İlk ve Acil Yardım Bölümü Koleksiyonu
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- PublicationFixation of superolateral platysma flap to the mastoid fascia: a novel isolated neck lift technique(Springer, 2024-09) Okumuş, Ayhan; 293876Background This study aimed to evaluate the utility of a novel neck lift technique based on fixation of superolateral platysma flap to the mastoid fascia in terms of postoperative aesthetic outcome and patient satisfaction within an 18-month follow-up period. Methods A total of 145 female patients who underwent isolated neck lift operation with the superolateral platysma flap technique were included. Global Aesthetic Improvement Scale (GAIS) scores (by the investigator) and the patient reported outcomes were recorded in terms of improvement in the cervicofacial angle, jowls, platysmal bands and malpositioned cervical fats, at 6 and 18 months, postoperatively. The complications were recorded at early postoperative period and at 1, 6 and 18 months, postoperatively. Results The median duration of follow-up was 18 months (range, 6–48 months). GAIS scores at 18th months, revealed exceptional improvement in the cervicofacial angle (82.8%), the jowls (93.1%), platysmal bands (93.1%) and malpositioned cervical fat (97.2%). Majority of patients were very satisfied with the treatment in terms of the aesthetic improvement. Complications involved the minor ecchymosis (17.2%) and minor skin circulatory problem (11.7%) in the early postoperative period, suture exposure (12.4%) in the postoperative 1st month, and cervical band reformation in the 6th (0.7%) and 18th (1.4%) months. Conclusion In conclusion, lateral displacement and fixation of superolateral platysma flap to the mastoid fascia seems to be a useful neck lift technique for correction of platysma- and skin-derived aging sings with minor and manageable complications, immediate return to everyday activities and a high patient satisfaction.
- ItemImpact of pre-stenting and bladder dranaige on intrapelvic pressure during retrograde intrarenal surgery(Wiley, 2024-12) Yeni, Sezgin; Kılıçarslan, Hakan; Ocakoğlu, Gökhan; Coşkun, Burhan; Çiçek, Mehmet Çağatay; Günseren, Kadir Ömür; Yavaşçaoğlu, İsmet; 278343Purpose: This study aims to assess the effect of pre-stenting and bladder drainage on intrapelvic pressure (IP) during Retrograde Intrarenal Surgery (RIRS). Methods: Eighty-five consecutive patients were prospectively enrolled and meticulously recorded in a data form. Forty-two patients meeting the inclusion criteria after applying exclusion factors. The patients were divided into two groups: Group 1 (21 patients with preoperative JJ stents) and Group 2 (21 patients without preoperative JJ stents). IP was measured during RIRS, and the impact of various factors, including pre-stenting, bladder drainage and hydronephrosis (HN) grade, on IP was analysed through univariate and multiple linear regression. Results: The perioperative mean highest IP (78 ± 18.2 mmHg vs. 110 ± 23.9 mmHg), median lowest IP (29 mmHg vs. 42 mmHg) and median overall IP (41 mmHg vs. 69 mmHg) were significantly lower in Group 1 compared to Group 2 (all p < 0.001). Multivariate analysis showed that pre-stenting and mild HN (Grade 0–1) were independent predictors of reduced IP. Conclusion: Pre-stenting led to a significant reduction in IP during RIRS, likely due to passive ureteral dilation. Additionally, bladder drainage with urethral catheter further decreased IP. These findings suggest that pre-stenting and bladder drainage should be considered as strategies to reduce IP during RIRS, potentially improving surgical outcomes.
- ItemMulti-inflammatory index as a novel predictor of new-onset atrial fibrillation after off-pump coronary artery bypass grafting(Polish Cardiac Soc, 2024-05) Yüksel, Ahmet; Velioğlu, Yusuf; Atasoy, Mustafa Selçuk; Müdüroğlu, Ayhan; Deşer, Serkan Burç; Gürbüz, Orçun; Aldemir, Mustafa; Çetintaş, Demir; Kılıç, Ali Önder; Badem, SerdarBackground: To our knowledge, a possible predictive relationship of the multi-inflammatory index (MII) with new-onset atrial fibrillation (AF) after off-pump coronary artery bypass grafting (CABG) has not yet been studied in the literature. Aims: We aimed to investigate whether the MII is a novel group of hematological markers for predicting postoperative new-onset AF in patients undergoing off-pump CABG. Methods: A total of 427 patients undergoing isolated off-pump CABG between October 2021 and December 2023 were enrolled in this retrospective observational cohort study and allocated to two groups: the AF group (n = 108) and the non-AF group (n = 319). The groups were compared in terms of baseline clinical patient characteristics, laboratory parameters, and operative and postoperative data. Results: The median values of age, length of hospital stay, platelet and neutrophil count, C-reactive protein level, systemic immune-inflammation index, MII-1, MII-2, and MII-3 were significantly greater in the AF group compared to the non-AF group in univariate analyses. In multiple explanatory variable logistic regression analysis, MII-1, MII-2, and MII-3 were determined to be significant hematological variables, and thereby these indices were considered the independent predictors of postoperative new-onset AF. Receiver operating characteristic curve analyses showed that to predict postoperative new-onset AF, MII-1 of 22.47 constituted the cut-off value with 62.0% sensitivity and 57.0% specificity, MII-2 of 141.77 constituted the cut-off value with 43.5% sensitivity and 76.8% specificity, and MII-3 of 5669 constituted the cut-off value with 63.8% sensitivity and 58.3% specificity. Conclusion: This study demonstrated for the first time that all MIIs predicted new-onset AF after off-pump CABG.
- ItemThe effect of different bed head angles on the hemodynamic parameters of intensive care patients lying in the supine position: a quasi-experimental study(Wiley, 2024-02) Yiğit Avcı, Şenay; Yılmaz, Dilek; 397256Aims: The aim of this study was to research the effect of different bed head angles on the hemodynamic parameters of intensive care patients lying in the supine position. Methods: This study was a non-randomized and non-controlled, quasiexperimental repeated measures study. The study was conducted with 50 intensive care patients aged 18 and over in a general surgery intensive care unit in Turkey. With each patient in the supine position, the bed head was raised to an angle of 0°, 20°, 30°, and 45° without a pillow, and the hemodynamic parameters of central venous pressure, systolic and diastolic blood pressure, heart rate, breathing rate, and peripheral oxygen saturation were recorded after 0 and 10 min. Results: It was found that the mean central venous pressure value measured at min 0 and 10 was higher when the intensive care patients' bed head angle was raised to 45° than when the bed head was at an angle of 0° or 20° (p < .05). It was found that the patients' other hemodynamic parameters were not affected by different bed head angles. Conclusions: It was concluded as a result of this research that in intensive care patients in the supine position, only central venous pressure was affected by bed head angle, and that central venous pressure measurement can be reliably made at a bed head angle of 30°.
- ItemThe role of ergonomics training and posture exercises in surgeons’ musculoskeletal system disorders(Turkish Surgical Assoc, 2024-09) Külekçioğlu, Sevinç; Dilektaşlı, Evren; 249947Objective: The surgeon needs to understand the risks involved in performing surgery with ergonomic errors. Although there are many barriers to ergonomic effectiveness, success begins with the surgeon’s awareness, recognition of existing obstacles, and education. The main purpose of the study is to evaluate the effect of ergonomic training and posture exercises on the surgeon’s pain, physical workload, psychological state, and quality of life to prevent musculoskeletal system disorders and extend career life. Material and Methods: Surgeons who had completed at least one year in their profession, worked an average of 40 hours a week, had musculoskeletal pain in at least one area, and volunteered to participate in the study, regardless of gender and age, were included in the study. Researchers carried out the ergonomics training and exercise program individually by giving face-to-face training. Surgeons were asked to complete the physical workload questionnaire (PWQ), Beck depression index (BDI), and short form health survey (SF-36) before and one month after the study. Changes in visual analogue scale (VAS) and activities of daily living were recorded. Results: Surgeons who received ergonomic training and exercise programs showed significant improvements in pain, physical workload, depression, and quality of life measurements. Conclusion: To prevent fatigue and pain resulting from the accumulation of ergonomic flaws, surgeons should be trained and guided on proper posture and endurance, and encouraged to maintain a comfortable and natural posture.
