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Öğe Abdominal cerrahide klonidin ve tramadol premedikasyonu: İndüksiyon, hemodinami ve erken postoperatif ağrı üzerine etkileri(2004) Alagöl, Ayşin; Turan, F. Nesrin; Pamukçu, Zafer; Esgin, Serpil; Arar, CavidanPremedikasyonda klonidin ve tramadol uygulamasının indüksiyon, hemodinami ve erken postoperatif ağrı üzerine etkilerini karşılaştırmak amacıyla, elektif abdominal cerrahi uygulanacak 62 olguya ameliyattan 45 dakika önce atropin 0.5 mg ile; klonidin 2 mg kg-1 veya, tramadol 1.5 mg kg-1 veya, salin intramusküler uygulandı. Ameliyat öncesinde sedasyon skoru; ameliyat öncesi ve süresince kalp atım hızı, periferik O2 satürasyonu, non-invaziv arter basıncı izlendi. İndüksiyon, intravenöz (verbal ve taktil uyarana yanıt kayboluncaya kadar) propofol ve atrakuryum 0.6 mg kg-1 ile sağlandı. Ameliyat bitiminde derlenme odasında; kalp hızı, ortalama arter basıncı, SpO2, ağrı (Numerik Rating Skala), analjezik gereksinimi ve bulantı-kusma, 90 dakika izlendi. Ortalama arter basıncı, indüksiyon sonrasında düştü (p<0.001); entübasyon sonrasında arttı (I. Grup için p<0.05; II. ve III. Gruplar için p<0.001); insizyon sonrasında II. ve III. Grupta yükseldi (p<0.001, p<0.05). Kalp atım hızı, üç grupta, premedikasyon sonrasında yükseldi (p<0.001); indüksiyon sonrasında düştü (p<0.001); entü-basyon sonrasında II. ve III. Gruplarda yükseldi (p<0.001). Gruplar arası değerlendirmede; ortalama arter basıncı, indüksiyon sonrasında III. Grupta en yüksek (p<0.05); kalp atım hızı, indüksiyon sonrasında I. Grupta III. Gruptan (p<0.05); entübasyon ve insizyon sonrasında I. Grupta diğer gruplardan düşüktü (p<0.05, p<0.001). Postoperatif ortalama Arter basıncı ve kalp atım hızı, I. Grupta 30, 60 ve 90. dk'larda; II. ve III. Gruplarda 30. dk.'da düştü (p<0.001). Ağrı skorları I. Grupta 30, 60 ve 90. dk'larda; II. Grupta 60 ve 90. dk'da III. Gruptan düşüktü. İndüksiyonda kullanılan propofol dozu, sedasyon, bulantı ve kusma gruplar arasında farksız bulundu (p>0.05). Sonuçta, abdominal cerrahide klonidin ve tramadol'ün premedikasyonda kullanılabileceği; klonidin'in entübasyon ve cerrahi insizyona hemodinamik yanıtı daha iyi baskıladığı ve daha düşük postoperatif ağrı skorları sağladığı saptandı.Öğe Comparing pulse pressure variation and pleth variability index in the semi-recumbent and trendelenburg position in critically ill septic patients(Mre Press, 2017) Karadayi, Selman; Karamanlioglu, Beyhan; Memis, Dilek; Inal, Mehmet Turan; Turan, F. NesrinIntroduction. Dynamic tests for predicting fluid responsiveness have generated increased interest in recent years. One of these tests, pulse pressure variation (PPV), is a parameter calculated from respiratory variations of pulse pressure. Another test, pleth variability index (PVI), is based on respiratory variations of the perfusion index and can be measured non-invasively by pulse oximeter. Previous studies have shown that both tests are valuable in determining fluid responsiveness. Methods. In this observational prospective study, our aim was to compare the PVI and PPV in order to identify a convenient tool for determining fluid responsiveness. Our study was performed in a surgical and reanimation intensive care unit. We enrolled one hundred mechanically ventilated adult patients diagnosed with sepsis. Exclusion criteria included brain death, spontaneous breathing, cardiac arrhythmia, and impaired peripheral circulation. We measured the PPV by arterial monitorization and the PVI by using Masimo Radical 7 in the 45 degrees semi-recumbent position (SP) and then 15 degrees Trendelenbug position (TP). We performed correlation and ROC analysis using a >13% fluid responsiveness cut-off value for the PPV and >14% for the PVI. Results. Between the SP and the TP, we did not observe significant decreases in PPV (from 14.17 +/- 10.57 to 12.66 +/- 9.64; p > 0.05), while we did observe significant decreases in PVI (from 21.91 +/- 13.99 to 20.46 +/- 14.12; p < 0.05). The PPV fluid responsiveness cut-off value in the SP and TP was 20% (78.95% sensitivity, 77.05% specificity) and 18% (76.67% sensitivity, 72.46% specificity), respectively. The PVI fluid responsiveness cut-off value in the SP and TP was 20% (80.49% sensitivity, 81.03% specificity) and 16% (81.25% sensitivity, 62.69% specificity), respectively. The area under the ROC of the PPV and PVI was 0.843 and 0.858 in the SP, respectively, and 0.760 and 0.747 in the TP, respectively. The PPV and PVI were correlated in the SP (r = 0.578; p = 0.001) and the TP (r = 0.517; p = 0.001). Conclusions. Our results showed that the PPV and PVI were correlated independent of position change in sepsis patients. Both tests appear to be equivalently reliable. However, the ability of the PPV and PVI to predict fluid responsiveness decreased in the TP in our study.Öğe Comparison of autogenous bone graft donor site haemostatic agents used in spinal surgery(Turkish Assoc Orthopaedics Traumatology, 2011) Copuroglu, Cem; Ercan, Selcuk; Ozcan, Mert; Ciftdemir, Mert; Turan, F. Nesrin; Yalniz, ErolObjective: The aim of our study was to investigate the effects of haemostatic agents used at the autograft donor sites in spinal fusion. Methods: The study included 66 patients (26 men, 40 women; mean age: 42.9 years) who underwent spinal fusion surgery between March 1999 and October 2002. Patients were randomly assigned to 4 different groups according to the haemostatic agents used during surgery. In Group 1, bone wax was used on the graft donor site. In Group 2, spongostan was used. In Group 3, spongostan was applied to the donor site and removed after 10 minutes. Group 4 Was the control group and no haemostatic agent was applied. Age, sex, diagnosis and incision shape were not taken into consideration during the selection of patient groups. Closed suction drainage systems were used for the evaluation of drainage amount. The drainage system was removed after 48 hours in patients with a daily drainage of less than 30 cc. Results: In Group 1, there was significantly less drainage than the other groups. Group 2 and Group 3 had less drainage than the control group. When a separate incision was used for graft harvesting, keeping the spongostan at the application site (Group 2) was more effective than its removal (Group 3). Conclusion: The application of bone wax and spongostan to bleeding cancellous bone surfaces at the donor site is a safe and effective method to reduce bleeding and hematoma. Bone wax is more effective than spongostan for haemostasis.Öğe Determining the Efficiency of Different Preoperative Difficult Intubation Tests on Patients Undergoing Caesarean Section(2017) Yıldırım, İlker; İnal, Mehmet Turan; Memiş, Dilek; Turan, F. NesrinBackground: Pregnancy-induced anatomical and physiological changes in the airway make airway management difficult in obstetric patients; thus, preoperative evaluation of the airway is important for obstetric patients. Aims: To determine the effectiveness of the modified Mallampati test; the interincisor, sternomental and thyromental distances and the upper limb bite test. The second aim was to assess the effectiveness of the combination of the upper limb bite test with the other tests in obstetric patients. Study Design: Cross-sectional study. Methods: Pregnant women (n=250) scheduled for caesarean section were analysed. The patients' ages, heights and weights were collected. Preoperative airway evaluation was done by using a modified version of the Mallampati test. The interincisor, sternomental and thyromental distances were measured, and the upper limb bite test was performed. The laryngoscopy difficulty was evaluated by using Cormack-Lehane classification. Results: No statistically significant differences were found between groups in age, height or weight (p>0.05). The modified Mallampati test and interincisor, sternomental and thyromental distances revealed a lower number of easy intubations than that determined by the Cormack-Lehane classification and a higher number of difficult intubations than the actual number of cases (p<0.05). The sensitivity and specificity of the modified Mallampati test, the upper limb bite test, the interincisor distance test and the sternomental and thyromental distance tests were found to be 73.08, 57.69, 84.62, 80.77 and 88.46 and 90.62, 99.11, 83.04, 84.37 and 87.05, respectively. When the combinations were examined, the sensitivity and specificity of the combination of the upper limb bite test with the modified Mallampati test were found to be 57.69 and 100, respectively. When the upper limb bite test was combined with the interincisor distance, the sensitivity and specificity were 46.15 and 100, respectively. We found a sensitivity and specificity of 93.75 and 95.30, respectively, for the combination of the upper limb bite test with the thyromental distance test. The sensitivity and specificity of the combination of the upper limb bite test with the modified Mallampati test and interincisor distance test were found to be 46.15 and 100, respectively. For combination of all the tests, the sensitivity and specificity was 42.31 and 100, respectively. Conclusion: When all combinations are evaluated in the decision of difficult intubation, the combination of the upper limb bite test and thyromental distance test is superior to the use of other methods alone to predict difficult intubation in pregnant women.Öğe The impact of nutritional risk screening 2002 and subjective global assessment upon prognosis for intensive care patients(Mattioli 1885, 2016) Gultekin, Ahmet; Memis, Dilek; Inal, Mehmet Turan; Uzundere, Osman; Turan, F. NesrinAims: The assessment of nutritional status aims to specify individuals and communities that are malnourished or under malnutrition risk, to develop healthcare programs aimed at meeting society's needs in the wake of the assessment. Subjective Global Assessment (SGA) and Nutritional Risk Screening (NRS) 2002 is assessed for intensive care patients, it turns out to be indicative of their prognosis simply and effectively. Methods: The age, weight, body mass index (BMI), APACHE II, SOFA score, biochemical parameters (albumin, prealbumin, total lymphocyte levels), triceps thickness from anthropometric measurements were recorded during the hospitalization process. The patients were classified as nutritionally risk (NRS2002 +) or nutritionally risk-free (NRS2002 -) after NRS2002 assessment. According to SGD, the patients were categorized as well-fed (SGD-A), slightly or moderately malnourished (SGD-B), and heavy malnourished (SGD-C). The nutritional changes in the patient were categorized as NRS2002 -/SGD A (good nutrition), NRS2002 +/SGD B (slight or moderate malnutrition), or NRS2002 -/SGD C (severe malnutrition). Results: It is found that 49,8% of the patients were in the well-fed group, 42,2% of them in the slightly-moderately malnourished group, and 8% of them in the heavy-malnourished group. While the rate of malnutrition increases as the patients' age increases, and as their weight and BMI decrease, albumin, prealbumin, total lymphocyte, triceps skinfold thickness values decrease as malnutrition increases. For the patients with higher malnutrition rate, the duration of stay in the intensive care unit and mechanic ventilators and the mortality rate increase. Conclusions: We found that mortality increased with malnutrition. The nutritional status should be followed, and a treatment plan should be drawn up in critical care patients. Thus; SGA, NRS 2002 and other objective methods for assessing nutritional status with high sensitivity and specivity can be recommended for evaluation of critically ill patients.Öğe Kraniyotomilerde çivili başlığa hemodinamik yanıtın önlenmesinde intravenöz sufentanil ile bupivakain infiltrasyonunun karşılaştırılması(2005) Turan, F. Nesrin; Alagöl, Ayşin; Pamukçu, Zafer; Çolak, AlkinAmaç: Bu çalışmada 10 µg intravenöz sufentanil ile cilde bupivakain infiltrasyonu kraniyotomilerde "Mayfield Holder" yerleştirilmesi sırasında ortaya çıkan hemodinamik yanıtın önlenmesi yönünden karşılaştırıldı.Gereç ve Yöntem: ASA I ve II grubundan, kraniyotomi geçirecek 20-58 yaşlarındaki 59 olgu, rasgele üç gruba ayrıldı. Grup S'ye % 09 NaCl infilitrasyonu ve iv 10 mg sufentanil; Grup B'ye çivi uygulanacak bölgelere 10 mg % 0.5 bupivakain ve iv % 09 NaCl; Grup K'ya intravenöz ve infilitrasyon olarak % 09 NaCl uygulandı. İndüksiyondan önce ve sonra; infiltrasyondan önce ve sonra; Mayfield'den önce ve sonra sistolik, diyastolik ve ortalama arter basınçları ile kalp hızları ölçülerek kaydedildi.Bulgular: Grup S'de sufentanil enjeksiyonu, arter basınçları ile kalp hızını anlamlı olarak düşürdü. (p< 0.01); (p< 0.001) Grup B ve K'de ise, infiltrasyon-enjeksiyon sonrasında arter basınçları ve kalp hızında anlamlı değişiklik saptanmadı (p >0.05). Kontrol grubunda Mayfield başlık sonrası arter basınçları ve kalp hızında artış saptandı (p< 0.001) ve 5 dk. sonra, hala yüksekti (p< 0.01, p< 0.001). Grup B'de ise, diyastolik (p< 0.05) ve ortalama arter basınçları (p< 0.01) ile kalp hızı (p< 0.05) yükseldi. Diyastolik ve ortalama (p< 0.01) arter basınçları 5 dk. sonra hala yüksekti. Grup S'de çivili başlık, hemodinamik parametrelerde artışa yol açmadı; bu düşük hemodinamik değerler, sufentanil enjeksiyonundan sonra ve çalışma süresince devam etti.Sonuç: Mayfield başlığı uygulaması sırasında çivili başlığa bağlı hemodinamik yanıtın önlenmesinde intravenöz 10 µg sufentanilin ve 10 mg % 0.5 bupivakain infiltrasyonunun etkili olduğu, ancak sufentanilin kan basıncını ve kalp hızını çalışma periyodu süresince düşürdüğü saptandı.Öğe Kraniyotomilerde deksmedetomidin infüzyonunun hemodinamik yanıtlar üzerine etkisi(2006) Alagöl, Ayşin; Pamukçu, Zafer; Karaçayır, Yücel; Çolak, Alkin; Turan, F. Nesrin; Kaya, GayeAmaç: Çalışmamızda, kraniyotomi operasyonlarında indüksiyon öncesinde başlayarak cerrahi insizyon öncesine kadar sürdürülen deksmedetomidin infüzyonunun, laringoskopi, çivili başlık ve cerrahi insizyona hemodinamik yanıtı önlemedeki etkinliği araştırılmıştır.Gereç ve Yöntem: Supratentoryal kitle nedeniyle opere edilecek ASA I-II grubundan 40 olgu, indüksiyondan 5 dk. önce rasgele iki gruba ayrılarak çalışma grubuna (n=20) 1 µg kg sa-1 deksmedetomidin, kontrol grubuna (n=20) % 0.9 NaCl infüzyonu başlatıldı. On dakika sonra entübasyon gerçekleştirildi ve iki grupta da infüzyon hızları % 50 azaltıldı. Kontrol grubunda çivili başlıktan 5 dk. önce 1 µg kg-1 fentanil, deksmedetomidin grubunda 2 mL % 0.9 NaCl iv verildi. İki grupta premedikasyon, indüksiyon ve idame ilaçları aynıydı.Bulgular: Deksmedetomidin grubunda infüzyonun 5. dakikasında kalp hızı ile sistolik ve diyastolik arter basınçları, öncesine göre düşük bulundu (p<0.001). Her iki grupta indüksiyondan sonra sistolik ve diyastolik arter basıncı düştü (p<0.001). Kontrol grubunda kalp hızı ve sistolik ve diyastolik arter basıncı, entübasyondan sonra öncesine göre (p<0.001) ve çivili başlık uygulanmasından 1 dk. (p<0.001) ve 5 dk. sonra (p<0.05), öncesine göre yüksek; cerrahi insizyon sonrasında öncesine göre kalp hızı (p<0.001), sistolik (p<0.001) ve diyastolik (p<0.05) arter basıncı yüksek bulundu. Deksmedetomidin grubunda entübasyon ve cerrahi insizyon ile hemodinamik parametrelerde anlamlı değişme saptanmadı; sistolik (p<0.001) ve diyastolik (p<0.05) arter basıncı, çivili başlıktan 5 dk. sonra, 1 dk. sonrasından düşüktü. Kontrol grubunda 6 olguda cerrahi insizyondan sonra fentanil gerekti; deksmedetomidin grubunda fentanil gereksinimi olmadı (p<0.001).Sonuç: Kraniyotomi operasyonlarında indüksiyondan önce başlatılan deksmedetomidin infüzyonu; entübasyon, çivili başlık, insizyon gibi uyaranlara hemodinamik yanıtı önlemede etkili bulundu.Öğe Laparoskopik kolesistektomi sonrası analjezide intraperitoneal bupivakaine meperidin eklenmesi(2002) Tükenmez, Barış; Turan, F. Nesrin; Alagöl, Ayşin; Çolak, Alkin; Pamukçu, ZaferLaparoskopik kolesistektomi sonrası analjezi amacıyla intraperitoneal (İP) uygulanan lokal anestezik ajana hem İP, hem de İV olarak meperidin eklenerek postoperatif ağrı, analjezik gereksinimi, hemodinamik ve yan etkiler karşılaştırıldı. Bu amaçla ASA I ve II grubundan 35 kadın ve 30 erkek hasta çalışma kapsamına alındı. Premedikasyon, anestezi indüksiyonu ve idamesi standart bir protokolle uygulandı. Ameliyat sonunda Grup I'deki olgulara (n=21) % 0.5 bupivakain 20 mL İP ve l mL serum fizyolojik (SF) İV; Grup II'deki olgulara (n=22) % 0.5 bupivakain 20 mL İP ve 50 mg meperidin İP; Grup III'teki olgulara (n=22) % 0.5 bupivakain 20 mL İP ve 50 mg meperidin İV uygulandı. Postoperatif ağri, analjezi süresi, analjezik gereksinimi, ortalama arter basıncı ve kalp atım hızı ; 0 ve 30 dk.,1, 2, 4, 8, 12 ve 24. saatlerde değerlendirildi. Her üç grupta da yeterli analjezi sağlandığı, VAS değerlerinin İP meperidin uygulanan grupta sadece bupivakain uygulanan gruba göre 0, 2 (p<0.05), 12 ve 24. (p<0.01) saatlerde düşük olduğu saptandı. İntraperitoneal meperidin uygulanan grupta VAS değerleri, İV meperidin uygulanan gruba göre 4 (p<0.01), 12 ve 24. (p<0.05) saatlerde düşük, bulundu (p<0.05). Analjezi süresi ve ek analjezik gereksinimi gruplar arasında istatistiksel olarak farklı bulunmadı. Gruplar arasında yan etkiler açısından fark saptanmadı. Sonuç olarak meperidinin İP uygulamada etkili olduğu ve İP bupivakaine eklendiğinde, tek bupivakainden daha düşük ağrı skorlarıyla birlikte olduğu saptandı.Öğe Omurga cerrahisinde IV nimodipin ve oral nifedipinin postoperatif epidural morfin analjezisi üzerine etkileri(2002) Turan, F. Nesrin; Pamukçu, Zafer; Alagöl, Ayşin; Çolak, AlkinOmurga cerrahisi sonrası hasta kontrollü epidural analjezi (HKEA) yöntemi ile morfin uyguladığımız 54 olguda, kalsiyum kanal blokerle rinden oral nifedipin ve IV nimodipinin morfin tüketimini azaltıp azaltmadığı değerlendirildi. Olgular rasgele 3 gruba ayrılarak, çift kör yöntemle, kontrol grubu ve IV nimodipin grubuna oral plasebo; kontrol ve oral nifedipin grubuna IV plasebo uygulandı. Nimodipin, indüksiyondan sonra 30 $mu$g/kg/sa infüzyonla başlatılarak 20 saat süreyle uygulandı. Nifedipin, ameliyattan 2 saat önce verildi. Uç grupta da epidural analjezi protokolü aynı idi. Epidural analjeziye ek olarak, morfin tüketimi ilk 8 saatte 10 mg'ı geçen ve ağrı skorunu >4 olarak belirten olgulara tenoksikam 20 mg IV uygulandı. Postoperatif ağrı skorları gruplar arasında farklı bulunmadı. Nimodipin grubunda ilk 24 saatte (p<0.05), 48 (p<0.05) ve 72 (p<0.001) saatteki toplam morfin tüketimi kontrol (sadece HKEA uygulanan) grubundan düşüktü. Nifedipin grubunda 24 saatteki morfin tüketimi kontrol gru-bundan farklı değilken, 48 (p<0.05) ve 72 saatteki toplam morfin tüketimi kontrol grubundan düşük bulundu (p<0.001) Sonuç olarak, preoperatif nifedipin ile, per ve postoperatif IV nimodipinin, omurga cerrahisi sonrasında, postopertif 72 saatlik epidural morfin tüketimini azalttığına karar verildi.Öğe Omurga cerrahisinde otojen kemik greftlerinin alındıkları bölgeye uygulanan hemostatik ajanların karşılaştırılması(2011) Çopuroğlu, Cem; Ercan, Selçuk; Özcan, Mert; Çiftdemir, Mert; Turan, F. Nesrin; Yalnız, ErolAmaç: Çalışmamızda, omurga füzyonunda kullanılan otogreftlerin, alındıkları bölgeye uygulanan hemostatik ajanların etkilerinin incelenmesi amaçlandı.Çalışma planı: Çalışmaya Mart 1999 ve Ekim 2002 tarihleri arasında spinal füzyon cerrahisi geçiren 66 hasta (26 erkek, 40 kadın; ortalama yaş: 42.9) kabul edildi. Hastalar hemostatik ajan seçimine göre rastgele 4 farklı gruba ayrıldı. Çalışma grupları; kemik mumu uygulanan hastalar (Grup 1), spongostan uygulanan hastalar (Grup 2), spongostan uygulanıp 10 dakika sonra alınan hastalar (Grup 3) ve hemostatik ajan uygulanmayan kontrol grubu (Grup 4) şeklinde oluşturuldu. Grupların seçiminde, hastaların yaşı, cinsiyeti, tanısı ve insizyonun şekli dikkate alınmadı. Hastaların drenaj miktarları kapalı emici drenaj sistemleri ile değerlendirildi. Drenaj miktarı günlük 30 cc’nin altına düşen hastalarda drenaj sistemleri 48 saat takip edilip sonlandırıldı.Bulgular: Grup 1’de hematom miktarında oldukça anlamlı bir azalma tespit edildi. Grup 2 ve 3’te gözlenen hematom miktarı kontrol gubundakinden az idi. Greft alımı için ayrı bir insizyon söz konusu olduğunda, spongostanın sahada bırakılmasının (Grup 2) uygulanıp alınmasından (Grup 3) daha etkin olduğu görüldü.Çıkarımlar: Kanayan süngerimsi kemik yüzeylerine, kemik mumu ve spongostan uygulanması kanama miktarını azaltır. Hemostaz açısından kemik mumu, spongostana göre daha etkindir.Öğe The prevalence of essential tremor in Edirne and its counties accompanied comorbid conditions(Taylor & Francis Ltd, 2019) Guler, Sibel; Caylan, Ayse; Turan, F. Nesrin; Dagdeviren, NezihObjective: We aimed to determine the prevalence and risk factors of Essential Tremor (ET) in Edirne and its districts, located in Western Thrace, which is the most western part of Turkey. Methods: In this study, 3008 individuals who could communicate and agreed to participate in the study were evaluated. To obtain the data from the applicants in 30 Family Health Centres in Edirne and its districts, a face-to-face questionnaire that consisted of 37 questions was prepared by the researchers. The questionnaire included general information, questions to evaluate potential concomitant comorbid conditions and questions regarding the symptomatology used in ET diagnosis, as well as questions to evaluate ET severity, was examined with the spiral test. Patients were classified by using the Washington Heights-Inwood Genetic Study of Essential Tremor (WHIGET) diagnostic and clinical evaluation scale. According to the diagnostic criteria for ET (used in participants who were examined and in those whose medical records were reviewed) were similar to those used in astudy conducted in Turkey. Results: Of 3008 individuals, 173 were diagnosed with ET according to the questionnaire results from Edirne and its districts, and the prevalence of ET was 5.8%. Approximately, 43.4% of the patients with ET were male, and 56.6% were female, which was not significantly different (p > 0.05). Participants with tremor related to alcohol withdrawal, hyperthyroidism, anxiety, depression other known causes of tremor were not considered to have ET. Thyroid disease was identified in 0.0% of the cases, and the control group was detected in 1.4%, which was not significantly different (p = 0.170). Psychiatric disease was identified in 0.0% of the cases, and the control group was detected in 1.3%, which was not significantly different (p = 0.271). Conclusions: ET prevalence studies will increase the awareness of the community and provide early diagnosis and treatment, as well as serve as a basis to reduce morbidity and improve the quality of life.Öğe The prevalence of restless legs syndrome in Edirne and its districts concomitant comorbid conditions and secondary complications(Springer-Verlag Italia Srl, 2015) Guler, Sibel; Caylan, Ayse; Turan, F. Nesrin; Dagdeviren, Nezih; Celik, YahyaWe aimed to determine the prevalence and risk factors of restless legs syndrome in Edirne and its districts, located in Western Thrace, which is the most western part of Turkey. In this study, 4003 individuals who could communicate and agreed to participate in the study were evaluated. To obtain the data from the applicants in 30 Family Health Centres in Edirne and its districts, a face-to-face questionnaire that consisted of 54 questions was prepared by the researchers. The questionnaire included general information, questions to evaluate potential concomitant comorbid conditions and questions regarding the symptomatology used in restless legs syndrome (RLS) diagnosis, as well as questions to evaluate insomnia and tension-type headache secondary to insomnia according to the ICD-II Criteria (International Classification of Sleep Disorders-II Criteria). Of 4003 individuals, 282 were diagnosed with RLS according to the questionnaire results from Edirne and its districts, and the prevalence of RLS was 7 %. Approximately, 47.9 % of the patients with RLS were male, and 52.1 % were female, which was not significantly different (p > 0.05). Anaemia was identified in 41.1 % of the cases and control group was detected in 19.4 %, which was significantly different (p < 0.001). Secondary insomnia was identified in 64.2 % of the cases with RLS and was not detected in 35.8 %, which was significantly different (p < 0.001). RLS prevalence studies will increase the awareness of the community and provide early diagnosis and treatment, as well as serve as a basis to reduce morbidity and improve the quality of life.Öğe The prognostic value of cerebral oxygen saturation measurement for assessing prognosis after cardiopulmonary resuscitation(Elsevier Science Inc, 2017) Inal, Mehmet Turan; Memis, Dilek; Yildirim, Ilker; Ugur, Hueyin; Erkaymaz, Aysegul; Turan, F. NesrinBackground: Despite new improvements on cardiopulmonary resuscitation (CPR), brain damage is very often after resuscitation. Objective: To assess the prognostic value of cerebral oxygen saturation measurement (rSO(2)) for assessing prognosis on patients after cardiopulmonary resuscitation. Design: Retrospective analysis. Measurements and results: We analyzed 25 post-CPR patients (12 female and 13 male). All the patients were cooled to a target temperature of 33-34 degrees C. The Glascow Coma Scale (GCS), Corneal Reflexes (CR), Pupillary Reflexes (PR), arterial Base Excess (BE) and rSO(2) measurements were taken on admission. The rewarming GCS, CR, PR, BE and rSO(2) measurements were made after the patient's temperature reached 36 degrees C. Results: In survivors, the baseline rSO(2) value was 67.5 (46-70) and the percent difference between baseline and rewarming rSO(2) value was 0.03 (0.014-0.435). In non-survivors, the baseline rSO(2) value was 30 (25-65) and the percent difference between baseline and rewarming rSO(2) value was 0.031 (-0.08 to -20). No statistical difference was detected on percent changes between baseline and rewarming values of rSO(2). Statistically significant difference was detected between baseline and rewarming GCS groups (p = 0.004). No statistical difference was detected between GCS, CR, PR, BE and rSO(2) to determine the prognosis. Conclusion: Despite higher values of rSO(2) on survivors than non-survivors, we found no statistically considerable difference between groups on baseline and the rewarming rSO(2) values. Since the measurement is simple, and not affected by hypotension and hypothermia, the rSO(2) may be a useful predictor for determining the prognosis after CPR. (C) 2016 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda.Öğe Turkish version of the Johns Hopkins Restless Legs Syndrome Quality of Life Questionnaire (RLS-QoL): validity and reliability study(Springer, 2015) Guler, Sibel; Turan, F. NesrinBackground and purpose Restless legs syndrome (RLS), as well as problems secondary to RLS, may worsen the quality of life. Our aim was to modify the Restless Legs Syndrome Quality of Life (RLS-QoL) questionnaire advanced by Abetz (Health Qual Life Outcomes 3:79, 2005) and to analyse the validity and reliability of the questionnaire. Methods Two hundred and one consecutive patients with RLS and forty-three control subjects were included in the study. Permission regarding the translation and validation of the RLS-QoL questionnaire was obtained. The translation was conducted according to the guidelines provided by the publisher. Results For the RLS subjects, the mean Insomnia Severity Index (ISI) score, the International Restless Legs Syndrome Severity Rating Scale (IRLSSG) score and the computed score of the RLS-QoL questionnaire were 22.60 +/- A 3.39, 24.83 +/- A 5.28 and 45.93 +/- A 17.62, respectively. Among the RLS subjects without insomnia, the mean (+/- standard deviation) ISI score, IRLSSG score and computed score of the RLS-QoL questionnaire were 6.67 +/- A 2.34, 15.11 +/- A 4.03 and 41.93 +/- A 16.12, respectively. A significant difference was identified between both groups on all scores (ISI: p = 0.001, RLS: p = 0.001). The groups with and without insomnia were similar regarding the computed score of the RLS-QoL questionnaire (p = 0.140). According to a correlation analysis, a significant correlation was identified between the ISI and IRLSSG or RLS-QoL scores (r = 0.513, p = 0.001 and r = -0.383, p = 0.001, respectively). Although the coefficient of correlation is significant between IRLSSG score and RLS-QoL scale score, it should not be considered as a powerful enough correlation (r = 0.190, p = 0.007). Most items also exhibited a strong correlation with each other. The internal consistency determined by Cronbach's alpha indicated an extremely good correlation (0.975). Discussion These findings suggest the Turkish version of the RLS-QoL questionnaire is a valid and reliable tool for the assessment of the quality of life in patients with RLS.Öğe TURKISH VERSION QUALITY OF LIFE IN ESSENTIAL TREMOR QUESTIONNAIRE (QUEST): VALIDITY AND RELIABILITY STUDY(Literatura Medica, 2015) Guler, Sibel; Turan, F. NesrinBackground - Our aim was to translate the Quality of Life in Essential Tremor Questionnaire (QUEST) advanced by Troster (2005) and to analyse the validity and reliability of this questionnaire. Methods - Two hundred twelve consecutive patients with essential tremor (ET) and forty-three control subjects were included in the study. Permission for the translation and validation of the QUEST scale was obtained. The translation was performed according to the guidelines provided by the publisher. After the translation, the final version of the scale was administered to both groups to determine its reliability and validity. Results - The QUEST Physical, Psychosocial, communication, Hobbies/leisure and Work/finance scores were 0.967, 0.968, 0.933, 0.964 and 0.925, respectively. There were good correlations between each of the QUEST scores that were indicative of good internal consistency. Additionally, we observed that all of the QUEST scores were most strongly related to the right and left arms (p=0.0001). However, we observed that all of the QUEST scores were weakly related to the voice, head and right leg (p=0.0001). Discussion - These findings support the notion that the Turkish version of the Quality of Life in Essential Tremor (QUEST) questionnaire is a valid and reliable tool for the assessment of the quality of life of patients with ET.
