Browsing by Author "Tekin, S"
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Item Effectiveness of clonidine and fentanyl addition to bupivacaine in postoperative patient controlled epidural analgesiaTopcu, I; Luleci, N; Tekin, S; Kefi, A; Erincler, TBackground and Objectives: The aim of this prospective randomized double-blinded study was to compare the analgesic and side-effects of bupivacaine in combination with clonidine or fentanyl during patient-controlled-epidural analgesia (PCEA) in the postoperative period after abdominal hysterectomy. Methods: 75 patients from 18 to 65 years of age with ASA status I - II were investigated. After preoperative epidural catheterization, the patients were operated in general anesthesia. After surgery, the patients were randomly allocated to 3 PCEA-groups: Group B 0.125% bupivacaine, Group F 0.125% bupivacaine plus 1 mu g x ml(-1) fentanyl, Group C 0.125% bupivacaine plus 0.75 mu g x ml(-1) clonidine (10 ml loading dose, 5 ml repetitive bolus dose, 10 min lockout time, 30 ml limit within 4h). During the following 24 hours, hemodynamic parameters, pain score using visual analog scale (VAS), total analgesic consumption, additional analgesic requirements, sedation, satisfaction, nausea scores and probable side-effects were evaluated. Results: Total analgesic consumption was not different between Group F and Group C, but lower than in Group B (p < 0.05). Additional analgesic use was not different between the groups. Group F and Group C had lower VAS-scores in 24 hours than Group B (p < 0.05). Hemodynamic and sedation scores of patients were not different. In Group C, incidence of nausea was lower and satisfaction of patients was higher (p < 0.05). Conclusions: Addition of clonidine or fentanyl to local anesthetics for PCEA can reduce the analgetic demand. Epidural clonidine can reduce postoperative nausea and is connected with higher patients' satisfaction.Item Comparison of analgesic activity of the addition to neostigmine and fentanyl to bupivacaine in postoperative epidural analgesiaTekin, S; Topcu, I; Ekici, NZ; Caglar, H; Erincler, TObjectives: To compare the analgesic and side effects of bupivacaine in combinations with neostigmine and fentanyl using patient-controlled-epidural analgesia (PCEA) methods in the postoperative period after abdominal hysterectomy. Methods: Seventy-five adult American Society of Anesthesiologists physical status I-II patients, aged 18-65 years were included in the study. The study took place in Celal Bayar University Hospital, Turkey between 20032004 years. After preoperative epidural catheterization, the patients were operated under general anesthesia. After surgery, the patients were randomly allocated in a double-blinded manner to receive PCEA and divided into 3 groups: Group B: 0.125% bupivacaine, Group N: 0.125% bupivacaine plus neostigmine 4 mu g kg(-1) and Group F: 0.125% bupivacaine plus 1 mu g kg(-1) fentanyl solutions (10 mL loading dose, 5 mL bolus dose, 10 min lockout time, 30 mL in 4 hour limit). During the following 24 hours, hemodynamic parameters, pain score using visual analog scale, total analgesic consumption, additional analgesic requirements, sedation, satisfaction, nausea scores and probable side-effects were evaluated. Results: Total analgesic consumption was 143.7 +/- 7.2 mL in Group B, 123.4 +/- 6.2 mL in Group N and 106 +/- 8.3 mL in Groups F. The mean value in Group F was significantly lower than Group N and Group B (p < 0.05), and was lower in Group N than Group B. Visual analog scale scores were lower in Group F than other groups (p < 0.05). There were no differences in side effects between all groups. Conclusions: Fentanyl and neostigmine by the PCEA method can be used safely for postoperative analgesia after gynecologic surgery. They increase analgesia quality and satisfaction without an increase in side effects.Item Validity and reliability of the Turkish version of the Innsbruck RBD-9 diagnostic inventory (IRBD-9-TR)Aslan-Kara, K; Ak, AK; Saritas, AS; Yilmaz, H; Metin, KM; Çokal, BG; Agan, K; Aksu, M; Akyildiz, UO; Demir, AB; Çevik, B; Ertürk, AY; Karadeniz, D; Öztura, I; Sünter, G; Tekin, S; Tezer, I; Berktas, DT; Totik, N; Senel, GBBackground Isolated rapid eye movement (REM) sleep behavior disorder (iRBD) is characterized by loss of the normal atonia of REM sleep accompanied by repetitive motor and behavior phenomena of dream content. Objective To evaluate the reliability and validity of the Turkish version of the original form of the Innsbruck Rapid Eye Movement Sleep Behavior Disorder Diagnostic Inventory (IRBD-9) scale (IRBD-9-TR) and ensure that this screening test can be easily used in the Turkish language. Methods The present is a multicenter and prospective study involving 184 patients: 51 with iRBD and 133 healthy controls. The iRBD patients were not diagnosed before submitted to video polysomnography (vPSG) and filling out the IRBD-9-TR. Results The optimal cut-off value for the IRBD-9-TR symptom score was of 0.28, with a sensitivity of 0.941 and a specificity of 0.947, and 94.4% of the patients were correctly diagnosed. The rotated factor loadings for the diagnostic accuracy of each individual question showed that the short version of the IRBD-9-TR (questions 1, 2, 3, 6, and 8) presented higher specificity and excellent discrimination of iRBD patients from healthy controls. The Cronbach's alpha coefficient for the symptom section of the IRBD-9-TR was of 0.857, and the Kappa coefficient, of 0.885. Conclusion The short version of the IRBD-9-TR presents good validity and reliability to be used as a screening test to assess iRBD patients. It is convenient and potentially useful in both outpatient clinical and epidemiologic research settings.Item Investigation of hematologic findings related to brucellosis in Anatolian regionÇelik, M; Arslan, Y; Topcu, E; Sahinoglu, MS; Altindag, D; Gürbüz, E; Atalay, E; Demircan, SK; Emre, S; Kirik, Y; Atasoy, PY; Özer, D; Ipek, D; Dogan, E; Atli, SB; Kusçu, EG; Alkan, S; Çiçek, Y; Yüksekkaya, E; Aldemir,Ö; Sahin, A; Ürkmez, EY; Al, SÖ; Boran, R; Mizrakçi, SO; Demiray, EKD; Ceylan, MR; Erdogdu, H; Tekin, SObjectives: To investigate the prevalence of hematologic findings and the relationship between hemogram parameters and brucellosis stages in patients. Methods: This multi-center study included patients older than 16 years of age who were followed up with a diagnosis of brucellosis. Patients' results, including white blood cell, hemoglobin, neutrophil, lymphocyte, monocyte, mean platelet volume, platelet and eosinophil counts were analyzed at the initial diagnosis. Results: In this study 51.3% of the patients diagnosed with brucellosis were male. The age median was 45 years for female and 41 years for male. A total of 55.1% of the patients had acute brucellosis, 28.2% had subacute, 7.4% had chronic and 9% had relapse. The most common hematologic findings in brucellosis patients were anemia (25.9%), monocytosis (15.9%), eosinopenia (10.3%), and leukocytosis (7.1%). Pancytopenia occurred in 0.8% of patients and was more prominent in the acute phase. The acute brucellosis group had lower white blood cell, hemoglobin, neutrophil, eosinophil, and platelet counts and mean platelet volume, and higher monocyte counts compared to subacute and chronic subgroups. Conclusion: It was noteworthy that in addition to anemia and monocytosis, eosinopenia was third most prominent laboratory findings in the study. Pancytopenia and thrombocytopenia rates were low.Item Consensus recommendations for botulinum toxin injections in the spasticity management of children with cerebral palsy during COVID-19 outbreakYalcinkaya, EY; Karadag Saygi, E; Özyemisci Taskiran, O; Çapan, N; Kutlay, S; Sonel Tur, B; Özlem, EL; Ünlu Akyüz, E; Tekin, S; Ofluoglu, D; Zinnuroglu, M; Akpinar, P; Özekli Misirlioglu, T; Hüner, B; Nur, H; Çaglar, S; Sezgin, M; Tikiz, C; Önes, K; Içagasioglu, A; Aydin, RSpasticity is the most common motor disturbance in cerebral palsy (CP). Lockdown in the COVID-19 outbreak has profoundly changed daily routines, and similarly caused the suspension of spasticity treatment plans. Besides, the delay in botulinum toxin (BoNT) injection, which is important in the management of focal spasticity, led to some problems in children. This consensus report includes BoNT injection recommendations in the management of spasticity during the COVID-19 pandemic in children with CP. In order to develop the consensus report, physical medicine and rehabilitation (PMR) specialists experienced in the field of pediatric rehabilitation and BoNT injections were invited by Pediatric Rehabilitation Association. Items were prepared and adapted to the Delphi technique by PMR specialists. Then they were asked to the physicians experienced in BoNT injections (PMR specialist, pediatric orthopedists, and pediatric neurologists) or COVID-19 (pediatric infectious disease, adult infectious disease). In conclusion, the experts agree that conservative management approaches for spasticity may be the initial steps before BoNT injections. BoNT injections can be administered to children with CP with appropriate indications and with necessary precautions during the pandemic.Item TRIP OPTIMIZATION FOR PUBLIC TRANSPORTATION SYSTEMS WITH LINEAR GOAL PROGRAMMING (LGP) METHODTekin, S; Köfteci, S; Aydin, MM; Yildirim, MSDetermination of the optimum trip schedules is an important problem for public transportation systems. It is complex task to assign optimum number of vehicles and determine the trip schedules for a public transport systems which consist of many routes. In the case of taking infrequent trip schedules, the existing passenger demand is not satisfied. Therefore waiting times are increased in the bus stops. In contrary, with more frequent intervals, unutilized capacity and higher operational costs are expected. Also, intense traffic density and environmental pollution are associated with the frequent trips. The optimum trip frequencies of the passenger demands varies during the hours of a day and is important for passenger satisfaction and operation efficiency of the system. Trip scheduling and vehicle assignment studies take attention in the current literature assisted with different optimization techniques and artificial intelligence method. In this study, only 10 different bus routes which is operated privately, were considered in the city center of Antalya and the Linear Goal Programming (LGP) was used to determine the optimum number of vehicles operated on the routes. The study results showed that the existing system performance can be preserved by reducing the frequency of specific trips and LGP is stated as an efficient algorithm for determining the optimum trip frequencies and number of vehicles in a public transportation systems.