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Öğe Asemptomatik İçicilerde Sigara Bağımlılığının Noninvaziv Perfüzyon Parametrelerine Etkisi(2021) Kaçmaz, MustafaAmaç: Tütün kullanımı, hastalıkların ve erken ölümlerin önde gelen nedenlerinden biridir. Dünya Sağlık Örgütünün tahminlerine göre tütün, dünya çapındaki ölümlerin yaklaşık %9'undan sorumludur. Ancak çoğu sigara tiryakisi özellikle asemptomatik dönemde iken sigaraya bağlı hiçbir anormal bulgularının olmadığını düşünmektedirler. Çalışmamızda asemptomatik sigara bağımlılarında, bazı perfüzyon parametrelerinde erken dönemde bozulma olup olmadığının tespit edilmesi amaçlanmıştır. Araçlar ve Yöntem: Çalışma randomize ve prospektif olarak her grupta 70 gönüllü olmak üzere toplam 140 kişi üzerinde gerçekleştirildi. Ölçümler Masimo rainbow SET cihazı ile gerçekleştirildi. Temel perfüzyon parametreleri kayıt altına alındı.Bulgular: Kalp atım hızı, methemoglobin (SpMet) ve karboksihemoglobin (SpCO) düzeyinin sigara kullanan grupta anlamlı düzeyde yüksek olduğu görüldü (p<0.05). Perfüzyon indeksi (PI) ve Plet değişkenlik indeksi (PVI) ölçümlerinde ise her iki grup arasında anlamlı düzeyde fark bulunamadı (p?0.05). Sigara kullananlarda bağımlılık süresi ile temel perfüzyon parametreleri arasında korelasyona rastlanmadı (p?0.05). Sonuç: Sigara kullanan bireyler henüz asemptomatik dönemde bile olsalar, yüksek düzeyde spCO, SpMet ve kalp atım hızına sahip olabilir. Bu bulgular, ilerde oluşabilecek önemli organ disfonksiyonlarının bir ön habercisi olabilir.Öğe Çocukluk Döneminde Üçüncü Ventrikül Kolloid Kiste Bağlı Gelişen Akut Hidrosefali(2019) Kaçmaz, MustafaKolloid kistler üçüncü ventrikülün nadir benign tümörleri olup tesadüfen bulunan kistlerden akut ölüme\rkadar çok geniş bir klinik sunum aralığına sahiptir. Bu kistlerde sık görülmeyen bir olay olan kistin\rbüyümesi, obstrüktif hidrosefaliye ve sonuçta hastanın durumunda ani kötüleşmeye ve ölüme neden\rolabilen yaşamı tehdit edici bir komplikasyondur. Üçüncü ventrikülde büyük kolloid kisti olup, literatürde in\rvivo tanı konmuş ani ölüme yol açan çocuk kolloid kist tıkanması vakası oldukça nadir bir durumdur. Acil\rservise ani şuur kaybıyla başvurup Akut Hidrosefali gelişmesi nedeniyle acil ventrikülostomi yapılmasına\rrağmen, 24 saat içinde beyin ölümü gerçekleşmiş olan bir 3. Ventrikül kolloid kist obstrüksiyonu vakasını\rsunuyoruz.Öğe Femoral nerve block versus spinal anesthesia in the treatment of saphenous vein ablation(Turkish National Vascular and Endovascular Surgery Society, 2022) Kaçmaz, Mustafa; Serhatlıoğlu, FarukObjectives: This study aims to compare the effects of spinal anesthesia and femoral nerve block and to determine the optimal anesthesia method for embolization of vena saphena magna. Patients and methods: Between December 2019 and March 2021, a total of 160 patients (89 males, 71 females; mean age: 44.4 years; range, 18 to 69 years) who were diagnosed with varicose veins and hospitalized for surgery in our cardiovascular surgery clinic were included. The patients were divided into two groups. The first group (Group S, n=80) underwent spinal anesthesia and the second group (Group F, n=80) underwent femoral nerve block for the surgical operation. Results: The mean arterial pressures (MAPs) were significantly lower in Group S compared to Group F. The mean time until surgery was earlier in Group S (4.57±1.0 min vs. 9.9±3.4 min, respectively; p<0.01). The mean duration of motor block was longer in Group S (3.4±1.1 h vs. 2.7±0.8 h, respectively; p<0.05). The mean duration of mobilization was statistically significantly shorter in Group F (6.1±1.7 h vs. 5.2±1.4, respectively; p<0.05). The development of urinary retention was statistically significantly higher in Group S (p<0.05). The mean patient satisfaction score after discharge was higher in Group F (3.5±0.5 vs. 2.9±0.8, respectively; p<0.05). The incidence of postoperative shivering was statistically significantly higher in Group S (p<0.05). Conclusion: Femoral nerve block, which is used for intraoperative anesthesia during the procedure of endovenous laser ablation, can be preferred as an alternative method to spinal anesthesia. © 2022 Turkish National Vascular and Endovascular Surgery Society. All rights reserved.Öğe Long-term 25-hydroxy vitamin D3 level of patients supplied with total thyroidectomy due to nodular goiter(Pamukkale University, 2022) Bolat, Hacı; Kaçmaz, MustafaIntroduction: One of the most important problems developing in patients who have undergone thyroidectomy is hypocalcemia. For this reason, the calcium (Ca) level is screened in patients, but it is not routinely screened for low levels of 25-hydroxy vitamin D3 (25-OH D3), which is found to be associated with many diseases in the postoperative mid-period, in normocalcemic patients who have undergone thyroidectomy. Material and method: The study included 60 normocalcemic patients (Group 1) who underwent thyroidectomy due to nodular goiter and 170 patients (Group 2) who applied with the suspicion of thyroid disease and who were evaluated as normal and who did not receive Ca and 25-OH D3 supplements (Group 2). Biochemical hypocalcemia was defined as a corrected Ca level of less than 8.0 mg/dL. 25-OH D3 levels of all patients at the postoperative 12th month were recorded by scanning their Ca levels and routine laboratory tests. Results: Measurements were made in 12th month postoperatively. The 25-OH D3 levels of the patients in Group 1 were lower than the 25-OH D3 lev els of the patients in Group 2 (p<0.001). The thyroxine (T4) hormone levels of the patients in Group 1 were higher than the T4 values of the patients in Group 2 (p=0.002). There was no statistically significant difference between the Ca levels of the patients in Group 1 and Group 2. (p>0.05). There was no difference between other measurement parameters. Conclusion: We think that in patients who underwent thyroidectomy due to nodular goiter, their 25-OH D3 levels should be screened in the postoperative period and replaced if necessary. © 2022, Pamukkale University. All rights reserved.Öğe The relationship of gastrointestinal complications and ventilator related status with gastric residual volume in intensive care patients(2021) Kaçmaz, Mustafa; Kocaöz, Fazilet; Destegül, Dilek; Turhan, Zeynep Yüksel; Bayraktar, MuhammetAim: Our study aimed primarily to determine whether there was a relationship betweentotal gastric residual volume (GRV) amounts and two different GRV thresholds andthe development of gastrointestinal intolerance in patients on mechanical ventilationin the intensive care unit (ICU) and secondarily, to determine the effects of differentGRV quantities on ventilator-related conditions (VAC).Methods: Seventy patients above the age of 18 who were scheduled to be fed withenteral nutrition (EN) for at least three days, were divided into two groups including 35patients according to GRV threshold values of 250 ml and 500 ml. The total amountsof GRV of the patients who did not exceed any of the two GRV thresholds during thefollow-up period of 72 hours were recorded and calculated. For all patients, necessarydata was recorded and high gastric residual volume rates (HGRV), times to reachtarget calories, mean GRV amounts, abdominal distension, vomiting, diarrhea, VACand infection-related ventilator-related complications (IVAC) were all observed.Results: Although there were statistically significant differences between the groupsin terms of the HGRV rates and the HGRV rates exceeding the determined thresholdvalues [p <0.05], there was no significant difference between the groups in terms ofabdominal distension, vomiting, diarrhea, VAC and IVAC (p> 0.05).Conclusion: The results of this study suggest that measuring the amount of GRVin intensive care patients fed by EN via the nasogastric tube in order to decide ongastrointestinal motility function and to reduce the complication rate, is not necessary
