Introduction: Intraluminal thrombolytic therapy is the first step treatment of thrombotic malfunction of tunneled hemodialysis catheters (THC). The factors that affect catheter restoration and also catheter survival following thrombolytic therapy are not well described. In this study, we aimed to reveal the predictors that affect the success of the procedure and also present post-restoration catheter patency after intraluminal thrombolytic administration. Method: This retrospective study included 62 patients with tunneled THC thrombosis treated with alteplase between 2017 and2020 in the study center. Age, comorbidities, the use of antiplatelet and anticoagulants, a history of catheter thrombosis, time on dialysis, the duration of the catheter were investigated as possible predictors of procedural success. The independent predictive factors for procedural success were evaluated by using backward stepwise likelihood ratio logistic regression analysis. Primaryand assisted patencieswere presented with Kaplan-Meier graphs. Results: Thrombolityc was administered to 62 patients 102 times. The median primary patency from the first thrombolytic administration to a second catheter thrombosis was 9 months (range 1-20 months). The overall median patency was 12 months (range 2-23 months). The overall procedural success rate was 79.4% (81/102).Multivariate analyses revealed that a history of prior catheter thrombosis was the only risk factor for procedural success (OR: 0.49; 95% CI: 0.26-0.91; p = 0.004). The need for a second dwell time among patients with prior history of thrombolysis was significantly higher compared to patients without a history of catheter thrombosis (12/26 patients, 46.2% and 6/55 patients, 10.9%; respectively; p = 0.001). Conclusion: The success of thrombolysis in subsequent de novo THC thrombosis decreases in patients who previously required intraluminal thrombolytic administration. Identifying patient subgroups with a high risk for THC thrombosis may be useful to investigate effective secondary prevention strategies.
INTRODUCTION AND AIM: Hepatitis B infection which is a life-threatening infection, is a major global health problem. Occupational exposure may be an important route of transmission. The aim of this study was to evaluate Knowledge of Hepatitis B Virus Infection and infection control practices among Faculty of Dentistry Staff, in Aydin province.
MATERIAL METHODS: In this cross-sectional study, hepatitis B vaccination status of the participants; knowledge levels, history of work accidents, general infection control practices were questioned. Knowledge levels were assessed with 63 propositions, each correct answer calculated as 1 point to calculate total knowledge score and then subgroup scores such as general information, information level scores for transmission routes, prevention approaches and risk groups, were calculated.
RESULTS: 54.4 % of participants told that they had received education about HBV infection, 67.5% told they had been vaccinated with Hepatitis B vaccine. 46.3% of those who stated that they had been vaccinated told that they checked antibody levels after vaccination. 27.8 % of participants stated that they had periodic inspection checks and 18.8 % stated that they had an occupational accident in terms of infection risk in the previous year. The mean total knowledge score over 63 propositions was 42.3±13.3. Total knowledge score were found lower in participants who were younger or dental students, who did not receive education about general infection control precautions and hepatitis B infection, who did not vaccinated with HBV, who did not have a history of contact with HBV-infected patients, who did not had an occupational accident in the previous year and who had less than a year of occupational experience.
CONCLUSION: In conclusion oral and dental health workers’ knowledge about hepatitis B infection and infection control practices were not at desired level. It is important to give educational activities regarding causes of infections and standard infection control precautions as earlier as possible in order to prevent horizontal transmission between patients and health workers.
Cardiac involvement in hydatid disease is more seldom than the involvement of the liver and the lungs.Cardiac cyst hydatid disease is diagnosed incidentally or by means of symptoms such as dyspnea and angina pectoris.Here, we present the case of a 45-year-old male patient who underwent open heart surgery for a randomly detected cardiac cyst hydatid during investigations carried out in a healthcare institution after accidentally falling from height.On the other hand, this patient did not have any complaints associated with hydatid disease before this event.
The aim of the study was to investigate the indicators of corrosive esophageal injury (EI) severity in children.We retrospectively reviewed data from children who accidentally ingested corrosive substance and underwent endoscopic evaluation over a one-year period. A total of 134 consecutive children with corrosive agent ingestion who underwent diagnostic endoscopy (74 boys, 60 girls) were included in this study. Patients were divided into two groups as low-grade and high-grade EI. Statistical differences and predictive values of common signs and symptoms and white blood cell (WBC) count of patients with low- and high-grade EI were analyzed.The majority of patients (70%) were asymptomatic at the initial examination. We found that drooling saliva and oral lesions were significantly more frequent in high-grade injury (p<0.05). Mean WBC count in the high-grade EI group was significantly higher than in the low-grade EI group (p=0.000). Sensitivity, specificity and predictive values of clinical findings in children were analyzed; none of them was shown to be valuable for estimating EI severity. WBC count was sensitive, but it is not a good predictor.Our study demonstrated the relationship between clinical findings and corrosive EI severity in children with accidental corrosive ingestion, but direct visualization of the esophagus is required for definitive diagnosis.
“Vakalarla Kalp Damar Cerrahisi” kitabı, Kardiyovasküler Cerrahisi konusunda kaleme alınmış çok sayıda değerli çalışmanın bir araya getirilmesi sonucunda okuyuculara sunulmuştur. Bu kitapta yer alan konular, Kalp Damar Cerrahisi alanındaki tedavilerin son gelişmelerini içermektedir. “Vakalarla Kalp Damar Cerrahisi” kitabı Kardiyovasküler Cerrahisi konusundaki yenilikler bağlamında alana katkı sağlamayı amaç edinmiştir. Kardiyak Cerrahide Protamin Kullanımı ve Advers Etkiler Mehmet TERCAN Kardiyak Vasküler Cerrahide Kan Koruma Stratejileri İlker Hasan KARAL Kardiyak Cerrahide Postoperatif Hemoraji ve Transfüzyonun Prediktörleri Yusuf Salim URCUN Koroner Arter By-Pass Cerrahisi Sonrasında Gelişen Komplikasyon Yönetiminde Ekokardiyografinin Yeri Sevil GÜLAŞTI Kardiyopulmoner Bypass ve Komplikasyonları Serpil ŞAHİN Nadir Anatomik Varyasyonlarda Koroner Arter Bypass Cerrahisi Cenk İNDELEN Düşük Sol Ventrikül Ejeksiyon Fraksiyonlu Hastalarda Koroner Arter Bypass Cerrahisi İbrahim Burak ŞEKER Akut Miyokard Enfarktüsü Sonrası Septal Defektin Cerrahi Tedavisi Emre YAŞAR Kalp Yaralanmaları Zafer Cengiz ER Kardiyak Minimal İnvaziv Cerrahi Teknikler Özlem ÇAKIRKÖSE Aort Kapak Koruyucu Cerrahileri Aytaç ÇALIŞKAN Aort Kapak Cerrahisinde Yenilikler İlker Hasan KARAL Transkateter Aort Kapak İmplantasyonu (TAVİ) Erişim Yolları Latif ÜSTÜNEL Mitral Kapak Onarımında İntraoperatif Transözefageal Ekokardiyografi ve Anestezi Yönetimi Ferdi GÜLAŞTI Mitral Kapak Replasmanı Sonrası Oluşan Posterior Ventrikül Rüptürlerine Yaklaşım Nihan YEŞİLKAYA Triküspit Kapak Hastalıkları Cerrahi Tedavisi Timuçin AKSU Erişkin Tip Alcapa Sendromu Görkem ÇİTOĞLU Atrioventriküler Septal Defekt Serpil ŞAHİN Büyük Arter Transpozisyonunda Tanı-Preoperatif-İntraoperatif-Postoperatif Yönetim Başak SORAN TÜRKCAN Total Anormal Pulmoner Venöz Bağlantı Tanı-Preoperatif-İntraoperatif-Postoperatif Yönetim Başak SORAN TÜRKCAN Perikaridyal Effüzyonlarda Perkütan ve Cerrahi Girişimler Tanıl ÖZER Konstriktif Perikardit Serkan GÜME İnfektif Endokardit Cerrahi Tedavisi Çiğdem TEL ÜSTÜNIŞIK Mikrobiyoloji Gözüyle Kardiyak Kist Hidatik Mehmet Hakan TAŞKIN Kalp Tümörlerine Vaka Eşliğinde Yaklaşım Murat Abdulhamit ERCİŞLİ Vakalarla Sternotomi Komplikasyonları İbrahim Murat ÖZGÜLER Postoperatif Derin Sternal Enfeksiyonlar Gökalp ALTUN Karotis Cisim Tümörleri Atıf YOLGÖSTEREN Karotis Arter Hastalığı ve Cerrahi Tedavisi Mohammad ALŞALALDEH Şafak ŞİMŞEK Torasik Aort ve Supratorasik Dallarının Yaralanmaları Atıf YOLGÖSTEREN Toraks Çıkışı Sendromunun Vasküler Komplikasyonları Derin ATABEY Proksimal Sol Subklavyen Arter Oklüzyonu Olan Hastaya Perkütan Translüminal Anjiyoplasti ve Stent Uygulaması İzzet EMİR Üst Ekstremite Vasküler Travmaları Fatih Avni BAYRAKTAR Abdominal Aort Anevrizmalarında Zor Anatomik Boyunlarda Endovasküler Girişimler Kaptanıderya TAYFUR Periferik Endovasküler Girişim Komplikasyonlarına Yaklaşım Ferhat BORULU Alt Ekstremite Vasküler Travmaları Ali Ahmet ARIKAN Akut Alt Ekstremite Emboli Tedavisinde Endovasküler Yöntemler Mehmet ATAY Onur SAYDAM Deniz ŞEREFLİ Majör Vasküler Cerrahi Esnasında Nöromonitörizasyon ve Spinal Kord Korunması Muhammed BAYRAM Prostetik Vasküler Greft Enfeksiyonları Gencehan KUMTEPE Vena Cava İnferior Yaralanmalarına Yaklaşım ve Alternatif Tamir Yöntemleri Hasan İNER Akut Venöz Tromboembolizmde Endovasküler Tedavi Mehmet Akif ÖNALAN Bahar TEMUR Derin Ven Trombozu Tedavisinde Cerrahi Trombektomi Yaklaşımı Şenel ALTUN Kronik Venöz Yetmezlik ve Tedavisi Hakan HANÇER Tolga BAŞ Venöz Ülserlerde Tedavi Yöntemleri Köksal DÖNMEZ Gebelikte Derin Venöz Tromboz ve Venöz Tromboemboli Serdar BADEM Lenfödem ve Tedavi Modaliteleri Burak AÇIKGÖZ Pelvik Konjesyon Sendromu Ergin ARSLANOĞLU Hemodiyaliz Hastalarında Uzun Süreli Kateter Erişimi Mahmut KIŞ Ekstrakorporeal Membran Oksijenizasyonu Desteği Altındaki Erişkin Hastaya Yaklaşım Mustafa Mert ÖZGÜR Pulmoner Tromboendarterektomide Olası Komplikasyonlar ve Süreç Yönetimi Hidayet DEMİR Vasküler Travmada Koagulopati ve Venöz Tromboemboli Ali Ahmet ARIKAN Elektronik Sigara ve Kardiyovasküler Hastalıklar Kıvanç ATILGAN Kalp Cerrahisinde Torasik İnsizyonlar Zafer Cengiz ER
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