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  • Küçük Resim
    Öğe
    Bariatrik cerrahi sonrasında morbid obez ve süper obezlerdeki pulmoner fonksiyonların karşılaştırılması
    (2018) Yormaz, Burcu; Ece, Ilhan; Çolak, Bayram; Yormaz, Serdar; Demirkıran, Hilmi
    Objective: Nowadays, The increase in incidence of morbidobesity is one of the most common health problems in theworld. Bariatric surgery has performed as a curative procedurefor morbid obesity. It has give rise to lose excess weight, healcomorbidities and to improve pulmonary functions in obeses..Our aim was to compare postoperative respiratory outcomesin morbidly obese patients who have underwent Laparoscopicsleeve gastrectomy.Material and Methods: Consecutive 124 morbid obesepatients who were underwent Laparoscopic sleevegastrectomy was followed up 6 months between the years ofmarch 2014 to july 2016 retrospectively. Patients were dividedinto two groups A and B. Group A patients who have BMIbetween 40-45kg/m2 and group B patients who have BMIbetween 45-50kg/m2. FEV1, FVC, FEV1/FVC, MSV,DV/VO2, DV/VCO2, VO2peak results, body mass index,postoperative oxygen saturation and comorbidites, werecompared between both groups. Student's t test,chi-squaretest was used for the variables and homogeneity in the patientgroup. Preoperative and postoperative values between thegroups were compared with the ANOVA test.Results: The mean age values, respiratory function values inboth groups were similar in preoperatively. In ourpostoperative results, there was a significant difference in theFEV1, FVC, FEV1/FVC, MSV, DV/VO2, DV/VCO2, VO2peak ratios and also identified significant difference inresolution and improvement of comorbidities.Conclusions: The results of the patients who underwentbariatric surgery and whose body mass index (BMI) was 40-45kg / m2 were statistically significant compared to thosewith body mass index between 45-50kg / m2. Theimprovement in pulmonary functions and the effect ofcorrection of comorbidities are higher in the morbidly obesegroup with laparoscopic sleeve gastrectomy.
  • Küçük Resim
    Öğe
    Bone mineral density in emphysema and chronic bronchitis phenotypes in hospitalized male chronic obstructive pulmonary disease patients
    (WILEY, 2020) Yormaz, Burcu; Cebeci, Hakan; Yılmaz, Farise; Süerdem, Mecit
    Introduction Risk of osteoporosis known to increase in chronic obstructive pulmonary disease (COPD), but is usually overlooked, especially in male patients. Objectives The present study compares the bone mineral density (BMD) measurements of male COPD patients with emphysema and the chronic bronchitis phenotype, and evaluates the association between density of emphysema and osteoporosis. Methods Ninety-four patients with COPD, and with emphysema and the chronic bronchitis phenotype, were included in the prospective study. A high-resolution computed tomography (HRCT) was used for the diagnosis of emphysema, and a dual X-ray absorptiometry was used to measure the BMD of the lumbar vertebrae and neck of the femur. Results Emphysema phenotype 45.75% and chronic bronchitis phenotype 54.25%, based on their clinical findings and a quantitative volumetric analysis by HRCT. Osteoporosis was found 60.47% and 17.65% of patients with emphysema and bronchitis, while osteopenia was detected 27.91% and 41.18% of patients with emphysema and bronchitis, respectively. A negative correlation was found between HRCT emphysema density and the bone densitometer t-score in patients with osteoporosis. Among the patients with osteoporosis, a positive correlation was found between Body Mass Index (BMI) and the bone densitometer t-score. Only BMI and emphysema score were found to be independent risk factors for a low BMD. One unit drop in BMI increased the risk of osteoporosis by 28% (OR = 1.28, 95% CI 1.14-1.45) (P < 0.001). One unit increase in emphysema score increased the risk of osteoporosis by 6% (OR = 1.06, 95% CI 1.03-1.09) (P < 0.001). Conclusion Especially male patients with emphysema, high dyspnea score, low BMI and frequent exacerbations should be evaluated for osteoporosis.
  • Küçük Resim
    Öğe
    Laparoskopik sleeve gastrektomi de pulmoner tromboemboli riskinin padua skoru ile değerlendirilmesi: retrospektif bir çalışma
    (2019) Yormaz, Serdar; Yılmaz, Hüseyin; Alptekin, Hüsnü; Acar, Fahrettin; Ece, İlhan; Çolak, Bayram; Yormaz, Burcu; Kafali, Mehmet Ertuğrul; Şahin, Mustafa
    Amaç: Pulmoner tromboemboli bariatrik cerrahide postoperatif dönemde yeterli önlem alınmazsa morbidite ve mortalitenin yüksek olduğu ve bu nedenle hızlı tanı ve tedavi gerektiren bir kompikasyondur. Toplumdaki morbid obezite oranı arttıkça pulmoner tromboemboli’ningelişme potansiyeli daha da artış göstermektedir. Çalışmamızın amacı pulmoner tromboemboli tanısı konularak tedavi edilen olgularınklinik, laboratuvar ve radyolojik sonuçlarınıretrospektif olarak değerlendirmekti.Gereç ve Yöntem: Bariatrik cerrahi kliniğimizde Mart 2014 ile Ocak 2016 tarihleri arasında morbid obezite nedeniyle laparoskopik sleevegastrektomi geçiren hastaların dosyaları retrospektif olarak incelendi. Olguların klinik, radyolojik, laboratuar, demografik özellikleri ilePadua skorları değerlendirildi. Hastaların postoperatif dönemdeki verileri ve komplikasyonları istatistiksel olarak değerlendirildi. Postoperatif pulmoner tromboemboli riskini etkileyebilecek faktörler tek değişkenli regresyon analizi ile değerlendirildi.Bulgular: Hastaların 146’sı (%55) kadın ,124’u (%45) erkekti. Ortalama yaş 44.7 4.3 (22-72) olarak belirlendi. Ayrıca ortalama operasyon sonrası hastanede kalış süresi 5.7 2.3(2-25) gündü. Hastalardan çok-yüksek-riskli(VHR) ve yüksek-riskli (HR) gruplara postoperatifdönemde pnömotik cihazı uygulanırken, orta-riskli(MR) ve düşük-riskli (LR) gruplara varis çorabı uygulandı. Uygulanan koruyucu işlemlere rağmen 3 hastada derin ven trombozu ve 2 hastada pulmoner tromboemboli görüldü (p0.05), herhangi bir mortalite saptanmadı.Hastalardaki postoperatif dönemde görülen gerileme ve postoperatif pulmoner tromboemboli riskini etkileyebilecek faktörler (vücut kitleindeksi, geçirilmiş venöz emboli öyküsü, immobilite ve komplikasyonlar ) istatistiksel olarak anlamlı olarak saptandı (p0.05).Sonuç: Bariatrik cerrahide pulmoner tromboemboli profilaksisi için öncelikle önerilen ilaç daima düşük molekül ağırlıklı heparindir. Hastalara bu koruyucu tedaviye ek olarak pnömotik cihaz ve/veya varis çorabı uygulaması gerekmektedir. Bariatrik cerrahide olası komplikasyonları önlemede pnömotik cihaz varis çorabı uygulamasına göre daha efektiftir.