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31.
Ozkara A Cetin G Mert M Akinci O Erdem CC Suzer K 《Texas Heart Institute journal / from the Texas Heart Institute of St. Luke's Episcopal Hospital, Texas Children's Hospital》2005,32(2):151-153
We report a case of successful reoperation for aortic arch dissection with use of the "arch-first" technique in a patient who had Marfan syndrome. Extracorporeal circulation was initiated via right subclavian artery cannulation, and the chest was entered through a clamshell incision for the best exposure. When the patient was cooled to 18 degrees C, the perfusion was stopped. After the 1st aortic arch anastomosis to a 30-mm Dacron graft, cerebral perfusion was reestablished via the right subclavian artery. The aortic repair was then completed. The cerebral ischemic time was 18 minutes, the aortic cross-clamp time was 69 minutes, and the total extracorporeal circulation time was 334 minutes. The patient was discharged from the hospital on postoperative day 10 with no neurologic impairment. The arch-first technique shortens the duration of brain ischemia. When combined with a clamshell incision, the technique is particularly helpful for reoperation of the aortic arch and thoracic aorta. 相似文献
32.
Delayed diagnosis of tuberculous arthritis 总被引:2,自引:0,他引:2
Erdem H Baylan O Simsek I Dinc A Pay S Kocaoglu M 《Japanese journal of infectious diseases》2005,58(6):373-375
Monoarticular tuberculosis (TB) affecting the knee is rare in all forms of TB (0.1-0.3%). We present the case of a patient with tuberculous arthritis in whom the diagnosis was belated due to a lack of familiarity with the disease; here, we emphasize the difficulties associated with the diagnosing joint TB. A 20-year-old man was referred to our department due to swelling of the right knee and the presence of persistent, mild pain for 4 years. The lack of systemic evidence of this disease, the indolent course of disease, and the presence of non-specific symptoms renders early recognition of this disease difficult. Furthermore, in cases in which a diagnosis cannot be reached simply by culturing the synovial fluid, synovial biopsy cultures should be considered in the diagnostic process, due to the high rate of positivity of such cultures. The diagnosis and treatment of articular TB are both urgent matters; surgical debridement and strict adherence to antituberculous chemotherapy tend to yield a satisfactory functional outcome. 相似文献
33.
Warkentin TE; Hayward CP; Boshkov LK; Santos AV; Sheppard JA; Bode AP; Kelton JG 《Blood》1994,84(11):3691-3699
Heparin-induced thrombocytopenia is characterized by moderate thrombocytopenia and thrombotic complications, whereas quinine/quinidine-induced thrombocytopenia usually presents with severe thrombocytopenia and bleeding. Using flow cytometry and assays of procoagulant activity, we investigated whether sera from patients with these immune drug reactions could stimulate normal platelets to generate platelet-derived microparticles with procoagulant activity. Sera or purified IgG from patients with heparin-induced thrombocytopenia stimulated the formation of platelet-derived microparticles in a heparin-dependent fashion. Further studies showed that heparin-induced thrombocytopenia sera also produced a marked increase in procoagulant activity. In contrast, sera from patients with quinine- or quinidine-induced thrombocytopenia did not generate platelet-derived microparticles nor generate increased procoagulant activity. However, quinine/quinidine-induced thrombocytopenia sera produced a significant increase in the binding of IgG to platelets in a drug-dependent fashion, whereas sera from patients with heparin-induced thrombocytopenia demonstrated no drug-dependent binding of IgG to platelets. We also observed increased levels of circulating microparticles in patients with acute heparin-induced thrombocytopenia compared with control patients. Our observations indicate that the generation of procoagulant platelet-derived microparticles in vivo is a plausible explanation for the thrombotic complications observed in some patients with heparin-induced thrombocytopenia. 相似文献
34.
Savas Sencan Emel Ece Ozcan-Eksi Isa Cuce Selcuk Guzel Baki Erdem 《Annals of physical and rehabilitation medicine》2018,61(1):33-37
Objectives
To investigate the prevalence of pregnancy-related low back pain (PRLBP) in women in Turkey, identify the factors associated with PRLBP and predict the risk of PRLBP.Materials and methods
This cross-sectional study included a total of 1500 pregnant women admitted to a prenatal care clinic in a secondary care hospital in Turkey between August 2011 and September 2014. All participants were asked to complete a survey questionnaire. The pregnant women who reported recurrent or continuous pain in the lumbar spine or pelvis for more than 1 week were offered a clinical examination for PRLBP by the spine physiatrist. The main outcome measure was the presence of PRLBP. We collected data on sociodemographic factors, previous obstetric history, daily habits, history of LBP, and functional disability scores as assessed by the Oswestry Disability Index (ODI).Results
The mean age of the 1500 women was 26.5 ± 5.5 years. The prevalence of PRLBP was 53.9%, mostly in the third trimester. Women with PRLBP in the third trimester were more disabled than those in the first and second trimesters (mean ODI 40.0 ± 16.7 vs. 34.9 ± 19.2 and 37.4 ± 15.3, respectively). Risk factors of PRLBP were history of LBP, PRLBP, and menstruation-related LBP as well as no housework assistance (OR = 5.394, 95% CI: 3.128–9.300, P < 0.001; 3.692, 2.745–4.964, P < 0.001; 2.141, 1.563–2.932, P < 0.001; 1.300, 1.029–1.64, P = 0.028, respectively).Conclusion
This cross-sectional study is the largest study of PRLBP in the literature and showed that about 1 in 2 women have PRLBP in any stage of pregnancy. History of LBP related and unrelated to previous pregnancy and menstruation are strong risk factors for PRLBP. Receiving no housework assistance is another risk factor. 相似文献35.
Bülent Çekiç Ömer Tarık Selçuk İclal Erdem Toslak Üstün Osma Hülya Eyigör Muhammed Kazım Erol 《Journal of Medical Ultrasonics》2018,45(3):487-492
Purpose
To evaluate extraocular orbital vessels with color Doppler ultrasound (CDU) and investigate the effects of severe obstructive sleep apnea (OSA) on retrobulbar blood flow.Methods
Between February 2014 and September 2015, 30 patients with severe OSA (apnea–hypopnea index (AHI) > 30) and 28 controls were prospectively included in this study. Intraocular pressure (IOP) was measured with a Goldmann applanation tonometer, and CDU was used to evaluate the retrobulbar vessels.Results
The mean AHI score for the OSA group was 63.2 ± 21.5 per hour. The IOP values were significantly higher in the severe OSA group (p < 0.05). The central retinal artery peak systolic velocity (PSV) (p < 0.05) and end-diastolic velocity (EDV) (p < 0.02), and the ophthalmic artery (OA) PSV and EDV, were found to be significantly lower in the OSA group (p < 0.05).Conclusion
Severe OSA causes an increase in IOP and a decrease in flow velocity in the retrobulbar circulation.36.
Accounting for Attribute‐Level Non‐Attendance in a Health Choice Experiment: Does it Matter? 下载免费PDF全文
An extensive literature has established that it is common for respondents to ignore attributes of the alternatives within choice experiments. In most of the studies on attribute non‐attendance, it is assumed that respondents consciously (or unconsciously) ignore one or more attributes of the alternatives, regardless of their levels. In this paper, we present a new line of enquiry and approach for modelling non‐attendance in the context of investigating preferences for health service innovations. This approach recognises that non‐attendance may not just be associated with attributes but may also apply to the attribute's levels. Our results show that respondents process each level of an attribute differently: while attending to the attribute, they ignore a subset of the attribute's levels. In such cases, the usual approach of assuming that respondents either attend to the attribute or not, irrespective of its levels, is erroneous and could lead to misguided policy recommendations. Our results indicate that allowing for attribute‐level non‐attendance leads to substantial improvements in the model fit and has an impact on estimated marginal willingness to pay and choice predictions.Copyright © 2014 John Wiley & Sons, Ltd. 相似文献
37.
38.
Yasar Kucukardali Oral Oncul Saban Cavuslu Mehmet Danaci Semra Calangu Hakan Erdem Ayse Willke Topcu Zuhal Adibelli Murat Akova Emel Azak Karaali Ahmet Melih Ozel Zahit Bolaman Bulent Caka Birsen Cetin Erkan Coban Oguz Karabay Cagla Karakoc Mehmet Akif Karan Selda Korkmaz Gulsen Ozkaya Sahin Alaaddin Pahsa Fatma Sirmatel Emrullah Solmazgul Namik Ozmen Ilyas Tokatli Cengiz Uzun Gulsen Yakupoglu Bulent Ahmet Besirbellioglu Hanefi Cem Gul 《International journal of infectious diseases》2008,12(1):71-79
OBJECTIVE: The purpose of this trial was to determine the spectrum of diseases with fever of unknown origin (FUO) in Turkey. METHODS: A prospective multicenter study of 154 patients with FUO in twelve Turkish tertiary-care hospitals was conducted. RESULTS: The mean age of the patients was 42+/-17 years (range 17-75). Fifty-three (34.4%) had infectious diseases (ID), 47 (30.5%) had non-infectious inflammatory diseases (NIID), 22 (14.3%) had malignant diseases (MD), and eight (5.2%) had miscellaneous diseases (Mi). In 24 (15.6%) of the cases, the reason for high fever could not be determined despite intensive efforts. The most common ID etiologies were tuberculosis (13.6%) and cytomegalovirus (CMV) infection (3.2%). Adult Still's disease was the most common NIID (13.6%) and hematological malignancy was the most common MD (7.8%). In patients with NIID, the mean duration of reaching a definite diagnosis (37+/-23 days) was significantly longer compared to the patients with ID (25+/-12 days) (p=0.007). In patients with MD, the mean duration of fever (51+/-35 days) was longer compared to patients with ID (37+/-38 days) (p=0.052). CONCLUSIONS: Although infection remains the most common cause of FUO, with the highest percentage for tuberculosis, non-infectious etiologies seem to have increased when compared with previous studies. 相似文献
39.
Are postoperative drains necessary with the limberg flap for treatment of pilonidal sinus? 总被引:1,自引:3,他引:1
Dr. Ergün Erdem M.D. Uğur Sungurtekin M.D. Mehmet Ne¢¢ar M.D. 《Diseases of the colon and rectum》1998,41(11):1427-1431
PURPOSE: Different methods for managing pilonidal sinus have been described in the literature. Our purpose was to evaluate the influence of postoperative drainage in Limberg flaps. METHODS: Forty patients with pilonidal sinus undergoing radical excision and reconstruction with Limberg flap between 1994 and 1996 were evaluated prospectively. After patients were assigned randomly to the two groups, the effects of drains were studied statistically in terms of wound complications, hospital stay, and recurrence rate. RESULTS: Except for two minor transient wound dehiscences, in all cases primary healing was achieved. Early wound complication rate was 7.5 percent and recurrence rate was 2.5 percent for both groups. There was no significant difference between the groups in early wound complications (P>0.05). The length of hospital stay was significantly longer in the drainage group (P<0.001). CONCLUSION: We conclude that Limberg flaps with no drains in place will result in shorter hospital stays without deleteriously affecting the surgical results of wide excision and primary closure with well-vascularized tissue. 相似文献
40.
Nesibe Korkmaz Seluk Nazik Raziye . Gümütakm Hanife Uzar Gülnur Kul Selma Tosun Aye Torun Hadiye Demirbakan Ayegül Seremet Keskin Asiye B. Kamaz Hüseyin A. Erdem Serhat Uysal Il D. Aliravci Emine Yeilyurt len Hüseyin Can Mustafa Deniz Ebru Demiray Gürbüz Uur Kostakolu Hilal Blükba 《International journal of clinical practice》2021,75(1)