Search

Objective: Recently, there are many researches about perfusion index which is measured by using pulse oximetry technology for evaluating the efficiency of peripheric nerve block. In this research; we aimed the evaluation between perfusion index and conventional methods about evaluating the success and efficiency of ultrasound guided infraclavicular block which was made on patients who had upper limb surgery. Material and Methods: 30 patients at the age of between 18-70 who will have a surgery of hand, forearm, arm by Orthopedics and Traumatology Department in American Society of Anesthesiologists I-II groups are taken into this research after the patient's and ethics committee's approval are taken. Our research was made as prospective. Ultrasound guided lateral sagittal infraclavicular block was applied to all patients with local anesthetic solution which was prepared as; 1 mg/kg 0.5% bupivakain+5 mg/kg 2% prilokain+NaCl 0.9% until reaching the solution limit of 45 cc. Basal values of heart rate, mean arterial pressure, peripheric oxygen saturation, perfusion index, cold sensory loss test, Pin-prick test and distal skin temperature and the values at the minutes of 5 th , 10 th , 15 th , 20 th , 25 th , 30 th are recorded. Results: When we compare the perfusion index values of the patients in research which were measured at different times, the difference was significant. When the measurements were compared as in double, differences between basal and 5 th , 10 th , 15 th , 20 th , 25 th , 30 th were significant. Time of cold sensory loss was 13.16±3.39 minutes (min 10 and max 25 minutes). Time of Pin-prick test positivity was 15.00± 4.23 minutes (min 10 and max 30 minutes). Motor block onset time was 10.66±3.40 minutes (min 5 and max 20 minutes). Conclusion: In this research; we showed that pulse-oximetry perfusion index can rapidly reveal the perfusion increase which is reasoned by sympathetic block that occurs after infraclavicular block and before sensory and motor block. It is concluded that it is a sensitive and simple method which can be used with traditional methods. Copyright © 2018 by Türkiye Klinikleri.

Objective: Our targets in this research are; measuring the changes on hemodynamic parameters and methemoglobin levels non-invasively by using pulse co-oxymeter (Radical 7 Masimo USA), early diagnosis of methemoglobinemia which can be due to local anesthetic substance and preventing its complications, evaluation of changes on hemodynamic parameters due to methemoglobinemia on patients who were applied retroclavicular and axillary blocks on upper extremity surgeries. Material and Methods: 40 patients at the age of between 18-70 who will have a surgery of hand, wrist, forearm and elbow by Orthopedics and Traumatol-ogy Department in American Society of Anesthesiologists I-III groups are taken into this research after the patient's and ethics committee's approval are taken. Our research was done prospectively. Ultrasound guided retroclavicular or axillary block was applied to all patients with local anesthetic solution which was prepared as; bupivacaine 0.5% 1 mg/kg+prilocaine 2% 6 mg/kg+NaCl 0.9% until reaching the solution limit of 40 cc. Basal values of heart rate, diastolic blood pressure, systolic blood pressure, mean arterial pressure, peripheric oxygen saturation, sensorial and motor block durations, perfusion index, and methemoglobin values and these values at the minutes of 10th, 20th, 30th were recorded. Results: When we compare the perfusion index values of the patients in research in both groups which were measured at different times; the difference between groups was insignificant on basal and 30th minute values but the difference was significant on 10th and 20th minute. In retroclavicular block and axillary block patients, the difference in methemoglobin levels which were measured on different times was significant. Conclusion: There was increase in methemoglobin levels that were measured by pulse-oxymeter in retroclavicular and axillary block patients but we thought that, this increasing was not enough to cause complication. Sensorial and motor block were established in all patients in each groups on 30th minute. Copyright © 2018 by Türkiye Klinikleri

Objective: Because it is a semi-enclosed environment, the process takes a long time, the noises from equipments and requires complete immobility the magnetic resonance imaging (MRI) requires some anesthesia during the procedure in adolescents and adults, especially with children. Material and Methods: Following the approval of the local ethics committee, anesthesia records were reviewed retrospectively of 1.008 patients whom underwent diagnostic MRI procedure and required sedation between the years 2006-2012. What type of anesthesia is applied for the patients’ according to their age and gender and what kind of adverse effects occured during the process were examined. Results: When patients complication status were analysied retrospective according to their age, gender, American Society of Anesthesiologists and mallampati, there was no significant difference (p>0.05). Following the procedure, patients' heart rate and oxygen saturation levels were significantly increased when compared with before the procedure (p

Background: Predominant histologic subtypes have been reported as predictors of survival of patients with pulmonary adenocarcinoma. Aims: To evaluate the predictive value of histologic classification in resected lung adenocarcinoma using the classification systems proposed by the International Association for the Study of Lung Cancer, American Thoracic Society, European Respiratory Society, and World Health Organization (2015). Study Design: Cross-sectional study. Methods: The histologic classification of a large cohort of 491 patients with resected lung adenocarcinoma (stages I-III) was retrospectively analyzed. The tumors were classified according to their predominant component (lepidic, acinar, papillary, solid, micropapillary, and mucinous), and their predictive values were assessed for clinicopathologic characteristics and overall survival. Results: The patient cohort comprised 158 (32.2%) patients with solid predominant, 150 (30.5%) with acinar predominant, 80 (16.3%) with papillary predominant, 75 (15.3%) with lepidic predominant, 22 (4.5%) with mucinous, and 5 (1.0%) with micropapillary subtype, and 1 (0.2%) with adenocarcinoma in situ. Overall 5-year survival of 491 patients was found to be 51.8%. Patients with lepidic, acinar, and mucinous adenocarcinoma had 70.9%, 59.0%, and 66.6% 5-year survival, respectively, and there was no statistically significant difference between them. Whereas patients with solid, papillary, and micropapillary predominant adenocarcinoma had 41.0%, 40.5%, and 0.0% 5-year survival, respectively. Compared to other histologic subtypes, patients with solid and papillary predominant adenocarcinoma had significantly lower survival than those with lepidic (p

Background and aims: Daily physical activity when performed sufficiently is widely known to have important health benefits. Reduced physical activity has been linked to several chronic health problems including chronic musculoskeletal compliants. Approximately 14-71% of adults experience neck pain at some points in their lifetime. The relationship between physical activity and neck pain is still controversial. The aim of this study was to compare physical activity levels of university students with and without chronic nonspecific neck pain (CNNP). Methods: The study was carried out amoung 118 university students at Pamukkale University in Denizli. The subjects were divided into two groups as having CNNP (group I, n=39) or not having CNNP (group II, n=79). The severity of neck pain was assessed by visual anolog scale (VAS) and neck disability index (NDI) was used for the assessment of disability resulting from CNNP. Physical activity levels of subjects were assessed the short form of International Physical Activity Questionnaire (IPAQ). Results: There was not any significant difference between two groups in terms of tptal physical activity levels (p>0,05). But a significant difference as found regarding vigorous-intensity activity levels which was lower with CNNP (p0,05, r=-0,11, r=-0,32). Conclusion: The results of study showed that the university students with CNNP had vigorous-intensity activity levels when compared with those who did not have CNNP which might be associated with depression and kinesiophobia as had been reported in previous studies.

Amantadine HCl antiviral ve antiparkinson etkili bir ilagtlr. Bu Gahgmada amantadine HCl in 1,2-naftokinon-4-sulfonik asit sodyum tuzu ile olugturduii;~ tiirev yardlrm ile spektrofotometrik milstar tayini geligtirilmigtir. Reaksiyon sulu ortamda, pH 10 da, 60 "C da ve 30 dakilsada tamamlanmaktaclr. Olugan tiirevin maksimum absorpsiyonu 451 nrn'de gozlenmigtir. 0lqu egrisi 5-25 pglrnl araslnda do$jrusaldlr. Geligtirilen yontem amantadin HC1 ic;eren kapsullere uygulm~ ve sonuglar USP XXIII yonterni ile istatistik olarak hyaslmgtlr., Amantadine HCl is used as an antiviral and an antiparkinson drug. We described spectrophotometric determination of amantadine HCl by derivatizationwith sodium 1,2-naphtoquinone-4-sulfonate in aqueous medium. The structureof the derivative was determined by IR, HI-NMR and mass spectral methods.The derivative was obtained quantitatively at pH 10 and 60 "C in 30 minutesand showed maximum absorption at 451 nm. The calibration curve obeysBeers's Law in the 5-25 pg/ml range. The proposed method was applied to thedetermination of amantadine HCl in pharmaceutical dosage form (capsule). Theresults were statistically compared with USP XXIII procedure.

Duchenne Muscular Dystrophy is an X-linked progressive neuromuscular hereditary disease which effects men and is seen in 1/3.500 frequency. Although the basic problem in this disease is musclular weakness; anesthetic approach in Duchenne Muscular Dystrophy is important because the disease might cause cardiac and respiratory problems during anesthesia. Moreover, inhalation anesthetics might be the reason for malignant hyperthermia and rhabdomyolysis. This case report aims at discussing the safe anesthetic approach in a 7 year old patient who was operated by orthopedic surgeons with Duchenne Muscular Dystrophy and right supracondylar humerus fracture. In this case ventilator was totally cleaned from anesthetic agents to avoid from malignant hyperthermia and rhabdomyolysis. 50% oxygen-air mixture and low dose propofol with remifentanil were used in total intravenous anesthesia. Because of the non-depolarizing muscle relaxant sensitivity, low-dose rocuronium and sugammadex were used as its reverse agent. No complications were encountered during preoperative and perioperative period. After the case was observed in intensive care unit, he was transferred to the orthopedics clinic. It has been concluded that use of propofol and remifentanil together with total intravenous anesthesia, and low-dose rocuronium bromide will be a safer anesthesia application., Isbir, A.C.; Cumhuriyet Üniversitesi Hastanesi Anesteziyoloji ve Reanimasyon A.D., Sivas, Turkey; email: cemilisbir@hotmail.com

Metformin is a biguanide antidiabetic high doses of which may cause lactic acidosis. Rosiglitazone is a member of thiazolidinedione antidiabetics group which increases insulin sensitivity. A 35-year-old female patient was admitted to hospital with the complaints of loss of consciousness, oliguria, nausea and vomiting after a history of 48 g of metformin, 108 mg rosiglitasone uptake for suicide. Hypotension, hypoglycemia and metabolic acidosis were observed in the patient, sos he was supported by mechanical ventilation due to the Glasgow coma scale 5. The patient was discharged liome on the 45th day after continuous venovenous hemodiafdtration, supplamentary treatment and 39 days of mechanical ventilation support. There must be a suspicion for metformin intoxication in the patients with high anionic gap metabolic acidosis, and who take overdose drugs for suicide. Since metformin associated hypoglycemia, lactic acidosis and hypothermia are reversible, early diagnosis of metabolic acidosis and cardiovascular support with hemodialysis and hemofdtraiion protect blood glucose level and body temperature, which allow for possible recovery., Düger, C.; Cumhuriyet University, Faculty of Medicine, Department of Anesthesiology and Reanimation, Sivas, 58140, Turkey; email: cevdetduger@gmail.com

Objective: In the last 3 years, intensive care unit patients who had under-gone percutaneous tracheostomy and surgical tracheostomy retrospectively were evaluated to determine the differences between the two methods in terms of complications. Methods: Patients who had been hospitalised in the intensive care unit in the last 3 years, with ages ranging from 18-65, who were intubated and had undergone tracheostomy were included in the study. Patients were divided into two groups: those with percutaneous tracheostomy and those with surgical tracheostomy. From the last 3 years, patients who had full data in the file were included in the study; the number of patients with surgical tracheostomy was 104, and the number of patients with percutaneous tracheostomy was 99. All data were obtained from patient charts, forms, and daily patient follow-up examination forms. Demographic characteristics of the patients and the Glasgow Coma Scale (GCS) data were recorded from the patient file and haemodynamic data, blood gas values, haemoglobin values of before and 1 day after the procedure were recorded. Any additional complications were also recorded. Results: Haemoglobin values after the procedure were significantly lower than values before the initiation of procedure in the surgical tracheostomy group but not in the percutaneous tracheostomy group. In the surgical tracheostomy group, 20 of 104 patients had bleeding after the procedure; there was repetition of endotracheal intubation in 22 patients during the acute phase, and subcutaneous emphysema was observed in 18. Bleeding was recorded in patients with percutaneous tracheostomy in 5 out of 99 patients, repetition of endotracheal intubation was performed in 7, and subcutaneous emphysema was observed in 5. Conclusion: The percutaneous tracheostomy technique, in terms of postoperative complications and bleeding, gives better results than surgical tracheostomy and could be used widely as a routine method for elective tracheostomy in intensive care units. © 2013 by Turkish Anaesthesiology and Intensive Care Society., Düger, C.; Cumhuriyet Üniversitesi, Anesteziyoloji ve Reanimasyon Anabilim Dali, 58140 Sivas, Turkey; email: cevdetduger@gmail.com

Objective: In this study we aimed to investigate the effects of bispectral index (BIS) and neuromuscular block monitoring on anaesthesia depth and recovery on cardiac patients, whom were scheduled to undergo open cholecystectomy operation under desflurane anaesthesia. Methods: After the approval of the Ethics Committee and consent of the patients, cases were divided into two groups. All patients received standard induction drugs, and 4-6% desflurane was used for maintenance of anaesthesia. In Group I, the anaesthesiologist was blind to BIS, and end-tidal volatile agent concentration (ETVAC) of desflurane was titrated according to the patients' haemodynamic changes. In Group II, ETVAC of desflurane was titrated to maintain BIS at 50-60. The haemodynamic data, BIS values, end-tidal volatile agent concentration (ETVAC) and train of four (TOF) values were recorded at pre-induction, post-induction, post-intubation, 1st and 5th minutes after surgical incision and then every 15 min. At the end of the operation, extubation time and time to reach aldrete recovery score ?9 were recorded in each groups. Additionally, neuromuscular agent and narcotic agent doses were recorded. Results: The BIS values were lower for Group I in all times, except preand post-induction times (p, Düger, C.; Cumhuriyet Üniversitesi, Anesteziyoloji ve Reanimasyon Anabilim Dali, 58140 Sivas, Turkey; email: cevdetduger@gmail.com

In recent years, the studies carried out for dissemination of conservation and reduced tillage technologies have been gaining in importance in our country as well as the world. The lack of suitable sowing machine is one of the most important factors hindering the dissemination of conservation tillage methods. In this study, the no-till sowing machines manufactured in our countries was evaluated according to technical properties. As a result of the research, it was observed that only a few companies have manufactured the no-till sowing machine. According to the examination of catalogs and user manuals, these machines are found to be possible classified under two groups, which are the precision notill sowing machine to sown the anchor crops such as cotton, corn, sunflower and the narrow-line no-till sowing machine to plant the crops such as wheat, fodder crops. It was observed that disc-type opener was used in the majority of the manufactured no-till planter and the precision no-till planters had coulters and row cleaners to clean and loosen the soil in front of the furrow openers. Besides, the planters mounted on rotorvator, disc-harrow and chisel plough was observed to be manufactured. Some manufacturers optionally marketed the combination of coulter and row cleaners., Son yıllarda korumalı ve azaltılmış toprak işleme yöntemlerinin yaygınlaştırılmasına yönelik yürütülen çalışmalara hem ülkemizde hem de dünyada oldukça önem verilmektedir. Korumalı toprak işleme yöntemlerinden birisi olan doğrudan anıza ekim yönteminin uygulanmasının başarısını sınırlayan en önemli faktörlerden birisi de uygun ekim makinasının olmamasıdır. Bu çalışmada, ülkemizde imal edilen doğrudan ekim makinalarının teknik özellikleri irdelenmiştir. Yapılan araştırmalar sonucunda, ülkemizde yalnızca birkaç firmanın doğrudan anıza ekim makinası imalatına yönelik faaliyette bulunduğu görülmüştür. İmal edilen bu makinaların katalog ve kullanım kılavuzlarının incelenmesi sonucunda, genel anlamda bu makinaları iki grup (geniş sıra aralığına sahip pamuk, mısır, ayçiçeği gibi çapa bitkilerinin ekiminde kullanılan hassas ekim makinaları ve hububat, yem bitkileri gibi bitkilerin ekiminde kullanılan dar sıralı kesintisiz ekim makinaları) altında incelemenin mümkün olabileceği görülmüştür. İmal edilen anıza ekim makinalarının büyük bir kısmında diskli ekici ayakların kullanıldığı ve hassas ekim makinalarında genellikle ekici ayakların önünde sap kalıntılarının temizlenmesi ve toprağın gevşetilmesi amacıyla çizi temizleyicileri ve çizi açıcılarının kullanıldığı görülmüştür. Ayrıca, çapa bitkilerinin ekiminde kullanılmak üzere rotovatör-pnömatik ekim makinası kombinasyonu ve hububat ekiminde ise diskaro-ekim makinası ve çizel ekim makinası kombinasyonlarının imal edildiği belirlenmiştir. Ekim makinası imalatını gerçekleştiren bazı firmalarda ise, pnömatik hassas ekim makinalarında kullanılmak üzere çizi açıcı ve temizleyicisi kombinasyonundan oluşan anıza ekim ünitesinin isteğe bağlı olarak satışının gerçekleştirildiği görülmüştür.

Introduction: Pseudoaneurysms can be occurred due to blunt or penetrating traumas that damages arterial wall completeness. Pseudoaneurysm of radial artery is seen rarely. In this case, a pseudoaneurysm due to radial artery catheterization at intensive care unit (ICU) is presented. Case: The patient was a 56 years old man that had amyotrophic lateral sclerosis at ICU. Radial catheter was removed because of skin flushing and pain at the 190th day of hospitalization. After 24 hours of removal of the catheter a 2×3 cm palpable and pulsatile mass was determined. The diagnosis of pseudoaneurysm was made by Doppler ultrasound. Because of mass enlarging and wound formations on first and second fingers, aneurismatic mass was removed and radial artery was ligated. The ulcerations on fingers recovered completely. Conclusion: Pseudoaneurysms can be seen after the removal of catheters at the patients who are catheterized for a long time and frequently. In order to prevent this it must be paid attention to asepsia, and must be pressed for enough time. The attempting area must be observed regularly for early diagnosis, the treatment must be done before dangerous complications have been occurred., Kol, I. Ö.; Cumhuriyet Üniversitesi, Tip Fakültesi Anesteziyoloji ve Reanimasyon Anabilim Dali, Sivas, Turkey; email: driclal@gmail.com

Objective: The aim of this study was to compare the effects of intrathecal hyperbaric bupivacaine, ropivacaine and levobupivacaine on the hemodynamic parameters, spinal blockade characteristics, Apgar scores and umbilical veneous blood gases changes in mother and newborn undergoing elective cesarean section. Methods: After the approval of the Ethical Committee and the patients, sixty patients of ASA physical status I-II, undergoing elective cesarean section under spinal anesthesia, were enrolled in this clinical study. Patients were randomized into three groups. Bupivacaine group (n = 20) receiving 8 mg hyperbaric bupivacaine and ropivacaine group (n = 20) receiving 12 mg hyperbaric ropivacaine and levobupivacaine group (n = 20) receiving 8 mg hyperbaric levobupivacaine. Hemodynamic parameters, sensorial and motor blockade characteristics, Apgar scores, umbilical venous blood gas values, postoperative VAS scores, and side effects were recorded. Results: The demographic data, sensorial blockade and duration of surgery of the study groups were comparable (p > 0.05). Also there was no significant difference among the groups with regard to the hemodynamic parameters but in all groups systolic, diastolic and mean arterial blood pressures were decreased when compared with basal values (p0.05). Conclusion: Intrathecally applied equally dosage hyperbaric ropivacaine and levobupivacaine in cesarean sections, could be used successfully without changing the hemodynamic parameters of mothers and newborns. Based on these data, spinal anesthesia with administration of hyperbaric levobupivacaine and ropivacaine can be applied as an alternative to bupivacaine for similar anesthesia conditions, shorter motor blockade duration and earlier patient mobilization times., Özdemir Kol, I.; Cumhuriyet Üniversitesi Tip Fakültesi, Anesteziyoloji ve Reanimasyon AD, 58140 Sivas, Turkey; email: driclal@gmail.com

Levothyroxine is presently dominant agent prescribed for thyroid hormone replacement; it account for 75% of all prescriptions for thyroid hormone products. Intoxication of levothyroxine might be associated with thyrotoxicose or it might causes mild clinical symptoms as well. In this study, we presented (18-years old) a case report of levothyroxine intoxication which was treated in the intensive care unit. In the management, gastric lavage, activated charcoal prophylthiouracil, propranolol, and Prednisolon were administered. The patient was discharge without any symptoms of thyrotoxicose or any other complications. This case report presents appropriate management of levothyroxine intoxication. Copyright © 2007 by Türkiye Klinikleri.

Objective: The present study aimed to determine the advantage and disadvantage of different postoperative analgesia methods in patients undergoing cesarean section or hysterectomy under general anesthesia. Material and methods: Following ethics committee approval and patient informed consents, 120 patients were recruited from the ASA I-III groups. Patients were divided randomly into 6 groups. IM-D group received intramuscular diclofenac sodium (75 mg) every 12 hours. IM-ME group received intramuscular meperidine (1 mg kg -1) every 6 hours. IM-DME group received intramuscular meperidine (1 mg kg-1)-diclofenac sodium (75 mg) combination every 12 hours. EP-MO group received epidural morphine (bolus of 3 mg and 0.06 mg mL-1 morphine; 6 ml h-1) infusion. EP-MOB group received epidural infusion of morphine-bupivacaine combination (bolus of 2 mg morphine + 35 mg bupivacaine combination, 2 mg ml-1 bupivacaine + 0.03 mg mL-1 morphine combination; 6 ml h-1). IV-MO group received intravenous morphine via patient-controlled analgesia (loading dose of 3 mg, bolus of 1 mg and 20 minutes lockout interval). Heart rate, mean arterial pressure, SpO 2, pain and sedation levels were recorded at 2, 6, 12, 24 and 48 hours. Furthermore, additional analgesic consumption and side effects were also recorded. Results: Effective analgesia was in groups IM-DME, EP-MO, EP-MOB, and IV-MO. However, the lowest pain scores were obtained in groups EP-MO and EP-MOB. Sedation scores were higher in groups EP-MO and IV-MO. While the highest additional analgesic consumption was in groups IM-D and IM-ME, there was no additional analgesic consumption in groups EP-MO, EP-MOB and IV-MO. Side effects were not observed in any groups that required treatment. The highest incidence of side effects were in group IV-MO whereas the lowest incidence of side effects were observed in groups IM-DME and EP-MOB. Conclusion: While there was effective analgesia in groups IM-DME, EP-MO, EP-MOB, and IV-MO, IM diclofenac + meperidine combination and epidural bupivacaine + morphine combination seemed more advantageous when the side effects were considered. Copyright © 2006 by Türkiye Klinikleri.

Aim: The aim of this study was to determine the effects of preemptive trampdol and lornoxicam on analgesia and stress response in the early postoperative period. Materials and Methods: Sixty ASA I-II patients, scheduled for open cholecystectomy were allocated randomly into three groups. Placebo in Control Group (Group K), 100 mg iv tramodol in Tramadol Group (Group T) and 8 mg iv lornoxicam in Lornoxicam Group (Group L) were administered 10 minutes before the anesthesia induction. The induction was performed with fentanyl 0.1 ?g kg-1 and thiopenthal 4-7 mg kg-1 sodium. Vecuronium 0.1 mg kg-1 was used for muscle relaxation, desflurane 4-6% and 50-50% N2O-O2 were used for maintenance. In preoperative and peroperative period, the patients' hemodynamic parameters were measured. In the postoperative period, the patients' hemodynamic parameters, Visual Analog Pain Scale (VAS) values, emergence score, first analgesic requirement time and total analgesic consumption were recorded. Three blood samplings were done at the preoperative period before the administration of the study drugs, at peroperative 30th minute and at postoperative 2nd hour to measure the levels of serum glucose, insulin, cortisol, prolactin, ACTH. Results: A significant difference was observed between control and tramodol groups in postoperative 15th and 30th minutes on visual analogue scale values. There was also significant difference among control, tramodol and lornoxicam groups in postoperative 2nd hour (p

Aim: The aim of this study was to compare the anesthetic offerts and peroperative tolerance: of remifentanil and alfentanil based total intravenous anesthesia (TI-VA). Materials and Methods: In this randomized, double-blinded study was applied at thirty patients of ASA physical status I and II who were scheduled for elective abdomen and urogenitale surgery lasting at least 2 h. Patients were randomly allocated to receive either remifentanil-propofol (group remifentanil) (n=15) or alfentanil-propofol (group alfentanil) (n-15). Anesthesia was induced with remifentanil 1 ?g kg-1 or alfentanil 40 ?g kg-1 with propofol 1.5 ?g kg-1 and maintained with infusion of propofol 70 ?g kg-1 dk-1 and either remifentanil 0.5 ?g kg-1 dk-1 or alfentanil 1 ?g kg-1 dk-1. In both groups, propofol infusions were constanted. Opioid dose was increased or decreased 50 % according to necessity. Hemodynamic parameters (systolic and diastolic blood pressure, and heart rate), extubation time, Aldrete recovery score, and consumption of remifentanil and alfentanil during operation were recorded. Frequency of nausea, vomiting and other side effects were recorded postoperatively. Results: Duration of operation and demographic data were similar among groups. The blood pressure and heart rate values of remifentanil group at tracheal intubation time were significantly higher than the alfentanil group (127.93±5.64 mmHg vs. 98.53±6.25 mmHg and 94.53±4.75 beat min-1 vs. 79.46±3.91 beat min-1, respectively) (p

Objective: In this study, we aimed to investigate the effects of dexmedetomidine on stress response and desflurane requirements. Method: Twenty five patients in the ASA I-II category who underwent elective abdominal surgery were divided into two groups randomly, as the study (Group D) and placebo (Group P) groups. Preoperative 1 ?g kg-1 dexmedetomidine was administered intravenously in group D, while saline solution was administered in group P. Anesthesia was induced with thiopental (3-6 mg kg-1) and fentanyl (2 ?g kg-1). Anesthesia was maintained with desflurane 3-6% and N2O 50% in oxygen. Heart rate (HR), mean blood pressure (MAP), SpO2 and Ramsey sedation scores were recorded in the preoperative period. HR, MAP, SpO2 and desflurane requirements were recorded in the intraoperative period. Postoperatively HR, MAP, SpO2, recovery and pain scores were recorded. Blood samples were obtained 4 times for the determination of cathecholamine levels. Results: Heart rate decreased at 5 minutes, during dexmedetomidine administration and just before induction. MAP values were not significantly different between groups. Desflurane requirements were lower in group D. Cathecholamine levels were similar in the two groups. Sedation scores were significantly higher in group D. Pain and recovery scores were lower in group D. Conclusion: The use of preoperative 1 ?g kg-1 of dexmedetomidine failed to constrain the hemodynamic and neuroendocrine responses, but decreased desflurane requirements during the intraoperative period.

The aim of this study was to compare Patient Controlled Sedation with propofol or a propofol-alfentanil combination in patients undergoing urologic endoscopic procedures under spinal anesthesia. The study was carried out on 50 male ASA I or II patients aged 35-75. Group I (n=25) received 0.3 mg kg-1 propofol, Group II (n=25) recevied 0.2 mg kg-1 propofol and 2 ?g kg-1 alfentanil using a patient controlled sedation device. Heart rate, mean arterial pressure, SpO2, respiratory rate, anxiety and sedation degrees were recorded before sedation, at the 15th and 30th minute of sedation and at the postoperative 30th minute. At the end of the operation, patient satisfaction, recovery time and presence of amnesia were assessed. Sedation scores were within desirable levels in both groups, but there was no difference in the sedation scores. While preoperative anxiety scores were high, peroperative and postoperative scores decreased significantly. There was no difference between the groups in recovery scores or patient satisfaction. None of the patients had amnesia during sedation. The adverse effects noted were 52% in group I, 24% in group II. It was concluded that there are no differences in sedation, anxiety, recovery scores and hemodynamic effects between the groups. We think that the propofol-alfentanil combination is superior since its adverse effects were fewer.

Aim: Although the thermodilution technique for cardiac output monitorization is the most common used clinical method, it is very invasive and has all risks of this. Therefore the importance of the noninvasive cardiac output measurement technique is increased. In this study we aimed to compare the safety of thermodilution method and partial CO2 rebreathing fick technique which is a noninvasive method, at the cardiac output measurement of mechanically ventilated critical care unit patients. Materials and Methods: The study was scheduled to 32 critical care unit patients who were between 23-75 ages and needed mechanical ventilation. Patients ventilated on controlled mechanical ventilation mode. Cardiac output measurements were done twice simultaneously in 4 hours intervals by invasive and noninvasively. Results: There were no statistically differences in cardiac output between the methods at the two measurement (p>0.05). There were a high correlation in cardiac output between the methods at the two measurement (p

Purpose: Sedation is a part of the therapy which is applied in intensive care units. We investigated the effects of propofol, midazolam and remifentanil on haemodynaemia and oxygen transport Material-Methods: Forty-five patients dependent on ventilators in the intensive care unit were included in our study and were separated randomly into 3 groups. Sedation levels were adjusted to 3 to 4 according to Ramsey sedation score, with the continual administration of an infusion of remifentanil 0.05 ?g/kg/min (±0.01), propofol 35 ?g/kg/min (±7) and midazolam 1 ?g/kg/min (±0.2). Following the ECG and intraarterial monitoring, a pulmonary artery catheter was inserted. CVP, PAP, PCWP, CO, SvO2, PaO2, SaO2 and Hb levels were measured, and CI, SVR, PVR, DO2, VO2 and O2ER were calculated by the thermodilution method(1st measurement). When the doses reached expected sedation levels, measurements were repeated (2nd measurement). Results: It was found that following sedation, MAP, HR, PAP, DO2 and VO2 parameters decreased in all 3 groups compared to the control values (p0.05). CO and CI values were significantly decreased in the remifentanil and propofol groups compared to control values (p0.05). Conclusion: The heamodynamic effects of remifentanil, propofol and midazolam are not different when used in intensive care unit for sedation.

HELLP Syndrome is characterised by hemolysis, elevated serum levels of aspartate aminotransferase and lactate dehydrogenase and low platelet count. The pathogenesis of HELLP Syndrome remains unclear. We presented the follow up of 7 HELLP syndrome cases in the intensive care unit between 2001-2003. Patients were between 18-28 years of age and gestational ages were between 26-38 weeks. HELLP syndrome occured in the antepartum period in 3 patients and in the postpartum period in the 4 patients. Three patients with Glasgow Coma Score between 3-4 died. Six cases required mechanical ventilation therapy. CT revealed brain edema in 3 patients. ARDS was diagnosed in 3 patients and acute renal failure developed in 2 patients. When respiratory functions and laboratory values returned to normal, 4 patients were transferred to obstetrics and gynecology ward. Because severe complications may develop in HELLP syndrome, we think that the patients must be observed in ICU until the clinical and laboratory findings recover.

SONUÇAraştırmamızda vardığımız sonuçlar aşağıdaki şekilde özetlenebilir :1 — Genetikle olduğu gibi, Türk popüiasyonu için de her iki cins için aynı sefalometrik normlar uygulanabilir. Kız ve erkeklerden meydana gelen örnekler ortalaması arasındaki farklar, kullanılan açıların çoğunluğu için İstatistik olarak manalı bulunmamıştır.2 —Başka popülasyonlar için saptanmış normların Türk popü-lasyonunda uygulanması sakıncalıdır. Zira örnek olmak üzere kıyasladığımız iki popülasyonun örneklerinin ortalamaları arasında genellikle istatistik olarak manalı farklar mevcuttur. 3 — Türk popülasyonundan alınan örnekle, Aiabamalı beyaz Amerikalılardan alınan örnek kıyaslandığında : a) ANB ve ANS -PNS 1 açılan dışındaki bütün açılara ait normlar farklıdır. b) Türklerde üst ve alt çenelerin bazal kısımları ön kafa kaidesine nazaran Amerikalı beyazlardan daha Öndedir. c) Alt ve üst çenelerin bazal kısımlarının ön-arka yönde birbirlerine nazaran ilişkileri aynı şekildedir. d) Yüz iskeleti yapısı dik yönde incelendiğinde, Türklerde beyaz Amerikalılara nazaran iskeletsel kapalı kapanış (skeletal closed bite) eğilimi görülmektedir. e) Üst ve alt kesicilerin gerek baş ve yüz iskeletine ve gerekse birbirlerine nazaran eğimleri Amerikalı beyazlara nazaran daha azdır. 4 — Türk popülasyonundan alınan örnekle, Amerikalı zencilerden alınan örnek kıyaslandığında : a) SNA ve SNB açıları dışındaki bütün açılar için farklı değerler bulunmuştur. b) Alt ve üst çenelerin bazal kısımlarının ön kafa kaidesine nazaran ön-arka yöndeki durumları aynıdır. cj Buna mukabil çenelerin bazal kısımlarının ön-arka yönde birbirleri ile münasebetlerinde, Amerikalı zencilerde alt bazal kavsin üst bazal kavse nazaran daha geride olduğu saptanmıştır. d) Yüz iskeleti yapısı dik yönde incelendiğinde, Türkler de iskeletsel kapalı kapanış Amerikalı zencilere nazaran çok daha barizdir. e) Üst ve alt kesicilerin gerek çenelerin bazal kısımlarına ve gerekse baş yüze nazaran eğilimleri Amerikah zencilerde, Türklerden çok daha fazladır. Alt ve üst kesici, eksenleri arasındaki açı da, Türk-lerdekinden bir hayli küçük dolayısıle dento-alveolar seviyedeki ileri itim çok daha barizdir.SUMMARYThe aim of the present investigation was determination of cephalometric norms in Turkish population with 'normal occlusion. Tha material is consisted of 26 female and 56 male adults whom with normal occlusion and acceptable facial harmony. The subjects were selected mainly from Dental faculty students.The investigation was carried out on the standard cephalometric roentgenograms. Tha angles were imaesured respectively SNA, SNiB, AMB. SND, 1 NA,'NB, 1 , Go-Gn-SN, MP , SN 1 , ANS-PNS 1.f t 1Error of measurement of each doubie determination were calculated using the 2dformula : --and expressed as the- percentage of the mean value.2nEach angle measured by two investigators on the same traving, then arit'iime-tic mean and standard deviation were calculated seperately for both sexes: Significance of differences between mean values of the two groups were assessed by means of the «t test*.Comparisons have been made between norms of white and negro American samples and Turkish sample.The findings of thes study can be summarized :1 — There is no statistically significant sex differences in the norms of two groups.2— There are statisticaly significant differences in norms when compared with various other racial groups. This is justified that the necessity of a Turkish norm is unavoidable for our cephalometric analysis.3 — When comparisons are made between Turkish sample and Alabama white American sample.â– a) There are significant differences between all the angles with the exception of AIMB and ANS-PNS 1 angles. (Table Mi).b) in relation with antenor cranial base, upper and lower basal bones are placed more anteriorly in Turkish sample than Alabama sample. c) At the antero-posterior direction, upper and lower basal bone relationship Is same in both samples. d) In vertical direction, assesment of the facial skeletal structure s'hows skeletal closed bite tendency in Turkish sample comparing with Alabama white American sample.e) Also the inclination of the upper and lower incisors were less obtuse in relation with facial skeleton, cranial base and to each other in Tur>ks than white Alabama sample.— 4 — The other comparisons were 'made with American negro sample. The findings are. a) There are significant differences between all the angles with the exception of SNA and SNJ3 angles. (Table ill).b) Antero-posteriorly upper and lower basal bones s'how no difference in relation with anterior cranial base.c) Although, upperbasal bone o2 American negro sample's placed more posteriorly in relation with lower basal bone.d) Also in the vertical direction, facial skeletal structure of Turkish sample is more significantly skeletal closed bite type than American negro sample.e) The inclination of the upper and tower incisors is more obtuse in American negro sample in relation with their basal bones and head than Turkish sample,, and the angle of between upper and lower incisors is less than the Turkish sample that explains the significance of dento-alveolar prooumbency. of American negro sample.

The practice of no-till in crop production has gained popularity in recent years because it is a superior soil conservation practice and offers reduction in fuel and labor requirements. But, its adaption is very slow in many countries because of lack of knowledge, experience and machines. A series of demonstration studies was conducted to observe the performance of the no-till systems in farmers’ conditions in South East Anatolia region of Turkey. Four demonstration sites were established, each of which was also planted with farmers’ application for wheat (Triticum Aestivum L.) after wheat, wheat after lentil (Lens Culinaris, L), wheat after cotton (Gossypium hirsutum L.) and lentil after wheat in 2009-2010 growing season. Yield was higher under no-till planting (1.50 t ha-1) than farmers’ application (1.10 t ha-1) for lentil production after wheat. The no- till planting had similar yield to farmers’ application for wheat production after wheat and lentil. The yield performance of wheat following cotton for no-till ridge planting and farmers’ application was not consistent at three demonstration sites. In conclusion, the studies of the demonstration showed that no-till planting may be used in lentil and wheat production following wheat and lentil under these weather and soil conditions in South East Anatolia Region of Turkey.

Amaç: BONCURE (Mevcut Bisfosfonat Kullanıcıları İçin Bonviva Bölgesel Avrupa Çalışması) ile daha önce günlük veya haftalık alendronat veya risendronat alan postmenopozal osteoporozu olan kadınlarda aylık ibandronat için hasta tercihinin değerlendirilmesi amaçlandı. Gereç ve Yöntemler: Bu prospektif, açık-etiketli çalışma, iki ardışık aşamadan oluşmuştur: A (tarama) ve B (tedavi) aşaması. A aşamasına kaydolan hastalar Aday Kimlik Anketi (CIQ) tamamladı. B aşamasında, Osteoporoz Hasta Memnuniyeti Anketi (OPSAT Q) tamamladıktan sonra, hastalar 6 ay boyunca aylık oral 150 mg ibandronat aldı. Tedaviden sonra, hastalar OPSAT-Q ve Tercihi Anketi tamamladı. Bulgular: Türkiye’den 223 hasta (yaş ortalaması 63,7±9,51) A aşamasına dahil edildi. Bunların arasında, 103’ü (%46,2) en az bir CIQ sorusunu "EVET" yanıtladı. Ortalama bileşik OPSAT-Q alan puanları; kolaylık (ortalama değişiklik, 15,3±17,7 puan), yaşam kalitesi (10,4±20,4 puan), genel memnuniyet (11,9±22,7 puan) ve yan etkiler (3,3±18,8 puan) için arttı. Altıncı ayda 177 hasta (%92,7) bir kez aylık doz programını tercih etti ve %99,0’u çalışma tedavisi ile uyumlu (?%80) idi. Otuz hasta (%15,6) çoğunlukla gastrointestinal olan hafif ve orta şiddette advers olay yaşadı. Sonuç: Postmenopozal osteoporozu olan kadınlar, günlük veya haftalık bifosfonat tedavisine göre aylık ibandronatı daha çok tercih etmekte ve bu tedavi ile daha memnun ve uyumlu olmaktadır. (Türk Os te opo roz Dergisi 2012;18:1-7) Aim: BONCURE (Bonviva for Current Bisphosphonate Users Regional European Trial), aimed to evaluate patient preference with monthly ibandronate in women with postmenopausal osteoporosis who previously received daily or weekly alendronate or risendronate. Materials and Methods: This prospective, open-label study consisted of two sequential stages, Part A (screening) and Part B (treatment). Patients enrolled into Part A completed the Candidate Identification Questionnaire (CIQ). In Part B, after completing the Osteoporosis Patient Satisfaction Questionnaire (OPSATQ), patients received monthly oral ibandronate 150 mg for 6 months. Following treatment, patients completed the OPSAT-Q and Preference Questionnaire. Results: A total of 223 patients (mean age, 63.7±9.51 years) were enrolled in Part A from Turkey. Among them, 103 (46.2%) answered YES" to at least one CIQ question. The mean composite OPSAT-Q domain scores increased for convenience (mean change

Cotton (Gossypium hirsutum L.) seeds are susceptible to low temperature and excess moisture in soil during seed emergence in years with high rainfall and low temperature in spring. Therefore, a two-year field experiment was carried out to evaluate effects of ridge tillage formed in autumn (RT-I), ridge tillage formed about a month before planting (RT-II) and flat conventional tillage (CT) cultivation systems on physical properties of soil and cotton growth. The RT-I and RT-II resulted in higher soil temperature and lower soil penetration resistance than CT at all depths. The RT-II gave highest emergence, earliest maturity and greatest seed cotton yield. In conclusion, ridge tillage formed a month before planting may be considered a good agronomic practice because it can provide favorable physical conditions in soil, while also improving growth and yield of cotton under weather conditions in spring in South East Anatolia Region of Turkey.

Amaç: Akciğer kanserli hastalarda yasam kalitesi ve öz bakım gücü düzeylerini, etkileyen faktörleri belirlemek ve öz bakım gücünün yasam kalitesi üzerine etkisini saptamaktır. Yöntem ve Gereç: Kesitsel tipteki çalısmanın verileri ?zmir Dr. Suat Seren Göğüs Hastalıkları ve Cerrahisi Eğitim ve Arastırma Hastanesi’nde 01-01-2006/01-01-2007 tarihleri arasında toplandı ve arastırmaya kemoterapi tedavisi alan 84 akciğer kanserli hasta alındı. Arastırmada veriler üç form kullanılarak toplandı. Bunlar; arastırmacılar tarafından hazırlanan sosyo-demografik anket formu, kanserli hastalarda yasam kalitesi ölçeği olan EORTC QLQ-30 ölçeği ve öz bakım gücü ölçeği. Veriler Student T-Test, Mann-whitney-U test ve Pearson correllation ile değerlendirildi. Bulgular: Hastaların %72.6’sı erkek, %66.7’si ilkokul mezunu, %28.6’sı isçi ve %100’ü evlidir. Hastaların %66.7’si küçük hücreli dısı akciğer kanseridir ve %46.4’ünde metastaz vardır. Yasam kalitesi erkeklerde, eğitimi ilköğretimden üzeri olanlarda, küçük hücreli akciğer kanserli hastalarda, hastalık süresi ve alınan tedavi üç aydan az olanlarda diğerlerine göre daha kötüdür (p, Aim: the aim of our study was to evaluate the quality of life of cancer patients and the levels of self-care agency. in addition, to determine the factors and to evaluate the relation between self-care agency and quality of life in chemotherapy treated lung cancer patients Material and Methods: This cross-sectional study conducted in the Dr Suat Seren Chest Diseases and Chest Surgery and Research Hospital, Izmir between the 1st of January 2006 and 2007. the population of the study was 84 chemotherapy treated lung cancer patients. the data was collected using 3 forms, the sociodemographic form, the EORTC QLQ-30 Scale and the Self-Care Agency scale. the Student T-Test, Mann-whitney-U test and Pearson correllation analysis were used for analysis. Results: the sample included 72.6% male, 66.7% primary level educated, 28.6% were workers, and all married. 56 patients (66.7%) have nonsmall cell carcinoma. 46.4% have metastatic carcinoma. We found that the quality of life is better in males, who are higher educated, have small carcinoma, and whose duration of disease was shorter/longer and received treatment than in those less have a worse quality of life than the others (p

In this study, for the purpose of determining physical and aerodynamic properties, some varieties of wheat, barley, chickpea and lentil were used. The length, width, thickness, geometric mean diameter, equivalent sphere diameter, sphericity, seed mass, bulk density, true density, projected area, terminal velocity, drag coefficient of each grain variety were determined. The theoretical terminal velocities of those grains were calculated by using equations corrected with the shape factor. For all the grains, theoretical terminal velocities were lower than the experimental values. The average experimental terminal velocity was found to be in the range of 7.52 to 8.14 m/s for wheat varieties, 7.04 to 7.07 m/s for barley varieties, 7.72 to 7.78 m/s for lentil varieties and 11.15 to 12.01 m/s for chickpea varieties. The drag coefficients of seeds according to projected areas in different positions and equivalent spheres were calculated. The drag coefficient in the position of the lowest projected area for all the grain varieties was higher than that in the other position. © Maxwell Scientific Organization, 2010.

BACKGROUND: The aim of this study was to compare quality of life (QOL) of mothers of children with disabilities with mothers of healthy children. METHOD: Five hundred and eighteen mothers living in Western of Turkey region completed the Short Form Health Survey (SF- 36). The mothers with children aged 8 to 312 months (190 mothers with physically disabled children, 182 mothers with intelligent disabilities children, and 146 mothers with healthy children) participated in the study. The mean age of the mothers was 33,89 ±7,2 years (ranges; 18- 68 years). RESULT: The motor developmental level of the children with disabilities described as follows; 43 apedal (11.5%), 87 quadripedal (23.3%), and 242 bipedal (65%). While significant differences among mothers in the following domains; “role limitations due to physical health”, “energy and fatigue”, “emotional well being”, and “general health” were found, no significant differences were detected concerning “physical functioning”, “role limitation due to emotional problems”, “social functioning”, and “pain”. These results show that the mothers with physical disabled children had less scores of the SF-36. When the mothers compared based on the motor developmental level of the children, significant differences were found in domains of the SF-36 Survey such as; “energy- fatigue”, “emotional well being”, and “general health”. Namely, the mothers with children with disabilities at apedal level had less scores of the SF-36 compared with mothers with children at bipedal or quadripedal level. CONCLUSION: Having a child with disability decreases QOL of the Turkish mothers. Also, the children at apedal level much more affect the QOL of the mothers than the children at bipedal or quadripedal level. The mothers with healthy children had better scores in domains of the SF- 36 compared to the mothers with disabled children.