Müge Taşdemir - Academia.edu (original) (raw)
Papers by Müge Taşdemir
Türk Göğüs Kalp Damar Cerrahisi Dergisi, 2006
... Tartışma. İleri sol ventrikül disfonksiyonu (LVD) ile birlikte koroner arter hastalığı (KAH) ... more ... Tartışma. İleri sol ventrikül disfonksiyonu (LVD) ile birlikte koroner arter hastalığı (KAH) olan olguların tedavisi zor ve tartışmalıdır. İleri LVD'li olgularda tıbbi tedavinin, anginanın kontrolünü sağlamada yetersiz kaldığı ve uzun ...
Türk Göğüs Kalp Damar Cerrahisi Dergisi, 2007
... Kalp ameliyatlarından sonra görülebilecek nörolojik ve nöropsikolojik komplikasyonlar iki ana... more ... Kalp ameliyatlarından sonra görülebilecek nörolojik ve nöropsikolojik komplikasyonlar iki ana grupta toplanmıştır. Tip 1 komplikasyonlar (%3-6) inme veya hipoksik ensefalopatiye bağlı ölüm, ölümle sonuçlanmayan yeni inme, geçici iskemik atak, stupor ve komadır. ...
Turkish J Thorac …, 2007
... Gökçen Orhan, Batuhan Özay, Murat Sargın, Mehmet Biçer, Erol Kurç, Müge Taşdemir, Serap Aykut... more ... Gökçen Orhan, Batuhan Özay, Murat Sargın, Mehmet Biçer, Erol Kurç, Müge Taşdemir, Serap Aykut Aka Dr. Siyami Ersek Göğüs Kalp ve Damar Cerrahisi Eğitim ve Araştırma Hastanesi, Kalp ve Damar Cerrahisi Kliniği, İstanbul ...
Texas Heart Institute journal / from the Texas Heart Institute of St. Luke's Episcopal Hospital, Texas Children's Hospital, 2007
In this study, we attempted to determine the role of off-pump coronary artery bypass grafting (CA... more In this study, we attempted to determine the role of off-pump coronary artery bypass grafting (CABG) in the myocardial and systemic inflammatory responses. Twenty patients who underwent elective CABG were enrolled in this study. Ten patients underwent on-pump CABG, and 10 patients underwent off-pump CABG. There were no differences between patients in preoperative clinical variables. We took systemic venous blood samples for the measurement of tumor necrosis factor-alpha, the MB isoenzyme of creatine kinase (CK-MB), and cardiac troponin I, and we took myocardial biopsies from the interventricular septum for chemiluminescence assay of reactive oxygen species (hydroxyl, hydrogen peroxide, hypochlorite, and superoxide). There was no significant difference in the myocardial tissue release of hydrogen peroxide, hydroxyl, hypochlorite, and superoxide between the 2 groups (P > 0.05). The systemic tumor necrosis factor-alpha levels in the off-pump group were significantly lower than in th...
Amaç: Bu çalışmada aortoiliyak tıkayıcı arter hastalıklarının (AİTAH) cerrahi tedavisinde transpe... more Amaç: Bu çalışmada aortoiliyak tıkayıcı arter hastalıklarının (AİTAH) cerrahi tedavisinde transperitoneal (TP) ve retroperitoneal (RP) yaklaşımlar karşılaştırıldı, avantaj ve dezavantajları değerlendirildi. Çalışmaplanı:Ekim 2003-Ağustos 2007 tarihleri arasında AİTAH için cerrahi tedavi uygulanan 55 hasta geriye yönelik olarak değerlendirildi. Çalışmaya alınan hastaların 30’u RP, 25’i TP yöntemiyle ameliyat edildi. Klinik özellikler, risk faktörleri, ameliyat sırası ve sonrası bulgular iki grup arasında analiz edildi ve karşılaştırıldı. Bul gu lar: Klinik özellikler ve risk faktörleri açısından iki grup arasında anlamlı bir fark saptanmadı. Sekiz cerrahi parametreden beşi RP yaklaşım lehine sonuç verdi. Yoğun bakım ünitesinde kalış süresi (p<0.01), hastanede kalış süresi (p<0.01), bağırsak fonksiyonlarının geri dönüş süresi (p<0.01), oral gıda alımına geçiş süresi (p<0.01), efor ağrı skoru (p<0.01) TP yaklaşıma göre anlamlı derecede daha iyiydi. Pulmoner komplika...
Türkiye Klinikleri …, 2009
Amaç: Bu çalışmanın amacı, diğer kalp rahatsızlıkları ile birlikte olan triküspit yetmezliklerind... more Amaç: Bu çalışmanın amacı, diğer kalp rahatsızlıkları ile birlikte olan triküspit yetmezliklerinde De Vega annuloplasti ile yeni bir malzeme olan biodegradable ringin karşılaştırılmasını yapmaktır. Gereç ve Yöntemler: Ocak 2004-Ocak 2008 tarihleri arasında mitral kapak hastalığı yanı ...
In this study, we attempted to determine the role of off-pump coronary artery bypass graft-ing (C... more In this study, we attempted to determine the role of off-pump coronary artery bypass graft-ing (CABG) in the myocardial and systemic inflammatory responses.Twenty patients who underwent elective CABG were enrolled in this study. Ten patients underwent on-pump CABG, and 10 patients underwent off-pump CABG. There were no differences between patients in preoperative clinical variables. We took systemic venous blood samples for the measurement of tumor necrosis factor-
Giris: Bu calismada amac, izole mitral kapak hastaligi nedeniyle mitral kapak replasmani yapilan ... more Giris: Bu calismada amac, izole mitral kapak hastaligi nedeniyle mitral kapak replasmani yapilan olgularda eslik eden hafif, orta, ileri fonksiyonel trikuspid yetmezligi nedeniyle yapilan trikuspid De Vega annuloplastinin uzun donem takipte ventrikul fonksiyonu ve yasam kalitesine etkisini ortaya koymaktir. Hastalar ve Yontem: Klinigimizde Ocak 2008-Temmuz 2008 tarihleri arasinda mitral kapak replasmani uygulanmis 86 hasta calismaya dahil edildi. Hastalar trikuspid kapak patolojisi ve trikuspid kapak tamiri yapilmasina gore gruplara ayrildi. Hastalarin preoperatif demografik verileriyle alti aylik ve 24 aylik ekokardiyografik ozellikleri kaydedildi. Bulgular: Birinci grup izole mitral kapak replasmani yapilan 49 hasta, ikinci grup mitral kapak replasmani ve beraberinde trikuspid De Vega yapilan 37 hastadan olustu. Iki grup arasinda preoperatif demografik veriler ve ekokardiyografik 6. ve 24. aydaki veriler incelendi. Yapilan istatistiksel analizler; trikuspid De Vega yapilan hastala...
Kosuyolu Heart Journal, 2019
Introduction: Pulmonary arterial hypertension (PAH) is an important risk factor for increased mor... more Introduction: Pulmonary arterial hypertension (PAH) is an important risk factor for increased mortality and morbidity during mitral valve surgery. In this study, we analysed the haemodynamic effects of the prostaglandin analogue iloprost in patients with PAH. Patients and Methods: We retrospectively analysed patients with PAH who were undergoing mitral valve surgery and had received intravenous iloprost therapy at our hospital from 1 January 2003 to 31 March 2013. Systemic and pulmonary arterial pressures were measured with catheterisation. The haemodynamic parameters were administered preoperatively and at 0 hours and 24 hours postoperatively. Results: A total of 135 patients had undergone mitral valve operations, of whom 78 patients were administered iloprost during the study period. Of all the cases, 29.9% were male and the average patient age was 54.45 ± 12.48 years. A comparison of the preoperative, hour 0 and hour 24 baseline parameters showed that pulmonary artery pressure and blood pressure statistically significantly decreased at postoperative hour 24 (p< 0.05). Age, preoperative EF and revisions were found to be statistically significant risk factors for mortality (p< 0.0001). Pulmonary pressures did not affect mortality and were not classified as risk factors. Conclusion: Iloprost treatment might improve postoperative outcomes in patients with high pulmonary arterial pressures and with decreasing pulmonary arterial pressures in the early postoperative period. Treatment with iloprost during the mitral valve replacement decreases high pulmonary arterial pressures and the peroperative mortality risk.
Value in Health Regional Issues, 2019
To evaluate the cost of healthcare with respect to the quality of anticoagulation in patients wit... more To evaluate the cost of healthcare with respect to the quality of anticoagulation in patients with deep vein thrombosis (DVT) treated with warfarin in daily practice via the database analysis of a tertiary care center in the period 2010 to 2013. Methods: Of 258 307 records in total, 42 582 unique patients with DVT and 32 012 patients with international normalized ratio (INR) measurements were included. Overall, 6720 unique patients with DVT diagnosis and one or more INR measurements were identified, and the records of 4377 out of 6720 unique patients were validated and included in the analysis data set. The cost analysis was based on direct medical costs from the payer's perspective. Cost items were related to healthcare resource utilization (inpatient and outpatient services) during the study period, which provided a basis for calculation of per-patient, outpatient, inpatient, and total direct medical costs.
Value in Health Regional Issues, 2019
To evaluate the cost of healthcare with respect to the quality of anticoagulation in patients wit... more To evaluate the cost of healthcare with respect to the quality of anticoagulation in patients with deep vein thrombosis (DVT) treated with warfarin in daily practice via the database analysis of a tertiary care center in the period 2010 to 2013. Methods: Of 258 307 records in total, 42 582 unique patients with DVT and 32 012 patients with international normalized ratio (INR) measurements were included. Overall, 6720 unique patients with DVT diagnosis and one or more INR measurements were identified, and the records of 4377 out of 6720 unique patients were validated and included in the analysis data set. The cost analysis was based on direct medical costs from the payer's perspective. Cost items were related to healthcare resource utilization (inpatient and outpatient services) during the study period, which provided a basis for calculation of per-patient, outpatient, inpatient, and total direct medical costs.
Phlebology: The Journal of Venous Disease, 2018
Objective To evaluate the international normalized ratio (INR) monitoring patterns in patients wi... more Objective To evaluate the international normalized ratio (INR) monitoring patterns in patients with deep vein thrombosis. Methods Of 32,012 patients with ≥1 outpatient INR measurement and 42,582 patients with confirmed deep vein thrombosis diagnosis registered to our hospital between 1 January 2010 and 31 December 2013, 6720 records were identified to have both deep vein thrombosis and international normalized ratio measurement, and 4.377 out of 6.720 single patient records were determined to be statistically analyzable. Results Median INR measurement frequency was 6.47 times/year and patients had INR levels of 2–3 in 34.3% of follow-up time. Having ≥70% vs. <70% of follow-up time within therapeutic range was associated with lower hospital admission frequency (9.7 vs. 10.3 times/year). Conclusion Our study revealed only one-third of the follow-up time to be spent within therapeutic INR, association of INR therapeutic range with lesser number of hospital admissions and INR monitor...
Acta Chirurgica Belgica, 2008
The goal was to review our experience in the management of carotid body tumours. A retrospective ... more The goal was to review our experience in the management of carotid body tumours. A retrospective study was performed of patients in whom carotid body tumour was diagnosed between 1998 and 2005. Data were retrieved from hospital discharge files. Fourteen patients were operated on. There were five patients in Shamblin class I, 4 in class II, and 5 in class III. Duplex examination was performed in all patients. Computerized tomography scans were performed in eight (57%) patients and magnetic resonance imaging scans in five patients (36%). Angiography was performed in all patients, preoperative embolization was attempted in 5 (36%). The blood loss for these patients was not less than for those without embolization. Three patients (21%) had postoperative cranial nerve deficits. All the deficits resolved. The internal carotid artery was injured in two patients and the external carotid artery was injured in three patients (36%). No stroke occured. Surgical resection is the treatment of choice for carotid body tumours. Observation of these tumours is not recommended because progressive growth is associated with increased risk of neurological deficits. Early surgical management is recommended to avoid neurological deficit due to a Shamblin class III tumour. We also do not recommend embolization.
Kosuyolu Kalp Dergisi, 2013
Bu çalışmanın amacı profilaktik olarak kullanılan kalsiyum dobesilatın koroner baypas grefti olar... more Bu çalışmanın amacı profilaktik olarak kullanılan kalsiyum dobesilatın koroner baypas grefti olarak safen ven kullanımı sonrası safenektomi komplikasyonlarını azaltmada etkili olup olmadığını göstermektir. Gereç ve Yöntem: Kliniğimizde akut koroner baypas grefti operasyonu yapılmış ardışık toplam 209 elektif koroner baypas olan hasta prospektif olarak taranarak iki gruba ayrıldı. Birinci grup, operasyonu gerçekleştiren ekipler tarafından rutin uygulama ile üç ay boyunca 2 x 500 mg/gün kalsiyum dobesilat verilen 98 hastadan, ikinci grupta ise herhangi bir şekilde operasyon sonrası kalsiyum dobesilat verilmeyen 111 hastadan oluştu. Bacakta gelişen dört potansiyel komplikasyon analiz edilerek birinci hafta, birinci ay ve üçüncü ay sonuçları karşılaştırıldı. Bulgular: Bu çalışmada, koroner baypas ameliyatı için safenektomi yapılan hastalarımızda kalsiyum dobesilat kullanımının; birinci haftada yüzeyel ve debridman gerektiren yara yeri infeksiyonlarında, ilk hafta ve birinci ayda selülit gelişimini önlemede, birinci ay ve üçüncü ayda ödemi azaltmada etkili olduğu görülmüştür. Sonuç: Koroner baypas operasyonu için greft olarak safen ven kullanılan hastalarda safenektomi komplikasyonları azalmak için üç ay süreyle kalsiyum dobesilat 2 x 500 mg/gün dozunda kullanımı önerilir.
Turkish J Thorac …, 2008
Bu çalışmanın amacı normal ve azalmış respiratuvar kapasiteli, aorta koroner bypass cerrahisi ve ... more Bu çalışmanın amacı normal ve azalmış respiratuvar kapasiteli, aorta koroner bypass cerrahisi ve kardiyopulmoner bypass geçiren hastalarda pulmoner fonksiyonları ve vasküler endotelyal nitrik oksit (NO) salınımı ile birlikte bronşiyal NO salınımındaki değişimleri değerlendirmektir. Çalışma planı: Yirmi normal pulmoner fonksiyonlara sahip hasta ile 20 azalmış pulmoner fonksiyonlu hasta çalışmaya dahil edildi. Entübasyondan hemen sonra, kardiyopulmoner bypass sonrası ve ameliyat sonrası altıncı saatte endotrakeal aspirasyon ve plazma örnekleri alındı. Respiratuvar fonksiyon durumları, bronşiyal ve vasküler NO salınımları değerlendirildi. Bulgular: Her iki grupta da, plazma ve bronşiyal NO salınımı ve respiratuvar kapasite kardiyopulmoner bypass sonrası yavaşça azaldı; respiratuvar indeks değerleri önemli derecede kötüleşti. Sonuç: Bu bulgular, kardiyopulmoner bypass'a girecek olan kronik obstrüktif akciğer hastalığı bulunanların, normal respiratuvar kapasiteli hastalarla benzer akciğer hasarına maruz kaldıklarını göstermiştir. Anahtar sözcükler: Kardiyopulmoner bypass; koroner arter bypass; akciğer kapasitesi ölçümü; nitrik oksit. Background: The aim of this study is to evaluate the pulmonary function and define the alterations in bronchial nitric oxide (NO) release in correlation with the vascular endothelial NO release in patients with normal and decreased respiratory capacity undergoing coronary artery bypass graft surgery under cardiopulmonary bypass. Methods: Twenty patients with normal pulmonary functions and 20 patients with decreased respiratory function were involved in the study. Endotracheal aspiration samples and plasma samples were obtained just after the entubation, at the end of the cardiopulmonary bypass and at the postoperative sixth hour. The respiratory functional status, bronchial NO release and vascular NO release were evaluated. Results: The NO levels in plasma and bronchial samples, and respiratory capacity were gradually decreased; and respiratory index values significantly deteriorated in both groups. Conclusion: These findings show that patients with chronic obstructive lung disease undergoing cardiopulmonary bypass have similar lung damage with patients who have normal respiratory capacity.
Kosuyolu Kalp Dergisi, 2012
Kosuyolu Kalp Dergisi, 2012
Kosuyolu Kalp Dergisi, 2013
Türk Göğüs Kalp Damar Cerrahisi Dergisi, 2006
... Tartışma. İleri sol ventrikül disfonksiyonu (LVD) ile birlikte koroner arter hastalığı (KAH) ... more ... Tartışma. İleri sol ventrikül disfonksiyonu (LVD) ile birlikte koroner arter hastalığı (KAH) olan olguların tedavisi zor ve tartışmalıdır. İleri LVD&#x27;li olgularda tıbbi tedavinin, anginanın kontrolünü sağlamada yetersiz kaldığı ve uzun ...
Türk Göğüs Kalp Damar Cerrahisi Dergisi, 2007
... Kalp ameliyatlarından sonra görülebilecek nörolojik ve nöropsikolojik komplikasyonlar iki ana... more ... Kalp ameliyatlarından sonra görülebilecek nörolojik ve nöropsikolojik komplikasyonlar iki ana grupta toplanmıştır. Tip 1 komplikasyonlar (%3-6) inme veya hipoksik ensefalopatiye bağlı ölüm, ölümle sonuçlanmayan yeni inme, geçici iskemik atak, stupor ve komadır. ...
Turkish J Thorac …, 2007
... Gökçen Orhan, Batuhan Özay, Murat Sargın, Mehmet Biçer, Erol Kurç, Müge Taşdemir, Serap Aykut... more ... Gökçen Orhan, Batuhan Özay, Murat Sargın, Mehmet Biçer, Erol Kurç, Müge Taşdemir, Serap Aykut Aka Dr. Siyami Ersek Göğüs Kalp ve Damar Cerrahisi Eğitim ve Araştırma Hastanesi, Kalp ve Damar Cerrahisi Kliniği, İstanbul ...
Texas Heart Institute journal / from the Texas Heart Institute of St. Luke's Episcopal Hospital, Texas Children's Hospital, 2007
In this study, we attempted to determine the role of off-pump coronary artery bypass grafting (CA... more In this study, we attempted to determine the role of off-pump coronary artery bypass grafting (CABG) in the myocardial and systemic inflammatory responses. Twenty patients who underwent elective CABG were enrolled in this study. Ten patients underwent on-pump CABG, and 10 patients underwent off-pump CABG. There were no differences between patients in preoperative clinical variables. We took systemic venous blood samples for the measurement of tumor necrosis factor-alpha, the MB isoenzyme of creatine kinase (CK-MB), and cardiac troponin I, and we took myocardial biopsies from the interventricular septum for chemiluminescence assay of reactive oxygen species (hydroxyl, hydrogen peroxide, hypochlorite, and superoxide). There was no significant difference in the myocardial tissue release of hydrogen peroxide, hydroxyl, hypochlorite, and superoxide between the 2 groups (P > 0.05). The systemic tumor necrosis factor-alpha levels in the off-pump group were significantly lower than in th...
Amaç: Bu çalışmada aortoiliyak tıkayıcı arter hastalıklarının (AİTAH) cerrahi tedavisinde transpe... more Amaç: Bu çalışmada aortoiliyak tıkayıcı arter hastalıklarının (AİTAH) cerrahi tedavisinde transperitoneal (TP) ve retroperitoneal (RP) yaklaşımlar karşılaştırıldı, avantaj ve dezavantajları değerlendirildi. Çalışmaplanı:Ekim 2003-Ağustos 2007 tarihleri arasında AİTAH için cerrahi tedavi uygulanan 55 hasta geriye yönelik olarak değerlendirildi. Çalışmaya alınan hastaların 30’u RP, 25’i TP yöntemiyle ameliyat edildi. Klinik özellikler, risk faktörleri, ameliyat sırası ve sonrası bulgular iki grup arasında analiz edildi ve karşılaştırıldı. Bul gu lar: Klinik özellikler ve risk faktörleri açısından iki grup arasında anlamlı bir fark saptanmadı. Sekiz cerrahi parametreden beşi RP yaklaşım lehine sonuç verdi. Yoğun bakım ünitesinde kalış süresi (p<0.01), hastanede kalış süresi (p<0.01), bağırsak fonksiyonlarının geri dönüş süresi (p<0.01), oral gıda alımına geçiş süresi (p<0.01), efor ağrı skoru (p<0.01) TP yaklaşıma göre anlamlı derecede daha iyiydi. Pulmoner komplika...
Türkiye Klinikleri …, 2009
Amaç: Bu çalışmanın amacı, diğer kalp rahatsızlıkları ile birlikte olan triküspit yetmezliklerind... more Amaç: Bu çalışmanın amacı, diğer kalp rahatsızlıkları ile birlikte olan triküspit yetmezliklerinde De Vega annuloplasti ile yeni bir malzeme olan biodegradable ringin karşılaştırılmasını yapmaktır. Gereç ve Yöntemler: Ocak 2004-Ocak 2008 tarihleri arasında mitral kapak hastalığı yanı ...
In this study, we attempted to determine the role of off-pump coronary artery bypass graft-ing (C... more In this study, we attempted to determine the role of off-pump coronary artery bypass graft-ing (CABG) in the myocardial and systemic inflammatory responses.Twenty patients who underwent elective CABG were enrolled in this study. Ten patients underwent on-pump CABG, and 10 patients underwent off-pump CABG. There were no differences between patients in preoperative clinical variables. We took systemic venous blood samples for the measurement of tumor necrosis factor-
Giris: Bu calismada amac, izole mitral kapak hastaligi nedeniyle mitral kapak replasmani yapilan ... more Giris: Bu calismada amac, izole mitral kapak hastaligi nedeniyle mitral kapak replasmani yapilan olgularda eslik eden hafif, orta, ileri fonksiyonel trikuspid yetmezligi nedeniyle yapilan trikuspid De Vega annuloplastinin uzun donem takipte ventrikul fonksiyonu ve yasam kalitesine etkisini ortaya koymaktir. Hastalar ve Yontem: Klinigimizde Ocak 2008-Temmuz 2008 tarihleri arasinda mitral kapak replasmani uygulanmis 86 hasta calismaya dahil edildi. Hastalar trikuspid kapak patolojisi ve trikuspid kapak tamiri yapilmasina gore gruplara ayrildi. Hastalarin preoperatif demografik verileriyle alti aylik ve 24 aylik ekokardiyografik ozellikleri kaydedildi. Bulgular: Birinci grup izole mitral kapak replasmani yapilan 49 hasta, ikinci grup mitral kapak replasmani ve beraberinde trikuspid De Vega yapilan 37 hastadan olustu. Iki grup arasinda preoperatif demografik veriler ve ekokardiyografik 6. ve 24. aydaki veriler incelendi. Yapilan istatistiksel analizler; trikuspid De Vega yapilan hastala...
Kosuyolu Heart Journal, 2019
Introduction: Pulmonary arterial hypertension (PAH) is an important risk factor for increased mor... more Introduction: Pulmonary arterial hypertension (PAH) is an important risk factor for increased mortality and morbidity during mitral valve surgery. In this study, we analysed the haemodynamic effects of the prostaglandin analogue iloprost in patients with PAH. Patients and Methods: We retrospectively analysed patients with PAH who were undergoing mitral valve surgery and had received intravenous iloprost therapy at our hospital from 1 January 2003 to 31 March 2013. Systemic and pulmonary arterial pressures were measured with catheterisation. The haemodynamic parameters were administered preoperatively and at 0 hours and 24 hours postoperatively. Results: A total of 135 patients had undergone mitral valve operations, of whom 78 patients were administered iloprost during the study period. Of all the cases, 29.9% were male and the average patient age was 54.45 ± 12.48 years. A comparison of the preoperative, hour 0 and hour 24 baseline parameters showed that pulmonary artery pressure and blood pressure statistically significantly decreased at postoperative hour 24 (p< 0.05). Age, preoperative EF and revisions were found to be statistically significant risk factors for mortality (p< 0.0001). Pulmonary pressures did not affect mortality and were not classified as risk factors. Conclusion: Iloprost treatment might improve postoperative outcomes in patients with high pulmonary arterial pressures and with decreasing pulmonary arterial pressures in the early postoperative period. Treatment with iloprost during the mitral valve replacement decreases high pulmonary arterial pressures and the peroperative mortality risk.
Value in Health Regional Issues, 2019
To evaluate the cost of healthcare with respect to the quality of anticoagulation in patients wit... more To evaluate the cost of healthcare with respect to the quality of anticoagulation in patients with deep vein thrombosis (DVT) treated with warfarin in daily practice via the database analysis of a tertiary care center in the period 2010 to 2013. Methods: Of 258 307 records in total, 42 582 unique patients with DVT and 32 012 patients with international normalized ratio (INR) measurements were included. Overall, 6720 unique patients with DVT diagnosis and one or more INR measurements were identified, and the records of 4377 out of 6720 unique patients were validated and included in the analysis data set. The cost analysis was based on direct medical costs from the payer's perspective. Cost items were related to healthcare resource utilization (inpatient and outpatient services) during the study period, which provided a basis for calculation of per-patient, outpatient, inpatient, and total direct medical costs.
Value in Health Regional Issues, 2019
To evaluate the cost of healthcare with respect to the quality of anticoagulation in patients wit... more To evaluate the cost of healthcare with respect to the quality of anticoagulation in patients with deep vein thrombosis (DVT) treated with warfarin in daily practice via the database analysis of a tertiary care center in the period 2010 to 2013. Methods: Of 258 307 records in total, 42 582 unique patients with DVT and 32 012 patients with international normalized ratio (INR) measurements were included. Overall, 6720 unique patients with DVT diagnosis and one or more INR measurements were identified, and the records of 4377 out of 6720 unique patients were validated and included in the analysis data set. The cost analysis was based on direct medical costs from the payer's perspective. Cost items were related to healthcare resource utilization (inpatient and outpatient services) during the study period, which provided a basis for calculation of per-patient, outpatient, inpatient, and total direct medical costs.
Phlebology: The Journal of Venous Disease, 2018
Objective To evaluate the international normalized ratio (INR) monitoring patterns in patients wi... more Objective To evaluate the international normalized ratio (INR) monitoring patterns in patients with deep vein thrombosis. Methods Of 32,012 patients with ≥1 outpatient INR measurement and 42,582 patients with confirmed deep vein thrombosis diagnosis registered to our hospital between 1 January 2010 and 31 December 2013, 6720 records were identified to have both deep vein thrombosis and international normalized ratio measurement, and 4.377 out of 6.720 single patient records were determined to be statistically analyzable. Results Median INR measurement frequency was 6.47 times/year and patients had INR levels of 2–3 in 34.3% of follow-up time. Having ≥70% vs. <70% of follow-up time within therapeutic range was associated with lower hospital admission frequency (9.7 vs. 10.3 times/year). Conclusion Our study revealed only one-third of the follow-up time to be spent within therapeutic INR, association of INR therapeutic range with lesser number of hospital admissions and INR monitor...
Acta Chirurgica Belgica, 2008
The goal was to review our experience in the management of carotid body tumours. A retrospective ... more The goal was to review our experience in the management of carotid body tumours. A retrospective study was performed of patients in whom carotid body tumour was diagnosed between 1998 and 2005. Data were retrieved from hospital discharge files. Fourteen patients were operated on. There were five patients in Shamblin class I, 4 in class II, and 5 in class III. Duplex examination was performed in all patients. Computerized tomography scans were performed in eight (57%) patients and magnetic resonance imaging scans in five patients (36%). Angiography was performed in all patients, preoperative embolization was attempted in 5 (36%). The blood loss for these patients was not less than for those without embolization. Three patients (21%) had postoperative cranial nerve deficits. All the deficits resolved. The internal carotid artery was injured in two patients and the external carotid artery was injured in three patients (36%). No stroke occured. Surgical resection is the treatment of choice for carotid body tumours. Observation of these tumours is not recommended because progressive growth is associated with increased risk of neurological deficits. Early surgical management is recommended to avoid neurological deficit due to a Shamblin class III tumour. We also do not recommend embolization.
Kosuyolu Kalp Dergisi, 2013
Bu çalışmanın amacı profilaktik olarak kullanılan kalsiyum dobesilatın koroner baypas grefti olar... more Bu çalışmanın amacı profilaktik olarak kullanılan kalsiyum dobesilatın koroner baypas grefti olarak safen ven kullanımı sonrası safenektomi komplikasyonlarını azaltmada etkili olup olmadığını göstermektir. Gereç ve Yöntem: Kliniğimizde akut koroner baypas grefti operasyonu yapılmış ardışık toplam 209 elektif koroner baypas olan hasta prospektif olarak taranarak iki gruba ayrıldı. Birinci grup, operasyonu gerçekleştiren ekipler tarafından rutin uygulama ile üç ay boyunca 2 x 500 mg/gün kalsiyum dobesilat verilen 98 hastadan, ikinci grupta ise herhangi bir şekilde operasyon sonrası kalsiyum dobesilat verilmeyen 111 hastadan oluştu. Bacakta gelişen dört potansiyel komplikasyon analiz edilerek birinci hafta, birinci ay ve üçüncü ay sonuçları karşılaştırıldı. Bulgular: Bu çalışmada, koroner baypas ameliyatı için safenektomi yapılan hastalarımızda kalsiyum dobesilat kullanımının; birinci haftada yüzeyel ve debridman gerektiren yara yeri infeksiyonlarında, ilk hafta ve birinci ayda selülit gelişimini önlemede, birinci ay ve üçüncü ayda ödemi azaltmada etkili olduğu görülmüştür. Sonuç: Koroner baypas operasyonu için greft olarak safen ven kullanılan hastalarda safenektomi komplikasyonları azalmak için üç ay süreyle kalsiyum dobesilat 2 x 500 mg/gün dozunda kullanımı önerilir.
Turkish J Thorac …, 2008
Bu çalışmanın amacı normal ve azalmış respiratuvar kapasiteli, aorta koroner bypass cerrahisi ve ... more Bu çalışmanın amacı normal ve azalmış respiratuvar kapasiteli, aorta koroner bypass cerrahisi ve kardiyopulmoner bypass geçiren hastalarda pulmoner fonksiyonları ve vasküler endotelyal nitrik oksit (NO) salınımı ile birlikte bronşiyal NO salınımındaki değişimleri değerlendirmektir. Çalışma planı: Yirmi normal pulmoner fonksiyonlara sahip hasta ile 20 azalmış pulmoner fonksiyonlu hasta çalışmaya dahil edildi. Entübasyondan hemen sonra, kardiyopulmoner bypass sonrası ve ameliyat sonrası altıncı saatte endotrakeal aspirasyon ve plazma örnekleri alındı. Respiratuvar fonksiyon durumları, bronşiyal ve vasküler NO salınımları değerlendirildi. Bulgular: Her iki grupta da, plazma ve bronşiyal NO salınımı ve respiratuvar kapasite kardiyopulmoner bypass sonrası yavaşça azaldı; respiratuvar indeks değerleri önemli derecede kötüleşti. Sonuç: Bu bulgular, kardiyopulmoner bypass'a girecek olan kronik obstrüktif akciğer hastalığı bulunanların, normal respiratuvar kapasiteli hastalarla benzer akciğer hasarına maruz kaldıklarını göstermiştir. Anahtar sözcükler: Kardiyopulmoner bypass; koroner arter bypass; akciğer kapasitesi ölçümü; nitrik oksit. Background: The aim of this study is to evaluate the pulmonary function and define the alterations in bronchial nitric oxide (NO) release in correlation with the vascular endothelial NO release in patients with normal and decreased respiratory capacity undergoing coronary artery bypass graft surgery under cardiopulmonary bypass. Methods: Twenty patients with normal pulmonary functions and 20 patients with decreased respiratory function were involved in the study. Endotracheal aspiration samples and plasma samples were obtained just after the entubation, at the end of the cardiopulmonary bypass and at the postoperative sixth hour. The respiratory functional status, bronchial NO release and vascular NO release were evaluated. Results: The NO levels in plasma and bronchial samples, and respiratory capacity were gradually decreased; and respiratory index values significantly deteriorated in both groups. Conclusion: These findings show that patients with chronic obstructive lung disease undergoing cardiopulmonary bypass have similar lung damage with patients who have normal respiratory capacity.
Kosuyolu Kalp Dergisi, 2012
Kosuyolu Kalp Dergisi, 2012
Kosuyolu Kalp Dergisi, 2013