TR Dizin İndeksli Yayınlar Koleksiyonu / TR Dizin Indexed Publications Collection
Permanent URI for this collectionhttps://hdl.handle.net/20.500.14365/4
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Article Determining the Factors Affecting the Satisfaction of Patient in Sedoanalgesia Due to Distal Radius Fracture in Emergency Department(Galenos Publ House, 2025-05-21) Ellidokuz, Hülya; Aksay, Ersin; Oray, Nese Colak; Özgür, Sefer; Güzelce, Mustafa Can; Colak, NeseIntroduction: Patients with distal radius fractures (DRF) are frequently admitted to the emergency departments (EDs). Reduction with procedural sedation and analgesia (PSA) and followed by plaster/splint are the treatment of choice. We aimed to determine the factors affecting the satisfaction in patients with DRF undergoing PSA. Methods: This prospective, observational, cross-sectional study included 70 patients with DRF. The socio-demographic features, comorbidities, level of satisfaction with PSA procedure, physical factors of the environment, physician and patient satisfaction were evaluated. PSA satisfaction scores “1, 2 and, 3” were grouped as “dissatisfied group” and “4-5” points as “satisfied group” with the Likert scale. Patient satisfaction was compared between the groups according to the satisfaction levels. Results: The median satisfaction level was found 4 (interquartile range 4-5). Their satisfaction with the given information about the PSA procedure and the cleanliness of the area where the procedure was performed was higher in the satisfied group than the dissatisfied group (p=0.014 and p=0.007, respectively). Also, as the level of residents of emergency physicians, the satisfaction of the patients increased (p=0.025). There was no significant difference between the groups in terms of age, gender, educational status, comorbidities, fracture type, additional injury, selected sedo-analgesic drugs, Richmond Agitation Sedation Scale and, complications (p>0.05). Satisfaction was high in all physicians. Conclusion: PSA procedure was satisfactory by a majority and can be performed safely in the ED. The residency period of the physician who performed the PSA, satisfaction with the given information about PSA and the cleanliness of the area were affecting the patient satisfaction.Article Histomorphometric Analysis of the Effects of Grape Seed Extract (vitis Vinifera) and Low-Level Laser Therapy (lllt) on Fracture Healing(2020) Kara, Muhammed İsa; İnan, Sevinç; Aydemir, Işıl; Taysı, Seyithan; Aras, Mutan Hamdi; Altundağ Kahraman, Sevil; Ege, Bilal; Kahraman, Sevil Altundag; Kara, İsa; Akgül, HasanAim: In this study, we aim to investigate the effects of supplementary Grape Seed Extract (GSE) and Low-Level Laser Therapy (LLLT)on fracture healing, oxidant and anti-oxidant system in experimental mandible fractures.Materials and Methods: 48 Wistar Albino rats (adult male, n=48) were used in our study. For all the subjects, a vertical fracture linethrough molar teeth in right mandibles was created and internally fixed using a four-hole microplate and four micro screws. Firstly,these subjects were randomly divided into 4 main groups (Control, GSE, LLLT, GSE+LLLLT) of 12 animals each, and then these wereindividually separated into two sub-groups of 7th and 21st days. The number of groups (n=6) was 8 in total. GSE of 300 mg/kg/day were provided to the subjects before they were sacrificed. LLLT of 23 J/cm2 was administered to two different points alongwith the fracture line at intervals of 48 hours for 7 days in the 7th day sub-groups and for 14 days in the 21st day sub-groups. Afterthe procedure, while biochemical values such as TAS, TOS and OSI are measured; histopathologically it was examined in termsof capillary number and width, inflammatory cell, fibroblast count, collagen fibers, osteoblast count, ossification and mature boneformations.Results: For biochemical analyses, there was statistically significant difference only in TAS values on either the 7th or 21st day forthe groups. Histological analyses showed that mandibular fracture healing were significantly better in the GSE and GSE+LLLT groupscompared to the control group. The group of only LLLT had limited recovery while the combination of GSE+LLLT was the best forossification.Conclusions: It is concluded that GSE may be one of the potential methods to accelerate fracture healings in mandibular fracturescommon in oral and maxillofacial surgery clinic and thus help patients recover in shorter time, and however LLLT can have positiveeffects on the process of ossification and recovery only when combined with the extract, which may result in better outcomes inclinical use.Article Evaluation of the Elasticity and Thickness of the Heel Fat Pad With Ultrasound in Plantar Fasciitis(2022-09-30) Yıldırım, Mahir Utku; Biçen, Ahmet Çağdaş; Ünal, Abdullah Meriç; Yıldırım, Utku Mahir; Unal, MericObjective The aim of this study was to evaluate thickness and elasticity of heel fat pad in patients with unilateral plantar fasciitis and to investigate the effects of age, sex, body mass index (BMI), and functional scores on plantar fasciitis. Material and Method 70 patients who had been suffering from unilateral plantar fasciitis longer than 6 months were enrolled in the study. The thickness and elasticity of fat pad were compared between the painful and healthy feet of the patients with ultrasound. For measurement of elasticity, shear wave elastography (SWE) was used. Comparative analysis was performed for thickness and elasticity variables between the painful and healthy feet with Mann–Whitney U and independent samples t-test. Results Average of age of the patients was 44±11.66. The average thickness of the heel fat pad was 17.9±3.1 mm on the affected side and 18.3±3.3 mm on the healthy side. The mean SWE value of the painful side was 23.9 m/s (range 9.3-32) and was 24.7 m/s (range 10.8-34) on the healthy side. Heel fat pad thickness was greater in the healthy feet than in the painful feet, but there was no statistical significance (p=0.448). The painful feet were stiffer, but the difference was statistically similar (p=0.347). BMI had a statistically significant impact on thickness of heel fat pad. Conclusion The results showed that a decrease in the heel fat pad thickness was a supporting finding of plantar fasciitis in patients with normal BMI but not in patients with BMI>25.Article Efficacy of Preoperative Mri in Detecting Biceps Tendon Pathologies in Rotator Cuff Tears: Correlation of Mri and Intraoperative Findings(2022-03-01) Biçen, Ahmet Çağdaş; Ünal, Abdullah Meriç; Ekin, Ahmet; Özkan, Mustafa; Unal, MericObjective The aim of this study is to evaluate the accuracy of magnetic resonance imaging (MRI) in detecting biceps lesions in patients with rotator cuff tears. Material and Methods A total of 168 patients operated on between January 2012 and February 2020 were included in the study. All the patients underwent arthroscopic surgery with the diagnosis of rotator cuff tears. All patients were operated on under general anesthesia and in the beach chair position. Demographic data and preoperative MRI findings were recorded. Arthroscopic findings were accepted as the standard reference and correlated with preoperative MRI records. Results In preoperative images, full-thickness rotator cuff tears were identified in 118 (70.2%) cases and partialthickness tears in 50 (29.8%) cases. Labrum/SLAP lesions were detected in 18 (10.7%) cases. Biceps disorders were reported in 51 (30.4%) cases. During the surgeries, we observed additional pathologies in 41 (24.4%) cases besides the preoperatively detected lesions. Rotator cuff and labrum/SLAP repairs were performed in the same surgical sessions. The majority of newly detected lesions were biceps lesions, being identified in 26 (15.5%) cases. In 41 (24.2%) cases tenodesis, tenolysis, or tenotomy were performed for biceps lesions. LHBT surgery was performed in 26 cases with negative MRI. Biceps lesions were confirmed in 77 (45.8%) cases intraoperatively; therefore, the accuracy of MRI in detecting these lesions was 66.2%. Conclusion Biceps lesions are among the common pathologies of the shoulder. Preoperative MRI is important in evaluation of the shoulder, but the efficacy of MRI may be limited in detecting biceps disorders. Arthroscopic surgery is crucial in diagnosis and treatment of LHBT lesions.Article Two- Stage Treatment of Extremity Deformities Associated With Thrombocytopeniaabsent Radius Syndrome(Turkish Assoc Orthopaedics Traumatology, 2022-12-21) Akdemir, Mehmet; Bicen, Cagdas; Ozkan, Mustafa; Bıcen, Ahmet CagdasObjective: The aim of this study was to evaluate the results of 2-stage treatment of upper and lower extremity deformities in patients with thrombocytopenia absent radius syndrome. Methods: Four patients (3 female, 1 male) with a mean age of 1.8 years (range 1-4) were included in the study. The patients were followed up for an average of 5.5 years. All 4 patients had bilateral radial longitudinal deficiency, whereas only 2 patients had bilateral fixed knee contractures. A 2- stage surgical procedure was implemented. The surgical procedure performed for radial longitudinal deficiency consisted of distraction with an Ilizarov frame in the first stage, followed by centralization performed in the second stage. Knee contractures were first treated using an Ilizarov frame, followed by a hamstring tendon transfer in the second procedure. Radiological evaluation of the radial longitudinal deficiency was done by measuring hand-forearm angle, hand-forearm position, and ulnar bowing preoperatively and at postoperative follow-ups. Knee contracture was evaluated by measuring the angle preoperatively and at postoperative follow-ups. Results: The mean hand-forearm angle values of patients at preoperative assessment, early postoperative period, and at the last follow-ups were 82.60, 5,80, and 11.10, respectively (P <.001). The hand-forearm position values were -14.25 mm, +11, and +7.1 mm, respectively (P <.001). The ulnar bowing values were 7.3 degrees, 4.5 degrees, and 2.9 degrees, respectively (P <.001). Recurrence of the radial longitudinal deficiency deformity requiring surgery occurred in 1 patient. In the other 3 patients, some deformity recurred but did not require surgical intervention. In addition, 1 patient with knee flexion contracture had a recurrence of the contracture that did not require surgical intervention. There was no circulatory disorder or skin necrosis in the lower or upper extremities of the patients. Conclusion: This study has shown us that two-stage treatment is a reliable method for lower and upper extremity deformities accompanying thrombocytopenia absent radius syndrome. However, recurrence is still a major problem. Level of Evidence: Level IV, Therapeutic StudyArticle Citation - WoS: 14Citation - Scopus: 12Analysis of Risk Factors Affecting Mortality in Elderly Patients Operated on for Hip Fractures: a Retrospective Comparative Study(Turkish Assoc Orthopaedics Traumatology, 2021-12-22) Biçen, Ahmet Çağdaş; Akdemir, Mehmet; Turken, Mehmet Aykut; Cekok, Kubra; Ekin, Ahmet; Turan, Ahmet Cemil; Biçen, Çağdaş; Çekok, Fatma KubraObjective: The aims of this study were (1) to investigate the effects of different demographic and perioperative modalities on mortality rates and (2) to compare mortality rates between different implants in elderly patients operated on for hip fractures. Methods: In this retrospective study, a total of 314 patients who were operated on for hip fractures were included study. Patients were then divided into four groups based in their implant types: long-stem cementless bipolar hemiarthroplasty (n = 124; 102 female, 22 male; mean age = 84.2 +/- 6.4 years), standard-stem cementless bipolar hemiarthroplasty (n = 74; 48 female, 26 male; mean age = 83.5 +/- 6.9 years), antegrade intertrochanteric nail (n = 61; 35 female, 26 male; mean age = 78.5 +/- 6.8 years), and total hip arthroplasty (n = 55; 34 female, 21 male; mean age = 72.5 +/- 4.3 years). Data including gender, age, duration from injury to surgery, American Society of Anesthesiologists (ASA) score, comorbidities, use of antiplatelet agents, Barthel Index of Activities of Daily Living, type of anesthesia, operation time, preoperative hemoglobin values, blood transfusions given, duration of hospital stay, complications, and type of fracture were recorded. Results: Overall, the mean follow-up was 36.5 (range = 0 - 107) months. The overall mortality rate was 53.2%. The median survival duration was 44.2 +/- 5 months (range = 34.3 - 54). Survival rates were found significantly different among the groups (P = 0.001). In the first three years postoperatively, the mortality rate was higher in the standard-stem bipolar hemiarthroplasty group, but in the long-term follow-up, the long-stem bipolar hemiarthroplasty group exhibited the higher mortality rates. It was observed that some parameters had statistically significant effects on the mortality rates. Male gender, higher age, lower hemoglobin values, increased number of blood transfusions, ASA scores >= 3, the existence of >= 3 comorbidities were found as main predictors of increased mortality rates. Conclusion: The results of this study have shown that age, gender, preoperative hemoglobin levels, ASA scores, and comorbidities are significant factors affecting mortality in elderly patients operated on for hip fractures. Long-stem cementless bipolar hemiarthroplasty appears to show similar rates of mortality with standard-stem cementless bipolar hemiarthroplasty.Article Citation - WoS: 4Histological and Biochemical Investigation of the Effects of Low Intensity Pulsed Ultrasound on Orthodontic Tooth Movement(Duzce Univ, 2019-03-25) Cesur, Mine Gecgelen; Onal, Tuna; Bilgin, Mehmet Dincer; Sirin, Fevziye Burcu; Inan, Sevinc; Koken, Ergun Cem; Alkan, Afra; Cesur, GökhanObjective: The goal of our study is to assess the effects of low intensity pulsed ultrasound on orthodontic tooth movement in rats. Methods: For this study, 40 adult male Wistar albino rats (12-weeks old age) were used from the Animal Laboratory at Adnan Menderes University. Rats were divided into four groups each of ten. Group 1 was the untreated as a control. In group 2, an orthodontic spring was used to move teeth. For groups 3 and 4, orthodontic treatment was combined with low intensity pulsed ultrasound at 16 J/cm2 or 48 J/cm2 for 14 days, respectively. Tooth movement was measured at the last day of treatment. Serum bone alkaline phosphatase (BALP) and C-telopeptide type I collagen (CTX-I) levels were analyzed biochemically. The number of osteoclasts, osteoblasts and inflammatory cells, capillary density and new bone formation was determined histologically. Receptor activator of nuclear factor-kappa B ligand (RANKL), osteoprotegerin (OPG), vascular endothelial growth factor (VEGF) and transforming growth factor-beta (TGF-beta) were assessed using immunohistochemical staining. Results: BALP and CTX-I levels in group 4 were significantly higher compared to control (p<0.05). Tooth movement and the number of osteoclasts, inflammatory cells and capillary density in group 4 were significantly greater than group 2 (p<0.05). The intensity levels of RANKL and OPG in group 4 were significantly greater than group 2 (p<0.05). Conclusions: Ultrasound is a noninvasive application and promising therapy for accelerating bone remodelling during orthodontic tooth movement.
