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Öğe Determining the efficiency of different malnutrition tests in septic patients(Reial Acad Medicina Illes Balears, 2021) Inal, Mehmet Turan; Memis, Dilek; Tek, Seyda Cigdem; Uyar, Ahmet Senol; Ozel, Muhammet Fatih; Ciftci, Taner; Turan, Fatma NesrinBackground and aims: Malnutrition is frequently detected in septic patients and is important cause of mortality. Methods: Numerical rating Scale 2002, Nutrition risk in the critically ill score and adductor pollicis thickness measurement are used to determine malnutrition in 287 septic patients. Results: The mean age was 66,57 +/- 16,31 years. The mean APACHE II score was 16,19 +/- 8,20 while the mean SOFA score was 5,89 +/- 3,49. To NRS 2002 test 171 was accepted as high malnutrition risk while 116 patients was accepted as low malnutrition risk. According to Nutric test, the risk of malnutrition was found to be low in 144 patients and found to be high in 143 patients. The mean APTM was detected as 20,20 +/- 2,21 mm. The cuff-off point for APTM was found as <= 21 mm. Conclusions: high risk of malnutrition was frequently observed in patients with sepsis and mortality was higher in high risk patients. Higher sensitivity was achieved when the tests were combined with each other. As a result, we recommend the use of malnutrition screening tests in patients with sepsis and combining the tests with each other.Öğe Evaluation of Pre-Delirium Score in Intensive Care Patients(Galenos Yayincilik, 2018) Inal, Mehmet Turan; Memis, Dilek; Inal, Volkan; Uyar, Ahmet Senol; Tek, Seyda Cigdem; Ciftci, Taner; Efe, SerdarObjective: Delirium is frequently seen in intensive care patients and causes prolongation of mechanical ventilation and intensive care stay. In intensive care patients, the pre-delirium score is a test used to detect delirium. We aimed to determine the prognostic value of the pre-delirium score in patients who stayed more than 24 hours in our intensive care unit. Materials and Methods: Between January 1, 2016 and December 31, 2016, pre-delirium scores were calculated for all patients stayed more than 24 hours in surgery, reanimation and internal medicine intensive care units. Pre-delirium score >= 50 was accepted as group 1 and <50 was accepted as group 2. The groups were compared with each other in terms of gender, age, Acute Physiology and Chronic Health Evaluation (APACHE II) scores, duration of hospitalization and mortality rates. Results: While a high pre-delirium score was determined in 196 patients (39.2%), a low pre-delirium score was determined in 304 cases (60.8%) (group 2). In group 1, the mean age was 68.47 +/- 15.83 years and the mean APACHE II score was 22.47 +/- 7.75; in group 2 the mean age was 59.18 +/- 18.48 years and the mean APACHE II score was 15.71 +/- 7.87, which was found significantly higher than group 1 (p<0.05). In group 1, the duration of hospitalization was 19.93 +/- 23.46 days and the mortality rate was 65.3%; in group 2, the duration of hospitalization was 13.02 +/- 20.01 days and the mortality rate was 40.5%. Significant difference determined in terms of duration of hospitalization and mortality (p<0.05). Conclusion: Early recognition and treatment of delirium will lead to significant improvements in the prognosis of intensive care unit patients. We think that the predelirium score can also be used as an important prognostic test in intensive care unit patients.Öğe Posterior Reversible Encephalopathy Syndrome: Two Case Reports(Galenos Yayincilik, 2019) Tek, Seyda Cigdem; Uyar, Ahmet Senol; Cakici, Zafer; Inal, Mehmet Turan; Memis, Dilek; Tekatac, Aslan; Sayin, CenkPosterior reversible encephalopathy (PRES) syndrome is a clinical-radiological condition characterized by headache, changes in consciousness, epilepsy and visual disturbances, and usually occurs in the posterior parietal and occipital regions with vasogenic edema due to different etiologic factors. Risk factors include preeclampsia/eclampsia as well as hypertension, human immunodeficiency virus infection, organ transplantation, immunosuppressive and cytotoxic therapy, and analgesics. Treatment is usually aimed at correcting the cause of PRES. The aim of this case report was to present the characteristics of PRES, which was secondary to eclampsia in two cases, to discuss the differential diagnosis and to review the literature.Öğe Simplified Weaning After Use of Quetiapine in a Patient: Case Report(Galenos Yayincilik, 2020) Inal, Mehmet Turan; Memis, Dilek; Demir, Emin Tunc; Uyar, Ahmet Senol; Arslan, Ismail; Bozkurtlu, PoyrazDelirium is an organic dysfunction including the brain's inflammatory response to injury, hormonal effects and changes in neurotransmission and neural network. Delirium is one of the major causes of weaning difficulty in intensive care unit (ICU) patients. In this case report, we tried to explain the successful weaning procedure in a patient using quetiapine after trying all treatment options due to delirium in the ICU. This report emphasizes that second-generation antipsychotics should be kept in mind in patients who cannot be disconnected from the mechanical ventilator due to delirium.Öğe Spontaneous Repetitive Tracheal Rupture(Galenos Yayincilik, 2019) Inal, Mehmet Turan; Memis, Dilek; Tuncbilek, Nermin; Tek, Seyda; Uyar, Ahmet Senol; Budak, Hasan; Yanik, FazliTracheal ruptures are one of the life-threatening situations in critical care unit and can be formed after trauma, intubation, tracheotomy, bronchoscopy or spontaneously. Significant risk factors for tracheal rupture include urgent intubation, use of stilet, high cuff pressure, recurrent intubation attempts, double lumen endotracheal tubes, very thick endotracheal tubes, female gender, short height, older age, tracheomalacia, tracheal stenosis, congenital tracheal abnormalities and chronic steroid therapy. Among these risk factors, corticosteroids can cause rupture by inhibiting collagen synthesis and reducing connective tissue stability. In this case report, a case with spontaneous recurrent tracheal rupture was defined and the underlying mechanisms and therapeutic approach to this complication that could be seen in patients using chronic steroids were discussed.
