or Anti-Cyclic Citrullinated Peptide (anti-CCP) positivity (p>0.05). Conclusion: Similar to patients with systemic vasculitis, PSS patients should be assessed for subclinical peripheral arterial diseases in the early stage and monitored closely with ABPI and CIMT measurements. The atherosclerotic process observed in PSS patients may be due not only to the inflammatory effect, but to many multifactorial issues such as immunological and genetic effects.Öğe Impact of elevated serum estradiol/free testosterone ratio on male varicose veins in a prospective study(Springer Wien, 2015) Ozcan, Sedat; Odabasi, Dolunay; Kurt, Tolga; Gur, Ali Kemal; Kunt, Aysegul; Balaharoglu, Yavuz; Kunt, Alper SamiAlthough some studies indicate an association between increased levels of estradiol and varicose veins in women, the role of sex hormones on varicose veins have a question mark in men. We investigated estradiol-2/free testosterone (E2/fT) ratio relationship on varicosity in 100 male patients dividing them into two groups. Group A (n = 46) had varicose veins with endocrinological problems, especially infertility, whereas group B (n = 54) also had varicose veins but no endocrinological problems. Venous blood samples were drawn from both groups in the morning to detect the levels of serum estradiol (E2), androstenedione, dehydroepiandrostenedione sulphate and free testosterone (fT). Patient history, physical examination, colour duplex ultrasound of both limbs and classification of CEAP were performed in both groups. Serum E2/fT ratio was calculated in correspondence with CEAP classification. CEAP classification is the varicosity classification, and it is concerned about the clinical class (C), etiology (E), anatomical distribution (A) and underlying pathophysiology (P). E2/fT ratio was significantly higher in group A (4.18 +/- A 0.54) compared with group B (2.98 +/- A 0.36). Moreover, there is a high correlation between serum E2/fT ratio and CEAP clinical classification in group A (4) compared with group B (2). Serum E2/fT ratio is associated with varicose veins in male patients.Öğe LEFT ATRIAL MYXOMA WITH ATYPICAL CLINICAL PRESENTATION(Carbone Editore, 2014) Kurt, Tolga; Ozcan, Sedat; Temiz, Ahmet; Ozbudak, Ersan; Gazi, Emine; Sacar, MustafaMyxoma is the most commonly seen primary cardiac tumour, with an incidence of 80-90% in the left atrium, followed by the right atrium and ventricle. Patients with atrial myxomas present with intracardiac obstruction, embolization to the pulmonary and systemic circulation, or constitutional symptoms. Hepatomegaly and increase of the liver transaminases levels involvement in myxomas are rare, has been described to cause hepatic insufficiency. We describe an interesting case of a 47-year-old patient with systemic findings and symptoms, which was primary symptomatially treated for several months in psychiatry, neurology and chest diseases clinics in other centres but never diagnosed, and undergoing emergency surgery in our clinic following determination of left atrial myxoma at tests performed by our cardiology department. The patient had no symptoms at examinations performed 6 months and 1 year postoperatively, and no pathological findings were determined.Öğe Left atrial myxoma with atypical clinical presentation(Acta Medica Mediterranea, 2014) Kurt, Tolga; Özcan, Sedat; Temiz, Ahmet; Özbudak, Ersan; Gazi, Emine; Saçar, MustafaMyxoma is the most commonly seen primary cardiac tumour, with an incidence of 80-90% in the left atrium, followed by the right atrium and ventricle. Patients with atrial myxomas present with intracardiac obstruction, embolization to the pulmonary and systemic circulation, or constitutional symptoms. Hepatomegaly and increase of the liver transaminases levels' involvement in myxomas are rare, has been described to cause hepatic insufficiency. We describe an interesting case of a 47-year-old patient with systemic findings and symptoms, which was primary symptomatically treated for several months in psychiatry, neurology and chest diseases clinics in other centres but never diagnosed, and undergoing emergency surgery in our clinic following determination of left atrial myxoma at tests performed by our cardiology department. The patient had no symptoms at examinations performed 6 months and 1 year postoperatively, and no pathological findings were determined.Öğe Mitral Yetmezlik Semptomlarıyla Bulgu Veren Sol Atriyal Miksoma(2014) Ozbudak, Ersan; Halıcı, Ümit; Kurt, Tolga[Abstract Not Available]Öğe Musculoskeletal System Injuries Due to Motorcycle Accidents in Aksaray(Elsevier, 2013) Komurcu, Erkam; Arik, Kasim; Golge, Umut Hatay; Nusran, Gurdal; Kurt, TolgaObjectives An increase in motorcycle accidents and injuries has been observed in recent years due to the rising number of motorcyclists. The purpose of our study was to evaluate musculoskeletal system injuries due to motorcycle accidents. Methods The files of 189 patients who presented at the Aksaray State Hospital Emergency Service with injuries due to motorcycle accidents were investigated retrospectively. Age, gender, and current trauma were recorded for each patient. Cases with musculoskeletal system injuries were evaluated according to site of injury, and subsequent morbidity and mortality were documented. Results Of the 189 patients, 168 were male (89.9%), and 21 were female (11.1%). Locomotor system injuries were present in 147 patients (77.8%). The number of patients presenting with multiple extremity injuries versus isolated extremity injuries were 26 (17.69%) and 70 (47.62%), respectively. Soft tissue trauma was present in only 51 patients (34.69%). The distribution of fractures and dislocations was as follows: 74 (54.81%), lower extremity; 48 (35.56%), upper extremity; 9 (6.67%), pelvic; and 4 (2.96%), vertebral injuries. Of the extremity injuries, injuries to the femur (27.41%) and tibia (19.26) were most prevalent, followed by hand and wrist (9.63%) injuries. Seven patients with multiple organ injuries died, while permanent disability due to extremity function loss occurred in 22 patients. Pulmonary embolism and osteomyelitis complications occurred in two patients and one patient, respectively. Injuries were reported most frequently in July between 23: 00 and 03:00 and 04:00 and 07:00. According to the records, 48 (32.79%) of the patients with musculoskeletal injuries were drunk. Conclusions Musculoskeletal system injuries due to motorcycle accidents cause lifelong disabilities. To reduce the frequency of accidents, social awareness should be increased, and training programs in motorcycle usage should be more effective and widespread.Öğe Preoperatif Bakılan Kan Parametreleri Koroner Baypas Komplikasyonları Hakkında Fikir Verir Mi?(Çanakkale Onsekiz Mart Üniversitesi, 2014) Yener, Ali Ümit; Bekler, Adem; Özkan, Muhammed Turgut Alper; Kiraz, Hasan Ali; Toman, Hüseyin; Çiçek, Ömer Faruk; Çokkalender, Ömer; Saçar, Mustafa; Özcan, Sedat; Kurt, TolgaKoroner baypas cerrahisi öncesi kan testlerinde bakılan parametrelerle koroner baypas cerrahisi sonrası görülen morbidite ve mortalite arasındaki ilişkinin ortaya konulması amaçlandı.Şubat 2013 - Haziran 2014 tarihleri arasında koroner baypas ameliyatı yapılan 181 hasta çalışmaya dahil edildi. Hastalardan alınan preoperatif hemogram değerleri ve komplikasyonlar kaydedildi.Hastalar NLR?2.78 ( n=60) ve NLR<2.78 (n=121) olacak şekilde iki gruba ayrıldı (NLR: Nötrofil lenfosit oranı). Univariate ve multivariate lojistik regresyon analizi ile mortalite belirteçleri bulundu.Tek yönlü regresyon analizi yapıldığında kros klemp süresi, PLR (platelet lenfosit oranı) ve NLR mortalite ile ilişkili bulunmuştur. Yapılan çoklu lojistik regresyon analizine göre kros klemp süresi, PLR ve NLR koroner baypas sonrası hastane içi mortalite için bağımsız birer risk faktörü olarak tanımlanmışlardır. Ameliyat öncesi bakılan basit kan testleri yardımıyla, koroner baypas cerrahisi geçirecek hastaların ameliyat sonrası morbiditeleri ve oluşabilecek mortaliteleri hakkında fikir sahibi olunabileceği çalışmamızla ortaya konulmuştur.Öğe ST elevasyonu olmayan akut koroner sendrom hastalarında koroner arter hastalığı yaygınlığı ile GRACE risk skoru arasındaki ilişki(2015) Bekler, Adem; Erbağ, Gökhan; Şen, Hacer; Turgut, Muhammed; Özkan, Alper; Yener, Ali Ümit; Kurt, TolgaAmaç: Akut koroner olayların global kaydı (GRACE) risk skorunun koroner arter hastalığı (KAH) hastalarındaki prognostik değeri daha önce gösterilmiştir. Biz burada ST elevasyonu olmayan akut koroner sendrom hastalarında (STEO-AKS), KAH varlığı ve yaygınlığı öngörüsünde GRACE risk skoru (GRS) ile Gensini skorunun (GS) karşılaştırılmasını amaçladık. Yöntem: Çalışmaya toplam 154 STEO-AKS hastası alındı. GRS ile ilgili skorlar başvurudaki spesifik değişkenlerle hesaplandı. KAH yaygınlığı GS ile değerlendirildi ve Hastalar GRS' ye göre düşük (GRS140) olarak 3 gruba ayrıldı. GRS ve GS arasındaki ilişki için spearman korelasyon analizi uygulandı. Bulgular: Tüm hastalarda düşük, orta ve yüksek risk gruplarında ortalama yaş (p<0.001), kalp hızı (p = 0.004), GS (p<0.001), anlamlı farklıydı. Hemoglobin ve lenfosit düzeyleri düşük risk grubunda, orta ve yüksek risk grubuyla karşılaştırıldığında anlamlı yüksekti ve yüksek duyarlılıklı troponin-T düzeyleri yüksek risk grubunda düşük ve orta risk grubuyla karşılaştırıldığında anlamlı yüksekti (sırasıyla, p = 0.022, p = 0.020, p = 0.036). Korelasyon analizinde, GRS ile GS arasında pozitif anlamlı korealsyon vardı (r = 0.353, p<0.001). Sonuç: STEO-AKS hastalarında KAH ciddiyetini öngörmek için yüksek GRS yardımcı olabilir.Öğe Süperior Mezenterik Arterin Ateşli Silah Yaralanmasının Ardından Safen Ven Grefti İle İnterpozisyonu(Çanakkale Onsekiz Mart Üniversitesi, 2014) Özcan, Sedat; Kurt, Tolga; Odabaşı, Dolunay; Gür, Ali Kemal; Toman, HüseyinÖzet Ateşli silah yaralanması nedeniyle değerlendirilen bir hasta multipl batın içi organ yaralanmasına ek olarak Arteria Mezenterica Superior yaralanması tespit edilmesi üzerine hasta serum seti ile geçici by-pass uygulanmış ve 100 km uzaklıktaki kardiyovasküler cerrahi merkezi olan bir kuruma sevk edilmiştir. Burada uygulanan safen ven grefti interpozisyonu ile ince bağırsakların canlılığı korunmuştur. Genel cerrahi pratiğinde çok önemli bir morbidite ve mortalitenin sebebinin multi disipliner bir yaklaşımla tedavi edilmesini sunmayı amaçladık.Öğe The Effects of Low Tidal Volume and Ventilation on the Lungs in the Postoperative Period during Cardio Pulmonary Bypass in the Heart Surgery(Çanakkale Onsekiz Mart Üniversitesi, 2014) Gür, Ali Kemal; Özcan, Sedat; Kurt, Tolga; Eker, Esra; Odabaşı, Dolunay; Destan, Buğra; Candan, Mehmet Akif; Ekin, AhmetThe occurrence of respiratory problems in patients after the open heart surgery still continues to be a problem, which disturbs the comfort of surgery in the postoperative period. In this study, we aimed to prevent the sequestration, which might occur in the lungs within the continuous ventilation of the lungs that are disconnected as a routine during the cardiopulmonary bypass (CPB) under the low tidal volume; also aimed to reduce the edema in the lung tissue during the postoperative period and present these results along with the literature. For this purpose, 40 coronary artery bypass surgery patients are examined as two groups (Group 1, Group 2), which are planned under elective conditions as consecutive.40 patients who underwent coronary artery bypass surgery were divided into two groups and examined. 20 patients (group 1; 13 males, 7 females; average age is 58±8), who were normally disconnected during CPB; and 20 other patients, who are ventilated with low tidal volume during CPB (group 2; 12 males, 8 females; average age is 60±5) are taken into the study. Attention paid to not to have differences in preoperative characteristics of the patients. Lung ventilator modes, arterial blood gas levels, extubation times, preoperative pulmonary function tests (PFT) ve the postoperative day 7th and 1st month PFT’s of both groups are compared. There are some significant differences between the patients of group 1 and group 2 as follows; the average partial oxygen (PO2) amount in arterial blood gases during the intensive care period with 40% oxygen after the surgery at the 2nd hour SMIV mode are 105±10 mmHg and 120 ± 20 mmHg respectively; SO2 values are 92±4 and 94±4 respectively; the average intubation times are 5,3 ±0,4 hours and 4,2 ±0,3 hours respectively; and oxygen saturations of service are 83% ± 5 and 90% ± 3 respectively for the 1st group and the 2nd group.When the ventilation of the lung with low tidal volume during the CPB is compared with the disconnection method applied normally; we conclude that the first method protects the lung functions better than the second one. It was seen in the light of our study; the pulmonary functions are better after the ventilation with low tidal volume, and respiratory complications are less likely to be detected.
