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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 THE COMMUNICATION BETWEEN THE PATIENTS' RELATIVES AND THE PHYSICIANS IN INTENSIVE CARE UNITS WITH RESPECT TO BRAIN DEATH(WILEY, 2017) Cicekci, Faruk; Kara, Iskender; Kara, Inci[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 A COMPARISON OF RECOVERY CHARACTERISTICS OF SEVOFLURANE AND PROPOFOL-REMIFENTANIL ANESTHESIA IN GERIATRIC PATIENTS(GUNES KITABEVI LTD STI, 2011) Celik, Jale Bengi; Topal, Ahmet; Erol, Atilla; Guven, Selcuk; Kara, InciIntroduction: In this study we aimed to compare the recovery characteristics of propofol/remifentanil and sevofluran/remifentanil anesthesia in 100 geriatric patients undergoing urological procedures. Materials and Method: The patients were randomized to receive either propofol-remifentanil (group P) or sevoflurane-remifentanil (Group S) anesthesia. Recovery characteristics, the time to post-anesthetic discharge scoring system (PADSS) score and Aldrete score of 9 point, Digit Symbol Substitution Test (DSST) and Trieger Dot Test (TDT) values were compared between two groups. Results: Extubation time was significantly shorter in group P than in group S (5.3 +/- 2.9 min vs 7.8 +/- 3.8 min, p=0.038). The times of first eye opening, response to verbal commands and orientation were similar in both groups. The time of Aldrete score of 9 points (grup P: 14.2 +/- 3.6 min, group S: 16.3 +/- 4.5 min) and PADSS of 9 points (group P: 19.3 +/- 5.7 min, group S: 22.1 +/- 4.2 min) were also similar (p > 0.05). Time to return to the normal value of DSST was significantly shorter in Group P compared with Group S, and TDT was similar in both groups (p > 0.05). No significant differences were observed in the incidence of postoperative complications and VAS score (p > 0.05). Conclusion: Both propofol-remifentanil and sevoflurane-remifentanil appears to be an adequate anesthesia in geriatric patients.Öğe Comparison of Spinal and General Anesthesia in Lumbar Disc Surgery(2011) Kara, Inci; Celık, Jale Bengu; Oc, Bahar; Apıllıoğulları, Seza; Karabaglı, HakanAmaç: Bu çalışmanın amacı genel (GA) ve spinal (SA) anestezinin perioperatif avantaj ve dezavantajlarını karşılaştırmaktır. Yöntem ve Gereç: Lomber disk operasyonu geçirecek rasgele 60 hasta (GA,n30, SA,n30) seçildi. Hastalar demografik veriler, peroperatif vital bulgular, ağrı skorları, kan kaybı miktarı, cerrah memnuniyeti, perioperatif komplikasyonlar ve hasatanede kalış süresi yönünden karşılaştırıldı. Bulgular: İntraoperatif ve postoperatif dönemde hipertansiyon ve taşikardi GA grubunda daha sıktı (p0.05). Cerrah memnuniyeti GA grubunda daha yüksekti (p0.05). Anestezi ve cerrahi süre GA grubunda daha uzun idi (p0.05), bu grupta bulantı, kusma, ağrı, daha fazlaydı ve antiemetik ve analjezik ihtiyacı yüksek bulundu (p0.05). Cerrahi sonrası 24 saat içinde derlenme odasında kalma zamanı, mobilizasyon, hastanede kalma zamanı, antiemetik ve analjezik gereksinimi, ağrı skoru, bulantı, üriner retansiyon ve baş ağrısı iki grupta benzerdi (p0.05), bununla birlikte bu dönemde kusma GA grubunda daha sıktı (p0.05). Sonuç: Lomber disk operasyonu geçirecek hastalar için spinal anestezi genel anestezi kadar güvenli ve etkindir. Spinal anestezinin spesifik avantajları antiemetik ve analjezik ihtiyacının daha az olması ve düşük komplikasyon oranıdır.Öğe Comparison of Spinal and General Anesthesia in Lumbar Disc Surgery(JOURNAL NEUROLOGICAL SCIENCES, 2011) Kara, Inci; Celik, Jale Bengu; Oc, Bahar; Apilliogullari, Seza; Karabagli, HakanAim: The purpose of this study was to compare the perioperative advantage and disadvantage between general (GA) and spinal anesthesia (SA). Material and Methods: Sixty patients (randomize GA, n=30, SA, n=30) undergoing lumbar disc surgery were enrolled. Patients were matched for demographic data, perioperative physiological changes, pain score, amount of blood loss, surgeon 'satisfaction, perioperative complications and length of stay in hospital. Results: Intraoperatively and postoperatively, the incidence of tachycardia and hypertension were more frequent with GA (p<0.05). The surgeon's satisfaction was reported to be higher in the GA group (p<0.05). Anesthetic and operative times were longer for patients in GA group (p<0.05), in whom more nausea, vomiting, pain and greater requirements for antiemetic and pain medication were also during PACU (p<0.05). 24 hours after surgery, PACU time, ambulation of day of surgery, hospital stay, requirement of antiemetic and analgesic medication, pain score, nausea, urinary retention and headache were similar in two groups (p>0.05), however vomiting was more frequent in GA group in this period (p<0.05). Conclusion: For patients undergoing lumbar disc surgery, spinal anesthesia was as safe and effective as general anesthesia. Specific advantages to spinal anesthesia include decreased antiemetic and analgesic medication and reduced overall complication rate.Öğe Comparison of the Perioperative and Postoperative Effects of Levobupivacaine and of Levobupivacaine plus Adrenaline in Pediatric Tonsillectomy: A Double-Blind Randomized Study(HINDAWI LTD, 2017) Cicekci, Faruk; Sizer, Cigdem; Atici, Sait Selcuk; Arican, Sule; Karaibrahimoglu, Adnan; Kara, InciObjectives. We aimed to assess the effects of levobupivacaine and of levobupivacaine + adrenaline administered during pediatric tonsillectomy on the postoperative period. Methods. A total of 90 patients between the ages of five and twelve were divided randomly into two groups before tonsillectomy: levobupivacaine only (0.5%) 0.4 mg.kg(-1) or levobupivacaine (0.5%) 0.4 mg.kg(-1) + adrenaline (1 :200.000) administered by means of peritonsillar infiltration. Primary outcomes were postoperative pain scores recorded at various intervals until 24 hours postoperatively. Secondary outcomes included postoperative nausea and vomiting (PONV), time to first oral intake, time to the first administration of analgesics and total consumption of analgesics, and the amount of bleeding for all children. Results. In both groups, patients had the same postoperative pain scores and PONV rates, and equal amounts of analgesics were consumed up to 24 hours postoperatively. The two groups also had the same time until first oral intake, recovery time and time to the first analgesic request, and amount of bleeding. Conclusions. Perioperative levobupivacaine infiltration on its own is a valid alternative to the combination of levobupivacaine + adrenaline for perioperative and postoperative effectiveness in pediatric tonsillectomy.Öğe A COMPARISON OF TWO DIFFERENT SEDATION TECHNIQUES IN GERIATRIC PATIENTS FOR ENDOSCOPIC UROLOGICAL SURGERY(GUNES KITABEVI LTD STI, 2012) Celik, Jale Bengi; Topal, Ahmet; Erdem, Tuba Berra; Kara, InciIntroduction: In this study, we evaluated the effectiveness and safety of intravenous propofol-fentanyl and ketamine-midazolam combinations for procedural sedation and analgesia in elderly patients undergoing urological endoscopic surgery. Materials and Method: This prospective study enrolled 80 patients aged 60-80 years ASA I-III requiring endoscopic urological procedures. Patients received intravenous bolus doses of either fentanyl 1 mu g.kg-1 and propofol 1-2 mg.kg-1 in group P or ketamine 1-1.5 mg.kg-1 and midazolam 0.1 mg.kg-1 in group K titrated according to Ramsay sedation scale in the range of 3-4. Results: There were no differences in vital signs, operating times and demographic variables. Time to Aldrete score >= 8 was similar in two groups. Time to PADSS >= 9 was significantly longer in group K than group P (p<0.05). The frequency of vertigo, nausea, vomiting, visual disturbances, laryngeal spasm and hallucinations were higher in group K (p<0.05). But pain of injection and respiratory depression were more frequent in group P (p<0.05). Excessive salivation, tachycardia, bradycardia, hypotension, hypertension were similar in both groups. Conclusion: Hemodynamic changes and degrees of sedation showed that propofol-fentanyl and ketamine-midazolam combinations can safely be used in geriatric patients undergoing endoscopic urological procedures. However, in the propofol-fentanyl group the incidence of side effects were lower and the recovery period was shorter than the ketamine-midazolam group.Öğe Determining the Effect of Sufentanil on Propofol Injection Pain(KUWAIT MEDICAL ASSOC, 2012) Saritas, Tuba Berra; Borazan, Hale; Kara, Inci; Tuncer, Sema; Otelcioglu, SerefObjectives: Propofol is a general anesthetic. Its most important disadvantage is pain on injection. Our aim was to evaluate the effectiveness of sufentanil on propofol injection pain (PIP). Design: Case control randomized double-blind study Setting: Anesthesia department of Selcuk University Meram Medical School, Turkey Subjects: A total of 160 adults, 18 to 65 years, ASA I-II patients, scheduled for operations under general anesthesia, were enrolled in this study. A 22-gauge intravenous (IV) catheter was inserted into a vein on the dorsum of the hand. Patients were randomly allocated to one of four groups to receive either saline or 0.5, 1, 2 mcg sufentartil in 2 ml volume. Thirty seconds after the intravenous (IV) injection of the pretreatment drug, 5 ml of 1% propofol at room temperature (Fresenius Kabi, Hamburg, Germany) was injected IV at rate of 0.5 ml/sec. Pain was assesed verbally and scored as none (0), mild (1), moderate (2), severe (3). Interventions: Prior injection of sufentanil or placebo Main Outcome Measures: Severity of PIP Results: Demographic data were comparable among four groups. Sufentanil at 1 and 2 mcg doses significantly decreased pain incidence when compared to the saline group (p < 0.05). Sufentanil 0.5 mcg had no effect.(p > 0.05). Although 2 mcg sufentanil decreased the incidence of PIP more than 1 mcg, there was no significant difference between these groups (p > 0.05). Conclusion: Sufentanil at one and 2 mcg doses reduced the incidence and severity of PIPÖğe EFFECT OF DEXMEDETOMIDINE ON PAIN CAUSED BY INJECTION OF PROPOFOL(NOBEL ILAC, 2012) Sarkilar, Gamze; Kara, Inci; Duman, Ates; Aygin, Feride; Okesli, SelminObjective: This study was designed to assess the local and systemic effects of two different pre-anesthetic infusion dose of dexmedetomidine in preventing propofol injection pain. Material and Method: Two hundred fifty adults were assigned into five groups. Before injection of propofol, group 1 (placebo n=50) received an infusion of saline solution, group 2 (n=50) received 0.5 mu g kg(-1) of dexmedetomidine and group 3 (n=50) received 1 mu g kg(-1) of dexmedetomidine from the same vein. Group 4 (n=50) received 0.5 mu g kg(-1) of dexmedetomidine and group 5 (n=50) received 1 mu g kg(-1) dexmedetomidine followed by an injection of propofol from a vein located in the opposite hand. Pain assessment was made immediately after propofol injection. Results: Two hundred twenty five patients completed the study. The number of patients who suffered from any degree of pain was significantly high when compared to dexmedetomidine group (p=0.05). When compared with placebo and opposite hand, administering dexmedetomidine from the same vein was more efficient to prevent propofol pain (p=0.003). 1 mu g kg(-1) of dexmedetomidine was similar to 0.5 mu g kg(-1) of dexmedetomidine in preventing propofol pain. Conclusion: Dexmedetomidine infusions in p re-anesthetic sedative doses of 0.5 mu g kg(-1) and 1 mu g kg(-1) decrease the incidence of propofol injection pain compared to placebo.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 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 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.Öğe Optimal Angle of Needle Entry for Internal Jugular Vein Catheterization with a Neutral Head Position: A CT Study(INFORMA HEALTHCARE, 2013) Ozbek, Seda; Apiliogullari, Seza; Erol, Cengiz; Kivrak, Ali Sami; Kara, Inci; Uysal, Emine; Koplay, MustafaPurpose: The aim of this study is to determine the optimal angle of needle entry in the sagittal plane for internal jugular vein (IJV) catheterization with the central approach while the head is in the neutral position. Methods: The contrast-enhanced carotid artery computed tomography angiographies of 123 consecutive patients were retrospectively reviewed. The point of merger between the sternal and clavicular heads of the sternocleidomastoid muscle was assumed as a clinical entry (CE) point. The angle between CE point and the center of the IJV, the depth, diameter of the vessels and the degree of overlap between the IJV and carotid artery (CA) were measured. Results: The angles between the CE point and the center of the IJVs were similar, 7 degrees +/- 13 degrees medial and 8 degrees +/- 12 degrees medial on the right and the left side, respectively. The center of IJVs from the CE point was between 0 degrees and 16 degrees toward the medial in 79.8% on the right side and 89.9% on the left side of patients. The diameters of the right IJVs were greater than the left IJVs (p = 0.001). The depth from the skin and overlap between IJV and CA did not vary between the two sides. Conclusions: When a central approach is used for right internal jugular vein (RIJV) cannulation with a neutral head position, the orientation of the angle of needle entry (i.e., 16 degrees) medially in the sagittal plane may quadruple the success rate of RIJV catheterization compared to the success rate of a laterally oriented angle of entry as recommended by the classic method.Öğe Palmar Skin Temperature Importance During Transthoracic Endoscopic Sympathectomy For Palmar Hyperhidrosis(2012) Oncel, Murat; Sudam, Guven Sadi; Karabaglı, Hakan; Kara, Inci; Celık, Jale BenguAmaç: Bu çalışmadaki amaç kişilerin yaş, tanı kriteri, sempatik zincir seviyesi, oluşan komplikasyonlar ve sonuçları ile hiperhidrozisde başarılı bir endoskopik sempatektomi arasında yapılan bir karşılaştırmayla birlikte operasyon esnasında kaydedilen palmar ısı değişikliklerinin başarılı bir sempatektomiyi kanıtlaması ve rehber olması açısından önemini vurgulamaktır. Metod: 51 hasta aşırı primer hiperhidrozis için bilateral endoskopik sempatektomi yapıldı. T2 ve T4 ganglionlarının çıkarımı esnasında sağ eldeki palmar ısı intraopertif monitorize edildi. Sonuçlar operasyon sonrası değerlendirildi. Tüm hastalar terlemenin yok olması, ameliyat sonrası gelişen komplikasyonlar rahatlamanın derecesi ve aşırı refleks terleme ve efektif ganglion çıkartımında yükselen palmar ısı yönünden değerlendirildi. Sonuçlar: Toplam 102 lateral sempatektomi yapıldı bunların; 76 tanesi (%76) T4 ganglion seviyesinde, 23 tanesi (%23) T3-T5 ganglion seviyesinde ve 1 taneside (%1) T2 ganglion seviyesinde yapılmıştır. Postoperatif komplikasyonlar minör düzeyde olup Horner sendromu görülmemiştir. Semptomların kaybolması hastalarda %100 olmuştur. Memnuniyet derecesi %92 olarak bildirilmiştir. Refleks terleme şiddetine göre %12 ılımlı,%8 orta derecede ve %6 şiddetli olmuştur. Tartışma: Palmar hiperhidrozis için her bir bireyde yapılan çeşitli derecelerdeki ganglionların eksizyonu mümkün olmabilmektedir. İntraoperatif monitorize edilen ısı degişimleri operasyonda doğru bir sempatik ganglionun çıkarılması için yararlı bir yöntemdir.Öğe Psychiatric Disorders and Association with Quality of Sleep and Quality of Life in Patients with Chronic Pain: A SCID-Based Study(WILEY-BLACKWELL, 2014) Annagur, Bilge B.; Uguz, Faruk; Apiliogullari, Seza; Kara, Inci; Gunduz, SuleObjectiveWe aimed to determine Axis-I psychiatric disorders in patients with chronic pain (CP) and compare control subjects determined by a structured clinical interview. Another objective of the study was to examine whether there is an association between psychiatric disorders and quality of sleep, quality of life, and demographic and clinical characteristics in patients with CP. DesignThe study sample was comprised of 108 patients with CP and 54 control subjects without pain. Psychiatric interviews were conducted with the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders (DSM)-IV (SCID). Also used were the Hospital Anxiety and Depression Scale, Hamilton Depression Inventory, Short Form-36, and Pittsburgh Sleep Quality Index (PSQI). ResultsThe rate of any Axis-I psychiatric disorder stood at 66.7% (any mood disorder, 50%; any anxiety disorder, 33.3%; any somatoform disorder, 20.4%; any substance use disorder, 16.6%), significantly more common in the patients' group compared with the control group. The most common psychiatric disorder was major depression (49.1%) in subjects with CP. Female gender, numbers of localization, and neck and back localizations were significantly higher in the SCID (+) group than the SCID (-) group. A statistically significant difference was observed between the SCID (+) and SCID (-) groups regarding visual analogue scale, depression and anxiety scores, mental component summary score, and global PSQI scores. ConclusionResults of this study suggest that psychiatric morbidity in patients with CP is frequently seen and may adversely affect quality of sleep and quality of life of the patients. Therefore, the patients with CP should be examined with respect to their mental status.Öğe Relationship between the Right Internal Jugular Vein and Carotid Artery at Ipsilateral Head Rotation(TAYLOR & FRANCIS LTD, 2013) Ozbek, Seda; Apiliogullari, Seza; Kivrak, Ali Sami; Kara, Inci; Saltali, Ali OzgulUltrasound-guided right internal jugular vein catheterization (RIJV) should be the first choice to decrease the catheter-related complications in high-risk hemodialysis patients. For this procedure, clinicians should identify the optimum positions of the RIJV, including its lower overlap with the carotid artery (CA) and high cross-sectional area of the vein. The aim of this prospective randomized study to evaluate the effects of mild ipsilateral head rotation combined with Trendelenburg position on RIJV cross-sectional area and its relation to the CA in adult patients. Forty ASA I-II patients who were undergoing elective surgery were enrolled for this study. The subjects were asked to remain supine in the 15-20 degrees Trendelenburg position. Two-dimensional ultrasound was then used to measure the degree of overlap between the RIJV and CA, the cross-sectional area of the RIJV. These measurements were compared between head rotation to the >30 degrees left, <30 degrees left, neutral, and <30 degrees right positions. When the head was in the >30 degrees left position, overlap was seen in 38 of 40 patients (95%). As the head was rotated from >30 degrees left to <30 degrees right, the CA-RIJV overlap (from 95% to 57.5%), and the cross-sectional area (from 14.2 mm to 8.7 mm) significantly decreased. In conclusion, when the head was turned to <30 degrees right, the CA-RIJV overlap significantly decreased, and the cross-sectional area also decreased. When clinicians determine the optimal head position before RIJV cannulation, it is important to consider the advantages and disadvantages of the different head positions from >30 degrees left to <30 degrees right.Öğe Repair of duodenal atresia under spinal anesthesia in a low-birth-weight preterm neonate: case report(W B SAUNDERS CO-ELSEVIER INC, 2012) Ciftci, Ilhan; Apiliogullari, Seza; Kara, Inci; Gunduz, Ergun; Duman, AtesDuodenal atresia is a well-recognized cause of neonatal bowel obstruction. General anesthesia with tracheal intubation is the traditional anesthetic technique for surgical correction of this condition. Metabolic abnormalities and fluid deficits coupled with residual anesthetics are known to increase the risk of postoperative apnea, prolonging the operating room time and delaying extubation. Spinal anesthesia (SA) is an accepted alternative to general anesthesia in formerly preterm infants. In the current literature, there are reports of successful use of SA for simple infraumbilical surgery and, occasionally, for upper abdominal surgery, but there is no information on the use of SA in neonates for duodenal atresia repair. We present a case of duodenal atresia in a preterm infant at a gestational age of 30 weeks with coexisting bronchopulmonary dysplasia successfully repaired under SA. Further studies that compare the adverse effects with the potential advantages of SA are warranted before future recommendations are made for neonates who are undergoing upper abdominal surgery. Crown Copyright (C) 2012 Published by Elsevier Inc. All rights reserved.Öğe Seeing Is Believing: Ultrasound-Guided Internal Jugular Vein Cannulation(LIPPINCOTT WILLIAMS & WILKINS, 2012) Kara, Inci; Apiliogullari, Seza; Duman, Ates; Celik, Jale Bengi; Ozbek, Seda[Abstract not Available]
