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Öğe The effects of intra-articular injection of ibuprofen on knee joint cartilage and synovium in rats(TURKISH ASSOC ORTHOPAEDICS TRAUMATOLOGY, 2019) Kutahya, Emine Cepni; Oc, Bahar; Ugurluoglu, Ceyhan; Duman, Ipek; Arun, OguzhanObjective: The aim of this animal study was to investigate the short and long-term local histomorphologic effects and the utility of intra-articular application of ibuprofen. Methods: Forty-six Wistar Albino rats were used in the study. The rats were randomized into 5 groups of 8 and a sham group of 6. The 40 rats in the study groups were anaesthetised with 60 mg/kg of ketamine, then 0.25 ml ibuprofen (25 mg) was injected to the right knee joint of each rat (ibuprofen group) and 0.25 ml 0.9% saline to the left knee joint as the control group. To the 6 rats in the sham group, only puncture was applied to both knee joints. The rats in each of the 5 study groups were sacrificed on days 1, 2, 7, 14 and 21 respectively. The histomorphologic changes were graded on a 6-point scale regarding inflammation of the synovia, cartilage tissue, and subchondral bone. Inflammation scores were compared using the Mann Whitney U-test and comparisons of the sacrifice day and drug used were evaluated with the Kruskal Wallis test. The p values below 0.05 were considered as significant. Results: Statistically significant difference was found between the ibuprofen injected knees (10/40) and the saline injected (0/40) and sham knees (0/12) in respect of hematoma positivity (p = 0.002). Significantly higher inflammation scores were found in ibuprofen injected knees on the 1st, 2nd, 7th and 14th days compared to controls and sham (p < 0.05). Inflammation scores were similar in ibuprofen injected knees with and without hematoma (p > 0.05). Inflammation of the ibuprofen injected group was most severe on day one and the severity of inflammation reduced gradually throughout the 3 weeks. Conclusion: Our results show that intra-articular injection of ibuprofen can cause intra-articular hematoma. It also leads to transient inflammation of the synovia that is more severe in the early period, which gradually recovers. (C) 2019 Turkish Association of Orthopaedics and Traumatology. Publishing services by Elsevier B.V.Öğe Is nimodipine really effective in head trauma?(ACADEMIC PRESS LTD- ELSEVIER SCIENCE LTD, 2009) Duman, Ates; Duman, Ipek; Ogun, Cemile Oztin[Abstract not Available]Öğe The relationship between vasoactive-inotropic score and mortality in adult patients with traumatic brain injury(TURKISH NEUROSURGICAL SOC, 2019) Kara, Iskender; Sargin, Mehmet; Bayraktar, Yesim Serife; Sahinoglu, Mert; Ildarov, Gurban; Duman, Ipek; Celik, Jale Bengi; Karabaglı, HakanAIM: To assess the feasibility of the vasoactive-inotropic score (VIS) in determining the amount of vasoactive support and its relationship with the mortality rate and characteristics of the patients with traumatic brain injury (TBI). MATERIAL and METHODS: This study was conducted with a retrospective design involving the years 2013-2018 in a university hospital which provides tertiary intensive care service. A total of 102 patients who were admitted in the ICU with the diagnosis of severe TBI, and also were followed by neurosurgery service and who received vasoactive and inotropic support were analyzed concerning VIS value. RESULTS: The median age of the patients was 34 years, and 69.6% of the patients were male. Mortality rate was 43.1%. In the group with mean VIS >= 10, the admission duration in the ICU and hospital were shorter (p<0.0001) whereas mortality rates were higher (81.1% vs 21.5% and p<0.0001). Besides, the number of patients with a VIS score of >= 10, >= 15 and >= 20 were higher in the group of patients who died (p<0.0001). The results of the multivariate analysis such as VIS >= 10 were significant. CONCLUSION: We can conclude that VIS, which is used to determine the amount of vasoactive and inotropic medicines during cardiac surgery and in sepsis patients, may be useful in predicting mortality in TBI patients.Öğe Short-Term Sevoflurane Anesthesia for Painless Lumbar Puncture in Children(LIPPINCOTT WILLIAMS & WILKINS, 2011) Apiliogullari, Seza; Duman, Ipek[Abstract not Available]Öğe The use of vasoactive-inotropic score in adult patients with septic shock in intensive care(TURKISH SOC MEDICAL & SURGICAL INTENSIVE CARE MEDICINE, 2019) Kara, Iskender; Sargin, Mehmet; Bayraktar, Yeşim Şerife; Eyiol, Hatice; Duman, Ipek; Celik, Jale BengiObjective: Sepsis and septic shock are significant causes of mortality and morbidity. In septic shock, vasopressors and inotropic support are given for the treatment of hypotension. This study was designed to investigate the relationship between the vasoactive-inotropic score (VIS) and the results of sepsis patients in ICU. Methods: The data of 392 patients who were followed up with the diagnosis of septic shock in adult ICU were recorded retrospectively. Vasopressors and inotropic support of the patients during the first 48 hours after the diagnosis of septic shock were recorded. Mean and peak VIS values were calculated according to these values. The patients were divided into groups according to the mean VlS >= 10, peak VIS >= 10 and intensive care results and statistical analysis was performed. Results: The median ages of the patients were 68 (54.25-79) years and 239 (61%) were male. Dopamine 188 (47.9%), noradrenaline 365 (93.1%), adrenaline 53 (13.5%) and dobutamine 15 (3.8%) were used in the patients. The mean VIS was 9 (4-15), while the number of mean VIS >= 10 patients were 192 (49%). Peak VIS values were 11 (5-20), and the number of peak VIS >= 10 patients were 220 (56.1%). The mortality rate of the patients included in the study was 42.1%. The mean VIS score(13 vs 6, p=0.000), mean VIS >= 10 patient ratio (71.5% vs 32.6%, p=0.000), peak VIS score (16 vs 8, p=0.000), and peak VIS >= 10 patient ratio (73.3% vs 43.6%, p=0.000) were higher in non-survivors. The parameters such as mean VIS [OR 1.123, 95% CI 1.027-1.229, p=0.011], mean VIS >= 10 [OR 3.455, 95% CI 1.625-7.345, p=0.001] and peak VIS score [OR 0.917, 95% CI 0.851-0.989, p=0.024] were determined as independent risk factors for mortality. Conclusion: We conclude that vasoactive-inotropic score may be useful in predicting the outcome of septic shock patients in intensive care units.Öğe Vapocoolant Spray vs Lidocaine/Prilocaine Cream for Reducing the Pain of Venipuncture in Hemodialysis Patients: A Randomized, Placebo-Controlled, Crossover Study(IVYSPRING INT PUBL, 2011) Celik, Gulperi; Ozbek, Orhan; Yilmaz, Mumtaz; Duman, Ipek; Ozbek, Seda; Apiliogullari, SezaObjective: Patients undergoing hemodialysis are repeatedly exposed to stress and pain from approximately 300 punctures per year to their arteriovenous fistula. This study was designed to measure pain associated with venepuncture during AVF cannulation and to compare the effectiveness of ethyl chloride vapocoolant spray, topical eutectic mixture of local anesthetics (EMLA) cream and placebo in controlling pain caused by venepuncture of arteriovenous fistula patients undergoing chronic hemodialysis. Methods: This randomized, placebo-controlled, crossover study, included 41 patients undergoing conventional hemodialysis three times a week. First intervention was conducted as baseline pain assessment (control). In the three consecutive dialysis sessions, every patient randomly received 1) ethyl chloride vapocoolant spray, 2) EMLA, or 3) placebo cream before venepuncture. Pain perception was recorded by patients immediately after cannulation on a 0-100 mm visual analogue scale (VAS). p<0.05 was considered as significant. Results: VAS scores presented a marked inter-individual variation during venepuncture. EMLA application resulted in significantly lower total pain scores compared to control and all other interventions (p<0.05). No patient experienced severe pain with EMLA or vapocoolant. The patients reported less moderate and severe pain with EMLA, and vapocoolant spray compared to control and placebo interventions. Moderate and severe pain scores were similar between EMLA and vapocoolant spray (p>0.05). Conclusion: Venipuncture for AVF cannulation causes mild to moderate pain in hemodialysis patients. Although local application of EMLA is more effective than in preventing venepuncture pain, ethyl chloride vapocoolant is as effective as EMLA for preventing mild to moderate puncture pain in patients undergoing hemodialysis.