23 research outputs found
Spontaneous Pseudoaneurysm of the Superficial Femoral Artery in Behcet's Disease—Endovascular Stent-Graft Treatment Combined with Percutaneous Drainage: A Case Report
No full textPermanent hemodialysis catheters: How long lasting are they?
No full textAmaç: Bu çalışmada kalıcı hemodiyaliz kateterlerinin takılmasında en uygun ve güvenilir yöntemler, bu yöntemlerin komplikasyonları ve kateterlerin açıklık oranları değerlendirildi. Çal ışm a planı: Ocak 2008 - Haziran 2012 tarihleri arasında kliniğimizde kalıcı hemodiyaliz kateteri takılan ve halen hastanemiz hemodiyaliz ünitesinde hemodiyaliz programında olan 127 hasta (72 erkek, 55 kadın; ort. yaş 65.0±14.7 yıl; dağılım 17-85 yıl) retrospektif olarak değerlendirildi. Hastaların yaşı ve cinsiyeti, kateterlerin takılma endikasyonları, takılma yerleri, çıkarılma nedenleri, kullanım süreleri ve katetere bağlı komplikasyonlar kaydedildi. Kateter ömrü, kateterin takıldığı tarihten katetere bağlı gelişen komplikasyonlardan dolayı çıkarıldığı tarihe kadar geçen süre olarak tanımlandı. Bulgular: Yüz yirmi yedi hastaya toplam 155 adet kalıcı hemodiyaliz kateteri yerleştirildi. Kateterlerin 79u sağ juguler ven, 22si sol juguler ven, 13ü sağ subklaviyan ven, sekizi sol subklaviyan ven, beşi sağ femoral venden yerleştirildi. Kateterler yedi hastada enfeksiyon, 13 hastada kateter içi tromboz, beş hastada kateter malpozisyonu, üç hastada ise diğer nedenlerle yeni bir kalıcı kateter ile değiştirildi. Sonuç: Kalıcı hemodiyaliz kateterlerinin kullanım süresi uygun kateter seçimi, uygun kateter giriş yeri, klinisyenin deneyimi ve işlemin ultrasonografi veya floroskopi kılavuzluğunda yapılması ile doğrudan iliş- kilidir.Background: In this article, we evaluated the most appropriate and safest methods to insert permanent hemodialysis catheters, the complications of these methods and catheter patency rates. Methods: Between January 2008 and June 2012, 127 patients (72 males, 55 females; mean age 65.0±14.7 years; range, 17 to 85 years) in whom a permanent hemodialysis catheter was inserted in our clinic and who continued to undergo hemodialysis program in the hemodialysis unit of our hospital were retrospectively analyzed. Age and sex of the patients, indication for catheter insertion, the localization, reasons for catheter removal, duration of use and catheter-related complications were recorded. Life of the catheter was defined as the period of time from the date in which the catheter was inserted to the date in which the catheter was removed due to catheter-related complications. Results: A total of 155 permanent hemodialysis catheters were inserted to 127 patients. Seventy-nine were inserted via the right jugular vein, 22 via the left jugular vein, 13 via the right subclavian vein, eight via the left subclavian vein, five via right femoral vein. A new permanent catheter was inserted due to infection in seven patients, due to catheter thrombosis in 13 patients, catheter malposition in five patients, and other complications in three patients. Conclusion: The duration of use of a permanent hemodialysis catheter is directly related to an appropriate catheter choice, appropriate localization for insertion, experience of the clinician and with the guidance of ultrasonography or fluoroscopy
Persistent Pleural Effusion after Open Heart Surgery: Giant Hydatid Cyst of the Liver and its Demonstrative Images. A Case Report
No full textEffect of clopidogrel on nitric oxide levels in an ischemia reperfusion model
No full textIschemia and reperfusion injury is a pathologic process with serious consequences, arising due to interruption of arterial blood flow. Restored blood flow achieved after the ischemic period causes formation of oxygen radicals by activation of a variety of substances and systems. In this study, we investigated the effect of clopidogrel, an antithrombocyte agent, on tissue nitric oxide (NO) levels in an experimental ischemia reperfusion model. For this purpose, 6 hours of ischemia and 4 hours of subsequent reperfusion were applied to the right lower extremities of the subjects. Clopidogrel therapy was started in one of these groups 10 days before the process (study group). NO levels were measured in all groups in the muscle, lung, and liver tissues, and in plasma. Lung, plasma, and liver NO measurement values had statistically significant differences among the groups. There was no statistically significant difference in the measurements made on the muscle tissue. Clopidogrel, which has previously been reported to be suitable to be used as a preventive agent of ischemia reperfusion damage, has had a reducing effect on the NO levels in tissues in the ischemia reperfusion model created in our present study
Delayed presentation of a penetrating subclavian arterial injury: case report
No full textSubklavian arter yaralanması lokalizasyonu nedeniyle oldukça nadir görülür. Yaralanma bazen çok rahatlıkla
saptanabilirken, bazen de arteriyel yaralanmaya ait bariz bulgular saptanamaz. Elli sekiz yasında olan ve atesli
silah yaralanması nedeniyle getirilen bayan olguda, basvurusu esnasında arter yaralanmasını düsündürecek
bulgular saptanamadı. Olguda yaralanmayı düsündürecek tek bulgu travmanın lokalizasyonuydu. Indirekt
bulgular nedeniyle hastanede gözlenen olgunun yapılan tetkiklerinde arteriyel yaralanma saptandı. Klinik
takibinin yirminci saatinde genel durumu ve hemodinamik parametreleri aniden bozulan olgu cerrahi
uygulanarak basarılı bir sekilde tedavi edildi.
Subklavian bölgesinden yaralanmıs olgularda, damar yaralanmasının kesin bulguları olmasa da, yaralanma
süphesi bulunan olguların hastane ortamında belirli bir süre gözlenmesi olası ölümcül komplikasyonları
engelleyecektir.Subclavian artery injuries are quite rare. While the arterial injuries can be detected easily at times, the related
symptoms may not be detected at all in some cases. Indirect evidences of arterial injury were detected in our fifty
eight year old case brought in with firearm injury. Arterial injury was confirmed by the tests performed while the
case was under observation in hospital due to indirect symptoms. Successful surgical therapy was performed on
the patient whose condition had suddenly worsened in the 20 hour of the clinical follow-up.Acertain period of
follow-up in the hospital setting of patients with injury in the subclavian area even when they show no initial signs
will prevent possible lethal complications
Ischemia-modified albumin use as a prognostic factor in coronary bypass surgery
No full textAbstract Background Various types of markers have been used so far in order to reveal myocardial perfusion defect. However, these markers usually appear in the necrosis phase or in the late stage. Having been the focus of various investigations recently, ischemia-modified albumin (IMA) is helpful in establishing diagnosis in the early stages of ischemia, before necrosis develops. Methods and Results 30 patients that underwent only coronary bypass surgery due to ischemic heart disease within a specific period of time have been included in the study. IMA levels were studied in the preoperative, intraoperative, and postoperative periods. The albumin cobalt binding assay was used for IMA determination. Hemodynamic parameters (atrial fibrillation, the need for inotropic support, ventricular arrhythmia) of the patients in the postoperative stage were evaluated. Intraoperative measurement values (mean ± SD) of IMA (0.67677 ± 0.09985) were statistically significantly higher than those in the preoperative (0.81516 ± 0.08894) and postoperative (0.70477 ± 0.07523) measurements. Considering atrial fibrillation and need for inotropics, a parallelism was detected with the levels of IMA. Conclusions IMA is an early-rising marker of cardiac ischemia and enables providing a direction for the treatment at early phases.</p
Efficiency of sirolimus in prevention of adhesions around vascular grafts
No full textBackground: Adhesions due to the reactions caused by the grafts used in the primary vascular operation can lead to various problems when a secondary operation is necessary. These problems include: bleeding, injuries to neighboring organs sand complications occurring due to a prolonged operation. We investigated the affects of sirolimus, which has antiproliferative effects on vascular adhesions. Methods: The abdominal aortae of rats were explored and abrasions inflicted. Following the fixation of a PTFE (Polytetra floroetilen) graft on the abdominal aorta, rapamycin (sirolimus) was applied (in powder form) on the grafts of the study group. Four weeks later a laparotomy was done and the adhesions developed were evaluated. Results: In the study group the adhesions were determined to be fewer in number and milder in severity. Severe adhesion were noted in the control group. Conclusions: Therefore, sirolimus applied around the prosthesis in vascular operations, was determined to be effective in preventing possible adhesions. Keywords: Sirolimus (Rapamycin), adhesion Nigerian Journal of Surgical Research Vol. 7(3&4) 2005: 285-28
