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Öğe Endovenous Laser Ablation under General Anesthesia for Day Surgery: Feasibility and Outcomes of the 300 Patients(MEDICAL TRIBUNE INC, 2014) Arun, Oguzhan; Oc, Bahar; Duman, Ates; Yildirim, Serkan; Simsek, Murat; Farsak, Bora; Oc, MehmetPurpose: Endovenous laser ablation (EVLA) for superficial venous insufficiency is traditionally performed under tumescent local anesthesia as day case surgery. The aim of this study is to evaluate the feasibility of general anesthesia in addition to tumescent anesthesia in patients undergoing EVLA. Methods: The anesthesia and clinical registration records of 341 extremities of 300 adult patients were reviewed and analyzed retrospectively. Demographic and clinical data, preoperative anesthetic evaluation data (ASA physical status, preoperative airway assessment, Mallampati score), type of supraglottic device, duration of anesthesia and surgery, any surgical and/or anesthetic complication, timing of mobilization and discharge, and postoperative course were evaluated. Results: Mean duration of operation and anesthesia was 28 (12-55) and 40 (20-65) minutes, respectively. Mobilization and discharge timing was 25 (11-45) and 139 (110-200) minutes, respectively. All patients were discharged the same day of surgery. Conclusion: The combination technique of administering general anesthesia with supraglottic device and tumescent anesthesia is a safe and effective method to reduce the patients' pain and discomfort during the EVLT procedure within the scope of day case surgery.Öğe Extremely Low Birth Weight Infants with Patent Ductus Arteriosus: Searching for the Least Invasiveness(FORUM MULTIMEDIA PUBLISHING, LLC, 2012) Oc, Mehmet; Farsak, Bora; Oc, Bahar; Yildirim, Serkan; Simsek, MuratPatent ductus arteriosus (PDA) is an important problem in premature infants. Extremely low birth weight infants (ELBWI) are so fragile with respect to surgical stress that minimally invasive procedures are required. We report 26 ELBWI cases with PDA who underwent surgical closure. All had failed indomethacin treatment, or it had been contraindicated. The mean gestational age at birth was 27 weeks (range, 24-38 weeks), and the mean birth weight was 960.96 g (range, 710-1440 g). The mean age at operation was 18.06 days (range, 7-34 days), and the mean body weight at operation was 989.42 g (range, 680-1460 g). There was no surgery-related mortality or morbidity. Our surgical procedures consisted of posterior muscle-sparing thoracotomy, clipping the PDA and no ligation, and closing the thorax without a tube thoracostomy. Muscle-sparing thoracotomy reduces the likelihood of long-term physical impairment and deformity, the clipping technique minimizes the dissection of surrounding PDA tissue, and the thorax is closed without a tube. Nursing care is simplified, costs are reduced, and the number of chest x-rays needed postoperatively is reduced. We believe that surgical closure of PDA without chest tube drainage can be accomplished safely in premature infants.Öğe P-wave parameters and cardiac repolarization indices: Does menopausal status matter?(ELSEVIER IRELAND LTD, 2012) Dogan, Umuttan; Dogan, Nasuh Utku; Basarir, Ahmet Ozgur; Yildirim, Serkan; Celik, Cetin; Incesu, Feyzanur; Ozdemir, KurtulusBackground and purpose: Data regarding electrocardiographic characteristics of postmenopausal women are lacking. In this prospective, cross-sectional study, electrocardiographic P-wave parameters and cardiac repolarization indices of age-matched pre- and postmenopausal healthy women were compared. We hypothesized that menopausal status would have a significant effect on cardiac electrical activity and hence electrocardiography (ECG) recordings. Materials and methods: Twelve-lead ECG recordings were obtained from 125 consecutively recruited postmenopausal healthy women aged between 44 and 54 years. The control group consisted of 125 age-matched premenopausal women. P-wave parameters and cardiac repolarization indices were measured and compared with respect to menopausal status. Results: Demographic features of premenopausal and postmenopausal women were comparable. There were no significant differences between two groups regarding mean values of heart rate, maximum and minimum P-wave duration, P-wave dispersion, maximum and minimum QT interval, and QT dispersion. Mean values of QT interval obtained from lead V5 were also similar. Corrected values which were calculated according to Bazett and Fridericia formulas also did not differ between the groups. Mean values of Tpeak to Tend (TpTe) (p < 0.001) and corrected TpTe (p = 0.001) intervals obtained from lead V5 were significantly shorter in postmenopausal women when compared to those without menopause. Conclusion: Tpeak to Tend interval decreased significantly while QT intervals and P-wave parameters did not change in postmenopausal women when compared to premenopausal women. Association of these findings with changes in levels of sex steroids and their prognostic implications need to be elucidated with further studies. (C) 2012 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.Öğe A rare giant pericardial cyst mimicking a paracardiac mass(CLINICS CARDIVE PUBL PTY LTD, 2016) Akbayrak, Hakan; Yildirim, Serkan; Simsek, Murat; Oc, MehmetPericardial cysts are rare benign lesions of the thoracic cavity and are mostly congenital anomalies. They are induced by an incomplete coalescence of foetal lacunae during the development of the pericardium. Pericardial cysts are usually unilocular, well marginated spherical or teardrop shaped and may be attached to the pericardium directly or by a pedicle. Of all pericardial cysts, 70 to 75% are located at the right cardiophrenic angle. We report a case that was incidentally diagnosed with only chest magnetic resonance imaging because of a paracardiac mass. In order to prevent complications, the giant pericardial cyst was excised outside of the pericardium with median sternotomy.Öğe The relationship between serum asymmetric dimethylarginine levels and subjective sleep quality in normotensive patients with type 2 diabetes mellitus(KOREAN ASSOC INTERNAL MEDICINE, 2015) Aribas, Alpay; Kayrak, Mehmet; Tekinalp, Mehmet; Akilli, Hakan; Alibasic, Hayrudin; Yildirim, Serkan; Gunduz, MehmetBackground/Aims: Poor sleep quality (SQ) is associated with increased cardiovascular mortality and morbidity. Additionally, asymmetric dimethylarginine (ADMA) is an independent predictor of cardiovascular mortality and morbidity. However, no sufficient data regarding the relationship between ADMA levels and SQ have been reported. The goal of the current study was to evaluate the association between SQ and ADMA levels in normotensive patients with type 2 diabetes mellitus. Methods: The study participants consisted of 78 normotensive type 2 diabetics. The SQ of all participants was assessed using the Pittsburgh Sleep Quality Index (PSQI). Patients with a global PSQI score > 5 were defined as "poor sleepers." Factors associated with poor SQ were analyzed using a multiple regression model. Serum ADMA levels were measured using high performance liquid chromatography. Results: The median ADMA levels of the poor sleepers were increased compared with patients defined as good sleepers (5.5 [4.2 to 6.6] vs. 4.4 [2.9 to 5.4], p < 0.01, respectively). However, the L-arginine/ADMA ratio was decreased in poor sleepers (p < 0.01). Global PSQI scores were positively correlated with ADMA levels (p < 0.01) and negatively correlated with the L-arginine/ADMA ratio (p = 0.02). ADMA levels were correlated with sleep latency (p < 0.01) and sleep efficiency (p = 0.01). Logistic regression analysis showed that ADMA levels (odds ratio [OR], 1.68; 95% confidence interval [CI], 1.16 to 2.44; p = 0.01) and body mass index (OR, 1.15; 95% CI, 1.01 to 1.31; p = 0.04) were associated with poor SQ independently of glomerular filtration rate, sex, age, duration of diabetes, hemoglobin A1c, total cholesterol, and systolic blood pressure. Conclusions: Self-reported SQ was independently associated with ADMA levels in normotensive patients with diabetes mellitus.