Turkish Journal of Thoracic and Cardiovascular Surgery, Oct 29, 2012
Amaç: Bu çalışmada; kronik obstrüktif akciğer hastalığı (KOAH) tanısı konmuş hastalarda koroner a... more Amaç: Bu çalışmada; kronik obstrüktif akciğer hastalığı (KOAH) tanısı konmuş hastalarda koroner arter baypas greftleme (KABG) cerrahisinin solunum fonksiyonları ve respiratuvar kas gücü üzerine olan etkileri araştırıldı. Ça lış ma pla nı: Bu klinik, prospektif çalışmada median sternotomi ile kardiyopulmoner baypas altında KABG cerrahisi uygulanan 18 yaş üstü 60 erişkin hasta; Kontrol (n=30) ve KOAH (n=30) grupları olarak ikiye ayrıldı. Ameliyat öncesi ve ameliyat sonrası solunum fonksiyonlarına (FEV 1 , FVC) ve respiratuvar kas gücüne (P i max, SNIP, P E max) ait değerler elde edildi. Bul gu lar: Gruplar arasında FEV 1 (p= 0.00) dışında ameliyat öncesi solunum fonksiyonları ve respiratuvar kas gücüne ait değerlerde anlamlı fark saptanmadı (p>0.05). Kontrol ve KOAH gruplarında; FEV 1 (sırasıyla, p=0.00, p=0.00), FVC (sırasıyla, p=0.00, p=0.00), P i max (sırasıyla, p= 0.00, p= 0.00), SNIP (sırasıyla, p= 0.00, p= 0.00), P E max (sırasıyla, p= 0.00, p= 0.00) değerleri ameliyat sonrası dönemde azaldı. Gruplar arasında ameliyat sonrası 3. günde elde edilen solunum fonksiyonları ve respiratuvar kas gücüne ait değerlerde anlamlı fark saptanmadı (p>0.05). KOAH grubuna kıyasla kontrol grubunda, grup içi FEV 1 (p= 0.01) ve FVC (p= 0.02)'deki yüzde azalmalar anlamlı olarak daha fazla saptandı. Grup içi respiratuvar kas gücü değerlerinin yüzde azalmaları gruplar arasında anlamlı fark oluşturmadı (p>0.05). So nuç: KOAH hastalarında ameliyat öncesi FEV 1 düşük saptanırken, FVC ve respiratuvar kas gücüne ait değerler KOAH hastalığı olan ve olmayanlarda benzer bulundu. Cerrahi girişim ile tüm hastalarda solunum fonksiyonları ve respiratuvar kas gücü değerleri azaldı. Eşlik eden akciğer patolojisi olmayanlarda, KOAH hastalarına kıyasla, FEV 1 ve FVC daha fazla oranda azaldı. Buna karşın KOAH varlığı, ameliyat öncesi respiratuvar kas gücüne ait değerleri ve bu değerlerde cerrahi ile oluşan değişiklikleri etkilemedi. Anah tar söz cük ler: Kardiyopulmoner baypas, kronik obstrüktif akciğer hastalığı, solunum fonksiyon testi, respiratuvar kas gücü testi.
Multisystem inflammatory syndrome in children (MIS-C) is a rare and severe condition that follows... more Multisystem inflammatory syndrome in children (MIS-C) is a rare and severe condition that follows benign COVID-19. We report autosomal recessive deficiencies of OAS1 , OAS2 , or RNASEL in five unrelated children with MIS-C. The cytosolic double-stranded RNA (dsRNA)–sensing OAS1 and OAS2 generate 2′-5′-linked oligoadenylates (2-5A) that activate the single-stranded RNA–degrading ribonuclease L (RNase L). Monocytic cell lines and primary myeloid cells with OAS1, OAS2, or RNase L deficiencies produce excessive amounts of inflammatory cytokines upon dsRNA or severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) stimulation. Exogenous 2-5A suppresses cytokine production in OAS1-deficient but not RNase L–deficient cells. Cytokine production in RNase L–deficient cells is impaired by MDA5 or RIG-I deficiency and abolished by mitochondrial antiviral-signaling protein (MAVS) deficiency. Recessive OAS–RNase L deficiencies in these patients unleash the production of SARS-CoV-2–triggered,...
PURPOSE: We aimed to evaluate the relationship between trauma patients' mortality and neutrophil/... more PURPOSE: We aimed to evaluate the relationship between trauma patients' mortality and neutrophil/ lymphocyte ratio (NLR) at intensive care units admission. METHODS: We examined 107 ICU trauma patients. Patients were divided into two groups as those who survived (Grup I) and deceased (Grup II). Patients' age, NLR, mean platelet volume (MPV), lactate value, length of stay in the intensive care unit, acute physiology and chronic health evaluation 2 (APACHE II) scores were examined. The effects of these factors on mortality were examined. RESULTS: 83 (77.58 %) patients were male, 24 (22.42 %) patients were female. The patients' mean age was 46.89 ± 19.06 years. The mean value of the lactate level was 3.25 ± 2.92, the mean value of MPV was 10.34 ± 1.02, the average value of NLR was 8.23 ± 8.11, the average score of APACHE II was 22.8 ± 8.75, and the average length of stay in the ICU was 11.33 ± 22.98 days. The relationship with mortality was evaluated between the groups, there was a statistically signifi cant difference in APACHE II scores. There was no statistically signifi cant difference between other variables. CONCLUSIONS: NRL, MPV, lactate levels were not suitable for the evaluation of trauma patients as an early prognostic factor like APACHE II during admission to ICU (Tab. 2, Fig. 1, Ref. 23).
Reproduktif donemde beyin tumorleri oldukca nadir gorulmektedir. Gebelikteki hormonlarin etkisi i... more Reproduktif donemde beyin tumorleri oldukca nadir gorulmektedir. Gebelikteki hormonlarin etkisi ile mevcut olan tumor boyutunda degisiklikler olabilir. Gebelige bagli olarakta gorulen bulanti, kusma gibi semptomlar beyin tumorunun tanisinda gecikmeye neden olabilir. Inatci olan bulanti, kusma ve bas agrisi varliginda beyin tumoru acisindan dikkatli olmak gerekir. Gebelik doneminde beyin tumoru tanisi alan 40 yasinda bir olguyu tartismayi amacladik.
Multisystem inflammatory syndrome in children (MIS-C) emerged in April 2020 in communities with h... more Multisystem inflammatory syndrome in children (MIS-C) emerged in April 2020 in communities with high COVID-19 rates. This new condition is heterogenous but resembles Kawasaki disease (KD), a well-known but poorly understood and clinically heterogenous pediatric inflammatory condition for which weak associations have been found with a myriad of viral illnesses. Epidemiological data clearly indicate that SARS-CoV-2 is the trigger for MIS-C, which typically occurs about 1 mo after infection. These findings support the hypothesis of viral triggers for the various forms of classic KD. We further suggest that rare inborn errors of immunity (IEIs) altering the immune response to SARS-CoV-2 may underlie the pathogenesis of MIS-C in some children. The discovery of monogenic IEIs underlying MIS-C would shed light on its pathogenesis, paving the way for a new genetic approach to classic KD, revisited as a heterogeneous collection of IEIs to viruses.
Purpose. Nowadays, as the number of patients waiting for organ transplant is increasing, it is im... more Purpose. Nowadays, as the number of patients waiting for organ transplant is increasing, it is important to diagnose brain death in intensive care units and to provide good donor care. We aimed to share our experience of donor care with the diagnosis of brain death in our clinic. Material and method. One hundred and fifty-one patients diagnosed in our clinic with brain death between June 2006 to 2018 were studied retrospectively. Findings. The mean age of the 151 patients was 46.6 (1e89) years. Fifty-seven (37.7%) of the 151 patients' families accepted donation. Ten out of 57 patients could not be organ donors for medical reasons. Eighty-four kidneys, 7 hearts, and 40 livers were transplanted to the patients. When the diagnosis at admission to the intensive care unit was examined, it was found that the most common diagnosis was intracranial hemorrhage (36.8%), followed by head trauma (21.05%), drowning in water (3.5%), and firearm injury (3.5%). The apnea test was applied to all cases, but 17 patients could not complete the apnea test. In order to support the diagnosis of brain death, in 63% of patients (n ¼ 95) radiological methods were performed. Cranial computed tomography angiography was performed as a radiological method. All cases were found to have received at least 1 inotropic support. We used dopamine in 41 patients, noradrenaline in 36 patients, dobutamine in 8 patients, and adrenaline in 3 patients. During the 12 months when the organ transplant coordinator was not on duty, there were no organ donors. It is important to maintain an organ and tissue transplant coordinator and an intensive care unit team for organ donation. Conclusion. In order to increase the cadaver donor pool, it is necessary to increase the number of brain death diagnoses and decrease the rate of family rejection. Therefore, patients with poor neurologic prognosis should be carefully monitored for brain death. Successful family discussions by an experienced and trained organ transplant coordinator should try to increase donation rates by emphasizing the importance of organ donation and the fact that brain death is a real death.
Turkish Journal of Thoracic and Cardiovascular Surgery, 2012
Amaç: Bu çalışmada; kronik obstrüktif akciğer hastalığı (KOAH) tanısı konmuş hastalarda koroner a... more Amaç: Bu çalışmada; kronik obstrüktif akciğer hastalığı (KOAH) tanısı konmuş hastalarda koroner arter baypas greftleme (KABG) cerrahisinin solunum fonksiyonları ve respiratuvar kas gücü üzerine olan etkileri araştırıldı. Ça lış ma pla nı: Bu klinik, prospektif çalışmada median sternotomi ile kardiyopulmoner baypas altında KABG cerrahisi uygulanan 18 yaş üstü 60 erişkin hasta; Kontrol (n=30) ve KOAH (n=30) grupları olarak ikiye ayrıldı. Ameliyat öncesi ve ameliyat sonrası solunum fonksiyonlarına (FEV 1 , FVC) ve respiratuvar kas gücüne (P i max, SNIP, P E max) ait değerler elde edildi. Bul gu lar: Gruplar arasında FEV 1 (p= 0.00) dışında ameliyat öncesi solunum fonksiyonları ve respiratuvar kas gücüne ait değerlerde anlamlı fark saptanmadı (p>0.05). Kontrol ve KOAH gruplarında; FEV 1 (sırasıyla, p=0.00, p=0.00), FVC (sırasıyla, p=0.00, p=0.00), P i max (sırasıyla, p= 0.00, p= 0.00), SNIP (sırasıyla, p= 0.00, p= 0.00), P E max (sırasıyla, p= 0.00, p= 0.00) değerleri ameliyat sonrası dönemde azaldı. Gruplar arasında ameliyat sonrası 3. günde elde edilen solunum fonksiyonları ve respiratuvar kas gücüne ait değerlerde anlamlı fark saptanmadı (p>0.05). KOAH grubuna kıyasla kontrol grubunda, grup içi FEV 1 (p= 0.01) ve FVC (p= 0.02)'deki yüzde azalmalar anlamlı olarak daha fazla saptandı. Grup içi respiratuvar kas gücü değerlerinin yüzde azalmaları gruplar arasında anlamlı fark oluşturmadı (p>0.05). So nuç: KOAH hastalarında ameliyat öncesi FEV 1 düşük saptanırken, FVC ve respiratuvar kas gücüne ait değerler KOAH hastalığı olan ve olmayanlarda benzer bulundu. Cerrahi girişim ile tüm hastalarda solunum fonksiyonları ve respiratuvar kas gücü değerleri azaldı. Eşlik eden akciğer patolojisi olmayanlarda, KOAH hastalarına kıyasla, FEV 1 ve FVC daha fazla oranda azaldı. Buna karşın KOAH varlığı, ameliyat öncesi respiratuvar kas gücüne ait değerleri ve bu değerlerde cerrahi ile oluşan değişiklikleri etkilemedi. Anah tar söz cük ler: Kardiyopulmoner baypas, kronik obstrüktif akciğer hastalığı, solunum fonksiyon testi, respiratuvar kas gücü testi.
We report the results of the International Infection Control Consortium (INICC) surveillance stud... more We report the results of the International Infection Control Consortium (INICC) surveillance study from January 2003 through December 2008 in 173 intensive care units (ICUs) in Latin America, Asia, Africa, and Europe. During the 6-year study, using Centers for Disease Control and Prevention (CDC) US National Healthcare Safety Network (NHSN; formerly the National Nosocomial Infection Surveillance system [NNIS]) definitions for device-associated health care-associated infection, we collected prospective data from 155,358 patients hospitalized in the consortium's hospital ICUs for an aggregate of 923,624 days. Although device utilization in the developing countries' ICUs was remarkably similar to that reported from US ICUs in the CDC's NHSN, rates of device-associated nosocomial infection were markedly higher in the ICUs of the INICC hospitals: the pooled rate of central venous catheter (CVC)-associated bloodstream infections (BSI) in the INICC ICUs, 7.6 per 1000 CVC-days, is nearly 3-fold higher than the 2.0 per 1000 CVC-days reported from comparable US ICUs, and the overall rate of ventilator-associated pneumonia (VAP) was also far higher, 13.6 versus 3.3 per 1000 ventilator-days, respectively, as was the rate of catheter-associated urinary tract infection (CAUTI), 6.3 versus 3.3 per 1000 catheter-days, respectively. Most strikingly, the frequencies of resistance of Staphylococcus aureus isolates to methicillin (MRSA) (84.1% vs 56.8%, respectively), Klebsiella pneumoniae to ceftazidime or ceftriaxone (76.1% vs 27.1%, respectively), Acinetobacter baumannii to imipenem (46.3% vs 29.2%, respectively), and Pseudomonas aeruginosa to piperacillin (78.0% vs 20.2%, respectively) were also far higher in the consortium's ICUs, and the crude unadjusted excess mortalities of device-related infections ranged from 23.6% (CVC-associated bloodstream infections) to 29.3% (VAP).
BACKGROUND: In our previous report on Turkish COVID-19 patients requiring intensive care, the 24 ... more BACKGROUND: In our previous report on Turkish COVID-19 patients requiring intensive care, the 24 patients in a single ICU were elderly and mortality was high. We extended our analysis to include patients admitted to ten ICUs. OBJECTIVES: Report the demographics, clinical features, imaging findings, comorbidities, and outcomes in COVID-19 patients. DESIGN: Retrospective. SETTING: Intensive care unit. PATIENTS AND METHODS: The study includes patients with clinical and radiological confirmed or laboratory-confirmed COVID-19 infection who were admitted to ten ICUs between 15 March and 30 June 2020. MAIN OUTCOME MEASURES: Clinical outcomes, therapies, and death during hospitalization SAMPLE SIZE: 974, including 571 males (58%). RESULTS: The median age (range) was 72 (21–101) years for patients who died (n=632, 64.9%) and 70 (16–99) years for patients who lived (n=342, 35.2%) ( P <.001). APACHE scores, and SOFA scores were higher in patients who died than in those who survived ( P <...
Turkish Journal of Thoracic and Cardiovascular Surgery, Oct 29, 2012
Amaç: Bu çalışmada; kronik obstrüktif akciğer hastalığı (KOAH) tanısı konmuş hastalarda koroner a... more Amaç: Bu çalışmada; kronik obstrüktif akciğer hastalığı (KOAH) tanısı konmuş hastalarda koroner arter baypas greftleme (KABG) cerrahisinin solunum fonksiyonları ve respiratuvar kas gücü üzerine olan etkileri araştırıldı. Ça lış ma pla nı: Bu klinik, prospektif çalışmada median sternotomi ile kardiyopulmoner baypas altında KABG cerrahisi uygulanan 18 yaş üstü 60 erişkin hasta; Kontrol (n=30) ve KOAH (n=30) grupları olarak ikiye ayrıldı. Ameliyat öncesi ve ameliyat sonrası solunum fonksiyonlarına (FEV 1 , FVC) ve respiratuvar kas gücüne (P i max, SNIP, P E max) ait değerler elde edildi. Bul gu lar: Gruplar arasında FEV 1 (p= 0.00) dışında ameliyat öncesi solunum fonksiyonları ve respiratuvar kas gücüne ait değerlerde anlamlı fark saptanmadı (p>0.05). Kontrol ve KOAH gruplarında; FEV 1 (sırasıyla, p=0.00, p=0.00), FVC (sırasıyla, p=0.00, p=0.00), P i max (sırasıyla, p= 0.00, p= 0.00), SNIP (sırasıyla, p= 0.00, p= 0.00), P E max (sırasıyla, p= 0.00, p= 0.00) değerleri ameliyat sonrası dönemde azaldı. Gruplar arasında ameliyat sonrası 3. günde elde edilen solunum fonksiyonları ve respiratuvar kas gücüne ait değerlerde anlamlı fark saptanmadı (p>0.05). KOAH grubuna kıyasla kontrol grubunda, grup içi FEV 1 (p= 0.01) ve FVC (p= 0.02)'deki yüzde azalmalar anlamlı olarak daha fazla saptandı. Grup içi respiratuvar kas gücü değerlerinin yüzde azalmaları gruplar arasında anlamlı fark oluşturmadı (p>0.05). So nuç: KOAH hastalarında ameliyat öncesi FEV 1 düşük saptanırken, FVC ve respiratuvar kas gücüne ait değerler KOAH hastalığı olan ve olmayanlarda benzer bulundu. Cerrahi girişim ile tüm hastalarda solunum fonksiyonları ve respiratuvar kas gücü değerleri azaldı. Eşlik eden akciğer patolojisi olmayanlarda, KOAH hastalarına kıyasla, FEV 1 ve FVC daha fazla oranda azaldı. Buna karşın KOAH varlığı, ameliyat öncesi respiratuvar kas gücüne ait değerleri ve bu değerlerde cerrahi ile oluşan değişiklikleri etkilemedi. Anah tar söz cük ler: Kardiyopulmoner baypas, kronik obstrüktif akciğer hastalığı, solunum fonksiyon testi, respiratuvar kas gücü testi.
Multisystem inflammatory syndrome in children (MIS-C) is a rare and severe condition that follows... more Multisystem inflammatory syndrome in children (MIS-C) is a rare and severe condition that follows benign COVID-19. We report autosomal recessive deficiencies of OAS1 , OAS2 , or RNASEL in five unrelated children with MIS-C. The cytosolic double-stranded RNA (dsRNA)–sensing OAS1 and OAS2 generate 2′-5′-linked oligoadenylates (2-5A) that activate the single-stranded RNA–degrading ribonuclease L (RNase L). Monocytic cell lines and primary myeloid cells with OAS1, OAS2, or RNase L deficiencies produce excessive amounts of inflammatory cytokines upon dsRNA or severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) stimulation. Exogenous 2-5A suppresses cytokine production in OAS1-deficient but not RNase L–deficient cells. Cytokine production in RNase L–deficient cells is impaired by MDA5 or RIG-I deficiency and abolished by mitochondrial antiviral-signaling protein (MAVS) deficiency. Recessive OAS–RNase L deficiencies in these patients unleash the production of SARS-CoV-2–triggered,...
PURPOSE: We aimed to evaluate the relationship between trauma patients' mortality and neutrophil/... more PURPOSE: We aimed to evaluate the relationship between trauma patients' mortality and neutrophil/ lymphocyte ratio (NLR) at intensive care units admission. METHODS: We examined 107 ICU trauma patients. Patients were divided into two groups as those who survived (Grup I) and deceased (Grup II). Patients' age, NLR, mean platelet volume (MPV), lactate value, length of stay in the intensive care unit, acute physiology and chronic health evaluation 2 (APACHE II) scores were examined. The effects of these factors on mortality were examined. RESULTS: 83 (77.58 %) patients were male, 24 (22.42 %) patients were female. The patients' mean age was 46.89 ± 19.06 years. The mean value of the lactate level was 3.25 ± 2.92, the mean value of MPV was 10.34 ± 1.02, the average value of NLR was 8.23 ± 8.11, the average score of APACHE II was 22.8 ± 8.75, and the average length of stay in the ICU was 11.33 ± 22.98 days. The relationship with mortality was evaluated between the groups, there was a statistically signifi cant difference in APACHE II scores. There was no statistically signifi cant difference between other variables. CONCLUSIONS: NRL, MPV, lactate levels were not suitable for the evaluation of trauma patients as an early prognostic factor like APACHE II during admission to ICU (Tab. 2, Fig. 1, Ref. 23).
Reproduktif donemde beyin tumorleri oldukca nadir gorulmektedir. Gebelikteki hormonlarin etkisi i... more Reproduktif donemde beyin tumorleri oldukca nadir gorulmektedir. Gebelikteki hormonlarin etkisi ile mevcut olan tumor boyutunda degisiklikler olabilir. Gebelige bagli olarakta gorulen bulanti, kusma gibi semptomlar beyin tumorunun tanisinda gecikmeye neden olabilir. Inatci olan bulanti, kusma ve bas agrisi varliginda beyin tumoru acisindan dikkatli olmak gerekir. Gebelik doneminde beyin tumoru tanisi alan 40 yasinda bir olguyu tartismayi amacladik.
Multisystem inflammatory syndrome in children (MIS-C) emerged in April 2020 in communities with h... more Multisystem inflammatory syndrome in children (MIS-C) emerged in April 2020 in communities with high COVID-19 rates. This new condition is heterogenous but resembles Kawasaki disease (KD), a well-known but poorly understood and clinically heterogenous pediatric inflammatory condition for which weak associations have been found with a myriad of viral illnesses. Epidemiological data clearly indicate that SARS-CoV-2 is the trigger for MIS-C, which typically occurs about 1 mo after infection. These findings support the hypothesis of viral triggers for the various forms of classic KD. We further suggest that rare inborn errors of immunity (IEIs) altering the immune response to SARS-CoV-2 may underlie the pathogenesis of MIS-C in some children. The discovery of monogenic IEIs underlying MIS-C would shed light on its pathogenesis, paving the way for a new genetic approach to classic KD, revisited as a heterogeneous collection of IEIs to viruses.
Purpose. Nowadays, as the number of patients waiting for organ transplant is increasing, it is im... more Purpose. Nowadays, as the number of patients waiting for organ transplant is increasing, it is important to diagnose brain death in intensive care units and to provide good donor care. We aimed to share our experience of donor care with the diagnosis of brain death in our clinic. Material and method. One hundred and fifty-one patients diagnosed in our clinic with brain death between June 2006 to 2018 were studied retrospectively. Findings. The mean age of the 151 patients was 46.6 (1e89) years. Fifty-seven (37.7%) of the 151 patients' families accepted donation. Ten out of 57 patients could not be organ donors for medical reasons. Eighty-four kidneys, 7 hearts, and 40 livers were transplanted to the patients. When the diagnosis at admission to the intensive care unit was examined, it was found that the most common diagnosis was intracranial hemorrhage (36.8%), followed by head trauma (21.05%), drowning in water (3.5%), and firearm injury (3.5%). The apnea test was applied to all cases, but 17 patients could not complete the apnea test. In order to support the diagnosis of brain death, in 63% of patients (n ¼ 95) radiological methods were performed. Cranial computed tomography angiography was performed as a radiological method. All cases were found to have received at least 1 inotropic support. We used dopamine in 41 patients, noradrenaline in 36 patients, dobutamine in 8 patients, and adrenaline in 3 patients. During the 12 months when the organ transplant coordinator was not on duty, there were no organ donors. It is important to maintain an organ and tissue transplant coordinator and an intensive care unit team for organ donation. Conclusion. In order to increase the cadaver donor pool, it is necessary to increase the number of brain death diagnoses and decrease the rate of family rejection. Therefore, patients with poor neurologic prognosis should be carefully monitored for brain death. Successful family discussions by an experienced and trained organ transplant coordinator should try to increase donation rates by emphasizing the importance of organ donation and the fact that brain death is a real death.
Turkish Journal of Thoracic and Cardiovascular Surgery, 2012
Amaç: Bu çalışmada; kronik obstrüktif akciğer hastalığı (KOAH) tanısı konmuş hastalarda koroner a... more Amaç: Bu çalışmada; kronik obstrüktif akciğer hastalığı (KOAH) tanısı konmuş hastalarda koroner arter baypas greftleme (KABG) cerrahisinin solunum fonksiyonları ve respiratuvar kas gücü üzerine olan etkileri araştırıldı. Ça lış ma pla nı: Bu klinik, prospektif çalışmada median sternotomi ile kardiyopulmoner baypas altında KABG cerrahisi uygulanan 18 yaş üstü 60 erişkin hasta; Kontrol (n=30) ve KOAH (n=30) grupları olarak ikiye ayrıldı. Ameliyat öncesi ve ameliyat sonrası solunum fonksiyonlarına (FEV 1 , FVC) ve respiratuvar kas gücüne (P i max, SNIP, P E max) ait değerler elde edildi. Bul gu lar: Gruplar arasında FEV 1 (p= 0.00) dışında ameliyat öncesi solunum fonksiyonları ve respiratuvar kas gücüne ait değerlerde anlamlı fark saptanmadı (p>0.05). Kontrol ve KOAH gruplarında; FEV 1 (sırasıyla, p=0.00, p=0.00), FVC (sırasıyla, p=0.00, p=0.00), P i max (sırasıyla, p= 0.00, p= 0.00), SNIP (sırasıyla, p= 0.00, p= 0.00), P E max (sırasıyla, p= 0.00, p= 0.00) değerleri ameliyat sonrası dönemde azaldı. Gruplar arasında ameliyat sonrası 3. günde elde edilen solunum fonksiyonları ve respiratuvar kas gücüne ait değerlerde anlamlı fark saptanmadı (p>0.05). KOAH grubuna kıyasla kontrol grubunda, grup içi FEV 1 (p= 0.01) ve FVC (p= 0.02)'deki yüzde azalmalar anlamlı olarak daha fazla saptandı. Grup içi respiratuvar kas gücü değerlerinin yüzde azalmaları gruplar arasında anlamlı fark oluşturmadı (p>0.05). So nuç: KOAH hastalarında ameliyat öncesi FEV 1 düşük saptanırken, FVC ve respiratuvar kas gücüne ait değerler KOAH hastalığı olan ve olmayanlarda benzer bulundu. Cerrahi girişim ile tüm hastalarda solunum fonksiyonları ve respiratuvar kas gücü değerleri azaldı. Eşlik eden akciğer patolojisi olmayanlarda, KOAH hastalarına kıyasla, FEV 1 ve FVC daha fazla oranda azaldı. Buna karşın KOAH varlığı, ameliyat öncesi respiratuvar kas gücüne ait değerleri ve bu değerlerde cerrahi ile oluşan değişiklikleri etkilemedi. Anah tar söz cük ler: Kardiyopulmoner baypas, kronik obstrüktif akciğer hastalığı, solunum fonksiyon testi, respiratuvar kas gücü testi.
We report the results of the International Infection Control Consortium (INICC) surveillance stud... more We report the results of the International Infection Control Consortium (INICC) surveillance study from January 2003 through December 2008 in 173 intensive care units (ICUs) in Latin America, Asia, Africa, and Europe. During the 6-year study, using Centers for Disease Control and Prevention (CDC) US National Healthcare Safety Network (NHSN; formerly the National Nosocomial Infection Surveillance system [NNIS]) definitions for device-associated health care-associated infection, we collected prospective data from 155,358 patients hospitalized in the consortium's hospital ICUs for an aggregate of 923,624 days. Although device utilization in the developing countries' ICUs was remarkably similar to that reported from US ICUs in the CDC's NHSN, rates of device-associated nosocomial infection were markedly higher in the ICUs of the INICC hospitals: the pooled rate of central venous catheter (CVC)-associated bloodstream infections (BSI) in the INICC ICUs, 7.6 per 1000 CVC-days, is nearly 3-fold higher than the 2.0 per 1000 CVC-days reported from comparable US ICUs, and the overall rate of ventilator-associated pneumonia (VAP) was also far higher, 13.6 versus 3.3 per 1000 ventilator-days, respectively, as was the rate of catheter-associated urinary tract infection (CAUTI), 6.3 versus 3.3 per 1000 catheter-days, respectively. Most strikingly, the frequencies of resistance of Staphylococcus aureus isolates to methicillin (MRSA) (84.1% vs 56.8%, respectively), Klebsiella pneumoniae to ceftazidime or ceftriaxone (76.1% vs 27.1%, respectively), Acinetobacter baumannii to imipenem (46.3% vs 29.2%, respectively), and Pseudomonas aeruginosa to piperacillin (78.0% vs 20.2%, respectively) were also far higher in the consortium's ICUs, and the crude unadjusted excess mortalities of device-related infections ranged from 23.6% (CVC-associated bloodstream infections) to 29.3% (VAP).
BACKGROUND: In our previous report on Turkish COVID-19 patients requiring intensive care, the 24 ... more BACKGROUND: In our previous report on Turkish COVID-19 patients requiring intensive care, the 24 patients in a single ICU were elderly and mortality was high. We extended our analysis to include patients admitted to ten ICUs. OBJECTIVES: Report the demographics, clinical features, imaging findings, comorbidities, and outcomes in COVID-19 patients. DESIGN: Retrospective. SETTING: Intensive care unit. PATIENTS AND METHODS: The study includes patients with clinical and radiological confirmed or laboratory-confirmed COVID-19 infection who were admitted to ten ICUs between 15 March and 30 June 2020. MAIN OUTCOME MEASURES: Clinical outcomes, therapies, and death during hospitalization SAMPLE SIZE: 974, including 571 males (58%). RESULTS: The median age (range) was 72 (21–101) years for patients who died (n=632, 64.9%) and 70 (16–99) years for patients who lived (n=342, 35.2%) ( P <.001). APACHE scores, and SOFA scores were higher in patients who died than in those who survived ( P <...
Uploads
Papers by Volkan Yarar