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Öğe A bifid sternum case underwent the earliest repair in the literature(2005) Demircan, Mehmet; Gürbüz, Necla; Karaman, AbdurrahmanAbstract: Inkomplet konjenital sternal kleft nadir bir anomalidir. Büyük çocuklarda daha kompleks rekonstrüksiyon ihtiyacından kaçınmak için, yenidoğan periodunda bu defektlerin primer olarak kapatılması önerilmektedir. Bu yazıda mümkün olan en kısa sürede primer onarılan bifid sternumlu beş günlük bir yenidoğan bildirilmiştir.Öğe Bir İnfantta Saptanan Servikal Subkutan Yerleşimli Kartilajinöz Koristoma(İnönü Üniversitesi Tıp Fakültesi Dergisi, 2007) Karaman, Abdurrahman; Ceran, Canan; Uğuralp, Sema; Gürses, İclal; Demircan, MehmetKartilajinöz koristoma çocuklarda oldukça nadir görülen bir patolojidir. Kitlenin total çıkarılması en seçkin tedavi yöntemdir. Bu çalışmada boyun lateral yerleşimli bir kartilajinöz koristoma olgusu sunulmuştur.Öğe Cervical subcutaneous cartilaginous choristoma in an infant(2007) Karaman, Abdurrahman; Ceran, Canan; Uğuralp, Sema; Gürses, İclal; Demircan, MehmetAbstract: Kartilajinöz koristoma çocuklarda oldukça nadir görülen bir patolojidir. Kitlenin total çıkarılması en seçkin tedavi yöntemdir. Bu çalışmada boyun lateral yerleşimli bir kartilajinöz koristoma olgusu sunulmuşturÖğe Çevresel Sigara Dumanının 7-10 Yaş Grubu Çocuklarda Testis Fonksiyonlarına Etkisi(İnönü Üniversitesi Tıp Fakültesi Dergisi, 2012) Karaman, Abdurrahman; Taş, Erkan; Temel, İsmail; Gürsoy, Şule; Demircan, MehmetPasif içicilik olarak tanımlanan çevresel sigara dumanına maruz kalma sık karşılaşılan bir durumdur. Bu çalışma ile pasif sigara içicisi durumunda olan 7–10 yaş grubu çocuklarda çevresel sigara dumanının testis fonksiyonları üzerindeki etkisini incelemeyi amaçladık. Gereç ve Yöntem: Çalışmaya ilköğretim okullarında okuyan, 7-10 yaş grubunda ek bir sağlık problemi olmayan erkek çocuklar dahil edildi. Pasif sigara içicisi durumunda olan (Pİ) 50 olgu ve olmayan (K) 50 olgu anket çalışmasıyla belirlendi. Belirlenen olguların serumlarından kotinin düzeyleri ile testis fonksiyonunun biyokimyasal göstergeleri olan testosteron, inhibin-B, anti-müllerian hormon (AMH) ile beraber FSH ve LH düzeyleri çalışıldı. Bulgular: Pİ grubunda serum kotinin düzeyleri K grubuna göre belirgin artmış bulundu (p<0,05). Testosteron, inhibin-B, FSH, LH düzeyleri K grubunda Pİ grubuna göre belirgin olarak yüksek bulunurken; bu yaş grubunda testosteron ile ters orantılı hareket eden AMH seviyelerinin K grubunda Pİ grubuna göre düşük olduğu saptandı (p<0,05). Sonuç: Elde ettiğimiz sonuçlar çevresel sigara dumanının testislerde fonksiyon bozukluğuna yol açtığını göstermektedir. Bunun da erişkin yaşlarda ortaya çıkabilecek infertiltenin nedenlerinden birisi olabileceği düşünülmektedir.Öğe Çocuklarda Üreterin Segmental Kistik Dilatasyonu(İnönü Üniversitesi Tıp Fakültesi Dergisi, 2010) Karaman, Abdurrahman; Demircan, Mehmet; Uğuralp, Sema; Özcan, Canan Ceran; Sığırcı, Ahmet“Segmental megaüreter” veya “segmental üreteral kistik dilatasyon” oldukça nadir görülen bir patoloji olup literatürde sadece birkaç olgu sunumu bildirilmiştir. Bu çalışmada sol taraf segmental megaüreter ve karşı taraf inkomplet üreteral duplikasyonu olan bir olgu sunulmuştur. Skrotal şişlik şikâyeti ile başvuran 2 aylık erkek olguda sağ hidrosel ve sol inmemiş testis saptandı. Olgunun antenatal ultrasonografisinde sağ renal pelviste dilatasyon saptanması üzerine postnatal değerlendirmesinde sol üreter orta kısmında kistik dilatasyon ile beraber sol renal pelvis ile distal üreterde hafif dilatasyon gözlendi. Laparotomide sol üreter orta kısımda belirgin kistik dilatayon ile birlikte sol renal pelvisin ve üreter proksimal ve distalinin normal olduğu görüldü. Dilate segment eksize edildi ve üretere uç uca anastomoz yapıldı.Öğe Damaging Effects of Total Parenteral Nutrition Formula on Vascular Endothelium(Lippincott Williams & Wilkins, 2015) Demircan, Mehmet; Gurunluoglu, Kubulay; Karaman, Abdurrahman; Mizrak, BulentObjectives: Sepsis in one of the most serious complications that can occur during total parenteral nutrition (TPN) procedures. In this experimental study, we investigated the effects of TPN, with or without lipid emulsion, on vascular endothelial damage. Methods: In total, 50 rabbits were used, divided into 5 groups of 10 each. TPN with lipids (group 1), TPN without lipids (group 2), and 0.09% saline (group 3) were given for 10 days via a central venous catheter. Group 4 received no treatment other than placement of a central venous catheter for 10 days. Group 5 was a control group. At the end of day 10, rabbits were sacrificed and tissue samples of liver, kidney, and inferior vena cava were prepared and examined by immunohistochemical methods for vascular cellular adhesion molecule (VCAM)-1 expression. Results: In tissue sections of liver, kidney, and inferior vena cava, VCAM-1 activity was increased prominently in TPN with and without lipids compared with the control group. VCAM-1 activity in the TPN with lipids group was decreased versus the TPN without lipids group (P > 0.05). Conclusions: The TPN procedure results in vascular endothelial cell damage not only in the vein where the solution is introduced but also in other parts of the vascular system. Even if it is not statistically significant, lipids in the TPN formula may decrease this endothelial cell damage, as shown by immunohistochemistry.Öğe Detorsiyon öncesi uygulanan caffeic acid phenethyl ester'in testiküler reperfüzyon hasarına etkisi(2000) Koltuksuz, Uğur; Uz, Efkan; Karaman, Abdurrahman; Özyurt, Hüseyin; Aydinç, Mustafa; Akyol, ÖmerÖz: AMAÇ: İskemi sonrası reperfüzyon hasarı birçok organda olduğu gibi testiste de kabul edilen bir fenomendir. Spesifik bir propolis bileşeni olan Caffeic acid phenethyl ester (CAPE) antioksidan özellikleri olan kimyasal bir bileşimdir. CAPE'in testiste detorsiyon sonrası reperfüzyon hasarını önleyici etkisinin olup olmadığını araştırmak için bir deneysel çalışma planladık. YÖNTEM: Kırk adet erkek erişkin Wistar Albino rat sham, torsiyon, serum fizyolojik-detorsiyon ve CAPE-detorsiyon olmak üzere her biri 10 rattan oluşan dört gruba ayırıldı. Torsiyon grubunda ratlar sol testise saat yönünde 720o torsiyon uygulandıktan iki saat sonra sakrifıye edildi. Serum fizyolojik-detorsiyon grubunda ratlara detorsiyondan 30 dakika önce 1 mi serum fizyolojik verildi ve detorsiyon uygulandıktan 4 saat sonra sakrifiye edildiler. CAPE-detorsiyon grubunda ise serum fizyolojik yerine yine detorsiyondan 30 dakika önce CAPE (10 pmol/kg) uygulandı. Sakrifiye edilen hayvanların her iki teslisleri malondialdehid (MDA) seviyesi ve ksantin oksidaz (XO) aktivitesinin belirlenmesi için alındı. BULGULAR: İpsilateral testiste torsiyon grubu ortalama MDA seviyesi ve XO aktivitesi sham grubuna göre anlamlı şekilde yükselmişti (P<0.001 ve P<0.01). Serum fizyolojik-detorsiyon grubu ortalama MDA seviyesi ve XO aktivitesi torsiyon grubuna göre anlamlı şekilde yüksek bulunurken (P<0.01 ve P<0.05), CAPE-detorsiyon grubunda ise anlamlı değişiklik gözlenmedi. Kontrlateral testiste bu iki parametre açısından gruplar arasında anlamlı fark yoktu. SONUÇ: Detorsiyon öncesi uygulanan CAPE'nin reperfüzyon sonrası ortaya çıkan ve hücre zarında lipid peroksidasvonu yaparak hücresel hasara sebep olan reaktif oksijen türlerini yok ederek reperfüzyon hasarına engel olmaktadır.Öğe The effect of environmental tobacco smoke on the testicular functions of 7-10 years old children(2012) Temel, İsmail; Gürsoy, Şule; Taş, Erkan; Demircan, Mehmet; Karaman, AbdurrahmanAmaç: Pasif içicilik olarak tanımlanan çevresel sigara dumanına maruz kalma sık karşılaşılan bir durumdur. Bu çalışma ile pasif sigara içicisi durumunda olan 7–10 yaş grubu çocuklarda çevresel sigara dumanının testis fonksiyonları üzerindeki etkisini incelemeyi amaçladık. Gereç ve Yöntem: Çalışmaya ilköğretim okullarında okuyan, 7-10 yaş grubunda ek bir sağlık problemi olmayan erkek çocuklar dahil edildi. Pasif sigara içicisi durumunda olan (Pİ) 50 olgu ve olmayan (K) 50 olgu anket çalışmasıyla belirlendi. Belirlenen olguların serumlarından kotinin düzeyleri ile testis fonksiyonunun biyokimyasal göstergeleri olan testosteron, inhibin-B, anti-müllerian hormon (AMH) ile beraber FSH ve LH düzeyleri çalışıldı. Bulgular: Pİ grubunda serum kotinin düzeyleri K grubuna göre belirgin artmış bulundu (p<0,05). Testosteron, inhibin-B, FSH, LH düzeyleri K grubunda Pİ grubuna göre belirgin olarak yüksek bulunurken; bu yaş grubunda testosteron ile ters orantılı hareket eden AMH seviyelerinin K grubunda Pİ grubuna göre düşük olduğu saptandı (p<0,05). Sonuç: Elde ettiğimiz sonuçlar çevresel sigara dumanının testislerde fonksiyon bozukluğuna yol açtığını göstermektedir. Bunun da erişkin yaşlarda ortaya çıkabilecek infertiltenin nedenlerinden birisi olabileceği düşünülmektedir.Öğe The effect of environmental tobacco smoke on the testicular functions of 7-10 years old children(İnönü Üniversitesi Tıp Fakültesi Dergisi, 2012) Karaman, Abdurrahman; Taş, Erkan; Temel, İsmail; Gürsoy, Şule; Demircan, MehmetÖz:Amaç: Pasif içicilik olarak tanımlanan çevresel sigara dumanına maruz kalma sık karşılaşılan bir durumdur. Bu çalışma ile pasif sigara içicisi durumunda olan 7–10 yaş grubu çocuklarda çevresel sigara dumanının testis fonksiyonları üzerindeki etkisini incelemeyi amaçladık. Gereç ve Yöntem: Çalışmaya ilköğretim okullarında okuyan, 7-10 yaş grubunda ek bir sağlık problemi olmayan erkek çocuklar dahil edildi. Pasif sigara içicisi durumunda olan (Pİ) 50 olgu ve olmayan (K) 50 olgu anket çalışmasıyla belirlendi. Belirlenen olguların serumlarından kotinin düzeyleri ile testis fonksiyonunun biyokimyasal göstergeleri olan testosteron, inhibin-B, anti-müllerian hormon (AMH) ile beraber FSH ve LH düzeyleri çalışıldı. Bulgular: Pİ grubunda serum kotinin düzeyleri K grubuna göre belirgin artmış bulundu (p<0,05). Testosteron, inhibin-B, FSH, LH düzeyleri K grubunda Pİ grubuna göre belirgin olarak yüksek bulunurken; bu yaş grubunda testosteron ile ters orantılı hareket eden AMH seviyelerinin K grubunda Pİ grubuna göre düşük olduğu saptandı (p<0,05). Sonuç: Elde ettiğimiz sonuçlar çevresel sigara dumanının testislerde fonksiyon bozukluğuna yol açtığını göstermektedir. Bunun da erişkin yaşlarda ortaya çıkabilecek infertiltenin nedenlerinden birisi olabileceği düşünülmektedir. Başlık (İngilizce):Çevresel sigara dumanının 7-10 yaş grubu çocuklarda testis fonksiyonlarına etkisi Öz (İngilizce):Purpose: To investigate the effect of environmental tobacco smoke (ETS) on the testicle functions of 7-10 years old children. Materials and Methods: The study included healthy male children aging between 7-10 years. Based on the questionnaire data, 50 passive smoking (PS) cases and 50 passive smoking free controls were determined. Serum levels of cotinine, and biochemical parameters of the testicle functions; testosterone, inhibin B, anti-mullerian hormone (AMH) along with FSH and LH levels were evaluated. Results: Serum cotinine levels in PS group were found higher than the controls (p<0,05). Testosterone, inhibin-B, FSH, and LH levels of the control group was found higher than the PS group. The AMH levels were found lower in the controls in comparison with the PS group (p<0,05). Conclusions: Our results showed that ETS leads to testicular dysfuntions. We think that preventing exposure to cigarette smoke in childhood is very important for their reproductive system.Öğe Effect of leflunomide on liver regeneration after partial hepatectomy in rats(Springer, 2010) Karaman, Abdurrahman; Kirimlioglu, Hale; Tas, Erkan; Karadag, Nese; Gulsul, Cebrail; Fadillioglu, Ersin; Demircan, MehmetPartial hepatectomy (PH) can be an inevitable surgical therapy in some conditions, such as hepatic malignancies, trauma or partial liver transplantation. Its capacity for regeneration distinguishes the liver from other essential organs. Regeneration is a complex process involving growth factors, cytokines, transcription factors, hormones, and oxidative stres products. In the event of ineffective or total absent liver regeneration, the lifethreatening picture of acute liver failure may supervene. In the present research, we studied the effect of leflunomide, a novel immunosuppressive and anti-inflammatory agent against autoimmune disease, on hepatic regeneration after PH in Wistar Albino rats. Thirty-five Wistar albino rats were divided into five groups: group 1, control; group 2, sham; group 3, drug control (was treated with leflunomide 10 mg/kg/d/i.g.); group 4, PH; group 5, PH + leflunomide. As for PH, approximately 70% of the rat liver was surgically removed under general anesthesia. On postoperative day 3, all rats were humanely killed. Catalase (CAT), superooxide dismutase (SOD) and myeloperoxidase (MPO) activities with malondialdehyde (MDA), nitric oxide and protein carbonyl (PC) levels were determined in remnant liver tissue. Inflammatory process and liver regeneration were evaluated with H&E and KI67, respectively. The tissue levels of MDA, PC and MPO were lower in group 5 than levels in group 1. PH significantly decreased the enzymatic activity of CAT (p < 0.05) and SOD. This reduction was significantly improved by the treatment with leflunomide. Histopathologically the enhancement of the liver parenchymal regeneration in the group 5 was significantly greater than the group 4. The findings imply that oxidative stress products play a preventive role in liver regeneration after PH and leflunomide ameliorates the regeneration probably by the radical scavenging and antioxidant activities.Öğe Effects of Tolterodine and Trospium Chloride on Renal Damage Induced by Partial Upper Urinary Tract Obstruction(Elsevier Science Inc, 2013) Karaman, Abdurrahman; Samdanci, Emine; Sayin, Sadegul; Karabulut, Ismail; Fadillioglu, ErsinOBJECTIVE To examine the efficacy of trospium chloride and tolterodine on the renal parenchymal inflammatory process and upper urinary dilation in rats with chronic partial upper urinary tract obstruction. MATERIALS AND METHODS A total of 32 rats were divided into 4 groups: group 1, control; group 2, obstruction; group 3, obstruction plus tolterodine; and group 4, obstruction plus trospium chloride. In all groups, except for group 1, partial upper urinary tract obstruction was induced by embedding the upper quarter of the right ureter into the psoas muscle for 14 days. At the end of the experiment, the rats were killed. The catalase, malondialdehyde, and protein carbonyl levels were determined in renal tissue. Tubular dilation and parenchymal inflammation were evaluated using hematoxylin-eosin staining. Smooth muscle actin and cytoglobin were examined with immunohistochemical staining. RESULTS The obstruction group demonstrated severe pelvic dilation and parenchymal inflammation and increased smooth muscle actin staining in the wall of upper urinary tract (P < .05). The treatment of the rats with tolterodine and trospium chloride markedly attenuated the inflammatory alterations and reduced tubular dilation. This treatment also reduced elevated oxidative stress product levels and restored the depleted renal antioxidant enzyme. CONCLUSION These findings imply that increased renal pelvic pressure can contribute to renal parenchymal injury in chronic pelvic upper urinary tract obstruction. Antimuscarinic medications such as tolterodine and trospium chloride exert renoprotective effects, probably by prevention of pelvic pressure increases. UROLOGY 82: 194-200, 2013. (C) 2013 Elsevier Inc.Öğe Frequency of enuresis, constipation and enuresis association with constipation in a group of school children aged 5-9 years in Malatya, Turkey(Turkish Journal of Medical Sciences, 2003) Uğuralp, Sema; Karaoğlu, Leyla; Karaman, Abdurrahman; Demircan, Mehmet; Yakıncı, CengizAbstract: The aim of this study was to determine the frequency of enuresis, constipation and enuresis associated with constipation in school children aged 5-9 years living in Malatya Municipality, Turkey. This is a descriptive cross-sectional study. All elementary schools in Malatya Municipality with kindergarten and preparatory classes took part in the study. All parents of the children aged 5-9 years enrolled in these schools were given a questionnaire. Completion of the questionnaire was voluntary. Of the parents, 1377 completed the questionnaire and these were evaluated. Overall enuresis frequency was 9.5%. Enuresis frequency was significantly higher among boys (11.2%) compared to girls (7.7%) (P < 0.05). Among children aged 9 years, enuresis frequency (3.9%) was significantly lower than in younger age groups (P < 0.05). The frequency of constipation was 12.4%. The frequency of the association of enuresis with constipation was 21.6%. The frequency of enuresis in Malatya is similar to that in the literature. It was found that about 1 in 4 enuretic children had constipation, and so seeking a constipation history in enuretic children is strongly suggested.Öğe Intrathoracic sewing needle: An unusual penetrating injury in two children(İnönü Üniversitesi Tıp Fakültesi Dergisi, 2009) Uğuralp, Sema; Harma, Birsen; Karaman, AbdurrahmanÖz: Toraksa batmış iğne çocuklarda rapor edilmemiştir. Nadir rastlanmasından ve tesadüfen tanı konmasından dolayı toraksa batmış iğne tesbit ettiğimiz iki olguyu sunduk. Toraksta keskin yabancı cisim görüldüğünde yabancı cisim aspirasyonunun yanısıra iğne batması ile oluşan penetran yaralanmalar da akla getirilmelidir. Başlık (İngilizce): Toraksa batmış iğne: İki çocukta sıradışı penetran yaralanma Öz (İngilizce): Intrathoracic sewing needle was not reported in children. We present two cases with intrathoracic sewing needle due to their rarity and incidental presentation. Even though rare, foreign body penetration should be considered as a potential cause in addition to aspiration when a sharp foreign body is detected in child’s thorax.Öğe Literatürde En Erken Onarılmış Bir Bifid Sternum Olgusu(İnönü Üniversitesi Tıp Fakültesi Dergisi, 2005) Demircan, Mehmet; Gürbüz, Necla; Karaman, AbdurrahmanInkomplet konjenital sternal kleft nadir bir anomalidir. Büyük çocuklarda daha kompleks rekonstrüksiyon ihtiyacından kaçınmak için, yenidoğan periodunda bu defektlerin primer olarak kapatılması önerilmektedir. Bu yazıda mümkün olan en kısa sürede primer onarılan bifid sternumlu beş günlük bir yenidoğan bildirilmiştir.Öğe Multiple Intestinal Atresia in Two Siblings Born of a Close Consanguineous Marriage: Case Report(Ortadogu Ad Pres & Publ Co, 2011) Uguralp, Sema; Karaman, Abdurrahman; Savaci, SerapHereditary multiple intestinal atresia is the rarest form of multiple intestinal atresia with a presumed autosomal recessive mode of inheritance. Two consecutive male siblings were admitted due to non-bilious vomiting. A plain radiograph of the abdomen revealed a single air bubble and expanded stomach in both siblings. Barium contrast study showed unused colon in the first sibling. In the second sibling, barium contrast study indicated rectal obstruction. On laparotomy, there were multiple gastrointestinal atresia in both of them. No chromosomal abnormality was observed with cytogenetic studies. The parents were first cousins. Here, we present two siblings with hereditary multiple intestinal atresia born of close consanguineous marriage, and discussed possible etiopathogenesis.Öğe Necrotizing enterocolitis due to congenital complete atrioventricular block(Annals of Medical Sciences, 2000) Koltuksuz, Uğur; Paç, Feyza A.; Gürsoy, M. Harun; Aydinç, Mustafa; Karabiber, Hamza; Çetin, Selma; Karaman, AbdurrahmanNecrotizing enterocolitis due to congenital complete atrioventricular blockÖğe Pain fentanyl consumption and delirium in adolescents after scoliosis surgery dexmedetomidine vs midazolam(Pediatric Anesthesia, 2013) Aydoğan, Mustafa Said; Korkmaz, Mehmet Fatih; Özgül, Ülkü; Erdoğan, Mehmet Ali; Yücel, Aytaç; Karaman, Abdurrahman; Toğal, Türkan; Durmuş, Mahmut; Çolak, CemilBackground: The study aim was to compare the efficacy of dexmedetomidinevs midazolam for sedation during the early postoperative period in adoles-cents who underwent scoliosis surgery.Methods: We performed a prospective, randomized trial in an intensive careunit (ICU) in a tertiary care center. In this study, 42 patients (American Soci-ety of Anesthesiology physical status I and II) who underwent scoliosissurgery were divided into two groups according to sedation protocols: groupdexmedetomidine (DEX) (n = 22) and group midazolam (MDZ) (n = 20).Adolescents (12–18 years) requiring mechanical ventilation underwent a con-tinuous infusion of either dexmedetomidine (group DEX; starting dose,0.4 lgkg1h1) or midazolam (group MDZ; starting dose, 0.1 mgkg1h1)with intermittent fentanyl, as needed. The efficacy of sedation was assessedusing the Richmond Agitation Sedation Scale (RASS). Quality of pain reliefwas measured using the Numeric Visual Analog Scale (NVAS). Delirium wasdetermined in patients in the RASS range of 2to+1 using the ConfusionAssessment Method for the ICU (CAM-ICU). Fentanyl consumption,incidence of delirium, NVAS scores, and hemodynamics were recordedpostoperatively at 2, 4, 6, and 24 h in the ICU.Results: The NVAS pain scores and fentanyl consumption at all the evalua-tion time points were significantly higher in group MDZ than those in groupDEX (P < 0.05). Further, total fentanyl consumption in group MDZ was sig-nificantly higher than that in group DEX (P < 0.05). Delirium was signifi-cantly higher in the group MDZ than that in group DEX (31.3% vs 12.5%)when analyzed as the endpoint of CAM-ICU (P < 0.05). The heart rate wassignificantly lower in group DEX compared with that in group MDZ at allthe evaluation time points (P < 0.05).Conclusion: Dexmedetomidine was associated with the decreased postopera-tive fentanyl consumption, NVAS scores, and a decreased incidence of delir-ium. These findings may be beneficial for managing sedation protocols inadolescents who have undergone scoliosis surgery.Öğe Pain fentanyl consumption and delirium in adolescents after scoliosis surgery dexmedetomidine vs midazolam(Pediatric Anesthesia, 2013) Aydoğan, Mustafa Said; Korkmaz, Mehmet Fatih; Özgül, Ülkü; Erdoğan, Mehmet Ali; Yücel, Aytaç; Karaman, Abdurrahman; Toğal, Türkan; Durmuş, Mahmut; Çolak, CemilBackground: The study aim was to compare the efficacy of dexmedetomidine vs midazolam for sedation during the early postoperative period in adolescents who underwent scoliosis surgery. Methods: We performed a prospective, randomized trial in an intensive care unit (ICU) in a tertiary care center. In this study, 42 patients (American Society of Anesthesiology physical status I and II) who underwent scoliosis surgery were divided into two groups according to sedation protocols: group dexmedetomidine (DEX) (n = 22) and group midazolam (MDZ) (n = 20). Adolescents (12–18 years) requiring mechanical ventilation underwent a continuous infusion of either dexmedetomidine (group DEX; starting dose, 0.4 lg kg1 h1 ) or midazolam (group MDZ; starting dose, 0.1 mg kg1 h1 ) with intermittent fentanyl, as needed. The efficacy of sedation was assessed using the Richmond Agitation Sedation Scale (RASS). Quality of pain relief was measured using the Numeric Visual Analog Scale (NVAS). Delirium was determined in patients in the RASS range of 2 to +1 using the Confusion Assessment Method for the ICU (CAM-ICU). Fentanyl consumption, incidence of delirium, NVAS scores, and hemodynamics were recorded postoperatively at 2, 4, 6, and 24 h in the ICU. Results: The NVAS pain scores and fentanyl consumption at all the evaluation time points were significantly higher in group MDZ than those in group DEX (P < 0.05). Further, total fentanyl consumption in group MDZ was significantly higher than that in group DEX (P < 0.05). Delirium was signifi- cantly higher in the group MDZ than that in group DEX (31.3% vs 12.5%) when analyzed as the endpoint of CAM-ICU (P < 0.05). The heart rate was significantly lower in group DEX compared with that in group MDZ at all the evaluation time points (P < 0.05). Conclusion: Dexmedetomidine was associated with the decreased postoperative fentanyl consumption, NVAS scores, and a decreased incidence of delirium. These findings may be beneficial for managing sedation protocols in adolescents who have undergone scoliosis surgery.Öğe Pain, fentanyl consumption, and delirium in adolescents after scoliosis surgery: dexmedetomidine vs midazolam(Wiley-Blackwell, 2013) Aydogan, Mustafa S.; Korkmaz, Mehmet F.; Ozgul, Ulku; Erdogan, Mehmet A.; Yucel, Aytac; Karaman, Abdurrahman; Togal, TurkanBackground The study aim was to compare the efficacy of dexmedetomidine vs midazolam for sedation during the early postoperative period in adolescents who underwent scoliosis surgery. Methods We performed a prospective, randomized trial in an intensive care unit (ICU) in a tertiary care center. In this study, 42 patients (American Society of Anesthesiology physical status I and II) who underwent scoliosis surgery were divided into two groups according to sedation protocols: group dexmedetomidine (DEX) (n=22) and group midazolam (MDZ) (n=20). Adolescents (1218years) requiring mechanical ventilation underwent a continuous infusion of either dexmedetomidine (group DEX; starting dose, 0.4g center dot kg1 center dot h1) or midazolam (group MDZ; starting dose, 0.1mg center dot kg1 center dot h1) with intermittent fentanyl, as needed. The efficacy of sedation was assessed using the Richmond Agitation Sedation Scale (RASS). Quality of pain relief was measured using the Numeric Visual Analog Scale (NVAS). Delirium was determined in patients in the RASS range of 2 to +1 using the Confusion Assessment Method for the ICU (CAM-ICU). Fentanyl consumption, incidence of delirium, NVAS scores, and hemodynamics were recorded postoperatively at 2, 4, 6, and 24h in the ICU. Results The NVAS pain scores and fentanyl consumption at all the evaluation time points were significantly higher in group MDZ than those in group DEX (P<0.05). Further, total fentanyl consumption in group MDZ was significantly higher than that in group DEX (P<0.05). Delirium was significantly higher in the group MDZ than that in group DEX (31.3% vs 12.5%) when analyzed as the endpoint of CAM-ICU (P<0.05). The heart rate was significantly lower in group DEX compared with that in group MDZ at all the evaluation time points (P<0.05). Conclusion Dexmedetomidine was associated with the decreased postoperative fentanyl consumption, NVAS scores, and a decreased incidence of delirium. These findings may be beneficial for managing sedation protocols in adolescents who have undergone scoliosis surgery.Öğe Patent urachus with stone: A case report(2000) Karaman, Abdurrahman; Çetin, Selma; Mutuş, H. Murat; Demircan, MehmetPatent urakus traktusunda taş içeren 8 yaşındaki bir erkek çocuk sunulmaktadır. Dünya literatürü incelendiğinde daha önce urakal kist olmaksızın içerisinde taş oluşan patent urakus olgusu bildirilmediği görülmüştür.
