Browsing by Author "Kelebek, Nermin"

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Comparison of different priming techniques on the onset time and intubating conditions of rocuronium
(Lippincott Williams & Wilkins, 2002-07) Yavaşçaoğlu, Belgin; Cebelli, V; Kelebek, Nermin; Uçkunkaya, Nesimi; Kutlay, Oya; Uludağ Üniversitesi/Tıp Fakültesi/Anesteziyoloji & Reanimasyon Anabilim Dalı.; AAI-7914-2021; AAG-9356-2021; 6602742300; 6507927878; 7801569062; 6701807296; 6602199747
Background and objective: The aim was to compare the effects of two different priming doses and priming intervals with the standard intubating dose of rocuronium on the onset time and intubation conditions. Methods: After induction of anaesthesia, 75 patients were randomly assigned to one of five groups. Patients in Group I received a priming dose of rocuronium 0.06 mg kg(-1) followed 2 min later by rocuronium 0.54 mg kg(-1), Group 2 received a priming dose of 0.10 mg kg(-1) followed 2 min later by a rocuronium injection of 0.50 mg kg(-1). Group 3 was given a priming dose of 0.06 mg kg(-1) followed 3 min later by administration 0.54 mg kg(-1) where Group 4 received a priming dose of 0.10 mg kg(-1) followed 3 min later by injection of 0.50 mg kg(-1). Group 5 received a placebo injection followed 3 min later by rocuronium 0.60 mg kg(-1). Results: Priming with a 3 min priming interval shortened the onset time of rocuronium irrespective of the dosage of (P < 0.001). Clinical duration of action was significantly longer after priming in Group 4 than in Group 5. Clinically acceptable intubation conditions were obtained in all patients. Conclusions: Priming with a 3 min priming interval was effective when rapid tracheal intubation with rocuronium was necessary. However, priming with rocuronium should be used carefully with special attention given to the possibility of hypoxia and aspiration of gastric contents in awake patients.
Impact of a basic nutrition course for residents at a faculty hospital
(Karger, 2008) Kırdak, Türkay; İşçimen, Remzi; Tanır, Burak; Kelebek, Nermin; Keskin, Murat; Korun, Nusret; Uludağ Üniversitesi/Tıp Fakültesi/Cerrahi Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Beslenme Ünitesi.; 0000-0001-8111-5958; 0000-0003-4526-4352; AAI-8104-2021; 8704181100; 16645821200; 24330408900; 7801569062; 23050640000; 6602316874
Background/ Aims: To assess whether a basic nutrition course for residents at a faculty hospital improves their knowledge of nutrition and increases the number of consultation requests for nutrition by alerting participants to the high prevalence of undernutrition in hospitals. Methods: The residents from 34 departments of basic, internal and surgical sciences were recruited to take a 1-day course. Questionnaires, designed to assess knowledge of nutrition, were completed at the beginning and at the end of the course. The results of the questionnaires and the number of consultation demands for nutrition before and after the course were compared. Results: The results of 161 participants were evaluated. The mean (8 SE) numbers of correct answers given to the first and second questionnaires were 14.9 +/- 0.22 and 18.7 +/- 0.21, respectively (p < 0.01). When the number of requests for nutrition consultation during 7-month periods (just before and after the course) were compared, the mean number of requests in each month during these periods were found to be 1.81 +/- 0.58 and 4.06 +/- 1.20, respectively (p < 0.01). Conclusions: A short course of basic nutrition for residents improves their basic knowledge and leads to an increase in the number of consultation requests for nutritional support.
Nosocomial Acinetobacter pneumonia: Treatment and prognostic factors in 356 cases
(Wiley, 2015-08-31) Özvatan, Tülay; Akalın, Halis; Sınırtaş, Melda; Ocakoğlu, Gökhan; Yılmaz, Emel; Heper, Yasemin; Kelebek, Nermin; İşçimen, Remzi; Kahveci, Ferda; Uludağ Üniversitesi/Tıp Fakültesi/Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Mikrobiyoloji ve Klinik Mikrobiyoloji Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Biyoistatistik Anabilim Dalı.; 0000-0001-8111-5958; 0000-0003-4820-2288; 0000-0002-3894-1231; AAG-9356-2021; AAU-8952-2020; AAI-8104-2021; AAH-6506-2021; AAH-5180-2021; 57074087100; 57207553671; 6505818048; 57073882900; 22037135100; 56191003300; 7801569062; 16645821200; 6602405968
Background and objective: Acinetobacter baumannii and A. baumannii/calcoaceticus complex are commonly encountered pathogens in nosocomial infections. This study aimed to evaluate the treatment and prognostic risk factors in nosocomial pneumonia caused by these microorganisms. Methods: The study was conducted retrospectively in Uludag University Hospital and included 356 adult non-neutropenic patients with nosocomial pneumonia. Results: Of the subjects, 94.9% (n = 338) had ventilator-associated pneumonia. The clinical response rate was 57.2%, the 14-day mortality 39.6% and the 30-day mortality 53.1%. The significant independent risk factors for the 30-day mortality were severe sepsis (OR, 2.60; 95% CI: 1.49-4.56; P = 0.001), septic shock (OR, 6.12; 95% CI: 2.75-13.64; P < 0.001), APACHE II score >= 20 (OR, 2.12; 95% CI: 1.28-3.50; P = 0.003) and empiric monotherapy (OR, 1.63; 95% CI: 1.00-2.64; P = 0.048). Multi-trauma (OR, 2.50; 95% CI: 1.11-5.68; P = 0.028) was found to be a protective factor. In patients with a clinical pulmonary infection score (CPIS) > 6 on the third day of treatment, both the 14- and 30-day mortality rates were high (P < 0.001, P < 0.001). Also, the 14- and 30-day mortality rates were significantly higher in the patients treated with empiric monotherapy compared with combination therapy (48/93 (51.6%)-46/123 (37.4%), P = 0.037 and 62/93 (66.7%)-65/123 (52.8%), P = 0.041, respectively) in pneumonia caused by imipenem-resistant strains. Conclusion: Mortality rates were high in pneumonia caused by imipenem-resistant A. baumannii or A. baumannii/calcoaceticus complex. In the units with a high level of carbapenem resistance, antibiotic combinations should be considered for empiric therapy.
Our experience on feeding ostomies
(Türk Cerrahi Derneği, 2008-10-01) Kırdak, Türkay; Özgüç, Halil; Keskin, Murat; İşçimen, Remzi; Kelebek, Nermin; Kıyıcı, Murat; Korun, Nusret; Kılıçturgay, Sadık; Kırdak, Türkay; Özgüç, Halil; Keskin, Murat; İŞÇİMEN, REMZİ; KELEBEK GİRGİN, NERMİN; KIYICI, MURAT; Korun, Nusret; KILIÇTURGAY, SADIK AYHAN; Uludağ Üniversitesi/Tıp Fakültesi/Genel Cerrahi Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Gastroenteroloji Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Anestezioloji ve Reanimasyon Anabilim Dalı.; 0000-0003-4526-4352; 0000-0002-3208-6211; 0000-0001-8111-5958; CZX-7145-2022; JIC-3640-2023; JZY-7001-2024; HKP-2533-2023; CZG-2204-2022; AAI-4213-2021; FJN-9955-2022; JGY-2962-2023
Purpose: The aim of the present study is to assess patient's profiles and complications related to the tube placement in patients undergoing Percutaneous Endoscopic Gastrostomy and surgical feeding ostomies.Materials and Methods: The retrospective data of 114 consecutive hospitalized patients who underwent enteral feeding ostomy procedures was evaluated by dividing patients into two separate groups as Percutaneous Endoscopic Gastrostomy Group and Surgery Group.Results: Of the 114 patients, 57 patients underwent surgical feeding ostomy procedures, and other 57 underwent Percutaneous Endoscopic Gastrostomy. The mean age of the patients requiring surgical ostomy was greater than that of the patients with Percutaneous Endoscopic Gastrostomy. All procedures in the surgical group were performed in the operating theater, but procedures in the endoscopy group were performed in intensive care unit (61.5 %), endoscopy suit (34.6 %), or patient wards (3.8 %). The number of patients having cancer in the surgical ostomy group was higher than the Endoscopy group significantly, p<0.001. On the contrary, 93 % of the patients in the Endoscopy group had neurologic problems. Total complication rates in PEG group, surgical gastrostomy and jejunostomy groups were 26.3 %, 25 % and 24.3 %, respectively.Conclusion: In conclusion, PEG procedure has some advantages such as simplicity, low complication rates, lower cost, long term enteral nutrition. For that reason, recently, there is an increase in use of PEG procedure. However, the situation in which the use of PEG is impossible, surgical enteral tube placement techniques are still valid alternatives.
Perinöral morfin ve fentanilin brakial pleksus blokajında anestezi ve analjezi üzerine etkileri
(Uludağ Üniversitesi, 1999) Kelebek, Nermin; Uludağ Üniversitesi/Tıp Fakültesi/Anesteziyoloji ve Reanimasyon Anabilim Dalı.
Çalışmamızda, aksiller yaklaşımla yapılmış brakial pleksııs bloğu altında el cerrahisi uygulanacak ASA I-II gruba giren 15'er kişilik 9 gruba ayrılmış toplam 135 olguda perinöral verilen morfin ve fentanilin blok başlama süresi, anestezi ve analjezi süresi üzerine etkilerini araştırdık. Preoperatif dönemde premedikasyon verilmeyen olgular işlem hakkında önceden bilgilendirildi. Tüm gruplara 100 mg %0.5 Bupivakain ve 200 mg % 2 Lidokain solüsyonu standart olarak verildi. Kontrol grubuna biç opioid verilmez iken intramusküler MMı ve MM2, perinöral MAı ve MA2 gruplarına sırasıyla 50 ng/kg ile 100 fig/kg morfin; intramusküler FMı ve FM2, perinöral FAı ve FA2 gruplarına ise sırasıyla 1 jıg/kg ile 2 ng/kg fentanil verildi. Olguların hemodinamik verileri, solunum sayılan, periferik oksijen saturasyonlan, sensorial ve motor blok düzeyleri ile ilk analjezik İhtiyaç zamanlan ve yan etkiler izlendi. Hemodinamik veriler, dakika solunum sayılan, periferik oksijen saturasyonlan açısından grupiçi ve gruplar arası anlamh farklılık bulunmadı. Perinöral fentanil uygulanan FAı ve FA2 gruplarında sensorial bloğun anlamh olarak daha erken başladığı saptanmasına rağmen, perinöral morfin uygulanan MAı ve MA2 gruplarında blok başlama süresinin kontrol grubu ve intramusküler gruplara göre değişmediği görüldü. 43Postoperatif analjezi süresine bakıldığında; ilk analjezik ihtiyaç süresinin kontrol grubuyla karşdaştırıldığında tüm gruplarda klinik olarak daha uzun olduğu saptandı. Ancak bu süre sadece perinöral ve intramusküler 100 pg/kg morfin verilen gruplarda istatistiksel olarak anlamlıydı. Opioidlerin yan etkilerinden bulantı, 100 fig/kg perinöral morfin verilen MA2 grubunda 2 olguda ve 100 ^ıg/kg intramusküler morfin verilen MM2 grubunda 1 olguda görüldü. Kusma, kaşıntı, idrar retansiyonu ve solunum depresyonuna hiçbir olguda rastlanmadı. Sonuç olarak; brakial pleksus bloğunda lokal anestezik solüsyon ile birlikte perinöral uygulanan fentanil ve morfinin postoperatif analjezi süresini etkilemediği ancak fentanilin blok başlangıç süresini anlamlı olarak kısalttığı sonucuna vardık.
Therapeutic plasmapheresis therapy in patient with thyroid storm in the intensive care unit
(Galenos Yayıncılık, 2020-01-15) Ertem, Aytül Coşar; Dağdelen, Melike Şeyda; Yıldız, Simge; Kahveci, Ferda Şöhret; Kelebek, Nermin; İsçimen, Remzi; COŞAR ERTEM, AYTÜL; Dağdelen, Melike Şeyda; Yıldız, Simge; KAHVECİ, FERDA ŞÖHRET; KELEBEK GİRGİN, NERMİN; İŞÇİMEN, REMZİ; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Anesteziyoloji ve Reanimasyon Anabilim Dalı.; 0000-0002-2767-1483; 0000-0003-2613-0084; 0000-0002-5882-1632; 0000-0001-8111-5958; 0000-0001-9020-5453; 0000-0003-4820-2288; AAI-8104-2021; HKP-2533-2023; ABE-2447-2020; DTR-4864-2022; CQC-3738-2022; IMY-6211-2023; GBC-7197-2022
Thyroid storm is a rare clinical condition, and failure in management can lead to multiorgan failure and carries a high mortality. The comprehensive treatment approach is the administration of antithyroid drugs and radioactive iodine and thyroidectomy. The treatment option of therapeutic plasmapheresis (TP) should be considered as a stabilizing measure, especially when patients have failed or can not tolerate conventional treatment. This case report aimed to share that TP might be an alternative approach to be added to standard treatment methods in life-threatening conditions.