PurposeWe evaluated the effects of body mass index (BMI) on thermoregulation in obese patients scheduled to undergo laparoscopic abdominal surgery.MethodsSixty patients scheduled to undergo laparoscopic abdominal surgery with no pre-medication were included in the study. The patients were classified into 4 groups according to BMI <24.9, 25–39.9, 40–49.9, and >50. Anesthesia was provided with routine techniques. Tympanic and peripheral temperatures were recorded every 5 minutes starting with the induction of anesthesia. The mean skin temperature (MST), mean body temperature (MBT), vasoconstriction time, and vasoconstriction threshold that triggers core warming were calculated with the following formulas: MST = 0.3 (Tchest + Tarm) + 0.2 (Tthigh + Tcalf). MBT was calculated using the equation 0.64Tcore+0.36Tskin, and vasoconstriction was determined by calculating Tforearm−Tfinger.ResultsThere was no significant difference between the groups in terms of age, gender, duration of operation, and room temperature. Compared to those with BMI <24.9, the tympanic temperature was significantly higher in those with BMI =25–39.9 in the 10th, 15th, 20th, and 50th minutes. In addition, BMI =40–49.9 in the 5th, 10th, 15th, 20th, 25th, 30th, 40th, 45th, 50th, and 55th minutes and BMI >50 in the 5th, 10th, 15th, 20th, 25th, 30th, 50th, and 55th minutes were less than those with BMI <24.9 (P<0.05). There was no significant difference in terms of MST and MBT. Vasoconstriction occurred later, and that vasoconstriction threshold was significantly higher in patients with higher BMIs.ConclusionUnder anesthesia, the core temperature was protected more easily in obese patients as compared to nonobese patients. Therefore, obesity decreases the negative effects of anesthesia on thermoregulation.
GirişH astane enfeksiyonları, uygulanan tüm kontrol önlemlerine karşın tüm dünyada halen önemli bir halk sağlığı sorunu olmaya devam etmektedir (1). Hastane enfeksiyonları hastanede yatış süresinin uzamasına, mortalite, morbidite ve tedavi giderlerinin artışına yol açmaktadır (2). The Centers for Disease Control and Prevention's (CDC's) ve National Nosocomial Infections Surveillance (NNIS) tanımlasına göre, yoğun bakım ünitesi (YBÜ) kökenliObjective: This retrospective study aimed to evaluate the effect of a restructured anaesthesia intensive care unit (ICU) on changes in infection rates and infections. Methods: Organisational restructuring was done in the anaesthesia ICU of Firat University Hospital after it was relocated on 14 March 2012. This study was designed to investigate the effect of restructuring on infection rates through a comparison of periods encompassing one year before relocation and one year after relocation. Nosocomial infections were diagnosed according to modified Centers for Disease Control and Prevention (CDC) criteria. In total, 406 patients who were over 18 years old and admitted to the ICU were included; they were hospitalised for 48 h or longer and had non-infectious diseases according to physical examination, laboratory and culture results on admission. The data of 214 patients (Group A) and 192 patients (Group B) were examined. Results: Parameters such as age, gender, primary diagnosis and mean GCS score at admission and mean duration of hospitalisation showed no effect on the rates of infection, but rates of total infection (41.1% vs. 25%), urinary (18.7% vs. 10.4%) and VIP (32.7% vs. 14.6%) were detected in Groups A and B. Statistically significant differences were found for the causative pathogens Pseudomonas (15.4% vs. 6.8%), Acinetobacter (18.2% vs. 12%) and Escherichia (8.9% vs. 2.1%); the mean duration of mechanical ventilation (15.01±16.681 vs. 12.22±17.595) and discharge with improvement (31.8% vs. 44.3%). Conclusion:We detected that restructuring(such as acclimatization, educated staff, hepa filter) caused a significant decline in infection rates. Because ICU staff may be a major cause of infection, we believe that providing education and conducting effective surveillance programs will be the most important factors for reducing infection rates. Keywords: ICU, acclimatisation, HEPA filter Amaç: Bu çalışmada yeniden yapılandırılan Yoğun Bakım Ünite-si'nin (YBÜ) enfeksiyon oranlarındaki değişimleri ve enfeksiyonlar üzerine olan etkisinin retrospektif olarak incelenmesi amaçlanmıştır. Yöntemler: Fırat Üniversitesi Hastanesi Anestezi YBÜ 14 Mart 2012'de yerinin tamamen değiştirilmesi ile yeniden yapılandırıldı. Bu tarihten önceki (Grup A) ve sonraki (Grup B) bir yıl içinde görülen enfeksiyon oranları karşılaştırılarak yeniden yapılandır-manın enfeksiyon oranları üzerine olan etkisi araştırıldı. Nozokomiyal enfeksiyon tanısı modifiye edilen "Centers for Disease Control and Prevention" (CDC) kriterleri, kültür sonuçları, fizik muayene, laboratuvar ve görüntüleme yöntemleriyle bir...
In this study, we aimed to investigate the effect of radiofrequency denervation procedure on pain and quality of life of patients with facet joint syndrome. Forty-seven patients who were admitted to our hospital with low back pain and diagnosed with facet joint syndrome between January 2018 and December 2018 were included in our study. The patients underwent denervation with radiofrequency under fluoroscopy in a sterile operating room condition. The pre-procedure and 6th month follow-up VAS (visual analogue scale) and ODI (Oswestry disability index) scores of the patients were recorded. When the demographic data of the patients were analysed, the mean age of the patients was found to be 52. Of the patients, 61.7% were female. In the evaluation of VAS and ODI scores, which we used to measure the efficiency of the procedure, the 6th month values were found to be statistically lower than the pre-procedure values (p<0.05). The first treatment for facet joint syndrome is bed rest and medical treatment. Resistant cases also benefit from physical therapy and intra-articular steroid injection. In patients unresponsive to these treatments, denervation with radiofrequency appears to be an effective method. At least two levels must be performed for the procedure to be successful. Studies have shown that pain decreases in the long term (6–12 months) and quality of life increases. We also obtained similar results in our studies. In conclusion, we think that RF (radiofrequency) can be used as an effective method in cases where other treatments fail.
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