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Öğe Accidental swallowing of the head of a dental mirror: Report of a rare case(ELSEVIER TAIWAN, 2012) Oncel, Murat; Apiliogullari, Burhan; Cobankara, Funda Kont; Apiliogullari, SezaForeign body ingestion/aspiration episodes are potential complications in all branches of dentistry. We report a case of swallowed head of dental mirror found in the esophagus. In this unusual case, a 26-year-old male who was anxious because of excessive pain accidentally swallowed the head of the dental mirror during examination. Given the absence of immediate clinical complications, the patient underwent a chest radiograph. The head of dental mirror was located in the middle third of the esophagus and was later removed by rigid esophagoscopy. To our knowledge, this is the first documented case of a swallowed head of dental mirror found in the esophagus. In addition to the clinical repercussions, this paper also discusses management strategies for patients who have accidentally swallowed components of dental instruments. Copyright (C) 2012, Association for Dental Sciences of the Republic of China. Published by Elsevier Taiwan LLC. All rights reserved.Öğe Clinical management of severe propafenone intoxication(AVES, 2015) Kara, Inci; Celik, Jale Bengi; Apiliogullari, Seza; Aydogan, EyupWe present a case of cardiopulmonary arrest after propafenone intoxication in a patient with normal cardiovascular function. She was admitted to the critical care unit within 40 min after 9000 mg propafenone consumption. Main findings were cardiac arrest, instable hemodynamics, and atrioventricular junction block. For its management, transient pacing was performed with catecholamine infusion. We achieved a good outcome in this case because of rapid resuscitation and aggressive treatment with monitoring and supportive care, including mechanical ventilation.Öğe Combination of ultra-low dose bupivacaine and fentanyl for spinal anaesthesia in out-patient anorectal surgery.(FIELD HOUSE PUBLISHING LLP, 2009) Apiliogullari, Seza; Duman, Ates; Tekin, Ahmet[Abstract not Available]Öğe Comments on "Local Anesthetic Systemic Toxicity"(OXFORD UNIV PRESS INC, 2016) Onal, Ozkan; Saltali, Ali Ozgul; Apiliogullari, Seza[Abstract not Available]Öğe Comparison of Nutritional Parameters among Adult and Elderly Hemodialysis Patients(IVYSPRING INT PUBL, 2011) Celik, Gulperi; Oc, Bahar; Kara, Inci; Yilmaz, Mumtaz; Yuceaktas, Ali; Apiliogullari, SezaAim: The aim of this study was to compare the nutritional biochemical parameters, prealbumin levels, and bioimpedance analysis parameters of adult and elderly hemodialysis (HD) patients. Methods: This prospective cross-sectional study included 50 adult HD patients (42.0 % female). Nutritional status was assessed by post-dialysis multifrequency bioimpedance analysis (BIA), serum prealbumin and other nutritional biochemical parameters. Results: Mean age of patients was 57.4 +/- 15.1 years (range: 30-83 years) and mean dialysis duration was 68.3 +/- 54.5 months (range: 3-240 months). When the patients were divided into two groups according to age of patients (<65 and >= 65), prealbumin (p=0.003), blood urea nitrogen (BUN) (p=0.000), serum creatinine (p=0.013), albumin (p=0.016), protein catabolic rate per normalized body weight (nPCR) (p=0.001), intracellular water (ICW)/total body weight (0.003), body fat mass (p00.000), lean body mass (p=0.031), lean dry mass (p=0.001), illness marker (p=0.005), basal metabolism (p=0.007), body mass index (BMI) (p=0.028), body fat mass index (BFMI) (p=0.000), fat free mass index (FFMI) (p=0.040) values were significantly different between the groups. In the elderly patients (age >= 65), body fat mass, illness marker, BMI, BFMI were higher compared to adult patients (age <65). Additionally, in the elderly patients, prealbumin, BUN, creatinine, albumin, nPCR, ICW/ total body weight, lean body weight, lean dry weight, basal metabolism and FFMI were lower than adult patients. Conclusions: Our results indicate that BFMI were higher, albumin, prealbumin, nPCR and lean body mass and FFMI were lower in elderly patients compared to adults. These results imply that elderly HD patients may be prone sarcopenic obesity and may require special nutritional support.Öğe COMPARISON OF SELECTIVE SPINAL ANESTHESIA AND LOCAL INFILTRATION ANESTHESIA UNDER MONITORED ANESTHESIA CARE TECHNIQUES IN PATIENTS UNDERGOING ANORECTAL DAY SURGERY(NOBEL ILAC, 2011) Duman, Ates; Apiliogullari, Seza; Tekin, Ahmet; Bodur, SaidObjective: In this prospective, randomized study, we aimed to compare the two techniques that we employ routinely in our clinic; selective spinal anesthesia (SSA) and local infiltration anesthesia under monitored anesthesia care (MAC) in terms of patient and surgeon satisfaction, time for ambulation (AT), time to be ready for discharge (RD). Material and Method: In group I (n=30), spinal anesthesia was achieved with 2.5 mg 0.5% hyperbaric bupivacaine in the sitting position. In group II (n=30), 0.25 mg.kg-1 of hetamine followed by 1-2mg. kg-1 of propofol were administered intravenously for sedation. Local infiltration anesthesia consisting of 5ml of 0.5% isobaric bupivacaine and 5ml of 2% prilocaine. Patient and surgeon satisfaction, AT, RD and side effects were compared. Results: The mean AT and RD were 38 min and 45 min respectively in group land, 43 mm and 57 min respectively in group II (p<0.05). While the groups were similar in terms of surgeon satisfaction, patient satisfaction was better in group I (p<0.05). Conclusion: When compared to local infiltration anesthesia under MCA, SSA technique provides better patient satisfaction together with shorter AT and RD times.Öğe Complex Regional Pain Syndrome in a Patient with Muscular Dystrophy(WILEY-BLACKWELL, 2014) Apiliogullari, Seza; Gunduz, Ergun; Aydin, Bahattin Kerem; Levendoglu, Funda[Abstract not Available]Öğe Do infants need higher intrathecal fentanyl doses than older children? - reply(WILEY-BLACKWELL, 2008) Apiliogullari, Seza; Duman, Ates; Gok, Funda[Abstract not Available]Öğe DOES A SPINAL BLOCK AT SACRAL LEVEL PROVIDE ADEQUATE ANESTHESIA FOR TRANSURETHRAL RESECTION OF THE PROSTATE CONDUCTED WITH CONTINUOUS IRRIGATION RESECTOSCOPE?(GUNES KITABEVI LTD STI, 2011) Apiliogullari, Seza; Sakalli, Melike; Duman, Ates; Balasar, Mehmet; Ogun, Cemile OztinIntroduction: It has been previously reported that a spinal block at L1 level is adequate for transurethral resection of prostate (TURP) if low bladder pressure is provided. This study aims to compare adequacy and the characteristics of spinal anesthesia with low dose bupivacaine and bupivacaine + fentanyl combinations for TURP conducted with continuous irrigation resectoscope. Materials and Method: After Ethical Committee approval and informed consent, 50 patients were included with randomization. Spinal anesthesia was conducted in the sitting position with 5 mg of hyperbaric bupivacaine + 0.4 ml 0.9% NaCl in group B (n=25) and 5 mg of hyperbaric bupivacaine + 0.4 ml (20 mu g) fentanyl in group BF (n=25). Sensory block levels, motor block properties, quality of intraoperative anesthesia, surgical convenience and side effects were recorded. Results: The groups were similar regarding maximum block levels (L2), motor block and hemodynamic, properties. Sufficient analgesia was provided without additional analgesics in 46 of 50 patients with a sensory block higher than S1. Two groups were similar in terms of the quality of anesthesia, convenience for the surgeon and side effects. Conclusion: Bupivacaine (5mg) with or without fentanyl provides safe and adequate anesthesia, with a sensory block higher than S1, when continuous irrigation resectoscope is used for TURP.Öğe The effect of 45-degree head up tilt on bloody tap during lumbar puncture in children(WILEY-BLACKWELL PUBLISHING, INC, 2009) Duman, Ates; Apiliogullari, Seza; Ogun, Cemile Oztin[Abstract not Available]Öğe Effect of menstrual cycle on orthodontic pain perception A controlled clinical trial(URBAN & VOGEL, 2016) Ileri, Zehra; Baka, Zeliha Muge; Akin, Mehmet; Apiliogullari, Seza; Basciftci, Faruk AyhanThe aim of this prospective, single-center, controlled clinical trial was to evaluate the effects of menstrual cycle phases on orthodontic pain perception. A total of 48 women between 16 and 20 years old with regular menstrual periods who were scheduled to undergo extraction of two upper first premolars for orthodontic treatment were enrolled in this study. Laceback ligatures were used to move canines distally. After activating the laceback ligatures, each patient completed a questionnaire in order to assess pain and quality of life. Pain perception was recorded by patients on a visual analogue scale (VAS) and a verbal rating scale-4 (VRS) immediately after activation (T1) and 24 h after activation (T2). During the appointment, each patient's menstrual-cycle phase (follicular or luteal) was determined by asking some questions about her cycle. For statistical analysis of data, the Mann-Whitney U, independent t test, and Wilcoxon tests were applied. Mean orthodontic pain score was 1.96 +/- 0.80 and 47.08 +/- 21.68 in the follicular phase, 1.92 +/- 0.82 and 46.25 +/- 18.92 in the luteal phase at T1 using the VRS and VAS, respectively. Orthodontic pain scores were worse in those patients in the luteal phase than those in the follicular phase (p < 0.05) in terms of both VRS (p = 0.025) and VAS (p = 0.046). No significant difference between pain scores at T1 and those at T2 in both luteal and follicular phases (p > 0.05) were observed. The menstrual phase has an influence on the perception of orthodontic pain which is higher in the luteal phase following the activation of laceback ligatures. In clinical practice, the phases of the menstrual cycle may have a significant role in how women perceive orthodontic pain.Öğe The effect of the trendelenburg position on the internal jugular vein's cross-sectional area in overweight and obese children(E-CENTURY PUBLISHING CORP, 2016) Sekmenli, Tamer; Nayman, Alaaddin; Onal, Ozkan; AriYuca, Sevil; Apiliogullari, Seza; Ciftci, Ilhan; Celik, Jale BengiBackground: The Trendelenburg position is a common technique used during internal jugular vein (IJV) cannulation in pediatric patients. There has been some speculation as to the correlation between Trendelenburg positioning and increases in the cross-sectional area (CSA) of the IJV in obese child patients. In the present study, we use ultrasound (US) measurements to assess and determine the predictivity of Trendelenburg positioning on the CSA of the right IJV in obese child patients. Methods: The researchers of this studyenrolled 30 cases from the American Society of Anesthesiologists (ASA) II of patients under the age of 18 who underwent ultrasonographic examination between December 2013 and March 2015. US images of the right IJV of each patient were obtained in a transverse orientation at the cricoid level. The CSAs of the right IJVs were measured undert wo different conditions applied in a random orderin a sealed envelope: State 0, in which the table was flat (no tilt) and the patient lay in the supine position; and State T, in which the operating table wastilted 20 degrees to the Trendelenburg position. Results: The change in the CSA of the IJV from the supine to the Trendelenburg position (0.99 cm(2) vs 0.96 cm(2)) was not significant. In contrast, the CSA of the right IJV decreased in 14 of the 30 patients (9 of the 14 were female). Conclusions: The Trendelenburg position does not cause the mean CSA of the right IJV in obese child patients to increase; in fact, the position causes the CSA in some patients to decrease. The researchers of this study do not support the use of the Trendelenburg position for IJV cannulation in obese child patients.Öğe The effectiveness of trendelenburg positioning on the cross-sectional area of the right internal jugular vein in obese patients(PROFESSIONAL MEDICAL PUBLICATIONS, 2015) Onal, Ozkan; Apiliogullari, Seza; Nayman, Alaaddin; Saltali, Ali; Yilmaz, Huseyin; Celik, Jale BengiObjective: Trendelenburg positioning is a common approach used during internal jugular vein (IJV) cannulation. No evidence indicates that Trendelenburg positioning significantly increases the cross-sectional area (CSA) of the IJV in obese patients. The primary aim of this study was to determine the effectiveness of Trendelenburg positioning on the CSA of the right internal jugular vein assessed with ultrasound measurement in obese patients. Methods: Forty American Society of Anesthesiologists II patients with body mass index >= 30 kg/m(2) undergoing various elective surgeries under general endotracheal anesthesia were enrolled. Ultrasound images of the right IJV were obtained in a transverse orientation at the cricoid level. We measured the CSA of the right IJV two different conditions in a sealed envelope were applied In random order: State 0, table flat (no tilt), with the patients in the supine position, and State T, in which the operating table was tilted 200 to the Trendelenburg position. Results: The change in the CSA of the IJV from the supine to the Trendelenburg position (1.80 cm(2) vs 2.08cm(2)) was not significantly different. The CSA was paradoxically decreased in 10 of 36 patients when the position changed from State 0 to State T. Conclusions: Trendelenburg positioning does not significantly increase the mean CSA of the right IJV in obese patients. In fact, in some patients, this position decreases the CSA. The use of the Trendelenburg position for IJV cannulation in obese patients can no longer be supported.Öğe The effects of dexketoprofen on duration of analgesia to a thermal stimulus when compared with a systemic control in a rat sciatic nerve block with levobupivacaine(WILEY-BLACKWELL, 2014) Kara, Inci; Apiliogullari, Seza; Taylan, Sengal Bagci; Bariskaner, Hulagu; Celik, Jale BengiThis study was designed to investigate whether dexketoprofen added to perineuraly or subcutaneously alters the effects of levobupivacaine in a rat model of sciatic nerve blockade. Thirty-six rats received unilateral sciatic nerve blocks along with a subcutaneous injection by a blinded investigator assigned at random. Combinations were as follows: Group 1 (sham) perineural and subcutaneous saline; Group 2, perineural levobupivacaine alone and subcutaneous saline; Group 3, perineural levobupivacaine plus dexketoprofen and subcutaneous saline; Group 4, perineural levobupivacaine and subcutaneous dexketoprofen; Group 5, perineural dexketoprofen and subcutaneous saline; and Group 6, perineural saline and subcutaneous dexketoprofen. The levobupivacaine concentration was fixed at 0.05%, and the dose of dexketoprofen was 1mgkg(-1). Sensory analgesia was assessed by paw withdrawal latency to a thermal stimulus every 30min. The unblocked paw served as the control for the assessment of systemic, centrally mediated analgesia. Perineural and subcutaneous dexketoprofen coadministered with perineural levobupivacaine did not enhance the duration of sensory blockade when compared with levobupivacaine alone. There were significant differences between the operative and control paws for time points 30-90min in the perineural levobupivacaine alone, levobupivacaine+dexketoprofen and subcutaneous dexketoprofen added levobupivacaine group. Significant differences were not determined between the levobupivacaine alone group and dexketoprofen added groups in operative paw. The effects of dexketoprofen are unknown for perineural administration. There is no significant difference between the analgesic effects of peripheral nerve blocks using levobupivacaine alone and plus subcutaneous or perineural dexketoprofen.Öğe The effects of intrathecal morphine on patient-controlled analgesia morphine consumption, postoperative pain scores and satisfaction in patients undergoing gynecologic oncologic surgery under general anesthesia(OXFORD UNIV PRESS, 2012) Kara, Inci; Apiliogullari, Seza; Oc, Bahar; Celik, Jale Bengi; Duman, Ates[Abstract not Available]Öğe The Effects of Positive End-Expiratory Pressure on Cross-Sectional Area of Internal Jugular Vein in Obese Patients(MARY ANN LIEBERT, INC, 2016) Kozanhan, Betul; Apiliogullari, Seza; Basaran, Betul; Iyisoy, Mehmet Sinan; Ozmen, SadikIntroduction: Obesity is one of the most important risk factors for complications of internal jugular vein (IJV) cannulation. The efficacy and safety of positive end-expiratory pressure (PEEP) are still under debate in obese patients. The aim of this prospective randomized ultrasound study was to investigate effects of different PEEP levels on the cross-sectional area (CSA) of right IJV and overlap with carotid artery (CA) in anesthetized obese patients. Materials and Methods: Seventy-two obese patients undergoing various elective surgeries under general endotracheal anesthesia were enrolled. We measured CSA of right IJV, margin of safety (MOS), and degree of overlap between CA and IJV at PEEP 0 (P0), 5 (P5), and 12 (P12) cm H2O levels. We defined a 20% increase in CSA as clinically relevant. Results: Data were collected for all the 72 patients enrolled in the study. Application of 12, but not 5cm H2O PEEP, resulted in a clinically significant increase in CSA of right IJV. When compared to P0, application of P5 and P12 increased both degree of overlap (p<0.001 each) and MOS (p<0.001 each). None of the patients experienced severe hypotension or bradycardia. Conclusions: Application of 12cm H2O PEEP provides a clinically significant increase in CSA of right IJV without relevant reduction of MOS in anesthetized obese patients.Öğe The effects of spinal anesthesia on auditory patients(ELSEVIER IRELAND LTD, 2016) Colpan, Bahar; Apiliogullari, Seza; Erdur, Omer; Celik, Jale Bengi; Duman, Ates; Senaran, Hakan; Ozturk, KayhanObjectives: Persistent or transient hearing loss (HL) is a less-recognized complication of spinal anesthesia (SA) in the pediatric population, although it has been previously reported in adults. The primary aim of this study was to investigate the effects of SA on auditory function in the pediatric population. Methods: After gaining institutional approval and parental consent, 30 American Society of Anesthesiologists physical status I-II children between 4 and 15 years undergoing lower extremity orthopedic surgery were enrolled in this prospective study. Spinal blocks were performed in the midline with a 25G Quincke needle using 0.5% hyperbaric bupivacaine. Transient evoked otoacoustic emission (TEOAE) and distortion product otoacoustic emission (DPOAE) tests were administered before surgery and one-day postoperative. Children with detected HL were retested on postoperative day seven. Preoperative and postoperative results were compared. A Wilcoxin Signed-Ranks test (with Bonferroni correction) was used for statistical analyses. Results: There was no statistically significant HL in the postoperative period compared to the preoperative period. In 29 of 30 patients, no difference was detected at any frequency tested. In one patient, TEOAE and DPOAE tests were found to be decreased on postoperative day one. In this patient, control tests were found to be improved on postoperative day seven. Conclusions: Administration of SA may results in a low probability of transient hearing loss with no clinical significance in children 4-15 years of age. (C) 2016 Elsevier Ireland Ltd. All rights reserved.Öğe Is a Neutral Head Position as Effective as Head Rotation During Landmark-Guided Internal Jugular Vein Cannulation? Results of a Randomized Controlled Clinical Trial(W B Saunders Co-elsevier Inc, 2012) Apiliogullari, Burhan; Kara, Inci; Apiliogullari, Seza; Arun, Oguzhan; Saltali, Ali; Celik, Jale BengiObjective: Central venous access remains a cornerstone procedure for a variety of clinical conditions. Ultrasound studies suggest that rotation of the head increases the magnitude of the overlap of the internal jugular vein with the carotid artery. The authors assessed whether a neutral position of the head during anatomic landmark-guided cannulation of the internal jugular vein (UV) was an attractive alternative to rotating the neck to a >45 degrees head turn. Design: A prospective, randomized, controlled study. Setting: An education and research hospital and a university-affiliated hospital. Participants: Eighty patients requiring central venous catheterization in the right IJV. Interventions: Under general anesthesia, patients were positioned in the Trendelenburg position with extension of the neck. In the rotated group, the head was rotated to the left at >45 degrees. In the neutral group, the head was placed in the neutral position. Right IJV cannulation was performed using the central approach with the needle angled toward the ipsilateral nipple. The primary outcome variable was the cumulative success rate, which was defined as IJV puncture achieved in the first 3 attempts using a finder needle. A p value of <0.05 was considered statistically significant. Measurements and Main Results: Groups were similar in terms of demographic data. The success rates of finder needle passes into the IJV on the first attempt were 87.5% and 37.5% (p < 0.05), and the cumulative success rates on the first 3 attempts were 97.5% and 57.5% in the rotated and neutral groups, respectively (p < 0.05). Carotid artery puncture only occurred in 2 patients in the rotated group. Conclusions: Because of the lower success rate, the neutral head position is not an attractive alternative for IJV catheterization when compared with the rotated head position in a central landmark IJV approach.Öğe Is spinal anesthesia not enough for major abdominal procedures of neonates?(WILEY-BLACKWELL, 2008) Apiliogullari, Seza; Duman, Ates[Abstract not Available]Öğe Left femoral vein is a better choice for cannulation in children: a computed tomography study(WILEY-BLACKWELL, 2013) Ozbek, Seda; Aydin, Bahattin K.; Apiliogullari, Seza; Kara, Inci; Erol, Cengiz; Ciftci, Ilhan; Duman, AtesBackground Central venous catheters are often required in emergency rooms and intensive care and/or those undergoing major surgical procedures. In this study, we aimed to gain a better understanding of the anatomy of the femoral vessel in relation to central venous cannulation. Methods The right and left (total of 180) femoral veins (FVs) of 90 consecutive pediatric patients were retrospectively evaluated using computed tomography images. Patients were divided into two groups according to their age: group 1, patients up to 9years of age; and group 2, patients between 9 and 16years of age. Results The position and overlap of femoral artery (FA) to FV are significantly different between the left and right sides in both groups (P=0.001). The left FV was most commonly located medial to the FA. However, the right FV was most commonly located posterior-medial to the FA. The incidence of overlap of the FA over the FV was significantly lower at the left side in both groups. Conclusion The incidence of overlap of the FA over the FV was significantly lower at the left side in pediatric patients. This finding was similar between the patients aged 28years and those aged 916years and may have significant clinical implications. Guiding clinicians to select the left FV of children for cannulation may result in lower arterial puncture rates while accessing the central vein.
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