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Balik AÖ, Özgültekin A, Aksoy Y. Transient bilateral third cranial nerve palsy following traumatic perimesencephalic subarachnoid haemorrhage. Br J Hosp Med (Lond) 2023; 84:1. [PMID: 36708344 DOI: 10.12968/hmed.2022.0341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Affiliation(s)
- Ayşe Ö Balik
- Department of Radiology, Haydarpaşa Numune Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Asu Özgültekin
- Department of Anesthesiology and Intensive Care, Haydarpaşa Numune Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Yener Aksoy
- Department of Anesthesiology and Intensive Care, Haydarpaşa Numune Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
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Çolak Ş, Genç Yavuz B, Yavuz M, Özçelik B, Öner M, Özgültekin A, Şenbayrak S. Effectiveness of ozone therapy in addition to conventional treatment on mortality in patients with COVID-19. Int J Clin Pract 2021; 75:e14321. [PMID: 33971067 PMCID: PMC8236993 DOI: 10.1111/ijcp.14321] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 04/01/2021] [Accepted: 05/03/2021] [Indexed: 01/08/2023] Open
Abstract
AIM In this study, we aimed to investigate the effectiveness of ozone therapy, which is one of the integrative medicine applications that has been used safely for many years, on the prevalence of mortality in patients receiving COVID-19 treatment. METHODS This was a prospective, controlled study conducted on patients with COVID-19 who were hospitalised. In this study, 55 patients were included. The patients were divided into two groups as the ozone and control group. Ozone therapy (major autohemotherapy) was applied to 37 patients who were being treated with the appropriate COVID-19 treatment protocol determined by the infectious diseases committee of our hospital. The ozone treatment protocol consisted of seven sessions (one session per day) of intravenous ozone administration, applied in a volume of 100 mL and a concentration of 30 μg/mL. Only the conventional COVID-19 treatment protocol was applied to 18 patients in the control group. Clinical follow-up was performed until the discharge of the patients from the hospital with successful treatment or until the mortality occurred. Factors affecting mortality were analysed using univariate regression analysis. RESULTS Intensive care unit (ICU) hospitalisation was required in 6 of the 37 patients who were treated with ozone (16.2%), while 4 of 18 patients in the control group required ICU treatment (22.2%) (P = .713). When the mortality rates between the two groups were compared, mortality was lower in the ozone group (P = .032). As a result of univariate logistic regression analysis performed to investigate the factors affecting mortality, treatment with ozone therapy was determined as a risk factor for mortality. Patients receiving ozone therapy appear to have a lower mortality risk (odds ratio [OR]: 0.149, 95% confidence interval [CI] 0.026-0.863, P = .034). CONCLUSION In this study, the findings suggested that the administration of ozone therapy along with the conventional medical treatment in patients hospitalised for COVID-19 could reduce mortality.
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Affiliation(s)
- Şahin Çolak
- Haydarpaşa Numune Training and Research HospitalDepartment of Emergency MedicineUniversity of Health SciencesIstanbulTurkey
| | - Burcu Genç Yavuz
- Haydarpaşa Numune Training and Research HospitalDepartment of Emergency MedicineUniversity of Health SciencesIstanbulTurkey
| | - Mürsel Yavuz
- Kosuyolu Rezonans ClinicIntegrative MedicineIstanbulTurkey
| | - Burak Özçelik
- Haydarpaşa Numune Training and Research HospitalDepartment of Emergency MedicineUniversity of Health SciencesIstanbulTurkey
| | - Metin Öner
- Haydarpaşa Numune Training and Research HospitalDepartment of Emergency MedicineUniversity of Health SciencesIstanbulTurkey
| | - Asu Özgültekin
- Haydarpasa Numune Training and Research HospitalDepartment of Anesthesiology and Intensive CareUniversity of Health SciencesIstanbulTurkey
| | - Seniha Şenbayrak
- Haydarpasa Numune Training and Research HospitalDepartment of Infectious Disease and Clinical MicrobiologyUniversity of Health SciencesIstanbulTurkey
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Coşkun E, Dinçer E, Turan G, Özgültekin A. Postoperative Analgesic Efficacy of Preemptive and Postoperative Lornoxicam or Tramadol in Lumbar Disc Surgery. Turk J Anaesthesiol Reanim 2019; 47:375-381. [PMID: 31572987 DOI: 10.5152/tjar.2019.60963] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Accepted: 10/24/2018] [Indexed: 11/22/2022] Open
Abstract
Objective To compare preemptive and postoperative analgesic efficacy of tramadol and lornoxicam administered before anaesthesia induction in lumbar discectomy. Methods This randomised, double-blind trial was conducted on 60 ASA I and II patients undergoing lumbar discectomy. Group L (n=30) received 3×8 mg day-1 lornoxicam, and Group T (n=30) received 3×1.5 mg kg-1 day-1 tramadol. A verbal rating scale (VRS), the duration of effective analgesia, the number of additional analgesics used, adverse effects and patient satisfaction were evaluated at the postoperative 30th minute and 1st, 2nd, 4th, 6th, 8th, 12th and 24th hours. Results There were no significant differences between Groups L and T regarding demographic and clinical characteristics, the number of additional analgesics and the duration of effective analgesia, adverse effects and patient satisfaction. VRS scores of the patients in Group T were significantly higher than those in Group L at the postoperative 30th minute (p=0.050) and the 1st hour (p=0.005). Conclusion Lornoxicam, which was used for preemptive and postoperative analgesia in lumbar disc surgery, had provided adequate and effective analgesia such as tramadol. Moreover, preemptive analgesia was quite effective in prevention and treatment of postoperative pain.
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Affiliation(s)
- Esma Coşkun
- Department of Anaesthesiology and Reanimation, Private Mozaik Hospital, Hatay, Turkey
| | - Emine Dinçer
- Clinic of Anaesthesiology and Reanimation, Haydarpaşa Numune Training and Research Hospital, İstanbul, Turkey
| | - Güldem Turan
- Clinic of Anaesthesiology and Reanimation, Fatih Sultan Mehmet Training and Research Hospital, İstanbul, Turkey
| | - Asu Özgültekin
- Clinic of Anaesthesiology and Reanimation, Haydarpaşa Numune Training and Research Hospital, İstanbul, Turkey
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Isik B, Turan G, Abitagaoglu S, Ekinci O, Özgültekin A. A comparison of the effects of desflurane and total intravenous anaesthesia on the motor evoked responses in scoliosis surgery. ACTA ACUST UNITED AC 2017. [DOI: 10.18203/2320-6012.ijrms20170654] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Background: In the present study, we compared the effects of total intravenous anaesthesia (TIVA) and desflurane anaesthesia on tcMEPs in scoliosis surgery.Methods: The study included 45 patients between the ages of 18 to 50 years, and classified as ASAI-II; which were planned to undergo posterior fusion/instrumentation operations for elective scoliosis. Anaesthesia was maintained using 50-150 mcg/kg/min propofol in Group T(TIVA), and desflurane (0.5 MAC) in Group D, and with infusions of 0.05-0.3 mcg/kg/min remifentanil at 50 % O2 + air in both groups, by applying drugs at doses so that bispectral index (BIS) would be maintained between 40 and 60 throughout the course of anaesthesia. The tcMEP responses were measured four times during the operation, and BIS, train-of-four (TOF), mean arterial pressure (MAP), heart rate(HR), and end tidal CO2(ETCO2) values were recorded simultaneously. In both group the anaesthesia was ended at the final surgical suture. The recovery parameters were recorded.Results: The groups were found not to differ regarding the demographic characteristics, duration of the anaesthesia and the surgery, remifentanil dosage, tcMEP, the simultaneously recorded TOF, MAP, HR and ETCO2 values, and the amount of perioperative bleeding. The cooperation time and the orientation time were shorter in group D. The tcMEP responses were recorded in the appropriate times and amplitudes in both groups. Conclusions: TIVA is primarily used in routine applications in spinal surgery; however our study results revealed that 0.5 MAC desflurane may also be safely used in association with remifentanil, with the resultant correct tcMEP responses.
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Leblebicioglu H, Koksal I, Rosenthal VD, Akan ÖA, Özgültekin A, Kendirli T, Erben N, Yalcin AN, Ulusoy S, Sirmatel F, Ozdemir D, Alp E, Yıldızdaş D, Esen S, Ulger F, Dilek A, Yilmaz H, Yýlmaz G, Kaya S, Ulusoy H, Tulunay M, Oral M, Ünal N, Turan G, Akgün N, İnan A, Ince E, Karbuz A, Çiftçi E, Taşyapar N, Güneş M, Ozgunes I, Usluer G, Turhan O, Gunay N, Gumus E, Dursun O, Arda B, Bacakoglu F, Cengiz M, Yilmaz L, Geyik MF, Şahin A, Erdogan S, Kılıc AU, Horoz OO. Impact of the International Nosocomial Infection Control Consortium (INICC) Multidimensional Hand Hygiene Approach, over 8 years, in 11 cities of Turkey. J Infect Prev 2014; 16:146-154. [PMID: 28989420 DOI: 10.1177/1757177414560249] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2014] [Accepted: 10/19/2014] [Indexed: 12/12/2022] Open
Abstract
AIMS To evaluate the effectiveness of the International Nosocomial Infection Control Consortium (INICC) Multidimensional Hand Hygiene Approach in Turkey and analyse predictors of poor hand hygiene compliance. DESIGN An observational, prospective, interventional, before-and-after study was conducted from August 2003 to August 2011 in 12 intensive care units (ICU) of 12 hospitals in 11 cities. The study was divided into a baseline and a follow-up period and included random 30-minute observations for hand hygiene compliance in ICU. The hand hygiene approach included administrative support, supplies availability, education and training, reminders in the workplace, process surveillance, and performance feedback. RESULTS We observed 21,145 opportunities for hand hygiene. Overall hand hygiene compliance increased from 28.8% to 91% (95% CI 87.6-93.0, p 0.0001). Multivariate and univariate analyses showed that several variables were significantly associated with poor hand hygiene compliance: males vs. females (39% vs. 48%; 95% CI 0.79-0.84, p 0.0001), ancillary staff vs. physicians (35% vs. 46%, 95% CI 0.73-0.78, p 0.0001), and adult vs. pediatric ICUs (42% vs. 74%, 95% CI 0.54-0.60, p 0.0001). CONCLUSIONS Adherence to hand hygiene was significantly increased with the INICC Hand Hygiene Approach. Specific programmes should be directed to improve hand hygiene in variables found to be predictors of poor hand hygiene compliance.
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Affiliation(s)
| | - Iftihar Koksal
- Karadeniz Technical University School of Medicine, Trabzon, Turkey
| | - Victor D Rosenthal
- International Nosocomial Infection Control Consortium (INICC), Buenos Aires, Argentina
| | - Özay Arıkan Akan
- Ankara University School of Medicine, Ibni-Sina Hospital, Ankara, Turkey
| | - Asu Özgültekin
- Haydarpaşa Numune Training and Research Hospital, Istanbul, Turkey
| | - Tanil Kendirli
- Department of Pediatric Critical Care Medicine, Ankara University School of Medicine, Ankara, Turkey
| | | | | | | | | | - Davut Ozdemir
- Duzce University Medical School Infectious Diseases and Clinical Microbiology, Duzce, Turkey
| | - Emine Alp
- Erciyes University, Faculty of Medicine, Kayseri, Turkey
| | | | - Saban Esen
- Ondokuz Mayis University Medical School, Samsun, Turkey
| | - Fatma Ulger
- Ondokuz Mayis University Medical School, Samsun, Turkey
| | - Ahmet Dilek
- Ondokuz Mayis University Medical School, Samsun, Turkey
| | - Hava Yilmaz
- Ondokuz Mayis University Medical School, Samsun, Turkey
| | - Gürdal Yýlmaz
- Karadeniz Technical University School of Medicine, Trabzon, Turkey
| | - Selçuk Kaya
- Karadeniz Technical University School of Medicine, Trabzon, Turkey
| | - Hülya Ulusoy
- Karadeniz Technical University School of Medicine, Trabzon, Turkey
| | - Melek Tulunay
- Ankara University School of Medicine, Ibni-Sina Hospital, Ankara, Turkey
| | - Mehmet Oral
- Ankara University School of Medicine, Ibni-Sina Hospital, Ankara, Turkey
| | - Necmettin Ünal
- Ankara University School of Medicine, Ibni-Sina Hospital, Ankara, Turkey
| | - Güldem Turan
- Haydarpaşa Numune Training and Research Hospital, Istanbul, Turkey
| | - Nur Akgün
- Haydarpaşa Numune Training and Research Hospital, Istanbul, Turkey
| | - Asuman İnan
- Haydarpaşa Numune Training and Research Hospital, Istanbul, Turkey
| | - Erdal Ince
- Department of Pediatric Critical Care Medicine, Ankara University School of Medicine, Ankara, Turkey
| | - Adem Karbuz
- Department of Pediatric Critical Care Medicine, Ankara University School of Medicine, Ankara, Turkey
| | - Ergin Çiftçi
- Department of Pediatric Critical Care Medicine, Ankara University School of Medicine, Ankara, Turkey
| | - Nevin Taşyapar
- Department of Pediatric Critical Care Medicine, Ankara University School of Medicine, Ankara, Turkey
| | - Melek Güneş
- Department of Pediatric Critical Care Medicine, Ankara University School of Medicine, Ankara, Turkey
| | | | - Gaye Usluer
- Eskisehir Osmangazi University, Eskisehir, Turkey
| | | | | | | | | | - Bilgin Arda
- Ege University Medical Faculty, Izmir, Turkey
| | | | - Mustafa Cengiz
- Harran University, Faculty of Medicine, Sanliurfa, Turkey
| | - Leyla Yilmaz
- Harran University, Faculty of Medicine, Sanliurfa, Turkey
| | - Mehmet Faruk Geyik
- Duzce University Medical School Infectious Diseases and Clinical Microbiology, Duzce, Turkey
| | - Ahmet Şahin
- Duzce University Medical School Infectious Diseases and Clinical Microbiology, Duzce, Turkey
| | - Selvi Erdogan
- Duzce University Medical School Infectious Diseases and Clinical Microbiology, Duzce, Turkey
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Leblebicioglu H, Erben N, Rosenthal VD, Atasay B, Erbay A, Unal S, Senol G, Willke A, Özgültekin A, Altin N, Bakir M, Oncul O, Ersöz G, Ozdemir D, Yalcin AN, Özdemir H, Yıldızdaş D, Koksal I, Aygun C, Sirmatel F, Sener A, Tuna N, Akan ÖA, Turgut H, Demiroz AP, Kendirli T, Alp E, Uzun C, Ulusoy S, Arman D. International Nosocomial Infection Control Consortium (INICC) national report on device-associated infection rates in 19 cities of Turkey, data summary for 2003-2012. Ann Clin Microbiol Antimicrob 2014; 13:51. [PMID: 25403704 PMCID: PMC4255447 DOI: 10.1186/s12941-014-0051-3] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2014] [Accepted: 10/24/2014] [Indexed: 11/10/2022] Open
Abstract
Background Device-associated healthcare-acquired infections (DA-HAI) pose a threat to patient safety, particularly in the intensive care unit (ICU). We report the results of the International Infection Control Consortium (INICC) study conducted in Turkey from August 2003 through October 2012. Methods A DA-HAI surveillance study in 63 adult, paediatric ICUs and neonatal ICUs (NICUs) from 29 hospitals, in 19 cities using the methods and definitions of the U.S. NHSN and INICC methods. Results We collected prospective data from 94,498 ICU patients for 647,316 bed days. Pooled DA-HAI rates for adult and paediatric ICUs were 11.1 central line-associated bloodstream infections (CLABSIs) per 1000 central line (CL)-days, 21.4 ventilator-associated pneumonias (VAPs) per 1000 mechanical ventilator (MV)-days and 7.5 catheter-associated urinary tract infections (CAUTIs) per 1000 urinary catheter-days. Pooled DA-HAI rates for NICUs were 30 CLABSIs per 1000 CL-days, and 15.8 VAPs per 1000 MV-days. Extra length of stay (LOS) in adult and paediatric ICUs was 19.4 for CLABSI, 8.7 for VAP and 10.1 for CAUTI. Extra LOS in NICUs was 13.1 for patients with CLABSI and 16.2 for patients with VAP. Extra crude mortality was 12% for CLABSI, 19.4% for VAP and 10.5% for CAUTI in ICUs, and 15.4% for CLABSI and 10.5% for VAP in NICUs. Pooled device use (DU) ratios for adult and paediatric ICUs were 0.54 for MV, 0.65 for CL and 0.88 for UC, and 0.12 for MV, and 0.09 for CL in NICUs. The CLABSI rate was 8.5 per 1,000 CL days in the Medical Surgical ICUs included in this study, which is higher than the INICC report rate of 4.9, and more than eight times higher than the NHSN rate of 0.9. Similarly, the VAP and CAUTI rates were higher compared with U.S. NHSN (22.3 vs. 1.1 for VAP; 7.9 vs. 1.2 for CAUTI) and with the INICC report (22.3 vs. 16.5 in VAP; 7.9 vs. 5.3 in CAUTI). Conclusions DA-HAI rates and DU ratios in our ICUs were higher than those reported in the INICC global report and in the US NHSN report.
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Leblebicioglu H, Öztürk R, Rosenthal VD, Akan ÖA, Sirmatel F, Ozdemir D, Uzun C, Turgut H, Ersoz G, Koksal I, Özgültekin A, Esen S, Ulger F, Dilek A, Yilmaz H, Dikmen Y, Aygún G, Tulunay M, Oral M, Ünal N, Cengiz M, Yilmaz L, Geyik MF, Şahin A, Erdogan S, Sacar S, Sungurtekin H, Uğurcan D, Kaya A, Kuyucu N, Yýlmaz G, Kaya S, Ulusoy H, İnan A. Impact of a multidimensional infection control approach on central line-associated bloodstream infections rates in adult intensive care units of 8 cities of Turkey: findings of the International Nosocomial Infection Control Consortium (INICC). Ann Clin Microbiol Antimicrob 2013; 12:10. [PMID: 23641950 PMCID: PMC3674978 DOI: 10.1186/1476-0711-12-10] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2013] [Accepted: 02/23/2013] [Indexed: 02/07/2023] Open
Abstract
Background Central line-associated bloodstream infections (CLABs) have long been associated with excess lengths of stay, increased hospital costs and mortality attributable to them. Different studies from developed countries have shown that practice bundles reduce the incidence of CLAB in intensive care units. However, the impact of the bundle strategy has not been systematically analyzed in the adult intensive care unit (ICU) setting in developing countries, such as Turkey. The aim of this study is to analyze the impact of the International Nosocomial Infection Control Consortium (INICC) multidimensional infection control approach to reduce the rates of CLAB in 13 ICUs of 13 INICC member hospitals from 8 cities of Turkey. Methods We conducted active, prospective surveillance before-after study to determine CLAB rates in a cohort of 4,017 adults hospitalized in ICUs. We applied the definitions of the CDC/NHSN and INICC surveillance methods. The study was divided into baseline and intervention periods. During baseline, active outcome surveillance of CLAB rates was performed. During intervention, the INICC multidimensional approach for CLAB reduction was implemented and included the following measures: 1- bundle of infection control interventions, 2- education, 3- outcome surveillance, 4- process surveillance, 5- feedback of CLAB rates, and 6- performance feedback on infection control practices. CLAB rates obtained in baseline were compared with CLAB rates obtained during intervention. Results During baseline, 3,129 central line (CL) days were recorded, and during intervention, we recorded 23,463 CL-days. We used random effects Poisson regression to account for clustering of CLAB rates within hospital across time periods. The baseline CLAB rate was 22.7 per 1000 CL days, which was decreased during the intervention period to 12.0 CLABs per 1000 CL days (IRR 0.613; 95% CI 0.43 – 0.87; P 0.007). This amounted to a 39% reduction in the incidence rate of CLAB. Conclusions The implementation of multidimensional infection control approach was associated with a significant reduction in the CLAB rates in adult ICUs of Turkey, and thus should be widely implemented.
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Eroğlu Ermiş Ö, Özgültekin A. Yoğun Bakım Hastalarında Kapiller Kaçağı Engellemede HES ve GELATİN Solüsyonlarının İdrar Mikroalbumin Düzeyleri ile Değerlendirilmesi. tybdd 2013. [DOI: 10.4274/tybdd.14633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Demir MK, Aker FV, Akinci O, Özgültekin A. Case 134. Radiology 2008. [DOI: 10.1148/radiol.2462050506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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