KLINIK MAKALE | |
1. | Tracheobronchial Foreign body Aspirations in Children Ufuk Çobanoğlu, Muhammet Can Pages 96 - 101 Aim: Foreign body aspiration may lead to a range of complications from infection related respiratory problems to fatal obstructions. The etiologic factor is frequently reported to be an accident, and parents’ or care-taker’ negligence have also play a role. This research aims to investigate the features of tracheo-bronchial aspiration cases admitted to Elazığ State Hospital and Van 100. University Medical Faculty Chest Surgery Clinic , and to find out whether these data are consistent with the literature. Methods: 52 pediatric patients who were admitted to our clinics between 1995 and 2007 with the pre-diagnosis of foreign body aspiration, were retrospectively reviewed in terms of gender, age, complaints, timing of consultation, physical examination findings, radiologic findings, type and, localization of the foreign body, types of treatment given, length of hospitalization, complications and mortality. Results: Of the 52 children, aged between 4 months and 5 years, 33 were girls (63 %) and 19 were boys (37 %). Foreign bodies was detected in 45 out of 52 cases. 21 of the patients were having cough, 11 were found dyspneic and 9 of them had no identifiable findings. The foreign bodies were taken out by rigid bronchoscopy in 43 (82.6 %)cases, and in 2 occaşions through thoracotomy. It has also been revealed that of all the cases, 21 (40.3 %) admitted to the hospital in the first 6 hours, 16 (30.7 %) in 24 hours, 6 (11.5 %) in 15 days, and 9 patients (17.3 %) consulted in the hospital after more than a month elapsed. Conclusion: Cases of childhood tracheobronchial foreign body aspiration have forensic medicine implications, they are mainly accidentally among the children under 5 years of age. A small number of these events occur due to negligence of the parents and caretakers. This series has been compiled to underline the fact that these events can be prevented by simple precautions by parents and care-takers. |
2. | Early Period Rehabilitation Results of the Patients with Traumatic Brain Injury Bilge Kara, Zeliha Başkurt, Ferdi Başkurt, M.Nuri Arda Pages 102 - 108 Aim: The purpose of our study was to evaluate the effectiveness of the early period rehabilitation programme applied to the patients with traumatic brain injury. Methods: A total of 38 patients, 18 females and 20 males, with over 9 points of Glasgow Coma Scale (GCS) who had been operated because of subdural hematoma were included in the study. Most common cause of traumatic brain injury was motor vehicle accident. Treatment program, consisted of neurophysiological approaches, was applied to the patients who had neurologic deficits and the patients who had not neurologic deficits were instructed to perform normal range of motion movements twice a day. The treatment programs of the patients were progressed as mobilization in bed, sitting, sitting balance, standing, standing balance, walking, stairing up and activity of daily living training with respect to functional level. To evaluate the effectiveness of the program; Functional Independent Measure (FIM) and Disability Rating Scale (DRS) were used. The evaluations were made on the first day of the rehabilitation program and on the day the patients were discharged. Results : At the end of the treatment program, positive improvements were assessed in the level of consciousness of the patients and the neurologic deficits. According to FIM and DRS scores, statistically significant improvements were assessed at the functional level and in the disability scores. The GCS scores correlated significantly with FIM and DRS scores. Conclusion : We conclude that the rehabilitation program that we applied in the early period of TBI is effective in increasing the independence level and decreasing the disability level. |
3. | Corrosive Poisoning Cases Consulted at OMU Faculty of Medicine, Emergency Service Bekir Karaarslan, Ahmet Turla, Berna Aydın Pages 109 - 113 Aim: In this descriptive study, we aimed to determine the demographic characteristics of cases affected by corrosive substances and to compare our results with those of similar studies and contribute to the possible preventive measures. Methods: 3057 forensic cases consulted at OMU Faculty of Medicine, Emergency Service in 2004, were investigated retrospectively for corrosive exposure. Results: Of 77 cases effected by corrosives, 58,4 % were males, 41,6 % were females and most of them (55,8 %) fell into 0- 9 age group. In 88,3 % of the cases, the etiologic couses were reported to be of accidental. Exposure to corrosive substances was mainly seen in summer (33 cases) and 24,7 % of the cases were affected by household bleach. In 40,3 % of the cases, no pathologies have been detected in physical examination. Two cases deid as a result of corrosive intake.. Conclusions: We believe that simple precautions such as producing corrosive substance package caps in a way that children cannot open, keeping them out of the reach of children, and parental education would lead to a decline in the number of corrosive poisoning cases. |
4. | Management of Cardiac Tamponade in Advanced Stage Lung Cancer Hasan Ekim, Mustafa Tuncer, Bülent Özbay Pages 114 - 116 Pericardial effusion leading to tamponade resulting from advanced lung cancer is a rare but life threatening complication of lung cancer. We report our experience of two female patients, aged 65 and 56, with malign pericardial effusion managed by surgical treatment. They were admitted to the cardiology department due to cardiac tamponade. Their echocardiographic examinations showed massive pericardial effusion and right ventricular diastolic collapse. Bronchoscopy revealed inoperable lung cancer in both cases. Repeated pericardiocenteses could not solve the problem. Therefore, surgical intervention was required in both patients. A pericardial-peritoneal window was created under general anesthesia for permanent drainage in both patients. Significant pericardial effusion has not been detected in the follow-up echocardiographic examinations during 3 and 8 postoperative months. The pericardial-peritoneal window, approached subxyphoidally, is a simple, safe, and effective surgical procedure and should be considered in salected patients with malign pericardial tamponade. |
OLGU SUNUMU | |
5. | Prophylactic Dantrolene Administration in a Case of Progressive Musculary Dystrophia with Malignant Hyperthermia Risk Ebru Efetürk Ekmekçioğlu, Cüneyit Aksu, Belgin Akan, Demet Albayrak, Nermin Göğüş Pages 117 - 119 Progresnine museuloey dysisophy (PMD) is a congenital and progressive disease which usually starts in childhood. For these patients, many surgical procedures might be necessary in the management of extremity sequels. Like the other muscular diseases, there is a high risk of MH in PMD. We present anaesthetic maintanence and Dantrolene prophylaxis in this particular PMD case who underwent a surgical precedure under general anaesthesia., . |
DERLEME | |
6. | LUNG ABCESS Ufuk Çobanoğlu, Aydın Deveci Pages 120 - 126 Pulmonary abscess is a localized area of necrosis and suppuration of the lung paranchyme sorrounded by reactive fibrotic tissue which result from various etiologies and pathological processes. Although the incidence of the disease has decreased since the introduction of antibiotic treatment, the prognosis is still poor in elderly, debilated, malnourished and immunocomprimised patients. |