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Öğe Adding Dexmedetomidine to Lidocaine for Intravenous Regional Anesthesia(2004) Memiş D.; Turan A.; Karamanlio?lu B.; Pamukçu Z.; Kurt I.Dexmedetomidine is approximately 8 times more selective toward the ?-2-adrenoceptors than clonidine. It decreases anesthetic requirements by up to 90% and induces analgesia in patients. We designed this study to evaluate the effect of dexmedetomidine when added to lidocaine in IV regional anesthesia (IVRA). We investigated onset and duration of sensory and motor blocks, the quality of the anesthesia, intraoperative-postoperative hemodynamic variables, and intraoperative-postoperative pain and sedation. Thirty patients undergoing hand surgery were randomly assigned to 2 groups to receive IVRA. They received 40 mL of 0.5% lidocaine and either 1 mL of isotonic saline (group L, n = 15) or 0.5 ?g/kg dexmedetomidine (group LD, n = 15). Sensory and motor block onset and recovery times and anesthesia quality were noted. Before and after the tourniquet application at 5, 10, 15, 20, and 40 min, hemodynamic variables, tourniquet pain and sedation, and analgesic use were recorded. After the tourniquet deflation, at 30 min, and 2, 4, 6, 12, and 24 h, hemodynamic variables, pain and sedation values, time to first analgesic requirement, analgesic use, and side effects were noted. Shortened sensory and motor block onset times, prolonged sensory and motor block recovery times, prolonged tolerance for the tourniquet, and improved quality of anesthesia were found in group LD. Visual analog scale scores were significantly less in group LD in the intraoperative period and 30 min, and 2, 4, and 6 h after tourniquet release. Intra-postoperative analgesic requirements were significantly less in group LD. Time to first analgesic requirements was significantly longer in group LD in the postoperative period. We conclude that the addition of 0.5 ?g/kg dexmedetomidine to lidocaine for IVRA improves quality of anesthesia and perioperative analgesia without causing side effects.Öğe Analysis of intervariable relationships between major risk factors in the development of coronary artery disease: A classification tree approach(2007) Türe M.; Kurt I.; Kürüm T.Objective: The purpose of this study is to determine how the major risk factors are related to each other in the development of coronary artery disease (CAD) using Chi-squared Automatic Interaction Detection (CHAID). Methods: All patients with suspected CAD seen in the cardiology clinic between January 1999 and February 2003 who underwent coronary angiography were included in the study. A retrospective analysis was performed in 1381 patients. In all patients' sex, age, type II diabetes mellitus, hypercholesterolemia, systemic hypertension, smoking status, family history of CAD, body mass index (BMI) were assessed. Results: According to classification tree, first-level split produced the two initial branches: female (unadjusted presence percentage = 48.07%) versus male (unadjusted presence percentage = 78.02%). For the male aged between 49-81 years and the female aged between 15-48, 49-60 and 61-71 years, diabetes mellitus was the most prominent risk factor. However, hypercholesterolemia was the best predicting variable for the females aged between 72-81 years. For the females of 15-48 years and 49-60 years age categories without diabetes mellitus, smoking status and family history of CAD had important contribution to the model. Conclusion: Sorting the major risk factors of CAD from the most to least according to the classification importance was resulted as sex, age, diabetes mellitus, hypercholesterolemia, family history of CAD and smoking status.Öğe Comparison of multiple prediction models for hypertension (Neural network, logistic regression and flexible discriminant analyses)(2005) Türe M.; Kurt I.; Yavuz E.; Kürüm T.Objective: In this study, we compared performances of logistic regression analysis (LR), flexible discriminant analysis (EAA) and neural networks (SA) in prediction of primary hypertension. Methods: Predictor variables were family history, lipoprotein A, triglyceride, smoking and body mass index. The data were collected from Cardiology Clinic of Trakya University Medical Faculty in Turkey, 2001. Logistic regression analysis, flexible discriminant analysis and neural networks were used for prediction of control and hypertension groups. Comparison of the performance of all models was done using receiver operating characteristic (ROC) curve analysis. Results: All models had areas under the ROC curve in the range of 0.793-0.984 and SA had sensitivity, specificity, and accuracy greater than 90% at ideal threshold. ROC curve areas of SA and LR, and SA and EAA were statistically different (p<0.001 and p<0.001 respectively), while ROC curve areas of EAA and LR did not differ (p>0.05). Conclusion: We concluded that family history, lipoprotein A, triglyceride, smoking and body mass index variables can be used for prediction of control and hypertension groups with statistically better performance of SA over LR and EAA.Öğe Comparison of Propofol and Dexmedetomidine, in Monitored Anesthesia Care(2004) Turan A.; Şapolyo Ö.; Karamanho?lu B.; Kurt I.; Pamukçu Z.In this study, we aimed to compare dexmedetomidine and propofol during monitored anesthesia care of patients undergoing septoplasty and endoscopic sinus operations in terms of haemodynamic, analgesic, sedative and side effects. Forty patients were premedicated with 0.06 mg kg-1 midazolam and 0.01 mg kg-1 atropine im, and randomly divided into two groups of 20 patients in each. In group I, sedation induction was done with propofol 0.8 mg kg-1 and then infusion was started as 2 mg kg-1 hr -1, whereas in group II, induction was done with dexmedetomidine 1 mg kg1 iv (infused in 5 mins) and infusion was started as 0.4 mg kg-1 hr-1. Infusion rates were adjusted according to sedation scale in both groups. All the patients received 1 mg kg-1 fentanyl after sedation induction and received 0.5-1 mg kg-1 fentanyl when visual rating scale was 4 and above, or when patient required. Intraoperative mean blood pressure (MBP), heart rate (HR), SpO2 and visual rating scale (VAS) were evaluated and recorded at 5, 10, 20, 30, 40, and 50 mins. At the end of operation Alderete scores were evaluated. MBP, HR, respiratory rate were recorded and pain was evaluated by VAS at postoperative 1, 2, 4, 6, 12 and 24hrs. When VAS scores were 4 or above diclophenae 75 mg was given. Aldrete scores at 15.min was lower in group II than in group I (p<0.05). Intraoperative VRS scores were indifferent, postoperative VAS values at 1, 2, 4 and 6hrs were found to be significantly higher in group I than group II (p<0.05). Intraoperative sedation scores were higher in all the measured times in group II (p<0.05). Time to first analgesic requirement was significantly prolonged in group II (p<0.05). Total diclophenac consumption was 123.8±83.5 mg in Group I and 33±48.7 mg in Group II being significantly higher in group I. In conclusion, dexmedetomidine can be used during monitored anesthesia care and may be an good alternative to propofol.Öğe Could the mosaic pattern of chromosomal abnormality predict overall survival of patients with myelodysplastic syndrome?(King Faisal Specialist Hospital and Research Centre, 2016) Uyanik M.S.; Demir A.M.; Kurt I.; Maden M.; Oz Puyan F.; Gurkan H.; Umit E.G.Objective/background Myelodysplastic syndromes (MDSs) are a group of monoclonal hematopoietic diseases consisting of a number of various entities. The presence of differences in chromosomal content of cells within the same individual is known as chromosomal mosaicism. The impact of mosaic pattern on the prognosis of MDS has been unclear. In this study, we aimed to determine the impact of mosaic pattern on the survival of patients with MDS. Methods We retrospectively evaluated 119 patients diagnosed with MDS at the Trakya University Faculty of Medicine, Department of Hematology. Giemsa-Trypsin-Giemsa banding was used to evaluate chromosomal abnormality. The effect of chromosomal abnormality mosaicism on overall survival and transformation to acute leukemia was evaluated by Kaplan-Meier survival analysis. Results The mean age at diagnosis was 66.3 years, and the mean disease duration was 24.2 months. Chromosomal abnormality was observed in 32.5% of patients. Patients with chromosomal abnormalities comprising at least 50% metaphases had significantly lower overall survival than patients with abnormality comprising up to 50% of all abnormal metaphases (p =.003). There were no differences in transformation to acute leukemia among patients with higher and lower chromosomal mosaicism (p =.056). Conclusion The most important outcome of this study was to demonstrate worse overall survival rates in MDS patients with higher abnormal chromosomal mosaicism than patients with lesser abnormal chromosomal mosaicism. Higher levels of abnormal chromosomal mosaicism did not predict transformation to acute leukemia. The cause of worse outcomes of patients with higher abnormal chromosomal mosaicism may be related to clonal mass. © 2016 King Faisal Specialist Hospital & Research Centre.Published by Elsevier Ltd.Öğe The Effect of Phantom Sensation on the Autocorrelation of Gait in Amputation(Institute of Electrical and Electronics Engineers Inc., 2023) Kurt I.; Ulukaya S.; Selcuk H.; Aydin N.S.; Salar S.; Keklicek H.Amputation affects the individual's entire life with a long rehabilitation and adaptation process. Phantom sensation is the sensing of the presence/position of the limb that existed before but subsequently lost its function. Our research aims to investigate the effect of phantom limb sensation on the autocorrelation of gait in individuals with transtibial amputation. In this context, autocorrelation function (ACF), rescaled range analysis (RRA), and power spectrum density (PSD) evaluations are employed to analyze the acceleration data of gait from the vertical plane. Subjects with unilateral trans-tibial amputation and prostheses were involved in the work. As a result, the gait profile of individuals with phantom sensation for approximately 512 steps on a non-perturbed ground is similar to healthy individuals by the results obtained from all three methods. This shows us that phantom sensation can be a functional part of gait and is a supporting factor for amputees in the adaptation process. © 2023 IEEE.Öğe Pediatric head injuries: A retrospective analysis of 280 patients(2005) Şimşek O.; Hiçdönmez T.; Hamamcio?lu M.K.; Kilinçer C.; Parsak T.; Tiryaki M.; Kurt I.BACKGROUND: To assess etiological factors, clinical features, radiological findings and recovery rates in pediatric head injuries. METHODS: Patients (n = 280) with head injuries (age range: 0-16 years) hospitalized in Trakya University Department of Neurosurgery between January 1995 and 2004 were analyzed statistically. RESULTS: According to Glasgow Coma Scale (GCS) the patients had minor (GCS: 13-15; 70.1%), moderate (GCS: 9- 12; 17.1%), or severe (GCS: 3 to 8; 6.8%). head injuries The most common etiological factor was fall from a height (34.3%); and the most frequently associated injury was extra-spinal skeletal injury (12.9%). Fifty-one patients (18.2%) underwent neurosurgical operation. 87.5% of them recovered completely, while 12.5% showed partial recovery or died, as graded by Glasgow Outcome Scale (GOS). There was a moderately strong correlation between initial GCS and GOS (r=0.53, p=0.01). CONCLUSIONS: Nearly half of the pediatric head injuries were caused by falls with good prognoses. In the school age, motor vehicle accident (MVA) was the most frequent trauma type. MVA was the most serious type of trauma as demonstrated by its low GCS and GOS scores. Polytraumas, subdural hematomas, cerebral contusions, subarachnoid or intracerebral hemorrhages, cerebral edemas, diffuse axonal injuries, and any cranial lesion which required surgery were found to be related with poor prognosis.
